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BISMARCK, N.D. (AP) — If an ailment landed you in the St. Alexius Medical Center a century ago, a nursing student would know to fix a mild soup to make you feel better. At least, that's what their textbooks instructed them to do to treat various illnesses when the hospital's nursing school opened in 1915.
While today's textbooks no longer suggest nurses become experts in chicken soup-making, at least one thing holds true as it did back then: The demand for nurses in North Dakota is through the roof.
"Many of our students have jobs months before they graduate," said Glenda Reemts, chair of the Division of Nursing at the University of Mary, which replaced the St. Alexius School of Nursing in 1960.
Others involved in nursing education in Bismarck say the same holds true at their institutions. The population boom fueling North Dakota's need for health workers echoes that of the era when pioneers flocked to the plains for a better life, the Bismarck Tribune (http://bit.ly/1AsaQVa ) reported.
Back then, not a single hospital existed between St. Paul and Seattle until a group of Benedictine nuns founded St. Alexius in the late 1800s.
"The demand was huge because we covered almost all of Dakota Territory," said Sister Mariah Dietz, vice president of mission integration at CHI St. Alexius Health. "There was nobody meeting that demand."
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When the St. Alexius School of Nursing opened 100 years ago, its initial cohort of 11 students handled a bit of everything.
The student nurses arrived at work before the sun rose to bathe patients, prepping them for the day with a clean face and combed hair.
The water they used came from the Missouri River for a steep price: $0.25 per barrel. It was so precious, Dietz said, that the students used the same water to wash patients, rinse their clothes and clean the hospital floor.
They attended classes taught by doctors throughout the day. Nuns took on the role of nurses before the school opened, despite having no real medical education.
Dietz recalls the story of the hospital's first administrator, Sister Alexis, whose mishap during her first time in the operating room illustrates why nurses need formal training.
"They started the surgery, and she promptly fainted," Dietz said.
When the nun came to, a doctor told her — quite firmly — to get up. Sister Alexis made sure never to faint again.
The early nursing students also cooked meals for the patients and prepared them for bed.
It was a similar situation at nearby Bismarck Hospital, now known as Sanford Health, which opened the region's first nursing school in 1909.
"Nurses really were jacks of all trades," said Karen Latham, chair of North Dakota State University Nursing at Sanford Health in Bismarck. "Over the years, many subspecialties have emerged to better meet the needs of those patients."
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Today's health care workers tend to adopt a team approach to patient care, which students practice before they ever set foot in a clinic.
Starting this fall, NDSU nursing students will do classroom demonstrations alongside University of North Dakota medical students also in Bismarck, Latham said.
The NDSU nursing facility has several labs set up to look like hospital rooms with interactive dummy patients. The babies, for example, can seize or turn blue and jittery.
The simulations expose them to a wider variety of scenarios than they may encounter during a stint learning in a clinical setting.
"There are some significant experiences you want students to have, but those situations don't necessarily arise for every student," Latham said.
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Though demand for nurses is high, those involved in local nursing education programs say they can't simply accept more students.
The U-Mary Division of Nursing caps undergraduate enrollment at 120 students despite a higher number of students interested in the field.
"That's limited by the clinical areas they are able to get their experience in," Reemts said.
In Bismarck, nursing students from U-Mary, NDSU, Bismarck State College, United Tribes Technical College and Bismarck Public Schools all need experience in a clinical setting to complete their programs.
Health care providers have only so many slots open for students. Many professionals work long hours and their departments are understaffed. Training a student adds to their workload, said Sarah Berreth, an instructor in the medical-related careers program at Bismarck Public Schools' Career Academy.
"It's a fine line," she said. "We don't want to burn them out."
The academy's high school students seeking to become certified nursing assistants must spend 16 hours working in local nursing homes. Those in the academy's advanced medical class need to job shadow a health care worker to complete their program.
"We hope to bring them future employers in return," instructor Jessica Mehlhoff said.
Many high school students who pass the North Dakota Board of Nursing CNA test go on to pursue a college-level degree in nursing. Often a CNA certification is required to be accepted into those programs.
"They need that patient experience, and they can get it here," Mehlhoff said.
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Those involved in nursing education say it must adapt to mimic the reality of the health landscape. Today, that means focusing more on prevention and wellness.
"Now because of shorter (hospital) stays, it has really pushed us into the community," Reemts said. "They have to be more independent practitioners."
Her U-Mary students don't just work at CHI St. Alexius or Sanford — they also gain experience at mental health and public health facilities, and even in patients' homes.
Rosanne Schmidt, chief nursing officer at CHI St. Alexius, sees that change as well.
Nursing, she said, used to revolve solely around taking care of sick hospital patients. Long gone are the days when students learned by practicing a recipe for soup.
"The goal is to keep people out of the hospital," Schmidt said. "You need nurses to do that."
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Information from: Bismarck Tribune, http://www.bismarcktribune.com
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