AUSTIN (KXAN) -- There is a growing problem across the country with a critical shortage of certified nursing assistants, or CNAs. It's especially troublesome in Travis County where a new study shows it's near last in the state for available CNAs. "[CNAs] are a critical aspect of the healthcare ecosystem," said Dr. Serena Bumpus, Texas Nurses Association CEO. A new study from Dwyer Workforce Development shows a significant shortage of CNAs in Travis County. New nurse anesthesia program in Austin aims to address growing demand "As nurses, we heavily depend on nursing assistants to help us provide basic care," Bumpus said. That care involves things from as simple as taking vital signs to making sure a patient is getting the right nutrition. "Our hospitals do not require you to be a CNA," Bumpus said. "When the state, in 2013, no longer made that a requirement of the job, many of them let that certification go." That's one reason Bumpus believes places, like Travis County, have seen a dip in numbers. "Most of the CNAs that you see in that data, they do work in long-term care, home care, and in hospice. Those entitites can sometimes be very under resourced," she said. State data shows over the last decade, Travis County has lost 45% of its CNAs. Travis ranks 245 out of 254 counties in the state for CNA per capita, according to Texas Health and Human Services. Besides burnout and low pay, Bumpus said this a return of a trend that was last seen in the 1990s. Nurses faced with low pay, high cost of living. These cities are worst "The whole healthcare system is a little stressed right now," she said, noting that it could take years to resolve. Bumpus said that school programs across the state, where teens can get real-world experience and trained to be a CNA, work as a short-term solution. But she wants to see pipelines that can fast-track students to get their training, and their nursing degree.