The New Kids on the Block

In our new age of instant gratification, the world at our fingertips, and ability to order a pizza and track the process down to the location of the delivery driver, it’s no surprise that a new trend is emerging with the true digital natives: Gen Z. With their new vocabulary IYKYK (if you know you know), TikTok, and baggy jeans vs. straight jeans debate, this generation is now pursuing something new: to begin a career before walking across the stage to receive their high school diploma. Workforce development initiatives beginning as early as middle school with guest speakers, career exploration in their junior year of high school, and hands-on skill training classes their senior year provide students with the opportunity to enter the workforce far better prepared than previous generations.

With an aging workforce, increasing population developing complex medical needs, and socioeconomic factors that influence community health, the need for nurses is at an all-time high. The national nursing workforce study completed by the National Council of State Boards of Nursing states that by 2027, 800,000 RNs and 184,000 LPNs indicate that they are likely to leave nursing. This is equivalent to 20% of total licensed RN/LPN workforce in the United States

Nursing workforce development initiatives may be the solution in place to fill this critical need. Preparing students during their formative years to enter the workforce with programs designed to help them succeed on their pathway to becoming a nurse? Say no more. Add in the opportunity to earn dual credit, tuition benefits, and on the job training before being on the job? This future nursing workforce generation will be ready and prepared for the healthcare field before walking across that stage.

Make Way: The Details

Though our two organizations could not be more vastly different—one being a rural 128-bed facility in Indiana, the other a nine-hospital academic health system in Kentucky—there is one thing we have in common: a passion for creating and developing tomorrow's nursing workforce.

Both organizations have implemented workforce development programs that align with organizational strategic goals, such as being the nursing employer of choice and deliverance of role model performance. With that in mind, they both developed and designed programs to offer high school students’ exposure to healthcare careers—improving career readiness while also awarding the opportunity to identify where their passion lies—with the end goal of retaining talent. The guidance provided in these programs helps support students in their decision and answer the ever-looming question “what do you want to be when you grow up?” 

Within the rural organization, a program was developed to allow juniors and seniors to complete a certified nursing assistant (CNA) program during their fall semester, followed by an internship in the spring where they work within the capacity as a CNA. Collaboration with community partners offers additional exposure to healthcare. Classes are hosted at a local community college’s nursing building, which allows participation in simulation labs and clinicals within the hospital and local nursing home. Once certified, students are then eligible to enter the organization as an employee.

The multi-system, urban organization has collaborated with local public high schools who offer allied health and pre-nursing programs to provide career exploration and internship opportunities. Students who are working toward CNA certifications through their high school pathway step out of the classroom and complete clinicals in the hospital. Through this, they practice skills while gaining valuable, hands-on experience. These initiatives immerse students in nursing and expose them to how interdisciplinary professions work to provide optimal care.

Both programs offer students the opportunity to solidify their career path to nursing or identify if another career is a better fit prior to high school graduation.

Overcoming Any Stumbling Block

Working with high school students certainly has its unique challenges. One challenge both organizations encountered dealt with students’ socioeconomic status. Students’ ability to navigate transportation to and from scheduled shadowing or in-person program activities was found to be a barrier. While the urban organization has opportunities to circumvent with the use of public transportation vouchers, this continues to be a barrier within the rural organization.

Another challenge expressed by both organizations pertains to student’s maturity level, and the ability to manage emotions in critical situations. Both programs meet this barrier head on by implementing eligibility criteria (including GPA requirements), and faculty recommendations. By providing in person interviews where program expectations are communicated, student readiness can also be assessed. This process ensures that students are prepared to responsibly encounter and navigate professional responsibilities.

Able to Walk the Walk

A day in the life of an NPD practitioner working in the realm of workforce development is comparable to other NPD practitioners, only replace your typical learner with a high school student.

We utilize collaborative partnerships, complete onboarding/orientation, oversee competencies, provide leadership, and develop others. We serve as a leader, mentor, and learning facilitator by helping high school students navigate a professional world that is different from the halls of their high school.

When someone enters the professional workforce, we expect timeliness, attendance, effective communication, adherence to dress code, and a certain level of professional performance. These are not often things that are typically enforced or even taught to high school students, so when they transition from high school to college or begin working in a professional setting, it can be a culture shock. Through onboarding and participation in these programs, we develop students’ professional skills and better prepare them to be successful in the healthcare environment. Students are taught to communicate effectively when issues arise, be responsible for their time and attendance, and see healthcare professional’s role modeling behaviors. Students are developing and practicing soft skills, in addition to their technical skills.

Circling the Block

Besides student feedback such as “I am so glad I have had this experience, it cemented my decision,” “I feel more prepared and knowledgeable about nursing,” and even “this real-world experience has shown me how to act maturely,” there have been incredible outcomes.

Within eight years, the CNA program at the rural organization has certified 99 students. Additionally, 63 chose to work within the organization as a CNA during their internship, with many deciding to remain employees while pursuing higher education after high school. In addition, the program has already graduated 10 nurses, with five choosing to return to the organization (bonus for interprofessional collaboration—one has become a physical therapist). With the program only accepting 10-15 students a year and many students attending bachelor nursing programs, the rural organization recognizes the need to focus on long-term commitment. However, the program aspires to accelerate the momentum from the past eight years, with students who graduate with a certification becoming employed with the organization, pursuing nursing degrees, and remaining with the organization.

Similarly, since the inception of career exploration in the multi-system organization in the fall of 2023, 206 students have participated, and many are seeking positions upon graduation this spring! While this program is in its infancy, there is hope to see it grow into other newly established nursing workforce pipeline initiatives; one of which is the organizations three tuition-funded nursing pathway programs. Ultimately, our workforce development programs hope to win the nursing workforce battle of recruiting and retaining nurses.

Owning the Block

In this leading age, NPD practitioners have a new call to action: developing the next generation of nurses before they even enter nursing school. Like every competent NPD practitioner, always keep your projected outcomes in mind.

• What are your strategic goals for your organization? Like most, at least one pertains to recruiting and retaining the nursing workforce. Start with an environmental scan.
• Are there healthcare programs in your local high schools in which you can create a partnership? Can your organization serve as a clinical site for these high school programs?
• Do you have the resources to provide job shadowing? Identify how you can become a partner for practice transition as they progress from high school student to healthcare professional.

Be a lifelong mentor, guide their journey, and act as an anchor to the organization (Harper & Maloney, 2022).

While these programs are a long-term commitment and may not produce immediate results, pipeline programs are an innovative, untapped approach to workforce development. Use of these programs expose young students to the healthcare environment, healthcare careers, and support them on their journey to becoming a healthcare professional. By forging a pathway to nursing, we are growing our own, retaining talent, and meeting the critical need of the nursing workforce. Much like the air marshal on the tarmac, these programs act as guiding light for directing a student’s healthcare career pathway. The sky's the limit for this future generation of nursing.

References

• About the national nursing workforce study. (2024). Retrieved from National Council of State Boards of Nursing: https://www.ncsbn.org/research/recent-research/workforce.page
• Harper, M.G., & Maloney, P. (Eds.). (2022). Nursing professional development: Scope & Standards of Practice. Association for Nursing Professional Development