RINIMC senior Jillian Corbin packs personal protective equipment in her family’s kitchen before heading to work as a certified nursing assistant providing home care during the COVID-19 pandemic.

When Jillian Corbin heard about the Rhode Island Nurses Institute Middle College Charter High School (RINIMC) at the beginning of her freshman year, she promptly filled out the paperwork and transferred. She never dreamed she’d be spending the final semester of her senior year of high school working on the frontlines of a pandemic as a certified nursing assistant (CNA), but that’s where she is today.

RINIMC opened in 2011 with a mission to diversify the nursing work force by making nursing careers more accessible to students from a high-poverty area of Providence, R.I. According to RINIMC Chief Executive Officer Pamela McCue, PhD, RN, the school, where 88 percent of students receive free or reduced-price lunch, also aims to eliminate health care disparities in the community.

One way RINIMC prepares students to study nursing is by offering college-level courses through a partnership with the University of Rhode Island (URI). RINIMC’s model is unique because it also partners with the Community College of Rhode Island (CCRI) to provide certification opportunities for students and community members to become CNAs or emergency medical technicians (EMTs). These certifications qualify students and other young adults for entry-level health care jobs, simultaneously increasing employment and health care knowledge in the local community.

Corbin has taken advantage of these opportunities. She completed her CNA coursework during her junior year of high school and began working 40 hours per week as a home health aide the next summer. When her senior year started, she reduced her work hours to weekends and after school. She is also completing her EMT certification.

Corbin says the job has kept her out of food service and retail and helps pay for essentials like car insurance. She feels a strong connection to her clients, whom she describes as a second family. “I think about them all week,” says Corbin. “Some clients need minimal help, but others are bedridden or have catheters, amputations, or ostomy bags, so I do a lot of personal care and other little things. Just talking to them can light up their room.”

When asked how her job has changed since the spread of COVID-19, Corbin says, “It’s been scary for the clients. I try to ease them when I can.” She notes that some health care workers have been exposed to the virus or have become infected, so her agency needs a lot more help, making Corbin’s 20 to 30 hours per week essential to the community.

The risk of becoming infected herself is not lost on 18-year old Corbin.

“I thought about not doing it for a day,” she says, “but then I decided it’s worth it because I see how much people need the help of a CNA or a nurse.”

RINIMC Chief Executive Officer Pamela McCue, PhD, RN

McCue, who has led RINIMC since its founding, expresses pride in the work of her school and its students. “We set out to diversify nursing and contribute to the Rhode Island health care workforce, and we’re doing it,” says McCue. Corbin is one of many RINIMC students and graduates studying nursing who, thanks to their certifications, are contributing in the current crisis. “They’re out there as CNAs and EMTs. Our graduates are doing the work.”

With funding from a recent grant, RINIMC plans to expand the certification programs in two ways. McCue says, “We’ve added a third certification for patient care technician, which is another high-demand entry-level position.” Although currently on hold due to shutdowns related to COVID-19, McCue explains, the school’s certification programs will also become available to students from other local high schools and to unemployed or underemployed adults in the community. Certification programs previously offered to non-RINIMC students in the summer will be expanded to year-round.

“These certifications are not the end goal,” McCue says, explaining that the end goal is to get participants to see themselves as health care providers. She hopes the field experience will motivate them to stay in health care and acquire more training and earning power. Corbin is a case in point. She has already taken multiple college-level courses through the RINIMC program and plans to attend CCRI in the fall of 2020 before transferring to URI to complete her bachelor’s degree in nursing.

Corbin will attend the Community College of Rhode Island in the fall before transferring to the University of Rhode Island to complete her bachelor’s degree in nursing.

“Attending RINI and working as a CNA changed my perspective on a lot of things,” Corbin says. “I used to be very shy. But working in health care, you need to be open and willing to talk to anybody. It’s taught me about empathy and compassion and about how to meet different challenges.” She adds that her work has raised her aspirations. “I want to be a nurse practitioner,” she says, “so being a CNA is just a start for me.”

RINIMC’s success has garnered much attention, and McCue has been approached about replication. She and other school leaders are currently forming a nonprofit to disseminate the model to other communities: “Next stop,” she says, “Albany, N.Y.” In McCue’s estimation, the RINIMC model “speaks to the social determinants of health” because the school is improving the health-related knowledge of the community while also increasing the earning power of individuals who live there. She says, “If we can go into underserved areas where the quality of education isn’t where it should be, then we can change the trajectory for each student’s family.”

