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A senior at South Rowan High, 17 year-old Lauren Helms is already employed in her chosen field, thanks to the skill training offered in the Allied Health Sciences curriculum of Rowan-Salisbury schools’ Career and Technical Education program and support supplied by Rowan Regional Medical Center. With her sights set on becoming a nurse practitioner, Lauren works a 16-hour day as both an honor-roll high school student and a patient care assistant at a local long-term care facility. Following graduation in June, she’ll take the exam to become a Certified Nursing Assistant (C.N.A.), completing the first important step in her career path.
Like most students enrolled in Allied Health Sciences classes in the system's five high schools, Lauren plans to use her certification as a springboard into nursing school. Not only is C.N.A. certification a prerequisite for nursing school admission, it also provides a way for students to work in the health care field and pay for college.
“That’s a great thing in today’s times,” explains North Rowan instructor Debbie Sousa, RN. She estimates 75% to 80% of C.N.A. program graduates continue their education to become registered nurses and nurse practitioners.
The program has other significant benefits, agrees Jesse Carson High School instructor Mary Welch, RN, who spearheaded the addition of the C.N.A. program to the school system’s health occupations track in 1990. “Retention has been great as far as keeping the kids here in Rowan County,” she says. “It’s good for the local economy and for the health care profession.”
“We see our graduates working all over the place,” adds South Rowan instructor Tina Leben, RN.
Another thing students gain from the program is career direction. Through three to four years of class work, hands-on practice in school labs, and more than 80 hours of clinical experience in local health care facilities, students discover if the profession is really one they want to pursue. “It’s very costly to go to college and find out you don’t like it,” says Ms. Welch.
For Lauren Helms and her classmates at South Rowan, the Allied Health Science course represents an opportunity to pursue a career and fulfill a calling.
“I’ve always wanted to be a nurse,” declares Haley Buder. “Always. I don’t have a second plan,” she adds. “It’s all I have. It’s all I know.”
Michelle Goodman, who admits loving “chaos and exciting things happening,” plans on becoming a neonatal or emergency room nurse.
An admitted “nurturing type person,” Jessica Sanders finds the health care environment both familiar (her mother is a medical receptionist) and stimulating. “I like to shake things up, to see things for myself,” she adds. The mix of textbook study and hands-on practice in the Health Science curriculum fits her learning style. “I’ve been in these classes for four years now,” she says. “And they’re the best I’ve ever taken.”
The students also share in common the primary attribute required of Certified Nurse Assistants – a desire to care for others. Each of them plans to work as a C.N.A. while attending nursing school.
Whether or not they go on to college or nursing school, students in the program graduate with a highly marketable skill in a stable profession. “With C.N.A. credentials, they can pretty much be guaranteed steady employment with benefits right out of high school,” says Ms. Welch. All graduates of the program are eligible to sit for the state board exam that includes written questions plus a demonstration of skill proficiency.
Certified Nurse Assistants fill an extremely important role in patient care, explains Debbie Martin, RN, instructor at East Rowan and coordinator of the clinical rotation at Rowan Regional Medical Center. She should know. She began her career as a C.N.A.
Among the duties of a C.N.A. are dressing, bathing and feeding patients, taking vital signs, assisting with catheter care and exercise regimens, observing and recording mental or physical changes in a patient’s condition.
C.N.A.s are in demand in hospitals, nursing homes, physicians’ offices and home health care agencies to provide hands-on, personal care to patients.
“Our students appreciate the opportunity they have been given to train for this career,” adds Ms.Welch. “They take it very seriously.”
Professional Training
In addition to educational guidelines set forth by the school system’s Career and Technical Education division, the Allied Health Science program must comply with the mandates of the North Carolina Board of Nursing for training Certified Nurse Assistants. “The Board demands that the program be structured so we all have the same equipment and teach the same skills,” explains Ms. Martin.
All instructors in the program are registered nurses and state certified teachers.
The curriculum begins in the ninth or tenth grade with a course covering medical terminology and an overview of the health care profession. Several of the schools include biomedical technology in the sophomore year. At the junior level, students in Allied Health I begin a focused study on the knowledge and skills required to become a certified nurse assistant. Seniors who want to continue in Allied Health Science II must make a formal application and meet the necessary requirements to earn one of the limited number of spots in the course that includes a full semester of clinical experience outside the classroom.
