When it comes to providing health services, the most precious resource of any healthcare system, hospital or provider’s office is its people: those who make up the healthcare workforce. Yet the nation’s expanding healthcare needs are outstripping the workforce size, creating a severe shortage of employees at all levels.
While there is no single solution to the healthcare workforce crisis, a unique partnership pairs Nemours Children’s Health with the state’s vocational-technical high schools to train high schoolers for healthcare careers.
Guests:
Yvette Santiago, Director, Community Engagement, Nemours Children’s Health, Delaware Valley
Margaret LaFashia, DNP, Director of Workforce Partnership Development, Nemours Children’s Health, Delaware Valley
Kyle Hill, EdD, Principal, Howard High School of Technology of the New Castle County Vocational-Technical School District, Wilmington, Delaware
Deanna Lee, Certified Clinical Medical Assistant, Nemours Children’s Hospital, Delaware, and student, Howard High School of Technology
Producer, Host: Carol Vassar
EPISODE 57 TRANSCRIPT
Carol Vassar, podcast host/producer:
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week, we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar. Now that you’re here, let’s go.
MUSIC:
Well Beyond Medicine!
Carol Vassar, podcast host/producer:
When it comes to providing healthcare services, the most precious resource of any hospital provider’s office or healthcare system is its people, the healthcare workforce. According to the US Bureau of Labor Statistics, in 2022, nearly 15 million people aged 16 and older were employed in healthcare occupations, accounting for 9.3% of total US employment. Still, it’s not enough. Healthcare worker shortages are real in the US. The causes include an aging US population, anticipated retirements from within today’s workforce, and the issue of burnout, which sometimes forces skilled, experienced workers from physicians and nurses to certified nursing assistants to leave the field altogether. It’s a crisis as laid bare during and exacerbated by the COVID-19 pandemic. Recruiting and retaining healthcare workers remains a priority across the US healthcare system, and there is no single solution.
Some models are working to put a dent in the shortfall, and we’ll talk about one of those models today. It’s happening in Delaware, and we had a chance to learn more about it when the Nemours podcast truck was on site during Well Beyond Medicine Day at Nemours Children’s Health in Delaware. It’s a unique and proven partnership between the Newcastle County Vocational Technical School District and Nemours Children’s Health. A bit later, we’ll talk with the principal of Howard High School, part of the Newcastle County Vo-Tech System, and one of his students about how this program has worked from their perspective. Right now, though, let’s get an outline of this School to Work program from Margaret LaFashia, Nemours Director of Workforce Partnerships in Delaware, and Yvette Santiago, wearing two hats in this interview, Nemours Delaware Director of Community Development and Board President of the Newcastle County Vocational Technical School District.
Yvette Santiago, Nemours Children’s Health:
Workforce development is extremely important. At Nemours, we know that there are many positions that we need to fill. In some instances, there are people retiring or leaving, and so we have to find opportunities by partnerships in the community to figure out how do we best support our pipeline into the healthcare workforce, and we look to our partners in the community to help fulfill those needs for us.
Carol Vassar, podcast host/producer:
The partnership with Howard High School is not unusual. There are many, it sounds like, partnerships for workforce development. Margaret, can you tell us a little bit about the partnership with Howard and then expand that out to how else we’re looking to develop the workforce of the 21st century, the 2030s if you will.
Margaret LaFashia, Nemours Children’s Health:
Absolutely. To piggyback first on what Yvette had stated that when looking at the workforce, I am a registered nurse, and we recognize that there is a shortage coming, if we’re not already in it, over the next 10 years of nurses. There are baby boomers who are going to be retiring, and there are folks that we need to start bringing into our health system. Looking at the workforce in the state of Delaware, we have vocational high schools that we are partnering with, and they have healthcare pathways. The pathways include nursing assistants and, medical assistants and dental assistants, EMTs, all folks that we could bring into Nemours at the beginning of their career and help chart their future towards eventually becoming a physician assistant or a nurse or even a doctor within the walls of Nemours. That has to start at the high school level. We really need to start reaching out to our young folks and helping to chart their path towards a career in healthcare.
