DENVER, Colo. — The pandemic exposed just how deep racial inequities across the health care industry are, but how do we fight that? For students and staff at Emily Griffith Technical College, it starts with training.

“We don't get to pick and choose who our patients are. We take care of all human beings, respect their heart, their soul, their culture, where they come from, what their place in life is,” said Lauren Law, a nurse and instructor at Emily Griffith Technical College.

This year, her classes are addressing racial inequities in healthcare more closely than ever before. This school is one of few in the nation training its students using manikins of color.

“It's different when you assess a Black person or person of darker skin,” said Law of why the manikins are necessary. “Your coloring, your bruising, your discoloration, illness, signs of illness, signs of assessment, it's going to look different. You won't know it unless you see it on a manikin and then you go out into the community and take care of those folks.”

A grant from the HCA Healthcare Foundation helped purchase the manikins and fund special training. Dr. Genene Duran, the dean of Health Sciences Administration, said these mannequins are just the start of bringing more equity to healthcare.

In addition to using the manikins, staff members also received 25 hours of training to recognize and fight bias in healthcare. Their training is then passed to students, so the next generation of health care professionals focuses on treating patients in a culturally sensitive way and in a way that recognizes the challenges patients of color disproportionately face.

“I would really hope that this is not something that's a novel idea, but something that becomes standardized practice,” said Duran.

Duran said making this training standard nationwide could be one step forward in solving bigger inequities.

“We know that in maternal health, Black women are disproportionately affected and that they die at higher rates,” said Duran. “We know that environmental health Black people are disproportionately affected as we are dealing with asthma at higher rates. There are just so many different situations as far as social determinants of health and health disparities that people of color are disproportionately impacted, and if we could start the conversations about them, then we could bring about the type of change that is necessary.”

Studies by the American Heart Association found that patients of color waited longer in emergency rooms than white patients. Hispanic patients waited the longest, with an average of 99 minutes of waiting compared to 71 minutes of waiting for white patients.

For Native American student Jaia Blackbear, embracing equity will not only help her better care for her patients, but it’s also helping her succeed in school.

“I think it's very important when you come into a classroom that's diverse, you don't feel intimidated; you feel comfortable, you feel relaxed and like understand that, ‘I can be somebody, and I can be great regardless of the color of my skin or my background,’” said Blackbear.

Blackbear is training to become a registered nurse.

“I definitely feel like this is my calling,” said Blackbear, who is already working in a nursing home taking care of seniors. “I'm Native American, and in my culture, it's very important that we take care of our elders, and the same love I give my own grandparents is the same love I give the residents that I'm around.”

Blackbear said she feels confident that the way she is learning to care for patients at this school will make her a better nurse, and she said she hopes one day, this will be the way everyone gets trained.

“It just helps you build that bond with your patient and your resident or, you know, my classmates, my instructor,” said Blackbear of the culturally competent training. “It just makes the learning process more fun and not so much like hard work, but it makes you want to learn instead of feeling like you have to.”

“It's really important that students of color see representations of people that look like them in the classrooms, manikins that look like them as they're practicing to become practitioners, as well as when they get into the field,” said Duran.

With inclusion in mind from the first day of training, the leaders at this college and their students know that in the years to come, healthcare can become a place where equity comes first.

CINCINNATI — Cincinnati State Technical and Community College was awarded a grant for $25,000 on Monday to help fight the growing worker shortage plaguing the nation and the local community.

The grant was presented to the college by the Association of Ohio Commodores Fund. According to the school’s president, Monica Posey, the money will support the college’s Workforce Focus Fund, which addresses important and timely workforce needs, particularly in cases when other funds are not available.

“We're now working to develop a nursing degree, a bachelor's degree in nursing to address the need,” said Posey. “We're creating new apprenticeship programs specializing right now in medical assisting for launching more high school partnerships so high school students can get advanced education.”

Nursing is just one of the industries currently struggling to keep workers. Casey Howard, a nursing student at Cincinnati State, works in an emergency room as a technician full time overnight while working toward becoming a nurse.

