In this country, approximately four out of every 100 young people who enter high school will not graduate. Among racial and ethnic minority populations, the dropout rate is even higher. According to data from the U.S. Department of Education’s National Center for Education Statistics, in 2005 dropout rates for African American and Hispanic high school students were 7.3% and 5% respectively, compared to 2.8% for Caucasian students and 1.6% for Asian American/Pacific Islander students.

Another cause for concern is the growing number of young people who do earn their high school diplomas but are not prepared academically to succeed in college. Universities and colleges throughout the country have been forced to establish remediation programs in response to incoming students’ lack of math and science knowledge.

Nursing schools have been particularly impacted by this trend. Many prospective students cannot pass the nursing entrance tests due to their deficiencies in math and language skills. A 2006 survey of nursing education programs in Michigan, conducted by the Michigan Center for Nursing, found that one of the most significant barriers students faced in trying to finish nursing school–second only to financial and family issues–was “inadequate preparation before entering the nursing program.”

In Michigan, the state has invested over $30 million in university and community college programs aimed at increasing the number of nursing graduates. The severe shortage of nurses in the state, and in the nation as a whole, is a crisis that will not be easily solved. However, one of the most inexpensive and expeditious ways to increase the number of nurses is to introduce young people to nursing careers while they are still in high school.

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The Department of Nursing at Madonna University in Livonia, Mich., recently received a two-year, $68,150 grant from the Blue Cross Blue Shield of Michigan Foundation to fund a project called Diversity in Nursing–High School-University Partnerships: Preparing Secondary Students for Nursing Careers. Its purpose is to increase the number of students from diverse backgrounds entering nursing programs and, through a series of academic activities in their sophomore, junior and senior years of high school, prepare them for success in a college/university curriculum. The project focuses on increasing high school students’ interest in choosing nursing as a career by bringing nursing educators and clinicians directly into the schools to help students gain a better understanding of the profession as well as better academic preparation.

The nursing school established a partnership with three urban high schools in the metropolitan Detroit area whose large students bodies represent a variety of ethnic backgrounds. Each high school was assigned a faculty mentor from the university, who worked with academic and career counselors at the school to schedule individual and group information sessions about nursing careers. There were also opportunities for students’ parents and guardians to meet with the mentors to discuss financial assistance and nursing scholarship programs.

The grant funding also enabled us to make opportunities available in each school for students to take the Nursing Entrance Test (NET), which tests students in areas such as math skills, reading comprehension and test-taking skills. Upon receipt of the results, the mentor and counselor met with each student individually, reviewed the student’s educational record for past, current and future coursework, and offered suggestions about the best program of study for a person considering entering a nursing program. This was an eye-opening experience for the students, as many of them did not realize the importance of taking algebra, biology and chemistry in high school.

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Instructors from Madonna University taught workshops on Saturdays and in the summer to help students improve in previously identified weak academic areas, such as math. Students were paid a $50 stipend upon completion of the workshop. The students responded enthusiastically to the intense assigned work. As a result, 98% of the workshop attendees improved their NET scores significantly on the retests. The high school teachers reported evidence of increased confidence among the students, as well a more realistic approach to their coursework.

Guiding the Counselors

Another strategy we used in the project was to hold health fairs and nursing career nights at each of the three schools. In addition to the faculty mentors, students enrolled in Madonna University’s nursing program also participated in these events. This gave the high school students an opportunity to meet real nursing students and ask them questions.

In the course of working with the high school counselors, the mentors noted that much of the counselors’ day was taken up with federal and state-mandated testing. As a result, they had limited time to assist students with career counseling. Fortunately, the state of Michigan had recently formulated and released a new directional mandate for counselors, to encourage them to better prepare students to fill job shortages in the state. At the same time, the state had announced fresh initiatives and increased funding for nursing education. The grant project’s advisory board, which consists of counselors, mentors and school administrators, as well as nursing, science, math and sociology faculty from the university, decided that the time was right for a conference that would invigorate counselors.

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The free conference was held in November 2006. Carole Stacy, MSN, RN, MA, director of the Michigan Center for Nursing, spoke to the counselors about the informational support and resources they could obtain through the center, such as literature about nursing careers and speakers who could come to the schools and give presentations to the students about trends in nursing. A panel of Madonna University nursing students discussed their experiences of being inadequately prepared when they entered nursing school and the kinds of information it would have been helpful to have received while still in high school. The students’ explanation of the money and time lost because of their need for remedial academic advising had a tremendous impact on the counselors.

One of the newer trends in student retention at many colleges and universities is an Office of First-Year Experience. Minority students in particular are more likely to drop out during the crucial first year of college. To address this problem, these offices work to assist struggling students by providing special services, such as tutoring and peer counseling groups. After speaking at the conference, Christine Benson, director of the Office of First-Year Experience at Madonna University, received many requests from the counselors to speak to students at their high school about realistically preparing for a nursing career.

The initial results of the Diversity in Nursing–High School-University Partnerships project are encouraging. To date, three students from the partner high schools have enrolled at Madonna University and another 12 are enrolled in nursing programs at local community colleges. To build on this success, the university is looking at ways to sustain the project after the two-year grant period ends. The Nursing Department has formed very strong relationships with the high schools, who have pledged their support to help make sure the program continues. Plans are also in the works to expand the program to elementary schools.

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The success of this project proves that when secondary school students are given the opportunity to learn that nursing is a rewarding career, and that being academically prepared for nursing school is critically important, they will work hard to achieve that preparedness. However, it is nurses who must reach out to the community, parents and schools to encourage students from all backgrounds to consider nursing as a career and help ensure that the nursing profession truly reflects the culturally diverse world in which we live.

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