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EPISODE: #93

Dr. Stacey Ocander, Nebraska Hospital Association: Helping Young People Choose Healthcare Careers

WorkforceRx with Futuro Health
WorkforceRx with Futuro Health
Dr. Stacey Ocander, Nebraska Hospital Association: Helping Young People Choose Healthcare Careers
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PODCAST OVERVIEW

Studies show that when it comes to getting people interested in any career, early exposure can make a significant impact on their ultimate choice. That helps explain why a program in Nebraska that’s aimed at cultivating interest in healthcare jobs begins in the third grade. As we learn in this episode of WorkforceRx, the Health Careers Pipeline Initiative is just one of several workforce development strategies being pursued by the Nebraska Hospital Association under the guidance of Dr. Stacey Ocander, the association's senior director of workforce and education initiatives. “You really have to start the excitement young. You have to be the people who establish the strongest relationship before something that may be negative in their life gets a hold of them,” says Ocander, a self-described creative disruptor. The program starts with exposing youngsters to thirty-two healthcare occupations and gradually winnows that number down to one or two as students discover their interests through summer camps and internships in middle school and high school. Ocander sees this sustained contact as critical. “My goal is by the time they're a senior, our hospitals are engaged to help them pay for that first two years of college to get them to that first license.” Join Futuro Health CEO Van Ton-Quinlivan for an encouraging exploration of innovative partnerships between hospitals and educators and the benefits of doing ‘business as unusual.’

Transcript

Van Ton-Quinlivan

Hello, I’m Van Ton-Quinlivan, CEO of Futuro Health, welcoming you to Workforce Rx, an exploration of innovations shaping the future of learning, work, and care.

 

Studies show that when it comes to getting people interested in any career, early exposure can make a significant impact on their ultimate choice. That helps explain why a program in Nebraska that is aimed at cultivating interest in healthcare careers begins in the third grade. The Health Careers Pipeline Initiative is just one of several workforce development strategies being pursued by the Nebraska Hospital Association under the guidance of Dr. Stacy Ocander, the association’s senior director of workforce and education initiatives.

 

As a lead consultant on the National Health Careers Pathway Program, Stacy led the development of a core curriculum in entry -level healthcare professions across 150 community colleges, high schools, and workforce organizations. She also brings clinical experience to her current work, having spent many years as a CNA and athletic trainer in orthopedic surgery, sports medicine, and rehabilitation. Thanks so much for joining us today, Stacey.

 

Stacey Ocander

Thank you, Van. It’s so good to see you and I really appreciate the chance to be with you. I reflected on the fact I started as a candy striper when I was fourteen and moving through to now… just to have the opportunity to help others in their pathway is certainly something I’m excited about.

 

Van

Well, we’re delighted to have you. As our listeners know, Stacey, states across the country are in a healthcare workforce crisis, and Nebraska, I would imagine, is no exception, with 10% of its counties having no registered nurse at all. Please help us paint a fuller picture of the challenge you are facing there in Nebraska.

 

Stacey

Yeah, thank you for that. You know, you are exactly right. Everyone across the country is facing a health care workforce crisis, and we’ve seen it over how many years, you know, where we will peak and valley, right? Feast or famine. I think the response to that feast and famine has often been we repeat history.  We reinvent the same programs that maybe we worked on fifteen years ago or twenty years ago, and that’s going to be the solution.

 

What we’re looking at here in Nebraska – this is just as a snapshot, because there’s certainly more — but our youth are leaving our state. Our kids are not working in the rural areas anymore. I wish I could say that every state had 100 % high school graduation rate, and that’s not the case. We’re facing a maternal desert 300 miles wide in the middle of our state. So when you think about that maternal desert…I think back twenty-four years and as  a young parent, would I have moved somewhere where I couldn’t get that maternal child care? Well, most likely not.

And then there’s retirement. Health care is hard work. No matter what you do in healthcare, it’s hard work and our bodies will only sustain so much, our hearts will only sustain so much. And the way that we give back, often, is we need to move into a different position, but not leave the profession.