“Patients are sick, we're understaffed, we're underpaid. It's exhausting, but it's rewarding,” she said. “You know, when you get the opportunity to actually help someone and make them feel better on their worst day, it's pretty amazing.”

Howard is like many of the students in the nursing program, non-traditional, juggling parenthood, education and work.

“Nursing is very rigorous,” said Janice Lockett, the nursing program chair. “We try to encourage our students to save up, put away some money. And we also have scholarships that come in and when they come in, we encourage our students to apply for them so that they don't have to work so many hours.”

Lockett hopes the grant money will funnel its way to students in the form of scholarships. In a press release, the school outlined how the money will be spent:

"The Workforce Focus Fund is used to pay for scholarships for students, updated equipment and facilities, developing new training programs, and outreach to junior and senior high school students who are our future workforce."

The Association of Ohio Commodores awarded grants totaling $80,000 in this first round to support training, professional development and other community activities that create and develop a strong Ohio workforce.

While most people seek safety during danger, Ebonique Johnson actually hurries to the frontlines.

“I’m running towards it because that’s where I’m needed the most,” said Johnson, a nursing student at Georgia State University in Atlanta.

Set to graduate in December, she’s looking to land a job at an ICU.

“I want to be where I’m needed,” Johnson said. “I want to help the COVID patients.”

That help could come sooner or later depending on where she gets a job.

Some states are waiving certain regulations and allowing nursing students to enter the workforce more easily. Other states, however, have prevented nursing students from working with COVID-19 patients altogether.

“We can’t hit the pause button with what’s going on, nurses are needed now more than ever,” said Dr. Regena Spratling, associate dean for GSU’s school of nursing.

She says coronavirus concerns have limited student access to hospitals for hands-on clinical training and that more courses are now being taught online.

“We’re really focusing on what they would be doing within the health care system as far as taking care of patients,” Spratling said.

Despite changes, GSU is seeing more people looking to join its nursing program.

For GSU nursing student Phillip Parnell, this pandemic is personal.

“One of my older relatives recently passed away with the virus,” he said.

The army veteran is now making his second career his first priority.

“When it hits home, it’s a different level of intensity,” Parnell said.

The Bureau of Labor Statistics says the health care industry needs more than 200,000 new nurses each year through 2026 just to replace retiring nurses.

“Although we never thought we would see a pandemic in our lifetime, it’s here,” Johnson said.

GSU students are happy to be leading the next generation of nurses while also fighting COVID-19 on the frontlines.

“We answer the call to be there for people,” Johnson said. “It’s our time to show up.”

The Biden administration announced Thursday that it will direct $100 million to the National Health Service Corps to help address the health care worker shortage.

Pulled from funding in the American Rescue Plan, the $100 million represents one of the nation’s biggest investments in a program that helps place primary care doctors in communities that have difficulty recruiting and retaining them. It's a five-fold increase from previous years, the Department of Health and Human Services said.

The National Health Service Corps offers loan repayments and scholarships to clinicians in exchange for multiple years of service in areas that have a health care provider shortage.

"Whether you're in rural America, or in a low income part of America, that shouldn't be a reason why you can't access good quality health care," Health Secretary Xavier Becerra said in a phone interview. "And so we want to help states that are going to try to do what they can to keep that public health workforce in those rural communities, those low-income communities, they're where people need them."

The announcement comes after the United States lost 17,500 health care employees in September, according to the Bureau of Labor Statistics. With the industry's employment figures now sitting at just under 16 million, the agency reported the country has lost 524,000 health care employees since the start of the pandemic. Job losses in nursing, hospitals and residential care saw the biggest drops in the industry last month.

Losing employees has in turn increased labor costs. Hospitals and other medical facilities have had to sharply increase spending on recruiting and retaining employees, according to a report published last week by Moody's Investors Services. That has led to boosted benefit options and sign-on bonuses that can go well into five figures since the start of the pandemic.

