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Finding Hope in the Midst of Challenges

Nursing program in the Northern San Joaquin Valley brings hope and opportunities to local health facilities and community members

HOPE Incumbent Worker Cohort 2020

Healthcare facilities throughout the Northern San Joaquin Valley (NSJV) have faced a challenge in growing their workforce. Local schools were educating and training certified Registered Nurses. Healthcare facilities were hiring the new graduates but after gaining some experience, they were transitioning to locations outside of the NSJV area. Local facilities were facing high turnover rates, which resulted in financial and resource loss.

“Some of our longstanding challenges in the Valley is that we tend to be a training ground. We train new graduates and within 6 months to a year, they leave our facilities to go to the Bay area or the Sacramento area, partly because they are not residents of our County. Our local hospitals and clinics have shared these sentiments for many years and pleaded that something be done to develop and create programs that would allow our local residents the opportunity to develop and pursue careers in healthcare, thereby mitigating the perception of a revolving door when it comes to training new grads” said Dr. Anitra Williams, Director of Nursing Operations at Dignity Health, St. Joseph’s Medical Center. ”

For educational partners like San Joaquin Delta College, a regional community college, that has to abide by state law California Senate Bill No. 1393, it can be challenging to establish efforts to prioritize local/regional candidates. The CA Senate Bill 1293 “prohibits a community college district from excluding an applicant to a registered nursing program on the sole basis that the applicant is not a resident of that district or has not completed prerequisite courses in that district.”

“One of the challenges we were facing at Delta College is that we were educating people who weren’t from here. With CA Senate Bill 1393 enacted, we can’t pick and admit people from just our region, we have our programs open to all applicants in California. With our Registered Nursing program, we usually have about 40% of students from our area,” explained Julie Kay, Dean of Health Sciences at San Joaquin Delta College.

With the parameters of CA Senate Bill 1393, the employment selection pool of local-residing graduates is scarce. There is urgency for new and creative solutions to meet the regional workforce demand.

According to a study from the University of California, San Francisco (UCSF) Healthforce Center, the total number of Registered Nurses (RN) in the San Joaquin Valley is predicted to decline between 2017 and 2030. At the same time, the demand for RNs is projected to grow more than 35%. The study suggested that “the primary policy solution for large projected RN shortages in the San Joaquin Valley is to increase the number of graduates from education programs in the region.”

The regional healthcare employee shortage could no longer go overlooked. Local healthcare facilities, education institutions, and workforce development agencies were getting weary and tired of going through the revolving door of students. In 2018, healthcare, education, and workforce development executives from the NSJV convened and strategized a new partnership to combat the shortage and create a long-term solution by launching HealthForce Partners (HFP). With this new innovative partnership, partners from across the sectors worked together to identify healthcare workforce gaps, like the RN shortage, and developed new career pathways and programs to address them. HFP not only addresses the talent needs of healthcare employers but also the employment and education barriers of community residents in NSJV.

Through this new collaborative partnership, Dr. Anitra Williams, Director of Nursing Operations at Dignity Health St. Joseph Medical Center, seized an opportunity to convene Julie Kay, Dean of Health Sciences at San Joaquin Delta College, Lisa Lucchessi, Director of Health Science Division at San Joaquin Delta College, Dr. Ginger Manns, Chief Nursing Officer at Community Medical Center, Dr. Debbie Tavernier, CSU Stanislaus, Aaron Mata, Principal at Health Careers Academy, and Valerie Fisher, Regional Director of California Healthcare Workforce Initiative. Calling themselves the “Make It Happen” Team, the group drafted a concrete plan to help high school students enrolled at Stockton Unified School District’s Health Careers Academy and incumbent workers at local healthcare facilities to make the transition into San Joaquin Delta College’s Associate Degree in Nursing program.

This new plan became the Helping People Elevate Program (HOPE). The HOPE high school pathway enables 22 High school students from a partnered high school, Health Careers Academy, to leverage dual enrollment at Delta College to complete their Nursing prerequisites. Through the dual enrollment students are on a pathway that would allow them to enter Delta College’s ADN program as early as 2021. Upon their high school graduation, students will matriculate into Delta College’s ADN program.

“After our orientation at Health Careers Academy the presentation, several moms had tears in their eyes. Some of the mothers came up to us and told us their story of how they weren’t able to finish high school and were currently 2-3 jobs to support their families,” said Dr. Williams. “They were in tears with the mere thought that their child would have an opportunity at a nursing career before the age of 21. They would be able to change their family and their life forevermore. There was so much hope in that room. I knew that I wanted to do something with the word hope because that’s what I saw when I was speaking to these parents.”

Incumbent workers at the local facilities were also facing challenges and hurdles in starting their nursing education. Thus, an incumbent work track was also established. Incumbent worker, Shazia Begum, has been employed at Dignity Health St. Joseph’s Medical Center for 15 years. She began her healthcare career at 18 years old working as PBX Operator and currently works as a Float Pool Secretary in the Patient Care Support Department.

Although Shazia enjoys her current job and previous positions, she felt that there was still something missing in her career path.

“I didn’t know what I wanted to do in school. I was constantly changing my majors. As a first-generation student, I didn’t have the support system to help me pursue higher education,” explained Shazia. “Being in the hospital, being in my job position, and also having someone sick at home, made me realize that nursing might be the best route for me.”

But pursuing a nursing career was not an easy path for her. As she was looking into courses and programs, she ran into hurdles with transferring coursework. Some schools wouldn’t take class credit from other schools so she would have to retake classes at the new school. She also completed a Licensed Vocational Nursing (LVN) program to help her get into a registered nursing program

“I finished the LVN program. I turned in all my courses and credits and completed all my prerequisites but I still couldn’t get into a registered nursing program. I’m thinking what am I doing wrong? I did everything that they told me to do. I lost hope,” said Shazia.

After years of facing barriers and hurdles in pursuing a nursing career, Shazia was accepted into the first HOPE Incumbent Worker cohort. The cohort includes 25 students from local facilities Lodi Adventist Memorial, Dignity Health St Joseph’s Medical Center, and Community Medical Centers. Similar to Shazia’s career path, the other students in the cohort have been working at their respective facilities for years but were also struggling to get into a local nursing program.

“We have built a strong relationship with our local facilities. Because we are working with a special population and special partnership it allows us to let those students automatically enter the program. Every semester we have 400 applicants and only 40 slots so it is a very competitive process. It gives the HOPE program students’ ability to come in without the competition,” explained Lucchessi.”

The HOPE program is the first of its kind. With the unique collaboration and standing relationships between education and local healthcare facilities, they both were able to come up with a solution that not only benefited their institutions but also helped cover the costs of programming.

“The partnership with education and hospitals makes the HOPE program model unique. We had a problem and we figured out a way to solve it,” said Kay. “The lectures and education piece is done by us and the clinicals are provided by the hospital and they pay for their students to complete their rotation. It takes away nothing from anyone else.”

The first incumbent worker cohort is expected to complete the ADN program in Spring 2021. For the local healthcare facilities, they are both able to grow their nursing staff size and equip them with the knowledge of the mission and values of their respective organization.

“It’s important for employers when hiring and training to look within the organization. You already know how they work and you already know how dependable they are. I think it’s best to use someone from their own facilities because they already know the environment and all the protocols. This is always going to be the community I’m going to live in. I’ve been here for all these years and I don’t have any plans on leaving,” concluded Shazia.

The HOPE Program has not only become a creative and innovative solution to address the nursing shortage in the NSJV area, it also provides an opportunity to elevate community members equitably and sustainably.

For more information, contact HealthForce Partners at


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