 

Van

I’d love to probe on your mention of rural communities. What makes rural communities different when it comes to the healthcare workforce as compared to maybe the urban centers, for example?

 

Stacey

I’m a northwest Iowa country girl, so rural America is deeply seated in my heart. When I think of any solution, I of course default back to what I know, what I grew up with. I was fortunate enough that the closest hospital was twenty minutes away. We certainly did not have health care in our hometown. Our EMS and FIRE was all-volunteer and to this day they are still volunteer. You know, the need for EMS services across this country is at a critical mass and we can certainly talk about that as we talk about other allied health workforce issues.

 

What I think is different is you know everybody in your hometown, so that adds a whole different dynamic to the healthcare worker. When someone walks in the door, you know the people who love them. They may be one of your own family members. You may be coming in today thinking you’re going to do CNA work and you may be pulled to do unit secretary work. I went out on a hospital visit a while ago and the CEO of the hospital, who’s also a nurse, got pulled into surgery.

 

So those are the things we don’t necessarily see in our urban areas because of basically the volume of people that are living in that area. But I will tell you, there’s still a workforce shortage in our urban areas. There is still a need to staff, there’s still a need for incentives, looking at top of scope and all of those things happen across both demographics. It’s the approach to which we can take based upon how many people we have to pull from.

 

Van

And usually in the rural areas, there may be one higher education institution compared to maybe some of the denser areas. What’s the situation in Nebraska?

 

Stacey

Yeah, we have a very strong community college system spread across our state. Certainly they all serve a different population. Their enrollments are much different. We have the university system which has made great gains of spreading across the state to try to get more access — not necessarily at entry level, which we all know is where our critical mass is for workforce — but certainly for anyone going on from their entry level, whether it be say an ADN or ASN for the nursing pathway.

 

But we also have our private institutions and I will tell you in our solutions that we work towards at NHA, we partner with every single one of them. You know, we look at every single one of them as part of our solution. I think often we think that the private schools are kind of out of reach for us, but they are so flexible in what we can and can’t do because they’re not tied into a large university system and so we rely on each and every one of them across our state.

 

So, I would not say that academic access is as much of an issue for us as I would say awareness of the academics that are offered is what we are faced with, which leads us to starting a pipeline in third grade.

 

Van

Yes. So let’s talk about the allied health workforce. You mentioned entry -level roles in allied healthcare, which is about 65% of the healthcare workforce. What challenges are you facing out there? You mentioned awareness.

 

Stacey

Definitely awareness, being current in everything, whether that be regulation, policy, know, how we’re addressing volunteer to paid, how we’re addressing in the field for like EMS to the ER or the emergency department. We are at a critical shortage in med lab scientists, med lab techs. We are in a critical mass shortage for rad techs and all those things that I think people assume that if you get so many miles outside of our urban areas, those are not services that need to be provided. They absolutely are.

 

We may not be hiring twenty of each of those in one of our smaller hospitals, but we still need them. And even our big systems are needing those. I will tell you the majority of the next six months of our work will be focused on not only continuing the great projects that we have in place now, but really focusing on the EMS issue in our state. As we know nationally, that has to be something we talk about.

 

Van

Tell us about Nebraska and the composition of the healthcare providers who are members of your Nebraska Hospital Association.

 

Stacey

Absolutely. So we have ninety-two member hospitals. We’re comprised of a ton of different make -ups, right? There may be a hospital up in north central Nebraska that has a census of two, but their quick clinics are very, very busy. They are running on step down beds. We’re facing an issue of hospital hoteling and how do we move patients on to that next facility or to home when there’s not care there or access to home health?

 

Our members are very diverse.  Every year the senior leadership at the Nebraska Hospital Association divides up all of our hospitals and we rotate that list and we visit every one of our ninety-two member hospitals. It gives us just a broad understanding of what a day in the life looks like. But then it also helps us to help them know what resources they can pull in from each other. How do they partner?

 

Van

In listening to the ninety-two hospitals, you’ve crafted some strategies for changing the course in Nebraska. So, talk us through that and who your key partners are.