In addition to dedicated classroom space, each school has a fully equipped lab furnished with hospital beds, wheelchairs, lifts, IV poles, and tables plus an astounding inventory of supplies from surgical gloves and stethoscopes to cotton swabs and rolls of dental floss. Here students practice what they’ve studied and are graded on following to the letter each step required to properly perform specific skills from bed making to catheter care.
“They have to be able to check-off in that skill for the State,” explains Ms. Leben. “That means they may have to do it again and again until they get it exactly right.”
“Sometimes it makes you nervous,” says Haley Buder. “The teachers can’t correct us. They can only tell us what we did wrong after it’s done.”
Each of the schools’ labs was initially equipped with donations from Rowan Regional Medical Center which continues to assist instructors in stocking the growing list of training supplies required by the Board of Nursing.
“We do get funds from the school system,” says South Rowan’s Tina Leben. “We could have purchased the hospital beds and other big items for the lab, but it would have blown our budget. I cannot say enough about how incredible the hospital has been in helping us get the things we need.”
Roger Withers, coordinator of CTE for Salisbury Rowan Schools agrees. “We are so grateful to the hospital for their support,” he says.
“There are a lot of hospitals in other counties that are not nearly as generous and student-friendly as Rowan Regional,” adds Ms. Welch.
For North Rowan’s Debbie Sousa, the relationship with Rowan Regional isn’t just valuable. “It’s essential,” she declares.
Real-World Practice
By the time students pull on their blue scrub uniforms for the first day of real-world clinical experience, they have practiced and been tested on every skill they’ll need.
“I felt very comfortable and confident,” says North Rowan student Jessica Honeycutt, 17, who began her rotation at Salisbury’s Lutheran Home at Trinity Oaks. Her first assignment was to move a patient from bed using a lift – a skill she’d already practiced with a partner in the school lab. “Mrs. Sousa trained us well,” she says of her instructor. Still, she admits, the responsibility of hoisting a patient across the room in mid-air was “a little scary.”
South Rowan’s Haley Buder was encouraged by her first experience as well. “They do stuff exactly the way we were taught,” she says of her training location at Liberty Commons Nursing Center. “Our teachers have us very well prepared.”
The complete clinical round for students includes experience in a long-term care facility, a hospital, and a physician’s office or similar environment, with instructors assigned to supervise students at each location. By Board of Nursing rules, an instructor can only supervise 10 students at a time.
Rowan Regional serves as the hospital site where students practice patient care activities under the direction of Ms. Debbie Martin.
“They work in pairs taking vital signs, monitoring intake and output, changing beds, bathing or moving patients,” she says. “They do whatever needs to be done in that hour.”
At the same time, other students get an opportunity to observe activities in areas such as physical therapy and radiology. By semester’s end, all Allied Health Science II students who plan to take the C.N.A. exam will have completed a clinical rotation in the hospital.
“It’s a great partnership,” says Ms. Martin who is also an 18-year employee of the medical center. “I work with former students every day who are either C.N.A.s or nurses,” she says. “It’s so nice to see them following through to their dream.”
Chief of Nursing Edwina Ritchie affirms, “Rowan Regional is very committed to working with students. It truly helps them and gives us an opportunity to build a strong health care team for the future.”
In addition to performing patient care activities during clinical rotations, students practice keeping a time sheet and maintaining medical charts and records. They’re also graded daily on their proficiency and professionalism – with points awarded, or deducted, in a wide range of measures from the whiteness of their shoes to whether or not they are wearing a watch with a second hand. Students reflect on their experiences in daily journals.
They learn, too, that patient care is about more than performing tasks correctly. “During clinicals, students build relationships with patients,” explains Ms. Martin. “It really affects them.” Some even go back to visit with patients, especially those in nursing homes, long after their required rotation has ended.
“We try to give students a broad range of experiences,” says Ms. Sousa. “Health care is one of the few careers that has so many opportunities in so many field,” she adds. “And it’s secure. These students won’t have to worry much about a shortage of job opportunities.”
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