Carol Vassar, podcast host/producer:
Talk about the partnership with, I believe it’s Newcastle Technical High Schools. How did that come about?
Margaret LaFashia, Nemours Children’s Health:
It came about because of Yvette Santiago, who is the President of the Vocational Schools here in Delaware, and Yvette and I work very closely together on community outreach events and opportunities for Nemours. She approached me about these career pathways. Lo and behold, the opportunity of creating a pipeline was really born out of those conversations and actually walking the halls of those high schools. We went on-site, visited the curriculum, and the instructors met the students, and they were very professional. They are eager to learn. They want to be in healthcare. What we did was we sat down with our Patient Care Leadership Team and created opportunities, and the opportunities extend to both unpaid internships and externships as well as paid co-op positions for those students who are certified in their field of specialty. Right now, they are a part of our staffing model, and the nurse managers and the directors have really embraced these students in the halls of our hospital. The students have really embraced being a part of the Nemours family.
Carol Vassar, podcast host/producer:
Yvette, my understanding is that you are a product of one of these high schools. Talk about your personal experience and your continued passion for the work that’s being done here.
Yvette Santiago, Nemours Children’s Health:
Absolutely. Yes, I’m an alumni of the Newcastle County Vocational Technical School District. I went to Delcastle, who is also one of our schools that we’re partnering with, and Margaret’s doing a lot of work there with the medical assistant, dental assisting program, and also, hopefully, in the near future, the surgical tech program. When I was at Delcastle, I was not focused on any of the allied health career areas. It was more of communications and graphics area. For me, it was an area of interest that I still dibble and dabble now, but I am a product of that school district. It is one of the most revered school districts in the country. It’s a model for vocational and technical education, and we lead the way in career and technical education and instruction. Hence, the reason why we have this strong partnership is because Nemours is always looking for top-tier talent and a diverse workforce, and we have this great resource right in our backyard that we can leverage.
Carol Vassar, podcast host/producer:
You are obviously passionate about it because you are a product of this wonderful education. How do you encourage the students when you talk to them to think about going into the allied health end of the pipeline?
Yvette Santiago, Nemours Children’s Health:
When I speak to students, I really talk to them from the perspective of what moves you and what are you excited about, and what do you envision yourself doing the rest of your life and being passionate about that every single day. Also, sharing with them the information around data that Margaret talked about, the need and the shortage in the healthcare field. If you have a passion for taking care of others, whether it’s children or adults or even our older adults in the geriatric population, that the healthcare field is one that is very promising that you can create opportunities for yourself, not just in one side of healthcare, but there are so many things that you can do in the healthcare field, whether it’s clinical or non-clinical.
You can enter in one area and then through exposure and education and additional training, you can end up in a totally opposite area of healthcare. The lanes for healthcare, the opportunity, the diversity in fields is pretty spectacular and amazing, and the need is great. And we need our young people to understand that and exercise their level of interest and seek folks like myself and Margaret and others in the healthcare industry to help provide that information and opportunity to them.
Carol Vassar, podcast host/producer:
It sounds like this is very much a model that could be replicated. Margaret, do you know of any other healthcare organizations that have partnered with their local or regional technical high schools to really grow this program similar to what’s happening here in Delaware?
Margaret LaFashia, Nemours Children’s Health:
That’s a great question. This work actually was born out of some research that I was doing. I was getting my doctoral degree and my topic was around increasing diversity in nursing. What we boiled it down to was reaching out to the communities around us and getting those kids into healthcare careers. Through my research, the only other children’s hospital in the nation is Boston Children’s, and they have a Lattice program, which is similar but not the same as what we’re doing. We are actually building our own, and we are learning that we are on the top end of the map of doing this. I have presented nationally at a couple of different conferences on this program that we are building. I’ve had other, like Minnesota Children’s reach out to me for insight in how they can build their own program. Yeah, we are actually leading the way on this journey.
Carol Vassar, podcast host/producer:
Talk about the need for diversity.