 

Stacey

I mentioned earlier that at NHA we consider everybody a potential partner. There’s not an exclusion. But I will tell you that our approach is partnering with people who want to find all the reasons to say “yes” before they consider “no.” And I almost want to say that’s the prerequisite, you know? Like, if you come to the table thinking of saying no, please don’t come to the table because that’s not where we’re at. That’s not what we need to do.

 

You know it, Van. In years past, we know what that looks like, and we know how much energy is taken in the unwilling.

 

Van

You’re looking for a coalition of the willing?

 

Stacey

It really halts all progress forward. So yes, we absolutely want that willingness. I laugh because one of our first projects, when I first came on to NHA a year ago, was one of our rural hospitals. And I said to the CEO, “I don’t have everything in place yet, but I just need you to say yes. I know that this sounds like madness but I just need you to trust me.” And she said, “Okay, okay.” And it’s just amazing what’s been going on now in that small rural hospital. But she knew that NHA was going to lead her in the right direction.

 

So you asked me about our partners. One of our absolute strongest partners is the Nebraska Center for Nursing. If anyone in any state thinks that they are the barrier, I would encourage them to develop a relationship. There is not a thing that really happens at the Center for Nursing where NHA has not had the opportunity to be at the table. Weekly conversations, we’ve helped redesign their website, which has become a recruitment tool, it is an absolute machine in data collection and that saves resources. If we’re not paying money that somebody else has already spent to collect data that’s right there, and it’s rich and useful data, we can allocate those resources somewhere else. You can do that when you have relationships and you have partners.

 

This is going to sound strange, but our legislature passed LB 227, which is millions and millions of dollars that have honestly allowed us to be innovative. It has allowed us to be creative disruptors, to not do what we always did, but to find a better way of doing things. And I know often people say, I can’t get through that legislature. It’s really building out the story and letting them in to see what’s the data look like and reporting your successes and finding your champions in the legislature. I teased some of our team the other day and I said I think this particular senator has become my new spirit animal, you know, just because they understand what the state looks like.

 

Van

Could you share a little bit of detail about that legislation? What were you trying to solve and what remedies were in the legislation?

 

Stacey

Yes, so LB 227 has been divided up to where part of the money filters through the Center for Nursing. It really is the pass-through fiscal agent. NHA’s role has been in addressing the vulnerable populations. It has been in my area of the workforce. We have six projects under that to increase clinical practice instructors at the bedside. So we left our MSNs in the classroom. That increased our enrollment this fall by 108 nursing students. And we’re so happy of that and proud of that.

 

The regulations say that if you can come up with an innovative approach, you can enter it into a project and so Dr. Ann Oertwich of the Center for Nursing and I wrote an innovative approach that said let’s take our ADN nurses that are RNs at the bedside and let them be clinical practice instructors for our nursing students. Let’s leave our MSNs in the classroom, but let’s have them mentor our clinical practice instructors.

 

Out of that money, we paid a healthy increase to their salary. We give 8% to the hospital for allowing us to use their staff. We pay the mentor back at the college, and we give the college 8% to allow us to use their faculty to mentor. But we also pay the student reimbursement for travel and overnight stay if they’re willing to go to a rural clinical rotation. And what has come out of that is we have two of our schools that have now added a rural rotation into their nursing program.

 

Van

That’s an impressive design. I’m so glad you’re sharing this on the podcast so that others can hear the playbook.

 

Stacey

Yeah, and that’s just really a couple of the six projects under LB 227. We are taking on a statewide onboarding where all student nurses will be onboarded through our platform versus the hospital systems having to have all these people that do onboarding, which takes hours away from them being in clinical service. So everyone that pops on through our partner Symphony Workforce and its Find the Why program will do a ten-day challenge. And if it’s on HIPAA, they will immediately take our micro credential for HIPAA and become certified. They have a digital resume, so the hospital can pull up the digital resume and those micro credentials are right across the top, so they know that the student is current in those and it can be anything from infection control, bloodborne pathogens, HIPAA, medical ethics, patient rights and communication. We throw financial literacy in there and an OSHA 10 training course.

