Solving the Nursing Shortage
The journey along the Nursing Education to Workforce (NEW) Pathway — a hallmark program of RFU’s College of Nursing, which welcomes its first class in the fall of 2022 — will begin long before students matriculate at Rosalind Franklin University.
A network of support, including mentoring, academic guidance and enrichment, along with clinical placements, internships and employment, awaits local high school students who enter the Nursing Education to Workforce (NEW) pathway, progress to admission at Lake Forest College and matriculate into a Master’s Entry into Nursing Practice program at RFU. As of early June, a substantive change request to offer the MSN-ENP program at RFU was under review by the Higher Learning Commission. NEW students will hail from high-hardship ZIP codes, where education levels, median incomes and life expectancies are substantially lower than those in more affluent suburbs. The pathway will attack one of the root causes of health disparities — low educational attainment. It will attract and retain diverse student cohorts that share an extraordinary commitment to equity. At stake is no less than the health and well-being of their own families and communities.
Systemic inequities that underlie poor health are revealed in Lake County Health Department data that show correlation between disparities in health and education, with dramatically higher rates of hypertension, obesity and diabetes among those who attain high school diplomas or less. Diversity of the healthcare workforce offers another telling metric. In Lake County, Black and Latinx nurses together account for 17% of the nursing workforce but make up 30% of the population, per the U.S. Census.
“The NEW pathway is a very bold vision and requires a holistic and long-term relationship with the student,” said College of Nursing Founding Dean Sandra Larson, PhD, CRNA, APRN, FAANA, FNAP. “Such a commitment is necessary to make a meaningful impact on their educational achievements and professional development, and to ensure they remain in the pathway. Optimally aligning a broad coalition of community organizations and individuals who are committed to engaging and supporting the nursing pathway students and their families will be the key to its success.”
“We could try and recruit talent from other places. But that overlooks the people who are already here: members of our communities that have suffered decades of disinvestment and chronic unemployment.”
A Nursing Education to Workforce Advisory Council is paving the pathway. Members include representatives from academia, business, government, health care and the community. The council is committed to the goal of building Lake County’s nursing workforce — the key strategy in advancing education equity in Lake County.
“Council members are actively working together to align their unique knowledge and capacities to help us build, resource, grow and sustain the pathway, which will help expand, develop and diversify the nursing workforce,” Dr. Larson said.
Bethany Williams, strategy and intelligence director for the nonprofit economic development group Lake County Partners, said the nursing pipeline must be filled “much earlier and more strategically.”
“Health systems are telling us that they desperately need people,” Ms. Williams said. “We could try and recruit talent from other places. But that overlooks the people who are already here: members of our communities that have suffered decades of disinvestment and chronic unemployment. We need to make an investment in their potential. We have an obligation to do that. And it’s not just a moral obligation. It’s an economic one.”
Karen Mahnke, MS, RN, NEA-BC, Northwestern Medicine Lake Forest Hospital vice president and Bernthal Family chief nurse executive, looks to a future in which the NEW pathway helps solve two major challenges, including a pipeline that can fill an estimated 300 annual openings for highly educated registered nurses over the next decade.
“The pandemic has been very challenging for those of us who work in health care,” she said. “We’ve seen turnover related to stress, life changes and relocation. Our goal is to establish a consistent workforce so that we can continue to provide outstanding patient care to support our Patients First mission. We also want our workforce to look like the patients that we care for. Diversity is key to that. It balances perspectives, leads to better decisions and more holistic, patient-centered care.”
The pandemic exposed significant health disparities among low-income communities whose members are underrepresented in higher-paying health professions like nursing, despite evidence that shows Black, Latinx and Native American health professionals are more likely than their counterparts to practice in underserved areas.
“We know that higher education fundamentally improves a person’s economic stability,” Dr. Larson said. “It impacts the social context and environment in which they live. It’s key to health equity and the promotion of community wellness. Our partners understand that if the end goal is well-educated nurses who hail from diverse backgrounds and who will help move their health systems forward, we must all work together, as partners, to realize an integrated vision.”
Aligning Education With Industry and Community Needs
“Nursing is a career that can help support a family,” said Demar Harris, a member of the pathway’s advisory board and director of programs for Lake County Workforce Development. “That’s what underrepresented individuals are looking for — in-demand, stable careers that pay sustainable wages.”
Mr. Harris’ mother worked as a nurse for the former Saint Therese Medical Center in Waukegan for more than 30 years.
“My brother and I would go there to study while she worked double shifts,” he said. “As an African American, that experience hits home. It’s very important that people of color from underserved communities who are typically underrepresented in health care are exposed to this career pathway. Patients should see equal representation. They should experience an inclusive environment. That helps build trust in the system.”
Mr. Harris is a proponent of how students in the NEW pathway will understand the clear connection and necessary steps between education, graduation and occupation.
“It is important that education is aligned with industry, and that education is aligned with the demand within the local community,” he said. “But ultimately, the pathway has elements of work, earn and learn that make it attractive to learners as they progress through the program.”
The pathway is designed to offer wraparound services to learners who face structural challenges in the pursuit of higher education and STEM careers. Many students at pathway partner Cristo Rey St. Martin College Prep in Waukegan — 94% of whom identify as first-generation college students — took on jobs to help support their families during the pandemic. They shouldered household responsibilities, including child care and e-learning for their younger siblings. The average family income for a Cristo Rey family of four is $41,717.
But despite those barriers, interest in nursing is strong among the student body, which is 95% Latinx and 5% Black.
“It’s been a challenge for our students to go straight into a nursing program, not impossible, but definitely a challenge,” said Cristo Rey College Counselor Sharon Holdvogt. “So to see that our students who do so well at Lake Forest College will have that opportunity to continue on, to gain a master’s of nursing, is huge. So often, our students who are interested in nursing speak about wanting to come back and work in their own community. Some of them have to translate for their families during medical appointments. They understand the importance of nurses who look like them and understand their culture.”
“We’re bringing together a network of support that will enable us to create a longitudinal, integrated, educational journey for students that begins long before they ever enter Rosalind Franklin University,” Dr. Larson said. “That’s going to enable us to create diversity in the workforce. It’s going to enable us to increase the supply of the nursing workforce. And perhaps most importantly, it’s going to enable us to optimally prepare the knowledge and skills of the future nursing workforce.”
“There’s very little that we’re able to accomplish without building a collective partnership,” Ms. Williams of Lake County Partners said. “The most successful solutions to complex challenges are always going to be multidisciplinary. That’s why RFU is such a great partner. Partnership and collaboration are baked into its culture. The university recognizes the role it plays in the community, not just as an educational institution, but as a neighbor, as a community partner.”
Judy Masterson is a staff writer with RFU’s Division of Marketing and Brand Management.