Margaret LaFashia, Nemours Children’s Health:
The need for diversity in nursing specifically, we did some data analysis in the state of Delaware and then also nationally and 81% of all active nursing licenses identify as white. Whereas if you look at our patient population for Nemours Children’s in the Delaware Valley, 58% of our patient population identifies as white. We have a huge opportunity to increase diversity in our healthcare careers. As Yvette stated right now, all kids really see is what they’re exposed to is on TV. They see a physician, or they see a nurse. They don’t realize that there’s so many other careers as well in healthcare. We are actually doing roadmaps right now for the different career pathways and how you start and how the path you would take to become a social worker in healthcare, a child life specialist, a respiratory therapist, and looking at all the career pathways. Because not only do we want to show these future potential clinicians that they can be a nurse, that there’s a lot of other opportunity within the health system.
Carol Vassar, podcast host/producer:
It sounds like there’s a lot of potential in this program. You’ve identified that potential. Yvette, where do you see this workforce development program that is really leading the nation in the future?
Yvette Santiago, Nemours Children’s Health:
I think the promise and the opportunity is absolutely huge. I think that as we continue to unpack this and really build the level of support and momentum across our organization and other organizations, we can really be the model for the country on how we can introduce students into the pediatric healthcare workforce. If they’re not interested in pediatrics, they will know it after going through a rotation with us. Part of us, our opportunity and responsibility is to highlight those opportunities through education and awareness and exposing students to that, otherwise they will not know. As we continue to pave the way for what this could look like for others in the country, I think that the promise is huge, and the opportunities are endless for students that want to get into the healthcare workforce.
Carol Vassar, podcast host/producer:
Yvette, how do you see this as going well beyond medicine?
Yvette Santiago, Nemours Children’s Health:
This is a great example of what it means to go well beyond medicine, beyond our clinical walls. We are in the community, we’re engaging with partners, we’re engaging with communities that represent vulnerable and disparate populations that without these opportunities this would not happen. We are working with education. We’re working with nonprofits. We’re working with many leaders that enable us to continue to highlight the issues that are important in the community so that we can continue to impact those social determinants of health to ultimately prevent students or patients from coming into our hospital or clinical practices for things that could be prevented. For us, when we’re talking about well beyond medicine is keeping the pulse on what’s happening in the community from a needs and resources perspective, highlighting that, and figuring out in what lane do we best fit in to fill some of those gaps and ultimately serve as a great leader and partner in the community.
Carol Vassar, podcast host/producer:
Today, Well Beyond Medicine Day in Wilmington, you’re doing a special donation, I think it was to Howard High School, but I’m sure you’ve made similar donations of scrubs because, well, why Margaret?
Margaret LaFashia, Nemours Children’s Health:
Well, as Yvette said, Well Beyond Medicine, we also have to recognize that these students that we are bringing in are also currently part of our patient population. They are in our community and are part of our bigger family. They approached us, and they had a need, and their need was that their students need scrubs. Scrubs are expensive, and until you actually obtain your first job, getting scrubs can be difficult. We worked with our clinical educator in her residency program, and she did a fantastic job. Her residency students have to do a community event every year, and they jumped at the opportunity. They took it upon themselves to reach out to all the nursing units, both internally in the hospital as well as in our ambulatory setting, and within weeks, were able to obtain brand new scrubs, used scrubs, gently used scrubs, but scrubs that definitely these students will benefit from and be able to wear proudly within our hospital and in their future career.
The one thing I wanted to add to what Yvette said, and you had asked the question of how do you get kids interested in healthcare? When we go into the schools, I will take a dentist with me, I will take a respiratory therapist with me, I take our educators with us. I’m one person who can say what my experience is, Yvette is one person, but the students really, they thrive on seeing it and hearing it from other individuals as well and professionals that come with us. And the professionals really that come with us from Nemours, they get really engaged. At first they’re like, “Okay, I can talk to a student about what I do.” By the time that they’re leaving, they are so energized and excited and realized, “Wow, just by talking about my career path and how I got here, I really can influence the next generation.” That was really key.
Yvette Santiago, Nemours Children’s Health:
For those that have gone out, for them to continue to spread the word to other leaders and clinicians and non-clinicians at Nemours to say, “Hey, I did this, and I think you would be great to go out and speak to students.” In order for us to continue that message of going well beyond medicine and executing on that, our leaders, our clinical leaders, non-clinical leaders going out talking about their experiences and engaging and exposing students to their story and to the great opportunities ahead is what enables us to continue to move the needle in this area.