 

So, those are very widely designed based upon the needs of our system, but that also rolls into our pipeline for our high school kids who are on paid internships. They’re taking the same onboarding and then they go into student nursing or any other allied health profession and it’s the same onboarding. So, we are always making sure that they are consistent and that there’s nobody out of compliance in one of our hospitals.

 

Van

Love that design. Well, this is a good moment for me to ask you about the Healthcare Heroes Elementary program. Walk me through how that is the start of the Health Careers Initiative that you’re also leading.

 

Stacey

If it weren’t a podcast, you’d probably see me up dancing because it’s probably my most favorite thing of all. So, I’ve only been at the NHA a year. My previous life has been as a college dean and all of those things. NHA approached me about writing a statewide curriculum and it’s important for me to say that we have so many pockets of excellence across our state, but it was getting something that was a little bit more concise, a little bit more consistent that could be in every part of our state, right? I agreed to do that if I could start it in third grade.

 

And I’m sure my colleagues now would look at me and think, we thought you were crazy to start in third grade, right? But you really have to start the excitement young. You have to be the people who establish the strongest relationship before something that may be negative in their life gets a hold of them. There should never be a reason why any student should say to me, “I didn’t know I could be this, or I didn’t know I could be that, or we only have the railroad in my community so I’m just going to work for the railroad.” Not that the railroad is anything wrong — my great grandfather worked for the railroad — but if that’s not their love, why should that be their default?

 

We had amazing funders, the Nebraska Hospital Association, the Nebraska Health Care Foundation — which is our long -term care/nursing home/assisted living organization — the Nebraska Medical Association, which are our docs, and Medica, all funded the writing and the development of that program.

 

So, I wrote the program, Healthcare Heroes, and it’s for third through sixth grade. It’s based on the American School Counselor standards on mindset and behavior. I did that because I wanted to make sure that the schools would feel comfortable, that there was a strong foundation for what they do in the school day and what we were bringing to the table. It’s one hour a week all school year long. In the first the first six to seven weeks, the students learn about their own values, their superpowers, those things, and then they’re introduced to thirty-two different health professions. But Van, I think the most interesting thing is it’s written so that even a person without any knowledge of healthcare could teach it.

 

Van

Does it tap out at sixth grade or would it be well received at the high school level, for example?

 

Stacey

So what happens after sixth grade is then in our middle school, our students start taking summer camps that we’ve partnered on with our Area Health Education Centers, our colleges, our Hospital and Nursing Home chapters. I wrote curriculum at that level so it can be a two week summer camp. So the goal is when they’re in elementary school, Van, they’re being exposed to thirty-two different professions. Now we’re getting them into middle school camps and we’re saying let’s narrow that to about fifteen and that doesn’t all have to be patient care. It could be diagnostics, it could be environmental, it could be finance, could be admin. But let’s still keep you in our world, right?

 

Then, with our partner, Symphony Health, we designed a hybrid internship when they get to 9th and 10th grade. So it’s all virtual, but these kids are connected to our hospital partners and they are working on our challenges. Industry pay the prize money for these. So these kids are winning scholarships, they’re winning actual money, you know, all sorts of things through that. But the key is we’re still connected to them.

 

And then in 11th and 12th grade, we have a project with Intern Nebraska. In fact, we’re getting ready to place twenty-one interns here in a few weeks, and they’re paid $20 an hour. I know I’m just like celebrating and the thing of it is it’s fifteen hours a week, but only five to six are actually at the hospital. Those other nine they are doing our challenges and our onboarding. So they can still participate in sports, band, music, time for academics. But Van they’re still connected to our hospitals.

 

You know, if you think of athletic recruiting, my goal is by the time they’re a senior, our hospitals are engaged to help them pay for that first two years of college. Get them to that first license. So it truly is third grade all the way through that associate degree level.

 

Van

So you talk about the camps that help students focus on fifteen occupations. Can you give some examples of what those range of occupations are?