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The Future of Nursing: Campaign for Action is excited to announce nine of its state-based Action Coalitions have each been selected to receive up to $25,000 for innovative ideas to advance nursing and build a Culture of Health. The winners were chosen based on their submission of replicable plans to continue working to implement at least one recommendation from the Institute of Medicine (IOM) report on the future of nursing, while also contributing to building a healthier America through nursing.

The winners are:

Colorado

The Colorado Action Coalition’s project seeks to advance nursing leadership by supporting the expansion of a nurse-led health care model to federally qualified health centers in the state. Nurse leaders interested in implementing this RN-based model will be offered a two-day workshop and team-based coaching. The project is called Nurses Leading the Transformation of the Practice Environment.

Massachusetts

The Massachusetts Action Coalition’s project, Promoting Health Literacy to Influence Health and Wellness of Students in the Community, aims to develop a health literacy initiative for students in select communities. The initiative will encourage nurses to become leaders and participants in existing school wellness committees. Participating nurses will receive population health training and access to resources from partners so they can be better positioned to shape school policies concerning school nutrition, physical activity, and other student health issues.

Michigan

The Michigan Action Coalition will create a networking platform featuring social and professional networking, as well as online education opportunities.    The aim of Nurses Connect is to  increase professional development opportunities and strengthen connections among nurses to increase job satisfaction, improve retention, and promote lifelong learning. The platform will include leadership development, mentoring, and Culture of Health components.

Nebraska

The Nebraska Action Coalition will involve nurses on an interprofessional committee whose purpose is to increase access to care by promoting the involvement of community health workers on interdisciplinary teams. The Nebraska Action Coalition will also participate in events that promote the importance of nurses leading in their communities to help build a Culture of Health. Such activity includes hosting regional conferences using the Robert Wood Johnson Foundation Culture of Health framework and other tools to assist communities in creating their Community Health Improvement Plans (CHIP). The information gathered will contribute to the development of a national CHIP model for other communities to use as they create their own plans.

Ohio

In an effort to promote nursing leadership and address local health-related issues, the Ohio Action Coalition will partner with Court Appointed Special Advocates (CASA) to encourage nurse participation in CASA’s efforts to train volunteers to advocate in court for the interests of an abused or neglected child.

Pennsylvania

The Pennsylvania Action Coalition project, a podcast series titled “At the Core of Care,” is an effort to showcase the stories of patients, families, and communities, and the creative efforts of nurses and other partners to better meet their health and health care needs. These podcasts will view a health care need through the lens of the consumer and highlight the ways that nurses and other organizations are intervening and partnering to transform the health care system.

Rhode Island

The Rhode Island Action Coalition seeks to improve its state’s health care system by creating a nursing curriculum, competency assessment, and development program to prepare nurses to become primary care providers in high-demand communities. Additionally, the state will develop a campaign to promote interprofessional practices among diverse organizations to foster collaboration within the health care environment.

Utah

The Utah Action Coalition aims to increase diversity in nursing by implementing strategies that include outreach to middle and high school counselors. The goal is to recruit students from underrepresented communities and backgrounds for nursing schools. To support diversity in nursing students’ academic progression and leadership, the Action Coalition will implement mentoring and support programs featuring mentors who represent a diversity of racial, ethnic, age, gender, and socioeconomic backgrounds.

West Virginia

The West Virginia Action Coalition will focus on nurse entrepreneurship, offering webinars and online training to teach skills and build a community for nurses to learn about becoming entrepreneurs. This project is based on the belief that nurses could have a large economic impact in the state and in their communities if they were more knowledgeable about business opportunities.

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• Distribution of population by race/ethnicity
• Percentage of population living in rural versus urban areas
• Distribution of population by federal poverty level
• Areas in which there is a shortage of primary health professionals

These statistics can guide your Action Coalition’s work in shaping a nursing workforce to better meet local needs and overcoming health disparities in your state. As you integrate other Culture of Health aspects into your work, consider how demographics play a role in health equity and fostering cross-sector collaboration.

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