Jasmine De Moya, 17, has dreamed for years of working in the medical field, and she yearned to spend time with older people, missing her grandparents, who live in the Dominican Republic. A program sponsored by the New Jewish Home health system in New York City that combines volunteering and free training for entry-level health jobs, career coaching and assistance on her college prep is helping make her hopes come alive.
Over the past three years, Jasmine has learned a lot about caring for older people, from the importance of speaking slowly and being gentle with frail residents who may have hearing or comprehension problems to how to brush their teeth or bathe them.
“We practiced first with mannequins, so when we actually [worked on residents] I was in shock,” she said. “Cleaning a body and their private areas, I never expected I would do that. But then I got used to it.”
Last summer, Jasmine completed a certified nursing assistant training course. She has also researched and applied for colleges and student loans with help from an organization that the geriatrics career development program provides to volunteers like her. After graduating from high school last month, Jasmine will start nursing school at Lehman College in the Bronx in the fall. She’ll be the first in her family to attend college.
Since it launched in 2006, the geriatrics career development program has helped more than 700 high school students from 10 underserved schools in New York City get hands-on experience with geriatric care at the New Jewish Home in Manhattan and the Harry and Jeanette Weinberg Gardens senior living facility in the Bronx. Ninety-nine percent of program participants graduate from high school, and more than 150 have gone on to college.
The advantages of the program are also evident for the New Jewish Home, which operates two nursing homes, senior housing and assisted living facilities and a home care business in the New York City area. By familiarizing young people with geriatric care careers, the system aims to address its growing need for workers as the tide of baby boomers enter their later years.
Six of the top 10 fastest-growing jobs in the decade leading up to 2029 are projected to be in health care, according to the federal Bureau of Labor Statistics, including home health and personal care aides.
“One of our biggest challenges is that there aren’t enough people who want to work in this industry,” said Dr. Jeffrey Farber, president and CEO of the New Jewish Home system. “People don’t want to work with older adults.”
The New Jewish Home began its career development program for teens 15 years ago with the idea of training and hiring them as nursing assistants, Farber said.
But it has become more than that. Working a few afternoons a week for three years with older adults, students gain insights into aging and develop relationships with residents, some of whom are assigned as mentors. It also gives students assistance with figuring out career goals and putting the pieces in place to get there.
“I think the students would be successful without us, but we provide the structure and resources to help them succeed,” said John Cruz, senior director of workforce initiatives at the New Jewish Home, who oversees the program.
Students generally must devote two afternoons after school every week and several weeks during the summer, said Cruz. The program curriculum, developed with Columbia University Teachers College, initially teaches students basics about patient privacy, Medicare/Medicaid and overcoming stereotypes about older people. By the time they’re seniors in high school, students can train as certified nursing assistants and work as paid interns supporting the residents on the days they spend at the facility.
As part of the program, students may also become certified in other jobs, including patient care technician, phlebotomist, EKG technician, and medical coding and billing staff.
The pandemic, however, changed things. The New Jewish Home in Manhattan was hit hard, with dozens of covid deaths at the 514-bed facility.
Since volunteers weren’t permitted inside the facility, the home instead hired many of them as part-time employees so they could continue to help seniors. This also gave students a chance to complete the clinical training portion of their certified nursing assistant coursework.
In addition to the program for high school students, the health system created a program in 2014 for people ages 18 to 24 who are unemployed and out of school, training them to become certified home health aides and nursing assistants. Nearly 200 have completed the program and the New Jewish Home has hired three-quarters of them, at a starting wage of $15 to $19 an hour.
Both programs are supported primarily by grants from foundations.
In February, the state announced that nursing homes could accept visitors again, following federal guidelines. But many nursing home residents still rely on virtual visits, and during the spring Jasmine spent her time helping them connect with their families and other loved ones by iPad or phone.
The isolation was hard on the residents, and students provided sorely missed company. Asked how the students helped her, resident Dominga Marquez, 78, said, “Just talk.”
“We are lonely,” said Marquez. “I have a lot of friends that used to come every week to visit but, with the pandemic, nobody came.”