 

Stacey Ocander

Yeah, sure. So what I do, and I think it’s probably one of the most important partnerships,  is I work closely with the colleges in a geographical area. For instance, if we know a hospital sitting out in Cozad, Nebraska has a need or these are the services they provide, I can work with one of our colleges. We have our kids on our platform tell us. What do I want to go into? Do I plan to leave the state? Where do I want to work? How far will I travel to go to school? All of those things. And then we look at who are the health professionals sitting around us and then those health professionals at those colleges, they come in and help teach the camp.

 

The camps are four hours a day for four days a week for two weeks. So, Monday may be respiratory therapy, Tuesday may be occupational therapy, Wednesday may be CNA and medical assisting. We really gauge it on what is the industry around there and what are the students in that space telling us that they want to do when they graduate.

 

Van

And I assume that both the elementary school experience — and as you mentioned the middle school and maybe even the high school — they’re all in -person experiences, with engagement with the curriculum?

 

Stacey

Yes, and it’s one hour a week. The other thing that I think is important is how do you staff, right? So a lot of these are in after school programs and they’ll say, “We just don’t have the staff.” Well, the beauty is we’ve partnered with Clarkson College, Chadron State College, Nebraska Wesleyan and our high school HOSA kids that are going in one hour a week and teaching these. Those are the facilitators that I’m training and they’re actually the ones going in and teaching it. We have folks that actually live at one of the nursing homes in a small community out west — one’s a retired nurse, one’s a retired teacher — and they actually go over to the elementary school and they teach it.

 

So for me, I think now we’re addressing elderly loneliness, an unintentional outcome of this program that I never even thought about. But we really are because it gives them value. They’re back being the people that they’ve been their whole life one hour a week.

 

Van

Well, this is such a thoughtful work. Congratulations, Stacey. And it’s hard for me to imagine that you could not have done that in one year. That’s amazing work.

 

Stacey

Yeah, so we piloted it in spring of 2024 in eight elementary schools across our state with 611 kids. As of yesterday morning, we have it in thirty schools and we’re at 3,087 kids in the third through sixth. And it’s amazing. We had successful summer camps. We had schools that said we loved it so much, can we please just run it all summer in our summer program? We said absolutely and then we have more programs on board to start in January.

 

Van

I’m sure that’s welcome news to our listeners who know that workforce development takes time and the fact that you were able to roll it out that fast and scale it that fast, congratulations.

 

Stacey

Thank you. And you know, to Van, I think it’s important for me to say they can hop in at any point. I don’t want any of our listeners to think, well, if they didn’t start in third grade, then those kids are all out. Absolutely not. They can start with us in 11th grade, they can start in 12th grade, they can start at the student nurse internship point, which is another one of the LB 227 programs. Through that funding, we will place student nurses in internships. So not their clinical, but their internship, and we will pay $9.25 toward their hourly salary.

 

Van

If somebody is wondering if the pathway program is maybe pigeonholing a student too early in one profession, how do you think about that?

 

Stacey

So like I mentioned earlier, we explore thirty-two different professions. Last week I was at one of our elementary schools — our local news station came out and visited — and when you ask the kids around the table, what do you want to be, they’re like, police officer, police officer, an Olympic athlete. There was one person who said a nurse. That did not bother me at all. Not one little bit because they don’t know anything other than a doctor or a nurse.

 

In one of the first lessons in our program, we hold up all these different cards with the names of healthcare jobs and none of them had a clue what any of those were. So we’re doing the right thing at the right time and we’re just exposing them. Then in middle school, we’re trying to help them narrow it down to about fifteen. And then we narrow it down to about ten and by the time they’re juniors and seniors, let’s narrow it down to about two. There will be so many of those that’ll say, “I wanna be in healthcare, but I don’t like blood.” Great, let’s help you redesign your pathway, right? But you can still be in health.

 

Van

I’m curious Stacey, if you license your Healthcare Heroes elementary program? Is that publicly available for others to use?

