Hospital leaders are not only seeking nurses — they are seeking nurses for today’s workforce realities.
At Barnes-Jewish College Goldfarb School of Nursing in St. Louis, that means making significant shifts.
Affiliated with Barnes-Jewish Hospital and BJC HealthCare, the college seeks to be reflective of the needs of the system and the community it serves — as seen with its new Psychiatric Mental Health Nursing and RN to BSN programs.
“As a college, we’ve shifted our mindset,” Angela Clark, PhD, RN, president of the nursing school, told Becker’s. “Curricula is not static; it’s continually advancing to prepare the modern nurse.”
Dr. Clark discussed this shift in more detail, shared the school’s approach to pipeline development and clinical readiness, and offered advice for other healthcare leaders who want to deepen ties with local nursing schools.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: What’s one shift you’ve made — or are currently making — in how Goldfarb prepares nurses for today’s workforce realities?
Dr. Angela Clark: We’ve made some big shifts, and one of them is to be fully reflective of the needs of our community and our health system. We’re trying to do this in real time. It starts with a structure that supports seamless communication between leadership within the health system and leadership at the college, nursing leaders within the health system, and then, our assistant deans, and then, between staff nurses and our educators, and then across our shared services of finance, HR, legal.
We’ve found that when we’re fully reflective, it ensures that the curricula across our programs for both graduate and undergraduate evolve with the same rapid advances in technology, care models, and patient care that our partners are experiencing.
That’s important for our curricula, so that we’re teaching what needs to be taught. So that we’re creating a workforce that can really respond. But also, our programming is fully based on workforce needs, and that’s part of us being reflective as well.
For example, our region needs behavioral health providers. So we’re launching a Psych Mental Health Nursing Program here at the college. We have associate degree nurses who want to advance their careers, and we have community hospitals in our system who are seeking Magnet. So we’re launching an RN to BSN program to support them.
As a college, we’ve shifted our mindset. Curricula is not static; it’s continually advancing to prepare the modern nurse. Our team is meeting regularly with all of our nursing stakeholders across the system for feedback and partnership with these changes. So when I say reflexive partnership, seamless alignment between the competencies and employer expectations.
The most basic way that we’re doing this is not just within our curriculum, but in our teaching practices at the most basic level, our learning spaces here at the college are identical to our hospital rooms. So we have the same technologies that we’re using, and we use the same documentation tools, pumps, and we have the same beds. We’re trying to remove any guesswork from our learners. We want our students, especially our BSN students, to have the same skills competency checklist that they’re using when new graduate nurses leave their residency programs. We’re trying to align all of that, which is really important for the workforce.
Q: How has your partnership with Barnes-Jewish Hospital and BJC HealthCare influenced your approach to pipeline development and clinical readiness?
AC: I’ve had the ability to zoom out and fully understand the direct impact that nursing programming and the success of our students have on the vitality of the workforce and the overall health of our region. They’re all one on this long continuum. When we take a system perspective or approach to the workforce, there are many more levers that, when pulled proactively and driven across this continuum of education and practice, can really drive a sustainable workforce that will thrive in this increasingly complex clinical environment.
We’re using data from our workforce initiatives here at the college, and what we’re seeing is a clear delineation between proactive solutions versus reactive solutions. The closer we are aligned with our academic practice partners — mine being BJC — we’re seeing that we can target different levers to support a workforce that will thrive.
An example of this is sign-on bonuses. A lot of hospitals provide sign-on bonuses, but what we’ve found is that when awarded earlier and paired with clinical opportunities for students or their final preceptor assignments, readiness to practice is enhanced. It also creates a culture change. Our new graduates feel welcome and part of the team. That’s all part of one lever.
But if we use that lever later down the road — say, have a later sign-on bonus — we might get the new graduate, but they won’t have been onboarded in our system. So the outcomes are better for everyone when positioned within the partnership.
Our college is positioned within the healthcare system, so we can adapt and respond quickly to our regional and system needs. I think of us as being an incubator for workforce initiatives. Healthcare is in a state of accelerated evolution, driven by an urgency of need that’s further empowered by new technologies, which create their own pressure. There’s also the pressure of rising expectations for efficiency.
We know that systems that can adapt to these types of challenges are going to thrive, and education partners and the curriculum we’re using have to be in line with all of these changes and still maintain the pace that systems are under to truly be partners in addressing the workforce shortage. We’re working very hard to do that.
Because we’re relatively small but have a lot of shared resources, when there’s an opportunity, we can adapt fairly quickly, work to get that implemented, bring all of our partners in to support what that looks like and then use data to say, “How do we continue to make this better? What are the outcomes on workforce for all of our various partners?” Whether it be [for] the community, the student/nurse, academia or practice.
Q: Do you have a specific example that shows how shared resources led to improved retention or another key result?
AC: There are a lot of scholarships that health systems provide to students in nursing schools. We’re in a state where we’ve had decreased enrollment, not just here in our region but across the state. When we reported as a college that we’re turning away qualified applicants for nursing schools based on finances alone, the health system responded back in partnership with us on what it would look like if we removed that challenge.