Kennedy Johnson, 17, said helping seniors experience virtual visits with their families during the pandemic made him realize how much he takes for granted.
“With the pandemic and doing the virtual calls, seeing how these families don’t get to interact with their loved ones every day, that really opened my eyes,” he said.
Working at the New Jewish Home was the first time Kennedy had ever been in a nursing home or seen the kinds of work that staff members do.
In the fall, he will start at Morehouse College in Atlanta and plans to major in political science. His goal: “I want to be a health care attorney so I can represent people … like this.”
Published courtesy of KHN (Kaiser Health News) a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Pro bono is defined as “being, involving, or doing professional and especially legal work donated especially for the public good.” Pro bono work has traditionally been relegated to attorneys. This was before the increasing cost of health care, the number of uninsured patients, and the economic slowdown. Now, more and more nurse practitioners are providing discounted rates, offering free services, or volunteering their time to free clinics and charities.
Let’s examine pro bono work and things you should consider when deciding how much pro bono work is appropriate for you. We’ll also delve into the advantages of pro bono work: for the patient, our societal image, and for you, both personally and professionally.
Why Should You Consider Pro-Bono Work?
Statistics indicate that roughly 10% of Americans under 65 do not have health care coverage, with a full 45% stating that they cannot pay for such coverage. Due to this, some 79 million Americans have medical bills that they cannot pay, and they are dealing with medical debt, which can destroy their credit rating and make it impossible for them to secure a new credit card, refinance the mortgage on their house, or apply for a personal loan.
As nurse practitioners see more patients struggling to pay for their health care, some providers, like Dr. Mary Newman, have started discussing their patients’ financial conditions during routine office visits. Additionally, many have cut fees or have devised creative payment arrangements. Dr. H. Lee Adkins of Ft. Myers, FL, for example, charges a flat fee to patients with chronic illnesses that covers monthly office visits, routine labs, and some vaccinations. Others are basing their costs on a sliding scale, providing free telephone consultations, or seeing two members of a household at the same time and charging for only one office visit. Still others donate their time to charitable organizations that run free clinics for uninsured or underinsured individuals.
The Many Options of Pro Bono Work
According to the AMA Journal of Ethics, when deciding whether to take on pro bono work, you have many options to consider:
- You may decide to devote all of your time to underprivileged patients. Should this be the case for you, transfer all of your affluent patients to colleagues … but be aware of the consequences of your actions. While you may experience a great deal of satisfaction serving those in need, you will also have to make financial sacrifices, including giving up your expensive office for something more modest.
- You may conclude that you want to help the indigent but just can’t afford the tremendous reduction of income to do it full-time. Set aside one day a week to treat the uninsured or those on Medicaid in your office, or work one day a week at a free clinic. The option of working in a free clinic would allow you to volunteer your time without your having to also volunteer your staff’s services.
- Maybe serving the underprivileged is just too costly for you at present, but you would like to pursue it in the future. While you gain financial stability and shore up your expenses in preparation for the big jump into pro bono work, you can convince a colleague to accept low-income patients or advocate for better access to health care services within your local community.
How much pro bono time you volunteer should be ethical and appropriate for you. Just keep in mind your professional responsibility and recognize your conscience. What do you need and aspire to be as a nurse practitioner? Also consider your personal situation and finances.
If you wish to serve the underprivileged population, but you just can’t justify the loss of income at the moment, there are things that you can do to make yourself better able to take the plunge in the future. For one, take a good look at how you use your supplies and resources. You may find that through hospital resource management, a system whereby you more effectively utilize your resources, you can remain financially solvent while devoting time to help those who need it most.
When you decide to volunteer your time and do pro bono work, you are allowing an economically disadvantaged patient to seek health care who might otherwise go without. A 2018 survey showed that roughly 40% of Americans passed up a medical test or treatment that was recommended within the past year because of the exorbitant cost, even when they were injured or suffering from an illness. Additionally, over 30% took less prescription medication than prescribed or did not fill a medication at all due to cost.