 

Stacey

It’s all copyrighted all the way down to the graphics. The NHA and our funders have all said it will be free for anyone in Nebraska. That is our commitment. Part of the way that we can do that, Van, is we have a small licensing that we do. So each school would have a license to use the program at a minimal cost. But an association in another state could say, we want it in fifteen schools and they’ll pay for that grouping of licenses. But they get all the curriculum, they get the book, mentoring, training and all of those things.

 

So yeah, it is available, but then we take those funds and put them right back into the program in our state.

 

Van
If a listener is wanting to knock on your door or somebody’s door to license that material, do they reach out to the hospital association or to you directly?

 

Stacey

Yep. They would reach out to me and then our team gets them connected. We share our pricing. We connect them with Symphony depending on how far out they want to build their pipeline. Some will say, we really just want the high school piece or we really just want the digital resume or we want the pipeline first or we’re ready to go. There’s so many different options. We love working with anyone. We’re galvanizing a national movement. Let’s get these kids aware of what’s out there.

 

Van

I love that, I love that. And I’m sure they can also reach out to you via LinkedIn.

 

Stacey

Yes, absolutely.

 

Van

Now, you mentioned a number of uses for your funding, everything from curriculum development to underwriting the student experience to stipends, for example. How do you think about what employers contribute versus what is funded by, for example, this legislation?

 

Stacey

The thing that we talk about with any one of our hospitals that come on board with us is that no money is given forever, right? We wish it would be. We have that funding and we feel good about the timeframe of that funding, but when you start to build our six projects into their culture, it becomes a part of their natural budget. If they look at their budgets and say, “We have people not using tuition remission, or we have so many requests, but we don’t have enough funding,” and we come in and say, “We’re doing all your onboarding,” then you can reallocate those funds, right?

 

If we’re doing your recruiting, one of the beauties is you can contact NHA and say, “I want you to send me your eight best candidates that you know are sitting in my community.” And then that’s what we do and say, “Now take care of our eight best as you’re looking for your top four.”  I said the program really takes it to working with students who are committed versus considering, and the funding piece for any industry is where are you going to align your funds with that? And that has to be their engagement. We cannot in any way rely totally on a grant, on legislative funding. You literally have to say, believe enough in it that it’s part of our culture, it’s part of our budget.

 

Van
Well, I am cheering you on. It’s so exciting to hear about all this great work that you have going on in Nebraska.

 

Stacey Ocander

Thank you.

 

Van

Why don’t we close out, Stacey, by asking what do you see as the future of the healthcare workforce and the care that is provided?

 

Stacey

Yeah, it’s so exciting. It really is. We use the words crisis and challenges and I like to say those are unbelievable opportunities to do business as unusual. It’s an opportunity to be a creative disruptor. You know, our model for the pipeline can be transferred to any industry. I wrote it specifically so we could send it off to any other industry by just having their curriculum. That’s really the future of healthcare.

 

You know, it’s healthcare providers understanding what is source control. It’s construction workers understanding how do you have to maintain infection control in the hospital. So it’s the team approach across industries.

 

I also see it as developing positions — which is a project we’re working on now — developing positions for kind of that utility batter, right? Say I’m sixty years old and I just can’t do that CNA heavy lifting work, but you’ve stacked enough of my credentials and given me enough opportunity that I can go do some occupational therapy tech stuff or PT tech or I can work as a community health worker and help with the social side of medicine.

 

So you know Van, I think it’s saying everything doesn’t need a two or four year degree — no shade to my academic friends — but what do they really need to know to provide the best care that they can and for themselves to survive in healthcare?

 

Van

Thank you very much, Stacey, for being with us today. We certainly learned a lot about what you’re doing. Your enthusiasm is contagious.

 

Stacey
Thank you, Van. I just appreciate the chance. As you can tell, I get excited talking about our projects, and I appreciate the chance to share that with other people and for you to give me that opportunity today. It’s always exciting to talk about things that we’re doing.

 

Van
Very exciting. I’m Van Ton-Quinlivan with Futuro Health. Thanks for checking out this episode of Workforce Rx. I hope you will join us again as we continue to explore how to create a future -focused workforce in America.