Alpine ISD’s nursing program sees growth
TRI-COUNTY — Medical personnel in training start work at the Big Bend Regional Medical Center this week, arriving at the hospital at 6:30 a.m. for the nurse’s change of shift in never worn scrubs.
The trainees are high school seniors from Alpine and Marathon ISDs working to become certified nursing assistants (CNAs). For the eight Alpine High School seniors, all girls, stepping into a real-life clinical setting is the culmination of three years of laboratory and classroom learning they first started as sophomores, when Alpine ISD established its CNA program.
“In a lot of ways it serves as a healthcare primer for kids going into lots of post-secondary opportunities, whether straight into the workforce or into higher education,” Alpine ISD Superintendent Michelle Rinehart said.
Now, what started in 2022 as a program with seven student participants has grown to a total of 65 participants, with 23 freshmen this year embarking on the four-year CNA class. “I was really shocked, honestly, that there was such an interest in it,” said District Nurse and CNA instructor Gayla Owen. “I know that we’re out here in the middle of nowhere, but we have all these young kids that want to be in the medical field. They’re just excited.”
The CNA certification program, one of Alpine ISD’s Career Technical Education (CTE) offerings — in addition to welding, graphic design and vocational agriculture — is funded by the Big Bend Regional Hospital District. Seed funds in the amount of $85,000 helped develop a CNA classroom and laboratory at the high school campus, complete with mock hospital rooms, medical dummies, a central supply closet, an EKG machine and a respiratory cart. Each student even has their own stethoscope.
Continual funding around $65,000 annually covers Owen’s salary, supplies, field trips and more. “Our CNA program would not be possible if the hospital district wasn’t financially supporting it because we don’t have the funding,” Rinehart said.
CNA students learn principles of health freshman year, medical terminology sophomore year, anatomy and physiology junior year and complete clinicals senior year. In order to become a CNA they need 60 hours of classroom instruction and 40 hours of clinical experience. They also have to pass a state test — part online exam, part demonstration of skills with a proctor.
Owen, a nurse with 24 years of experience, said she is also ensuring her trainees have the basic skills they’d need to work in a doctor’s office, like how to perform an electrocardiogram test, even though that skill isn’t required to pass the state exam.
The CNA certification alone is enough to get the students a job right out of high school. Owen herself worked as a CNA part time in college. “I tell these girls all the time that CNAs are like the most important person on the floor,” Owen said. “They’re the eyes, the ears, they’re with the patients a lot. And they report to us nurses. They help with baths and meals, and they play a big, big role in everything.”
For some, though, the CNA certification may be a stepping stone to other jobs in the medical field that require post-secondary education. Members of the CNA senior class — 17 and 18-year-olds — that spoke with The Big Bend Sentinel aspire to become a surgeon, an ultrasound technician, a neonatal intensive care unit (NICU) nurse, a nurse practitioner and either a physical therapist or to work in labor and delivery.
Senior Rikki Vega said her experience in the CNA class has been invaluable. “I never would have thought I wanted to go into nursing until this class came,” Vega said. “But now I know.”
She’s CPR certified, knows how to check respiratory rates and blood pressures, has traveled on field trips to Austin for Texas Board of Nursing disciplinary hearings and visited the simulation lab at University of Texas Permian Basin. “We got to see mannequins that could breathe and blink and give birth,” Vega said. “They could moan and groan. It was a good experience.”
When asked what it felt like to find a career direction so early in life, Vega said, “It feels like a relief.” “We’re already starting somewhere, like a CNA is already a job, and we just work our way up from whichever part of nursing we want to be in,” Vega said.
Senior Hope Dominguez agreed that participating in Alpine ISD’s CNA program has given her a sense of where she’d like to go after high school. “I do want to do something in healthcare that relates to nursing,” Dominguez said. “This class has definitely helped push me towards that.”
Alpine ISD eighth graders visit the high school to hear presentations about each of the CTE programs they have the option to join. Dominguez said she was attracted to the field of nursing because she knew she wanted to choose a career that involves helping people.
