A nursing shortage that has only been exacerbated by the strains of a global pandemic is now well into its second year. Some colleges in Minnesota are responding with stepped-up programs, all of which are needed.

The University of St. Thomas, however, is taking an ambitious approach that re-envisions nursing with an eye toward underserved communities. The heart of this plan is to reach out into these communities for nursing candidates, while also training nurses in how to understand other cultures and the impact their care can have on individual and community health.

"We're a blank slate," said MayKao Hang, dean of the university's Morrison Family College of Health, which soon will feature undergrad and graduate nursing programs that emphasize care for historically overlooked populations, whether they are communities of color or rural areas that present their own special needs. "The vision is informed by a lot of planning and by my own life health experience."

The model arises from groundwork done over years to examine ways in which nursing could address health disparities, Hang told an editorial writer. "We know that 80 percent of what influences good health occurs outside the walls of hospitals and clinics," she said.

"Our school of nursing is being set up to go where the people are. It is designed to address what we can do to create better health outside the hospital, through work in the community and partnerships."

Hang said the school is working to create a partnership with the Minneapolis Downtown Improvement District, so that in addition to traditional hospital placements, there will be clinical rotations that embed students to provide care to the homeless, and with the St. Paul Public Library system to help provide health education to children and families. "Students will get everything required by accreditation, but so much more," Hang said. "It's a street-level approach to clinical education."

Hang is also acutely aware of the health provider shortage in rural areas, and of the shortcomings of programs that have typically relied on loan forgiveness as incentives for locating to rural areas.

"We consider this an underserved area," she said, "so our approach will be to recruit rural students who want to go back and serve the communities they come from."

To broaden its reach, she said, the school is looking beyond the often stringent requirements for traditional nursing school programs. While the school still prefers a 3.0 grade-point average, "we won't only be looking at metrics like GPA and SAT scores. We'll be looking at life experiences, characteristics of students. We want a 'change the world' mind-set from our students."

There is a desperate need to broaden the ranks of nurses in just this way, to look at the entire range of experiences that can do so much to enrich the profession and the care provided. "Students of color are underrepresented in nursing," Hang said, as are those from rural areas and men in general. The school is aiming to have about a third of its students from those historically underrepresented areas.

The benefits, she said, will be many. "For instance," she said, "If you look at shortages in central Minnesota, it's really bad. The dynamics of practicing in a rural community are vastly different. Nurses there are often called on to be leaders in many ways that go beyond patient care. We want to attract students who want to be in those areas, not for just a few years until their loans are forgiven. They will enjoy being there because they grew up there and want to serve that community." The same goes for immigrant communities, refugees and communities of color, Hang said.

To ensure success, she said, "we are working right now on raising money for nursing scholarships and supports that will help with advising and mentorship programs. Our job is to ensure learning happens for our students, not create obstacles to 'weed them out.'"

Hang is no stranger to this kind of pioneering approach. The former president and CEO of the Wilder Foundation, she was known for developing broad-scale community initiatives, with a strong emphasis on racial equity and systemic, generational change. As the first dean of the health school at St. Thomas, she brings those same skills, vision and passion, and nursing will be better for it.