Carol Vassar, podcast host/producer:
Yvette Santiago is Director of Community Engagement, and Margaret LaFashia is Director of Workforce Partnerships, both at Nemours Children’s Health, Delaware. Yvette also serves as Board President of the Newcastle County Vocational Technical School District. Deanna Lee is a high school senior who last year obtained her first job working as a certified nurse assistant or CNA at Nemours Children’s Health. She is one of hundreds of students across the four high schools in the Newcastle County Vo-Tech system, gaining the skills, knowledge, and experience to enter a career in healthcare and other fields and doing so even before crossing the stage at their high school graduation. Deanna and her principal, Dr. Kyle Hill from Howard Technical High School, boarded the Nemours Podcast truck to provide details on the program and first-hand insights on how it has given students like Deanna a leg up as they head directly into the workforce or move on to college.
Dr. Kyle Hill, Principal, Howard High School:
At NCCVT and Howard, all four of our schools truly embrace the model of preparing students to be college and career-ready. We live that by making sure that all of our students leave with a certification. If no certification exists in the career area, then they leave with college credit. What makes us unique is most schools have CTE Pathways, CTE standing for Career and Technical Education. What makes our schools different is our students get 10 credits, which means by the time they’re seniors able to sit for a certification exam that is usually taken as an adult, at the cost of not having some electives. During their senior year, they’ve completed all of their credits for graduating high school except for two, one English and one Math. Our students are able to take that one class per semester and then go out to work each day at 9:30.
Howard offers 14 career paths. Some of them are your traditional career paths in vocational education such as plumbing, carpentry, and masonry, but we also have college pathways as well, nursing, medical assisting, dental, teacher academy, and academy of finance. We give students an opportunity to explore all 14 during their freshman year to get a true experience for what the field actually has to offer. Then, about midway through their freshman year, they make their selection, and they spend the remainder of their high school career learning and developing in the career path of choice.
Carol Vassar, podcast host/producer:
Talk about the partnership with Nemours. It sounds like many of your students have the opportunity to be certified medical assistants and actually work here at Nemours. How did that partnership come to be? How has it been for you all?
Dr. Kyle Hill, Principal, Howard High School:
I think first it starts with our Board. Our School Board is comprised of folks in the industry who are aware of the employment needs, so they’re able to direct us and the schools to prepare students for what jobs are currently needed and what’s going to be needed in the future. Our Board President, Yvette Santiago, is a graduate of NCCVT and is well aware of the things that we do on a daily basis and how we can be of benefit to our community. Through her leadership with Nemours, she connected our schools with Nemours to find pathways for co-op opportunities for students like Deanna, as well as opportunities to participate in philanthropic efforts like today, where we’re preparing meals for families that are food insecure, providing scrubs for our students who may have some financial challenges and can’t afford the scrubs. It just provides one less challenge for them to have to deal with so they can pursue their passion for medicine and ultimately get an opportunity to co-op and/or go to college and pursue their medical career.
Carol Vassar, podcast host/producer:
Deanna, you had the opportunity as a freshman to look at all 14 of the offerings at Howard High School. You chose the medical pathway. Why?
Deanna Lee, student, Howard High School:
I just always wanted to help people. I feel like that’s something I’ve always been interested in, and I like the medical field because it’s just always evolving. There’s always something new to learn. It’s new things coming out every day, and I just really like that aspect of just being hands-on with people and helping people and just having that aspect of learning and constantly being challenged throughout the day. I love medical assistant. I think it’s so fun. My shop teacher, she was so nice and I just loved it. I loved the atmosphere. I loved what we did and I loved what we learned about. Yeah.
Carol Vassar, podcast host/producer:
I’m assuming you like Nemours as well, maybe even more.
Deanna Lee, student, Howard High School:
Yes.
Carol Vassar, podcast host/producer:
What do you like about the job that you’re doing? You’re on par with adults who are probably much older than you are coming into this field, maybe later in their careers. What is it like as a high school senior coming into a workplace, a profession? How does that all work, and how do you feel about that?
