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Home-grown nurses

Rural hospitals play role in filling nursing shortage

Harvey nursing students Jessica Coombs, left, and Heather Osborn, engage in a pediatric simulation inside Bismarck State College’s new simulation truck.

Sarah Gregg is a home-grown nurse who now helps train others to become nurses in her home community of Harvey.

Nurses like Gregg are part of the success story of the Dakota Nursing Program, which brings together college nursing programs and rural hospitals to address the state’s nursing shortage.

Gregg said she had just moved to Harvey in 2011 when she heard about the program. She already held a bachelor’s degree in biology and was an Emergency Medical Technician, which easily fulfilled the prerequisites to secure a spot in St. Aloisius Medical Center’s first nursing class.

“I think it would actually have been impossible for me to pursue nursing at that point in my life had I not had the program in Harvey. We are at least an hour or two hours away from Bismarck or Minot,” Gregg said.

Gregg, who became the nurse educator at St. Aloisius last August, is a registered nurse working toward her master’s degree. Of the 19 graduates since the program’s start in Harvey in 2011, seven are employed at the local nursing home and Gregg works at the hospital.

Gregg said the accelerated course is intensive for students during the 11 months of practical nurse training and additional nine months for registered nursing training. The result is a high quality education, though, she said.

“We put out very good nurses, very competent nurses,” she said.

Three students currently are enrolled in an LPN course in Harvey. Gregg said she hopes to spur increased enrollment because the local medical community still needs more nurses. The hospital has had to rely on traveling staff to meet its needs.

Across the state, the Dakota Nursing Program has 195 students enrolled in the LPN training and about 140 in the associate-degree RN training, said Julie Traynor, program director, Devils Lake.

The program trains more than 300 practical nurses and associate-degree nurses each year through the four participating colleges. Training is offered in 15 locations across North Dakota through a combination of face-to-face lab and clinical courses and theory courses over Interactive Video Network and online formats.

Dakota College at Bottineau offers program sites in Minot, Rugby and Valley City. Williston State College offers the program in Tioga. Bismarck State College works with Ashley, Garrison, Harvey, Hazen and Hettinger, while Lake Region State College has programs in Grand Forks and Mayville.

Tioga Medical Center recognized the need to serve as a host facility after a nurse training program in New Town closed. There were two local instructors in the New Town program who were recruited to teach part-time at the hospital.

The medical center now is training a second class of eight future LPNs, having graduated five in its first class. The program was in the process earlier this year of attaining certification to offer an RN program.

Once eligible to offer both LPN and RN programs, the intent is to alternate the courses each year, said Ryan Mickelsen, chief operating officer at the hospital and advisory board member for the program.

So far, students have come from outside Tioga’s medical system, but Mickelsen said the hope is to recruit in-house certified nursing assistants to advance their educations. Students have largely been from the local area, though, including Tioga, Ray, Stanley, Crosby and Williston. The program can take up to eight students in a class.

“Our hope is to get them in our system, see how we operate and want to come work for us,” Mickelsen said. So far, one LPN has joined the medical center, which has been forced by nursing shortage to look to contract nurses. Remaining LPN graduates have gone on for RN training.

CHI-St. Alexius Hospital in Garrison started its LPN program two years ago. The hospital recently was approved by the Board of Nursing to begin an RN program this fall.

Tod Graeber, administrator, said the Garrison program can take up to eight students at a time. It had six students who came from Garrison, Turtle Lake and Underwood the first year and currently has three students. So far, all have been going on to the RN program.

About half have come into the program as certified nursing assistants. Graeber said the initial idea was to recruit CNAs, provide them some financial help or loan repayment as incentives to work at the facility after graduation.

Two students finishing their RN training in May have agreed to come back to Garrison, and Graeber said there is a possibility of others doing the same. These are nurses the hospital would not have were it not for the program, he said.

The Garrison hospital has recruited international nurses to address its staff shortage, but still has had vacancies.

In addition to the in-patient care, the hospital has a 28-bed nursing home. The Benedictine Living Center in Garrison, which has partnered on the nursing training program, has a 50-bed home.

Graeber also is administrator for the Turtle Lake hospital. He said it was at a North Dakota Hospital Association conference that staff from both Garrison and Turtle Lake saw what other hospitals were doing with the Dakota Nursing Program and decided they could do the same.

“So we got ahold of the right people and it just took off. It went quick. Luckily, the governor, with his Main Street Initiative, got his staff to support it, and I had a lot of people from the state reach out and say, ‘If you need any help, you let us know and we’ll make sure you get this done,'” Graeber said.

Financially, hosting the nursing program has been reasonable, Graeber said. BSC splits the instructor cost if the program has more than five students and has landed grants to acquire the more expensive equipment. The Garrison hospital provides the classroom and skills lab.

“It’s been pretty cost effective,” Graeber said. “We’re very excited about the program, and we’ve really thrown our support behind it because I think it’s a good way to get some homegrown people a good job and an opportunity to advance themselves.”

The difficulty for many rural hospitals is finding an instructor, but Graebe said Garrison was fortunate in having Kishori Kelsey, a bachelor-degreed nurse at Turtle Lake, willing to take on the role. She is working toward her master’s degree.

Staff nurses in the smaller, rural hospitals typically serve as part-time faculty for the programs.

“They get to satisfy their love for teaching and still have that great patient-contact job, where they are working on the front lines,” Traynor said.

A nurse holding a four-year bachelor degree can teach the clinical LPN program. To teach the RN course, a nurse must have a master’s degree.

“With the Dakota Nursing Program, we are very strong with growing our own faculty,” Traynor said. “We started in 2004, and we are seeing now that the people who have been educated in the communities are now nurse practitioners in those communities. They have gone on to get their bachelor’s degrees and then their master’s degree. Some of them are teaching for us.”

Medical facilities have been good partners in enabling nurses to teach while working and/or earning advanced degrees, she said. Traynor credits much the program’s success to the communities and their medical facilities.

“If they just say ‘come in’ and then wash their hands of it, it’s not really going to be successful. There has to be community commitment and support,” she said.

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