This happened in 2022, and we decided to pilot a tuition-free program for 30 students who, in exchange for a three-year work commitment, could go to nursing school with their tuition covered by the system. It was wildly successful. We’ve now scaled that pilot, which we call the BJC Full-Ride Scholars Program, to 252 scholars. The benefits are significant to the college, students, their families, the system, and the community. Our enrollment has increased because of this.
At the college, we’ve had 133 of those scholars graduate. They’re already employed across 11 of our hospitals. That program has a 98.5% retention rate, and we’ve been at it for three years, which is incredible.
There are other interesting findings that we’re able to help with and work with our nursing partners and leadership to see how we’re meeting their needs. For example, 33% of those graduates went to the highest needs area in the hospital. It’s important to know that we have the opportunity to get those areas filled just by aligning with students and future nurses.
From a student success perspective, there’s a 99% NCLEX pass rate among those students. There are a lot of benefits to that. There’s this whole new concept of supporting students longitudinally — what does that look like in partnership with systems? You build loyalty with the student, reduce onboarding time post-graduation. It’s an incredible investment, and we proudly support diverse learners, advance human-centered care, strengthen community health, and reduce disparities — all through meaningful partnerships.
Q: Many leaders are rethinking how they build not just a workforce, but a sustainable talent ecosystem. What does that look like in nursing education right now?
AC: Here at the college, we’ve expanded our recruitment strategy to include entire communities. We have a full-time equivalent who’s a faculty member fully dedicated to educating kindergarten through 12th grade students and their families about nursing and healthcare opportunities. Not just nursing, though. It’s various healthcare opportunities. And she’s working on partnerships to bring those students into not just our building but across different areas, like respiratory, radiology — other areas of shortages.
And, any given week in 2024 here at the college, we had over 100 students from area high schools in our building, learning about healthcare, learning about research, learning about lab sciences — not just nursing. As a school of nursing, we have resources that greatly benefit our community partners, like our high schools, charter schools, and community colleges. They really value the benefit of having access to our STEM facility, skills lab, and virtual reality spaces. Our faculty are very knowledgeable in helping drive that — and so are our staff — about college readiness or training program readiness.
We’ve been very vested in opening our doors to opportunities that enrich the pipeline for the health system in the future. We’ve been very creative in partnership to support that. And I think there’s a lot of work being done in that area, but nursing is a key player in supporting that for other strategies as well.
Q: What advice would you offer to other healthcare leaders who want to deepen ties with local nursing schools, or even build academic programs of their own?
AC: Reach out to your regional universities, colleges, and schools of nursing in your region. Chances are, there are programs that are in need of partnership.
We hear this a lot across the country: “There’s a shortage of clinical placements.” But then hospitals say, “There’s not enough local nursing programs.” That’s often not the case. So it’s important to know what’s happening in your community and have those conversations so you can support building these partnerships. They’re really key to aligning talent and workforce to practice, and it cannot be done in silos.
There’s ample opportunity for us to improve partnerships. There are a lot of fiscal and resource advantages to these partnerships. We’re providing opportunities for RN advancement, and at the same time, we have a faculty shortage — so we’re getting partnership from the health system to have faculty and preceptors for our students. We’re kind of driving that sustainability within ourselves.
When you have an excellent nurse who then turns into a preceptor — that student experience is enhanced. There’s a reduced time to independence. It’s driving the culture that then supports new grad nurses and onboarding. Then they have excellent first-year retention.
So when you partner, you can start to change your culture to drive a workforce that’s sustainable. And that’s been something that we’ve worked really hard on.
Additionally, there are a lot of innovative models in partnership together, and the way that those are successful is by considering how we are going to share structures and governance and align your mission to support what the needs of your community are.
And then, consider flexible programming. Within our partners here at the college, I can offer nursing education in a lot of different ways, but I may not know what the needs of primary care providers at the health system are. So when we found out they want weekend evening options, we started a weekend evening option program.
We’re looking at graduate programming. The nurses within our system are requesting more hybrid options, so we’re doing more hybrid and online options. There’s a need for return-to-work nurses and programming, so we’re offering that free of charge across the community to really support the workforce.
But it all started with what’s happening with our chief nursing officers, with our hospital presidents, and what are their actual needs? And as I need, say, to grow our CRNA program — I’m working very closely with hospital presidents and medical directors and the Department of Anesthesiology all to make sure that we’re doing this in alignment as partners, so that we’re utilizing resources the way that we need to.
And then, of course, we’re taking all of that data to create high-efficiency models across our partnership.
The other thing is it doesn’t have to be somebody who’s necessarily close by. We have partners that are well over an hour away, to support rural and underserved areas and share our resources. We have affiliation agreements with rural colleges and universities that don’t have schools of nursing. And what we’re trying to do is to make sure that there’s opportunity for nursing education in rural areas. And we have hospitals in those areas, so then they have a workforce.
But that’s all been very new, and it’s all part of the very clear strategy.
