Nursing apprenticeships in rural areas

Lake Region State College uses different approaches to train more nursing students. (Photo: LRSC)

Katie Nerison has worked in healthcare since she was 15. Throughout her career, nurses and directors encouraged her to pursue her degree, which cost and time made nearly impossible. Then, her employer hosted a meeting about nurse apprenticeships with Lake Region State College (LRSC).

“I thought, ‘This is amazing,’” said Nerison, who is currently a medical aide at Nelson County Health System in rural northeast North Dakota. “Having the employer pay tuition and being able to work was a huge help.”

Today, Nerison is a student at LRSC in the practical nursing program. She plans to graduate with her certificate in July 2023 and continue her work commitment with Nelson County Health System with her newly acquired licensed practice nurses (LPN) license.

This article is part of a monthly series provided by the National Council for Marketing & Public Relations (NCMPR), an affiliated council of the American Association of Community Colleges.

Finding nurses is a nationwide issue, but it’s especially difficult in rural America. That’s what spurred Lake Region State College in Devils Lake, North Dakota, to look at apprenticeships in nursing. LRSC is a small, rural community college with a large service area; and apprenticeships as a whole were new to the college.

“We looked at careers that matched programming offerings, many of which would fall in a nontraditional category,” said LRSC President Doug Darling.

When one hears “apprenticeships,” the traditional fields of electrician or construction come to mind, but registered apprenticeships exist in a variety of careers, as listed with the U.S. Department of Labor (DOL). LRSC developed its first apprenticeship program in the simulation field using the standards developed by the DOL’s Office of Apprenticeship and various grants. Today, the apprenticeship list includes cyber security support technician, network support technician, helpdesk technician, electronics technician/simulation degree, electromechanical technician/technical studies, nursing and certified nurse assistant.

An innovative approach to nursing

The North Dakota Board of Nursing embraced LRSC’s request of nursing apprenticeships back in 2021 as an “innovative approach”: The program helps students earn a wage while attending college and learning skills on the job, which may create an ideal solution for employers desperate to fill critical shortages.

The “innovation in nursing education” approach was put into rule by state’s nursing board to:

  1. Foster innovative models of nursing education to address the changing needs in healthcare. 
  2. Ensure that innovative approaches are conducted in a manner consistent within the board’s role of protecting the public.
  3. Ensure that innovative approaches conform to the quality outcome standards and core education criteria established by the board.

Healthcare employers have been receptive to the federally registered apprenticeship model for both nurse assistants and practical nursing. An apprenticeship program is also available for the registered nurse as an expanded internship while the college waits for DOL to add it to the list of approved occupations. A small, rural long-term care facility was the first to come aboard, followed by Sanford Health, the state’s largest healthcare employers. Healthcare systems and long-term care facilities in communities statewide continue to offer apprenticeships to address their employment needs.

Apprenticeships, especially in healthcare, are attractive to employers, increasing staff retention, decreasing recruitment costs and improving patient care quality.

“Many of these apprentices already are working within the organization as nurse assistants, medical aides and other areas but have always had a goal of becoming a nurse but unsure of how to do it without incurring a large debt load,” said Melana Howe, LRSC’s resource development/corporate liaison/apprenticeships coordinator. “Others have degrees in completely different occupations and are transitioning into an entirely new occupation. I see this in nursing more than the other apprenticeship program.”

Wendy Anderson

For Wendy Anderson, another apprentice through Nelson County Health System, the apprenticeship program was a perfect tie-in to her path to become a nurse. As a certified nurse assistant, Anderson earned her medical aide credential. With the apprenticeship model, Anderson can tackle additional duties as she accomplishes the items on the skills checklist instead of waiting until earning her certificate.

“The apprenticeship approach is the perfect transition, as I’ll be working at a higher level sooner and support the team with a broader sense of skills,” Anderson said.

Nerison. the student who’s been studying healthcare since she was 15, says it’s also a great opportunity especially for those who didn’t have a chosen career path right out of high school. Plus, students have in-house supporters.

“It’s busy, but I really feel you need to work to see what you really like and want to make into a career,” she said. “And with the apprenticeship program, I have mentors at work who guide me.”

Spreading the wealth

Lake Region State College is helping other institutions grow apprenticeships by participating in a grant awarded to North Dakota Career and Technical Education. LRSC has also shared its model with the state’s Tribal College System, which will design the program based on its local job markets and community needs, Darling said.

Hess Corp. is investing $12 million over the next four years to provide support like tuition assistance and stipends, and Halliburton and Nabors Industries will invest $1 million apiece.

“Taking a work-based learning model and allowing students to earn their degrees while on the job instead of entering the workforce with only the credential can alleviate the pressures for all involved,” Darling said.

About the Author

Erin M. Wood
Erin M. Wood is director of college relations at Lake Region State College in North Dakota. She is also the North Dakota representative on NCMPR’s District 5 Executive Council.
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