Regardless of your personal decision whether or not to pursue pro bono work, a highly debated topic is whether, like attorneys, providers should be required to do pro bono work by the medical societies to which they belong. At this time, most perform at least some pro bono work, but it often goes unrecognized by the public. Society as a whole used to admire doctors, but due to malpractice suits and increasing public scrutiny, the reputation of health care has been severely tarnished. Requiring pro bono work could restore some of the faith the public once had in providers.
Volunteering your medical services also has numerous personal benefits. It boosts your mental health in the following ways:
- The meaningful connection with others helps to relieve stress and anxiety.
- It boosts your happiness. Studies have revealed that human beings are programmed to help others, and the more we do so, the happier we feel.
- It provides a sense of purpose that you may have lost in your practice.
- It increases your self-confidence and provides a feeling of accomplishment.
- It allows you to create new friendships and strengthen the friendships you already have.
- It can give you a sense of pride and positive identity.
Volunteering can also benefit your professional life:
- You gain more experience and competence.
- You further develop your current skill sets.
- You expand your network of other medical professionals.
- You gather positive exposure for your personal business.
And if you prefer to donate your time in a nonclinical way, that is also possible. You can join the board of directors of a non-profit group, for example, or mentor others. Hippocrates, the founder of the Hippocratic Oath, stated that one of the primary responsibilities of a medical professional was to be a teacher. If you choose to mentor junior nurse practitioners, for example, you will help them with their personal growth and make them better nurses.
There are so many in society who cannot afford health care insurance and are drowning in medical debt. Medical professionals can improve patients’ health without adding to their financial burden. And it can also do you a world of good, both personally and professionally.
Nurse of the Week Diane Foxen has two callings. The Sunnyvale, California nurse cares for human infants during shifts lasting up to 16 hours in the neonatal ICU at Santa Clara Valley Medical Center, and works part-time at El Camino Hospital as well. After she leaves the ICU, Foxen goes on shift at home, treating newborn felines as a volunteer for her local Humane Society. Her home-grown kitten clinic has been a refuge during the pandemic: “Kittens are bouncing around, running around, jumping up in the air. There’s no way you cannot laugh if you have a kitten or puppy in your life because they are just funny. And in this time of COVID, everybody needs a little bit of funny.”
Over the past decade, she has fostered some 200 homeless kittens, occasionally making room for 13 at a time. Foxen’s first feline charge was Smudge, a young tuxedo cat who was suffering from lymphoma. Smudge was expected to live for no more than six months, but under Foxen’s care he survived for three years. Cristie Kamiya, chief of shelter medicine at the Silicon Valley Humane Society said, “Having a foster parent of Diane’s caliber taking on some of the most challenging cases has been critical to our mission. Diane has literally saved the lives of the many kittens she has taken in.”
After she had taken Smudge under her wing for the Humane Society, the Society was quick to adopt Foxen: “I started getting phone calls from the Humane Society, saying, ‘Hey, Diane, we’ve got this really sick kitten—it’s just like NICU nursing—can you take care of it?’ And so now my specialty is fostering very sick ringworm kittens.”
Although ringworm is a skin fungus, it is so contagious that many cats are put to sleep simply to prevent it from spreading. When Foxen fosters kittens with ringworm, she isolates them in a special room, where she treats them with medicated baths and oral fungicides until they are worm-free.
Tending to the rescued kittens is emotionally rewarding, and also helps to relieve the stress of working in an ICU. Foxen told the Mercury News that “They say that we’re heroes but actually, especially after that second lockdown where I sheltered away from my sister, these kittens were my heroes. They’re giving me that contact that I need. They’re giving me a safe place to cry my tears where I’m not burdening anybody else who has had a hard time with this themselves.”
Her volunteer work with animals complements her career and enriches her life: “Having this transition from a kitten that may not make it to this healthy kitten that is now running around and playing, that is just reward in itself,” she said. “Having a foster—whatever animal—I highly suggest it; it can really help people make it through tough times.”
The full story on Diane Foxen is available at Los Altos Online.
