From healthcare worker crisis, new opportunities and pathways emerge

By Sarah Earle

Elizabeth Wright, an alum of the Dartmouth-Hitchcock Workforce Readiness Institute Medical Assistant Apprenticeship program, tends to a patient at the Alice Peck Day clinic in Lebanon. Photo courtesy of Dartmouth-Hitchcock.

Matthew McDonald was a first-year nursing student at the University of New England in Biddeford, Maine, when COVID-19 made its appearance. The frightening and heartbreaking tales from hospitals didn’t scare him away from his career choice. Quite the opposite. 

“When you hear about nurses who didn’t have any PPE and decided to treat their patients anyway … it makes me want to embody and emulate that attitude,” McDonald, a 2019 graduate of Merrimack Valley High School and a former student at Concord Regional Technical Center, told Reaching Higher last spring. “I want to be part of that.”

To ease a healthcare worker shortage made more urgent amid the pandemic, educators and employers are in search of more young people like McDonald. Several new initiatives are paving the way to promising healthcare pathways. Along with targeting some of the most pressing needs in the industry, these programs address some of the common obstacles for students interested in pursuing healthcare careers. 

LNA Extended Learning Opportunities 

Several Seacoast-area high schools have just begun piloting a Licensed Nursing Assistant (LNA) program that students can complete as an Extended Learning Opportunity (ELO), a credit-bearing learning experience that happens outside of the traditional classroom. 

“There’s been a few of us that have really been pushing for this for a couple of years,” said Kerrie Alley-Violette, President of the NH Extended Learning Opportunity Network and Career Pathways Coordinator at Sanborn Regional High School in Kingston. Many Career and Technical Education centers have LNA programs, she explained, “but if a student doesn’t decide ahead of their junior year, it’s kind of too late. We’re really looking at some alternative ways for those kids to get that training.” 

Emaris Henault, an alum of the Dartmouth-Hitchcock Workforce Readiness Institute Pharmacy Technician Apprenticeship program, works at Dick Hall’s House Pharmacy at Dartmouth College in Hanover. Photo courtesy of Dartmouth-Hitchcock.

Funded with American Rescue Plan funds through the NH Needs Caregivers! Initiative, the program includes a classroom curriculum as well as a clinical component in an assisted living facility or nursing home. More than just a certificate program, the semester-long opportunity incorporates what are known as the four pillars of ELOs: research, reflection, product, and presentation. 

In addition to providing an additional route to LNA certification for high school students, the program offers personalized guidance. “I know the healthcare organizations and facilities. That’s a big piece of it,” said Lynn Carpenter, Program Director for NH Needs Caregivers. “I’m trying to get to know the students as they’re taking the class as well. … Our big goal is to make sure our students are having a really great experience.”

The program also addresses cost barriers: Coursework, testing, materials, and uniforms are all free for participating students. 

Another benefit: Despite the healthcare working shortage, RN programs remain highly competitive in the United States, and LNA certification can give students a leg up. “It’s a great base for someone who’s interested in becoming an RN,” Alley-Violette said. “It can really help with the college application process.”

Healthcare Pre-apprenticeships

Meanwhile, the Community College System of NH is rolling out a healthcare pre-apprenticeship, the first of its kind in the state, through a partnership with Dartmouth- Hitchcock in Lebanon. The goal is to provide a stepping stone to federally registered apprenticeships in three in-demand roles: medical assistant, surgical technologist, and pharmacy technician.  

Through 14 weeks of coursework at River Valley Community College in Claremont, students will get a solid foundation in the healthcare field through coursework in medical terminology, anatomy and physiology, professional skills, and sector-specific math. During that time, they’ll also work at least four hours a week at the medical center, earning $17 per hour. 

“They’ll learn everything about how a hospital operates. … They’ll work in dietary, they’ll work in facilities management, they’ll work in administrative, they’ll work in inpatient,” said Anne Banks, the Apprenticeship NH High School Grant Manager for CCSNH. “It’s really such a great opportunity. They’re exploring different pathways and seeing how a whole hospital works together while they’re learning at the same time.” 

Sarah Johnson, a current apprentice in the Dartmouth-Hitchcock Workforce Readiness Institute Surgical Technologist Apprenticeship program, works in the operating room at the medical center in Lebanon. Photo courtesy of Dartmouth-Hitchcock.

Students who complete the program can then go on to one of Dartmouth-Hitchcock’s federally registered apprenticeships, also paid, while earning college credit through Colby Sawyer College in New London. 

Like the Seacoast ELO program, the pre-apprenticeship program is designed for students who face barriers entering healthcare pathways. “The population of high school students that we’re targeting are those students who have an interest in healthcare but maybe for whatever reason – scheduling, distance … available seats, transportation … couldn’t get into a career and tech ed center,” Banks said. 

Students can work with their ELO or work-based learning coordinators to gain credit for the courses if they wish, Banks said. She also hopes to grow the program over the coming months and years. 

“We’ve already started to talk to some other healthcare organizations to bring this program to them,” she said. “We can take this curriculum that was built and just take it to them to build a similar model, to help build that across the state.”


Collaborative Solutions

Several other initiatives that could affect the healthcare worker pipeline are underway as well. Last month, the NH House passed HB 1661, a bill that aims to address some of the challenges Banks described. Developed with significant input from Career and Technical Education (CTE) leaders, the bill aims to expand CTE access by initiating calendar alignment requirements and formalizing requirements for embedded credits. That bill is currently being reviewed by the Division II House Finance Committee. 

Lawmakers also recently passed a bill that establishes curricular transfer pathways between the Community College System of New Hampshire and the University System of New Hampshire, formalizing and supporting efforts already underway between the two systems. The prime sponsor of HB 1530, Representative Oliver Ford (R-Chester), said that the intention of the bill is to generate conversation about student access to post-secondary programming.  In testimony for that bill, CCSNH Chancellor Mark Rubinstein described a partnership that allows students to earn an RN degree at one of the state’s community colleges, then transfer to Granite State College to earn their bachelor of science degree in nursing. “I think that’s an excellent model because, in addition to addressing the needs of students who are place-bound, it also addresses the need for affordability,” Rubinstein said. The program is also a creative method of addressing the RN shortage in the state. 

NHTI and Manchester Community College have both expanded their healthcare pathways in recent years. Through NHTI, students in Concord Regional Technical Center’s medical terminology course can take part in a job-shadow experience at Concord Orthopaedics. 

MCC has responded to the increased need for healthcare workers during the pandemic by building an additional lab for LNA training, and the school recently partnered with the International Institute to offer English instruction tailored to New Americans aspiring to become LNAs.

The COVID pandemic created one of the most monumental challenges to healthcare in recent history. For students who see those challenges as opportunities, healthcare leaders want to be sure nothing else stands in their way.

“We know what the need is right now and how desperate it is,” Banks said. “And we know that those students are out there.” 

Follow us on Facebook and Twitter and sign up for our newsletter to stay informed about current updates. And, join the New Hampshire Education Network (NHEN), our network of New Hampshire parents, educators, business leaders, and community members who are interested in education policy!