“Covid has basically caused a laser focus on the glaring gaps and dysfunction across the American health care system,” said Tener Veenema, a scholar focused on workforce issues at Johns Hopkins University's Center for Health Security. “Making investments to redistribute health care providers into rural areas, low-resourced areas, is so important because we know how much they are suffering from a lack of access to good health care.”

States will be able to apply for grants until April and the Department of Health and Human Services predicts it will make up to 50 awards as high as $1 million per year over the course of four years.

Participating states won’t have to match funds or share costs in any way to obtain the grants, and they can use 10 percent of the award for administrative costs.

“With these funds, states can design programs that optimize the selection of disciplines and service locations, and tailor the length of service commitments to address the areas of greatest need in their communities,” said Diana Espinosa, the acting administrator of the Health Resources and Services Administration, which oversees the program. “This investment will make a tremendous impact on access to primary care and addressing health disparities at a critical time.”

The project start date isn't until September 2022, so it won't have an immediate effect on the current labor shortage. It represents, however, the latest push by the Biden administration to address the issue that experts believe will only get worse over the next decade.

President Joe Biden pulled $100 million this year from the American Rescue Plan to support the Medical Reserve Corps, an all-volunteer army of doctors, nurses and medical support teams in hopes of accelerating the pace of Covid-19 vaccinations.

"A hundred-million dollars isn’t going to take care of everybody," Becerra admitted. "But it’s certainly going to go a long way in helping our state partners get resources to those local communities, so they can keep that health care worker there, keep them trained, ready and prepared to keep them healthy."

With demand for travel nurses through the roof, staffing agencies and nurses are feeling the pressure.

“I've been a nurse for 10 years, I've never seen anything like this before, said emergency room nurse Abigael Kaszar. “And it's, I mean, it's just something for the books. It's just crazy.”

Kaszar works through Aya Healthcare and she was at three hospitals over the past year, including one in New York City at the height of the area’s virus outbreak.

Kaszar says she's always keeping an eye on open ER positions. At the end of spring, there were a couple hundred. Now, there are over 4,000.

Another staffing agency, Travel Nurse Across America, tells us their requests from facilities are up 175% year over year.

The agency says it's because hospitals want staff that can jump right in.

“Being able to go from one hospital to another, and to understand and learn the different policy and procedure very, very quickly is difficult. And so these nurses are very talented and can come in and start working on a dime,” said Jill Eliassen, VP of Clinical Services at Travel Nurse Across America.

Kaszar is now at a hospital in California, where she says the ER is just overwhelmed.

COVID-19 patients who get discharged can't always go home, but other facilities they'd normally go to are full, so they stay in the hospital longer. The intensive care unit fills up too.

Patients who have nowhere else to go trickle down to the ER, which still has ambulances and other new patients coming in.

All of this is happening while hospitals are trying to isolate COVID-19 patients from others.

“It's just very busy and these people are just so sick, and it's a really big challenge keeping up. It's an emotional challenge, it's sad and it's scary and it's, I mean, so many of these infections were preventable. You feel so much regret and you feel sad for these people,” said Kaszar.

Travel Nurse Across America is encouraging short breaks between contracts because their nurses are getting burnt out.

“These nurses are also having to be psychiatrists and counselors and support for family members that are in a hospital due to COVID and aren't able to be with their loved ones,” said Kathy Kerstiens, Sr. VP of Client Services at Travel Nurse Across America.

The agency thinks the demand for travel nurses won't let up until at least mid-summer, when they can finally get more relief.

CINCINNATI — A Cincinnati woman said she has been struggling to get into Cincinnati State’s nursing program due to some of the requirements for its students.

Justine Jones has spina bifida and uses a wheelchair, which creates an obstacle for her to meet the college's rule that nursing students must be registered as State Tested Nursing Assistants. Ohio requires those individuals to be able to lift 25 pounds. Now, she's petitioning the college to change its requirements.

