Alessandra Martinelli, 39, had been working at the Belfast Community Co-op for about four years when she decided she was ready to change careers.
Some of her peers had gone into nursing, and Martinelli realized she would also be well-suited to it. She excelled in biology and considered herself a “natural caretaker.”
It was only last year, when she was interviewing for a certified nursing assistant position at MaineHealth Waldo Hospital in Belfast, that Martinelli learned that its parent group had partnered with Eastern Maine Community College to offer on-the-job training to would-be nurses as they completed their associate’s degree. Martinelli immediately went home to apply to EMCC, where she is now one of eight people in the program’s initial cohort at the Belfast hospital.
As a mother of four who lives in Belfast, Martinelli was drawn to the program because she would’ve faced significant challenges in attending nursing school classes elsewhere.
“I can’t say enough how great it is,” Martinelli said. “Every nurse there wants us to be the best nurse that we can be. They are supportive, they are inclusive. I feel so blessed and so lucky…that’s where I want to go and work after I finish nursing school.”
A number of Maine hospital organizations are now trying out these kinds of programs, which aim to lower the barriers for potential workers to enter the nursing field.
It’s a critical issue, given that health care organizations have encountered many difficulties in recruiting and retaining workers since the pandemic. Many of those staffers are leaving the workforce for retirement or other reasons, even as Maine’s population ages and faces more complicated health problems.
New programs have helped health care groups to hire more nurses in the last few years. A study last year by the Maine Hospital Association tracked the ongoing shortage of nurses in Maine and found that it had shrunk from 2,250 in 2021 to 2,115 in 2024, even as the demand for nurses grew during that time.
But the current programs may not be enough to meet the expected growth in demand for nurses over the next five years, from a total of 18,900 registered nurses now to 20,700 in 2025, according to the study. Without stronger recruitment and retention efforts, the study projected that the net shortage could reach 2,877 nurses by 2030.
Now, with the fear of a shrinking workforce, hospital systems are trying to get creative with solutions. Staffing shortages have made it harder for them to treat patients, resulting in longer waits for Mainers who need medical care. It’s also resulted in less revenue flowing into hospitals and the need to pay higher rates for short-term nurse contractors, all of which have contributed to acute financial problems and service cuts in recent years.
The midcoast appears to face some of the greatest recruiting challenges, with last year’s study finding that the region made up of Waldo, Knox, Lincoln and Sagadahoc counties had the smallest portion of registered nurses who’d started within the past five years, at just 17.3 percent compared to a statewide level of 21.7 percent.
At MaineHealth Waldo Hospital, the new two-year program allows the student nurses to complete clinical training on-site and with oversight from working professionals. It will accept new cohorts of students every other year and is open to current employees of the hospital on the condition that they return to work there for at least two years afterward.
Many full-time nurses who left the workforce during the pandemic were parents who needed to care for their children at home, and the partnership aims to help people in that situation like Martinelli who can’t make hourslong commutes outside Waldo County for work every day.
Smaller pilot programs offer unique benefits, said Shanna Borrows, a former clinical instructor at EMCC who is now the nurse manager of acute and critical care at MaineHealth Waldo. Smaller cohorts allow for the same hands-on experience earlier and faster than nurses who attended larger programs.
“We weren’t having to split our time between 40 or 50 students,” Borrows said, “so they were passing meds, they were doing assessments, they were assessing patients way before their peers in Bangor were.”
An identical program is offered at MaineHealth Lincoln Hospital in Damariscotta, in collaboration with Central Maine Community College and Central Lincoln County Adult Education. MaineHealth employees may also participate in a partnership to receive their bachelor’s of science degrees in nursing through the University of New England.
The state’s other biggest health care organization, Brewer-based Northern Light Health, is also using on-the-job training to help fill its staffing shortages.
Through its Work to Grow Program, students accepted to a nursing program can be paid full-time to complete their coursework, said Catharine MacLaren, Northern Light’s vice president of talent acquisition and workforce development. In return, students work a set number of hours per week in a hospital setting and commit to staying there after graduation. Some 135 students have so far participated in Work to Grow since it started in 2018. The system has also benefited from a federal grant that funds the use of simulations to train registered nurses in rural settings, MacLaren said.
Providing aspiring nurses on-the-job training may also help to ensure that more graduates are immediately entering the workforce. MacLaren said hospitals used to hire many nursing graduates before they had even taken their certification exams, but that since the COVID pandemic, more graduates have been taking breaks between the end of their education and starting their careers, which has exacerbated some of the recent staff shortages.
In addition, Northern Light is trying to get younger Mainers interested in the health care field at an early age.
“We try to get in front of high school students to really talk about, ‘What could your trajectory look like if you wanted to get into a meaningful and well-paying healthcare job?’” MacLaren said. “We want to make sure that the people who are interested have the opportunity, and that it isn’t some kind of pipe dream because they don’t have the resources.”