California Community Colleges Helping Address Nursing Shortage

610 200 Nadine Ono

First cohort of Single Subject Pilot Project students, left to right: Hanna Mae Descalso, Maureen Pinera, Charmaine Miralles, Professor Gabi Aliyev, Jordan Reyes, Mark Castillo

(Photo Credit: Ann Durham/Grossmont College)

Internationally-trained nurses face a difficult barrier to practice in California. The California Board of Registered Nursing requires that, in specific courses, both classroom instruction and clinical practice must take place concurrently. In some nursing schools overseas, they are offered in consecutive semesters, which is deemed a “deficiency” and makes the applicant ineligible to take the NCLEX-RN (National Council Licensure Examination), the national exam required to practice in the state.

Often, these nurses need to take only one or two courses to satisfy the requirement, but with impacted nursing schools, finding a spot in just one course is difficult. A pilot project at Grossmont College aims to assist these internationally-trained healthcare professionals by offering courses to Single Subject Students. This summer, five students were chosen from more than 75 highly-qualified applicants to be in the first Single Subject Course offered, an Obstetrics and Pediatrics course. Medical-Surgical, Geriatrics and Psychiatric-Mental Health are the other courses included in the state requirement.

“Until now, what people have done is call every nursing school they can find,” said Ann Durham, director of the San Diego Welcome Back Center and the San Diego/Imperial Health Workforce Initiative Deputy Sector Navigator. “Unless a student fails or withdraws from the class, there is no room for an internationally-trained nurse to take just that one subject that they need.”

International nurses have gone to great lengths to qualify for the California NCLEX-RN. Some have traveled to other states, which don’t have this specific requirement, and obtained their license thinking that it is transferrable to California, but it’s not.

Durham spoke to one nurse who contemplated taking one course at a for-profit institution in San Francisco. It would have cost $15,000. He was so desperate, he considered taking out a loan, then living out of his car and showering at a gym (because housing is too expensive) for the duration of the coursework. The cost of the course and requirements to take it through the Single Subject Pilot at Grossmont College was less than $500 for in-state students.

The Obstetrics portion of this summer’s pilot was taught by Dr. Gabi Aliyev, a full-time faculty member at Grossmont College’s nursing school. “It’s a really great and very strong program to be in and to graduate from in general and I think it was helpful for them in terms of getting ready for the NCLEX.” Aliyev also has experience as an international healthcare professional. She was a physician in the former Soviet Union and graduated from the Welcome Back Center's MD-to-RN program at Grossmont College. She initially attended Grossmont College to learn English and entered the nursing program. She continued her education to receive a master’s and doctorate.

“I would like to thank you from the bottom of my heart for all the hard work/struggles of all the people that worked to enable this program,” wrote Charmaine Miralles, one of the five pilot students. She received her BSN in the Philippines and has lived in the U.S. for three years. She took and passed the NCLEX in Texas, but still didn’t qualify for a California license because of the concurrency requirement. Miralles had tried for a year to access an OB course before finding the Single Subject course at Grossmont this summer. Now that she has successfully completed the course, she is on track to become a licensed RN in California. “This is truly life-changing for all of us.”

Most of the internationally-trained nurses who immigrate to the U.S. must work in lower paid and lower skilled jobs until they get their license, sometimes outside of the healthcare field. Obtaining their license allows them to move from a job that may not provide a living wage to a profession with a solid middle-class and above income.

Grossmont College’s Single Subject Pilot Project is a project of the California Community College Chancellor’s Office’s California Healthcare Workforce Academy and funded by the Strong Workforce Program Statewide Coordination Fiscal Omnibus Grant. The Health Workforce Initiative and the San Diego Welcome Back Center.

Although Durham and others have been trying to find a solution to this structural barrier for years, funding was only secured this spring. On short notice, she and the team at Grossmont College and the Welcome Back Center were able to secure the clinical spots and implement the project. She added, “Everyone involved in the project, from participants to faculty to administrators, are grateful to our industry partners for providing clinical placements for the students.” 

The Single Subject Course pilot is one example of improving the workforce pipeline by providing international healthcare workers access to courses needed obtain their state license. Strengthening the state's workforce pipeline with strategies like these will be one of the topics discussed at the 2017 California Economic Summit, to be held in San Diego November 2-3.

Over the course of the next year, Durham plans to continue working on developing processes, policies and procedures for Single Subject Courses. “The need is great and the benefit is tremendous! If more of these health care professionals can work at a level that matches their education and expertise, it not only benefits the communities where they work and the patients they serve, it benefits society and it benefits them as individuals and their families as well. It’s just such a win-win-win!”


Nadine Ono

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