“It was definitely heartbreaking when they told me no the first time,” Jones said. “I’ve been in and out of the hospital so much, I was just, like, this is what I want to do. I want to give this care to patients,” said Jones.

She said Cincinnati State’s two-year program is her quickest and most affordable pathway toward a nursing career in the area.

“Nursing is so broad that not every nurse is going to be at a patient’s bedside trying to help them get out of bed,” said Jones. “I can be in a doctor’s office or a case manager for people with disabilities.”

University of Cincinnati Blue Ash, for example, does not require the state-tested status. However, the UC Blue Ash Nursing Department requires students to have the ability to perform certain physical functions. According to the student handbook, "The student must be able to safely and competently push, pull, lift and transfer adult and pediatric patients to chair, commode or other locations, as well as operate health-related equipment."

A spokesperson told WCPO UC Blue Ash College has an essential functions form that must be signed by a health care provider to ensure the student can provide safe competent care. The student is required to have a physical exam before they start the program, annually while in the program, along with immunizations, etc.
The physical should indicate that the student can complete the tasks on the essential functions form -- tasks like administering CPR, medications, and operation medical equipment, among others. If they cannot complete all tasks listed, UC Blue Ash College said it works with the UC Accessibility Resources office and clinical partners to see what accommodations we can provide.

Southern State Community College also requires nursing students to meet physical requirements. The student handbook says students often must carry objects weighing 25-50 pounds.

Cincinnati attorney Richard Goldberg says a public school receiving public funds could face a lawsuit if it is found to discriminate based on disabilities.

“She could ask for lost wages, lost future wages and attorney fees,” said Goldberg.

Cincinnati State responded to Jones’ concern in a written statement:

"Cincinnati State cannot comment on any individual student's situation out of respect for the student's privacy and as required by the Federal Educational Rights and Privacy Act (FERPA). In general, for every educational accommodation requested, the college undertakes a deliberative process to determine whether an accommodation to a course or program can be made in light of the competencies and skills expected of the field, such as in nursing, culinary, IT, welding, etc."

Jones already works for a hospital in scheduling and said she'll find out Monday if Cincinnati State accepts her. She e-mails with WCPO in which staff point to the policy and accommodations that must be considered.

“Even if I don't get into the program, I’m hoping that they’ll at least consider changing their policies so that someone after me can get in and achieve their dream,” she said.

As we recognize nurses this week, the World Health Organization is deeming all of 2021 the year of the nurse.

It's an effort to encourage global investment in nursing.

The WHO has been calling on countries to increase education funding to employ more nurses.

Stride is a K-12 program that's offered in several states.

It helps students get to the front lines quicker.

High school students have the opportunity to graduate as certified nursing assistants without any additional schooling.

But if they want to take their career further to become a licensed practical nurse or a registered nurse, that experience helps them get their foot in the door.

The health careers program director at Stride says earning her CNA certification is something she did while in college that made a big difference.

"I was able to work at a local hospital and gain some additional experience, and it really helped me," said Dr. Sherri Wilson, the health careers program director at Stride. "It was value-added in my nursing program because I was already exposed to the clinical skills by working as a certified nursing assistant."

Since Stride allows students to leave high school with this certification, she says it can help with the nursing shortage.

It allows students to make a decision sooner if it's something they want to pursue.

One stride student who is about to graduate said she's eager to start helping with the pandemic.

"Seeing how much nurses can continue to just push forward, it's so inspiring," Megan Hanson, a Stride nursing student, said. "I think it's just an added bonus that we get to help and hope to fight like on the front lines and help to make medical decisions for people."

If a school doesn't offer the Stride program, there are still several options high schoolers can pursue to see if nursing is for them.

"Volunteer opportunities are great for students interested in healthcare and nursing," Dr. Wilson said. "It provides great exposure for students, and I think over time, there will be additional opportunities opening up for students to volunteer."

She says many schools also have nursing or health care explorer clubs.

Job shadowing and mentorship are also great ways to gain experience early on.