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A prescription for poverty? A career in nursing

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Nurses may also have greater immunity from the job-destroying creep of automation than some health care workers. It’s possible that machines could learn to perform the work of radiologists, for example, in the next five years, according to some computer scientists. But because nursing demands interpersonal skills and emotional intelligence, it can’t easily be done by robots, say futurists, medical professionals and technology experts. Instead, the work of nurses may be supercharged by artificial intelligence.

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In his 2015 book “The Rise of the Robots: Technology and the Threat of a Jobless Future,” Martin Ford suggests that the spread of AI could create a new class of middle-skill health care professionals who use machine learning to supplement their existing knowledge (and perform more of the work that’s done today by doctors).

But the path to nursing isn’t easy — and already technological advances are making it tougher. Many high school graduates haven’t acquired the critical thinking and math skills necessary to train for nursing jobs, educators say. As the delivery of care grows more complex and data-driven, and AI begins to augment the job, colleges will need to continually update their training and work more closely with high schools to pave pathways to the field.

“There’s a huge gap in understanding among guidance counselors about what nurses do,” said Janet Haebler, a senior associate director at the American Nurses Association and a former community college instructor. “Many don’t understand the basics that need to be built early on,” she said. “It does require a heavy background in math and science.” It also entails critical thinking and data analysis.

Students’ math skills don’t add up

Philadelphia and other big cities are ground zero for a national push to require nurses to complete more training. In 2010, the Institute of Medicine and the Robert Wood Johnson Foundation issued an influential report calling for 80 percent of nurses to hold bachelor’s degrees by 2020. While Community College of Pennsylvania (C.C.P.) graduates can typically find registered nursing jobs at long-term care facilities and other nonhospital settings, many hospital RN positions demand a baccalaureate. Some community colleges have inked agreements with universities so that nurses can earn a bachelor’s (or even a master’s) at lower cost without leaving their campus.

But simply completing a two-year degree is a challenge for many. Before entering C.C.P.’s nursing program, students must pass intermediate-level algebra. But that’s easier said than done: At least 65 percent of all new students, campuswide, arrive unprepared for that course and must first take remedial math, school officials said. Each semester after they enroll in nursing, students take a math competency test, covering relatively basic topics such as converting milligrams to grams. This past semester, only half of the 120 students in their first year of the nursing program passed.

For students who’ve taken years off before college, adjusting to the academics tends to be particularly difficult.

 Laquon Jackson receives help from his Introduction to the Health Care Professions instructor, Elizabeth Dalianis. Caroline Preston / The Hechinger Report

When Laquon Jackson graduated from John Bartram High School in Southwest Philadelphia, he was a tall, amiable teen who liked biology and math but didn’t take his studies too seriously. That was nine years ago. Since then, Jackson has held jobs in food service and studied briefly at Delaware County Community College before family turmoil caused him to drop out. But after he supported his father through a terminal illness, Jackson re-enrolled in school at C.C.P. He intends to become a nurse, he said, because he “wants to be that person who really takes care of other people.”

Jackson, 26, is two years above the median age for C.C.P. students, and he’s been a little nervous about the digital skills now required. His high school math courses practically feel like a lifetime ago. At C.C.P., Jackson placed into a remedial course that will require him to pass three semesters of math.

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Laura Davidson, an associate professor of dietetics and allied health, said many new students simply lack the confidence to puzzle through math problems. “They’ve had not just bad experiences but in some cases traumatic experiences around math,” she said. “They’ve been taught that they just can’t do it, and you have to start telling them, ‘Yes, you can.’”

The college started working last year with nearby Universal Audenried Charter High School to introduce its students to in-demand health care skills at a younger age. As part of the dual-enrollment program, this semester high school seniors take a medical terminology course on C.C.P.’s campus. In addition, the community college recently tweaked its Introduction to the Health Care Professions course to give its own first-year students a clearer sense of the paths to health care occupations. Now, besides learning the basics of how to communicate with patients, evaluate privacy issues and use medical terminology, students are exposed to a range of health care occupations (dental hygienist, medical assistant and medical technologist among them) and must prepare a plan for how to get there.

“Sometimes people have unrealistic expectations,” said Deborah Rossi, head of the allied health department at C.C.P. “They might want to be a nurse but don’t really want to see blood.”

Barbara McLaughlin, who chairs C.C.P.’s department of nursing, said the new course has made a difference: “We’re starting to see a group of people with at least one leg up.”

Is empathy robot-proof?

The retooling at C.C.P. offers just a hint of the changes coming to nursing education. Joan Stanley, chief academic officer with the American Association of Colleges of Nursing, said her group recently started a task force to explore updating nursing education to allow students to stay on track as the field changes direction to include more integrated care across health disciplines, with a greater focus on the social factors behind illness, treatment in nonhospital settings and technological advances. “We need to start now to emphasize these new areas of practice,” she said, “the use of big data, the use of AI programs to improve outcomes and diagnoses.”

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