“I didn’t really know how I could do that, and then when I saw the nursing class, I was like, ‘That’s definitely a way to help people,’” Dominguez said.
Owen said rarely does anyone who enters the program drop out, and even though they are still in training, her CNAs are already in high demand, with partners constantly reaching out to help. Texas Tech, for example, will soon host telemedicine training. “There’s just so many people that want a piece of us,” Owen said.
Students from Marfa and Marathon ISDs may soon have the opportunity to join Alpine ISD’s CNA program under a new initiative called the Rural Pathway Excellence Program (RPEP.) “The RPEP idea is for rural districts to work together across district lines to open up some of their CTE — career and technical education — programs to each other,” Rinehart said.
One of the few public education bills passed in the 2023 legislative session, HB 2209 established the RPEP program and made it possible for districts participating in the program to receive additional CTE state funding — $3,000 to $4,500 per student.
But to be eligible for that monetary boost from the state — which Rinehart said could help close funding gaps for her district — the program will have to meet certain state requirements and become a designated “innovation zone,” by the Texas Education Agency (TEA).
Requirements include having at least three districts and two higher institutions involved — in this case Marfa, Alpine and Marathon ISDs, with less than 1,600 students total, and Sul Ross State University and Odessa College. The Big Bend Innovation Zone is in its planning year, and will not fully launch until the 2025-26 school year.
The initiative is largely being headed up by Yvonne Realivasquez, director of the RPEP program, whose new position is made possible by two donations of $25,000 each from the Still Water and Permian Basin Area foundations. Realivasquez technically works for the nonprofit Education Partnership of the Permian Basin, but is on Alpine ISD’s payroll and represents all three partner districts.
Realivasquez said the end goal of the program is to have each district specialize in a CTE program, for example Alpine ISD’s might be nursing, while Marfa ISD’s is welding. While Alpine ISD currently offers several CTE programs, both Marathon and Marfa only offer welding.
But it is likely that new CTE programs will be added once more revenue comes in, just not in the program’s first year, Realivasquez said. Even if no new programs are added, all three districts will get additional money for students participating in the partnership.
While other nearby districts have CTE programs, including HVAC/electrical, JROTC, energy and education, it will be up to a forthcoming market study to determine what industries in the Big Bend region are both in demand and high paying — a requirement of the program — that students might train in.
“Tourism is a huge part of our industry,” Rinehart said. “Does it intersect with this CTE work? Maybe, maybe not, depending on how those studies come out.”
The current plan is to involve 28 students in the program in its inaugural year and grow from there. Challenges, including transportation, still need to be worked out, Realivasquez said. “If you have students from Marfa and Marathon who want to come and join the CNA program, then we talk about, okay, how do we get them here so that they can participate in the instruction, in the practical and the clinical,” Realivasquez said. “There are challenges and all of that — of course there are — because you’re talking about schedules and putting kids on the road.”
While CTE programs are designed to launch students straight into the workforce, students may still opt to pursue further certifications, associate and four-year degrees, as many of the CNA students told The Sentinel they plan to do.
Pursuing that further education may lead them outside of the Big Bend, but the hope is that by ramping up CTE programs, districts may eventually help solve local workforce shortages, which are widely recognized to exist in the fields of education, child care and healthcare. “We’re building those skill sets in people who, even if they leave now, might be back,” Rinehart said.
Programs designed for retention are already in place. This year, Sul Ross and Big Bend Regional Medical Center awarded full-ride nursing scholarships to several local students, which involve two-year appointments at the hospital after graduation.
Rinehart said allowing local districts to utilize each other’s CTE programs, and access sorely-needed additional funding for doing so, is one of few rural education-focused initiatives from the Legislature that will allow Alpine, Marfa and Marathon ISDs to use resources wisely in a collaborative versus repetitive manner, while remaining in their home districts.
“I think the power in this is it’s one of the first rural facing, specifically-funded initiatives from the state in a long time, and it is specifically focused on collaboration, not consolidation,” Rinehart said. “I want you to be a Mustang. I want you to be a Shorthorn. We’re going to be the Bucks. You still get your own school identity, but then you get access to another CTE program that you otherwise may not have.”