Deanna Lee, student, Howard High School:
At first, I definitely do think it was an adjustment. I feel like because this is actually my first job, so it was my first time ever working with other people and going to work. It was an adjustment for me. I really had to learn how to communicate really well with my coworkers. I had to learn how to communicate well with patients and patient families. It was definitely an adjustment, but I do feel like it’s necessary for me to learn this. I do want to continue working in medicine. It’s definitely been a learn in progress I feel like. Definitely, for sure.
Carol Vassar, podcast host/producer:
You have a success story here. I’m sure there are many other success stories, Kyle, Yvette is another. Tell me about somebody who stands out for you in terms of having been at Howard, having been on the medical track and is now moving forward in their career.
Dr. Kyle Hill, Principal, Howard High School:
Well, I will say one thing that stands out is our incredible staff. All of our CTE teachers come from industry, so they’re not classically trained as teachers. We blend both worlds, those teachers that teach our academic courses that were classically trained as teachers and those that came from industry that prepare our students. Not only the technical part of the career path, but it’s the employability skills, the soft skills, things that you were just speaking with. [inaudible 00:21:54] They get hands-on opportunities. All of our shops have a room where they can learn theory, and then they have a lab where they can actually go in and use equipment. It helps our students become more familiar with the equipment that they’re going to see in the workplace.
So, like Deanna and, we have another student, Katie, who works for Nemours as well, they’re doing outstanding. The feedback that we receive is that the students are prepared. It’s a testament to their families. It’s a testament to their instructors and it’s a testament to their own work ethic to be in this environment, be a teenager, but perform like an adult in the workplace.
Carol Vassar, podcast host/producer:
Deanna, you said this is your first job.
Deanna Lee, student, Howard High School:
Yes, it is.
Carol Vassar, podcast host/producer:
My first job was in a bakery. You’re way ahead of me, and I’m sure you’re way ahead of many of your peers. What do your peers and your friends think about the fact that you are working as a professional in a profession in a hospital?
Deanna Lee, student, Howard High School:
I definitely do feel like my friends are really supportive of me. I think they understand that I have a job and I have to work, but I definitely do feel like they’re always there supporting me. I tell them about my days at work, and they’re just always really encouraging. Especially my shop classmates, I tell them like I’m having a hard time with this and that, but they help me a lot. Katie, I tell her, “Oh, I’m struggling with this at work.” She tells me, “Oh, this is what I do. This is how I did it”, or, “This is what somebody told me.” Yeah, I definitely do feel like it’s a learning experience for everybody. I tell people about Nemours all the time and what I do, and if that’s something they’re interested in. I ask about things for people all the time, so I definitely do feel like it’s just really supportive, and I’m lucky to have people around me that’s really supportive and also people around me who are like-minded and have the same interests as me to continue supporting me in everything.
Carol Vassar, podcast host/producer:
What’s next for you?
Deanna Lee, student, Howard High School:
College. I’ve recently been applying to colleges, and local colleges, and hopefully, I want to study Biology, then, I want to go to med school, and I want to work with cancer patients.
Carol Vassar, podcast host/producer:
Deanna Lee is a Nemours CNA and a senior at Howard High School of Technology in Wilmington, Delaware. She spoke to us alongside her school’s principal, Dr. Kyle Hill. Thanks to everyone who stepped onto the Nemours podcast truck at Well Beyond Medicine Day in Delaware to share their stories. Kyle Hill, Deanna Lee, Margaret LaFashia, and Yvette Santiago. Thanks to you for listening.
What do you see working when it comes to workforce development? Leave us a voicemail on our podcast homepage NemoursWellBeyond.org. There, you’ll also find previous podcast episodes. You can leave a review and you can subscribe to the podcast so you’ll never miss a future episode. Che Parker, Susan Masucci, Cheryl Munn, and Lauren Tata are the production team on this episode, and we are grateful for all they do behind the scenes. I’m Carol Vassar. Join us next time as we learn more about a revolutionary gene therapy for Duchenne’s Muscular Dystrophy. Until then, remember, we can change children’s health for good well beyond medicine.
MUSIC:
Well Beyond Medicine!