Nurse of the Week
Nicole Smit has a favorite motto: “To make a difference in this
world, you don’t have to be brilliant, rich or perfect, you just
have to care.”
Smit, a 28-year-old
RN from New Zealand, has so far made three volunteer trips to Uganda
to care for patients in settings ranging from the slums of Kampala,
the national capital, to remote villages in outlying rural areas. In
the course of her visits, she has helped to build a village medical
center, provided testing for HIV and malaria—serving 100 patients
over the course of a few hours—and has worked with a charity
specializing in wound care for children living on the streets. “What
I do here is certainly very different to what I do when working in a
hospital in a first-world country,” she remarks.
After spending three
years as an RN at home in New Zealand, Smit volunteered for her first
trip to Uganda in 2017. From the start, her journey impressed upon
her the vast gulf between healthcare in developing countries and
first-world countries like New Zealand and Australia. “There are
many prevalent health problems here that I had never dealt with at
home…” She fell in love with Uganda, though, and has returned
each year between stints working for a nursing agency in Australia.
Smit made it back to
New Zealand just before lockdown took effect, but her experience has
left her deeply concerned about the vulnerability of Uganda in the
face of the pandemic. “I think if there were to be a massive
outbreak like there has been around the world, I think they would
definitely struggle.” In addition to suffering from overpopulation,
she notes, people living in villages and rural regions in the country
are endangered by their lack of access to reliable information. Smit
comments, “I am sure some of those people may not even know what
is happening. They are quite isolated and there is no social media or
Her commitment to
healthcare in Uganda has led to recognition from Smit’s alma mater,
which awarded her their first Villa Maria Past Pupil’s Association
Mercy Grant, and in 2019 Zonta International included her among their
100 Women of Achievement.
privileges mean so much to me because my dream is that I might
inspire even one person to make their small mark on the world, which
in turn could mean the absolute world to one person.”
For more details on
Nicole Smit, see these Otago Daily Times stories from March
In business, it is often said that it’s not what you know, it’s who you know. When it comes to landing a job and building a career, who you know can make a crucial difference. The idea of networking is to build relationships, identify different fields of interest, and attract more career opportunities before you need them. For nursing students, that means networking before graduation. Here are three ways students can benefit from networking.
1. You can learn from your professors’ experiences.
It’s the people you know who bring job opportunities to your attention and could help you to get your foot in the door of a lifelong career that includes professors, says Constance M. Dallas, PhD, RN, FAAN, an associate professor at the College of Nursing at the University of Illinois at Chicago. [et_bloom_inline optin_id=optin_18]
“Few nursing students enter school with definite ideas about what type of nursing they want to practice or with an understanding of how many different types of nursing exist,” she says. “Take time to get to know us and find out what choices we made that lead us to where we are today. What are our passions? How were we influenced by our experiences in school? How did we end up teaching?”
2. You can take advantage of college resources.
Networking during student years is beneficial because there are more opportunities and resources available in colleges and universities in comparison to most workplaces. Networking at professional events, such as student nurse association meetings or honor society events, may bring forward information about new positions, new facilities, or even new projects that could offer professional development opportunities.
Jan Jones-Schenk, DHSc, RN, NE-BC, national director of the College of Health Professions at Western Governors University, believes joining a professional association or volunteering as a student is a great way to develop leadership skills and meet people who can help you problem-solve ideas related to your own professional advancement.
“For me, my work in my state nurses association led to me a position on the ANA Board of Directors and to become the President of the American Nurses Credentialing Center,” she says. “I didn’t set out with those goals, but I did set out with a passion for nursing and nurses and I found like-minded colleagues right in my own state.”
3. Sometimes the most random event can have an enormous impact.
While working as a student nurse at a humanitarian event, Delilah Villarreal, RN, a regional nursing director for Epic Health Services, was able to meet many influential physicians and nurses.
“They were able to share their work experiences with me and also offered to write letters of recommendation on my behalf,” she says. “My letters of recommendation helped me land my first job and start my nursing career.”
Networking with other nursing professionals allows nursing students to learn about real-life nursing experiences in advance so that they can make the best possible decision for their future when the time comes.