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Medical Center Uses Career Growth and Foreign Nurses to Combat Shortage

Chief Nursing Officer Matthew Choate and Workforce Development Coordinator Megan Foster stand in the lobby of Central Vermont Medical Center. The two are part of a team combating a nurse shortage by providing more support for career growth and by hiring nurses from abroad. Photo by Tom McKone.
Central Vermont Medical Center isn’t immune to the state and national shortage of nurses, but it has diagnosed the problem, come up with treatments, and is making progress. How big is the challenge? Of the 500 nursing and nursing-related positions at the medical center, 100 are either filled by temporary employees or vacant.

In a recent interview at the hospital, Workforce Development Coordinator Megan Foster and Chief Nursing Officer Matthew Choate said that they are using about 60 “traveling nurses” — professional staff from outside the region who work on temporary, more expensive contracts — and another 25 temporary licensed nursing assistants. But they’re working to resolve this problem.

“We’ve been developing our own staff, and we’ve put in our own career pipeline programs and our own training programs,” Foster said. “Another area that we’ve been looking into is being able to bring [nurses] in from overseas.”

Before the pandemic hit and caused delays, Central Vermont Medical Center had started addressing the shortage in two ways: creating new career growth opportunities — Pathway programs — that make it easier for employees interested in nursing to either become a nurse or move their nursing career forward, and applying for a federal employment-based immigration program that allows it to hire nurses from abroad.  Three Pathway programs are underway and thriving. 

The LPN Pathway Program, in which a medical center employee earns a licensed practical nurse certificate, graduated its first class of 13 last summer and has another eight students set to graduate this summer. Two more cohorts (one with eight students, the other with 10) begin this fall.

For this program, the hospital partners with the Community College of Vermont (CCV) and Vermont Technical College. In the first year, employees work full-time and take CCV classes, paid for by the college. In the second year, employees remain full-time employees, working 24 hours a week with an extra 12 paid hours for classwork, labs, clinical instruction and studying. Students pay for these classes, but if they stay at the medical center for three years, at the end of each year they get reimbursed one-third of the cost of the courses.

The RN Pathway Program, in which employees earn an “Associate of Science in Nursing degree, leading to RN [registered nurse] licensure” is similar to the second year of the LPN Pathways Program. The employee continues to receive full pay and benefits while working at the medical center 24 hours per week with 12 hours slated for coursework. In this program, employees pay for the courses and CVMC reimburses them half after one year and the other half after the second year.

The LNA (licensed nursing assistant) Pathways Program includes working full-time as a geriatric assistant at Central Vermont Medical Center’s Woodridge Rehabilitation and Nursing facility under the supervision of a licensed nurse. The medical center partners with the Central Vermont Career Center and the Randolph Technical Career Center so that high school students can begin working toward becoming a licensed nursing assistant while still in high school; applicants do not have to be high school students to qualify. The program can be a lead-in to the LPN Pathways Program. One advantage of this program, Foster notes, is it creates an advantage for young people to stay in Vermont.

Choate said employees who go through the LPN and RN Pathways programs may take a year longer to get those licenses than if they went to college and didn’t work; but in this case, they can work the whole time and have no long-term debt when they finish.

A second initiative brings in experienced nurses from day one.

After considering several companies, the medical center contracted with Avant International, a Florida-based company that brings foreign nurses to the United States through the federal Department of Immigration’s Employment-Based 3 (EB-3) Program.

Choate said Avant has a database with medical professionals in 64 countries who want to come to the United States. To participate, nurses must already have a bachelor’s degree or the equivalent and at least five years’ experience. Avant vets applicants, and the medical center makes all hiring decisions.

Nurses participating in this program start with several weeks of orientation into American life and American hospital procedures, which also serves to validate their nursing skills, Choate said.

Foster added that the nurses must be proficient in English and said that they have talked with Avant to make sure the nurses who may come here know they are coming to small towns in a rural area. Foster and Choate said that Avant provides the foreign nurses with assistance in finding housing as well.  

The nurses make a three-year commitment, can bring family, and may apply to continue to work in the United States afterward. The first cohort of up to 14 international EB-3 nurses is expected to arrive this fall. The medical center does not yet know where they will be coming from.

“The hope is that they will take root in [the] community and stay longer than three years,” Choate said.

Foster said she and Choate are two of the four people who have been immediately involved in the Pathways and EB-3 programs since its inception. The others are Robert Patterson, vice president of human resources and clinical operations, and Geoff Farnum, manager of nursing education.

The nursing Pathways programs have been so successful, Foster said, that they have launched a small pharmacy technician program and are in the process of developing programs for surgical and lab technicians. Much smaller, these programs are being developed with other medical centers in order to have a large-enough cohort.