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Immigrants Learn Nursing Skills as They Learn English

Many jobs in the United States can be outsourced, or done by workers in other countries. Much of the clothing sold in the U.S. is made in other countries, for example.

One job that cannot be outsourced, however, is health care. That is one reason nursing is a growing field.

Another reason is the large number of aging Americans, called “Baby Boomers” - the children of the late 1940s through the 1960s. They are getting older and many are entering hospitals and nursing homes.

Now those nursing jobs are available to immigrants looking for the American dream.

At Carlos Rosario International Public Charter School, a program started in 2009 to train nurse aides. A nurse aide is a person who works with a nurse to give basic services, such as feeding, washing, making beds, and moving patients.

Need for nurse aides

The staff of Carlos Rosario researched the need for entry-level employees before starting the Nurse Aide Training program, or NAT. Curriculum developer Heather Tatton-Harris explains the process.

“We were looking at what the DC area job growth was - what areas, what jobs were growing, in DC, and health care was one of the fastest growing opportunities for students like ours to get new jobs. And then at the same time, we surveyed our student population to see what jobs they were interested in.”

The NAT program started in 2009 with high-level speakers of English as a Second Language.

In 2014, a pilot program began for intermediate level speakers of English. Students continue to improve their English at the same time they learn how to work as a nurse aide. The program combines teaching by a professional nurse trainer with instruction by an English as a Second Language, or ESL, teacher.

Tatton-Harris helped to design the new nurse aide training class for ESL students. She says that it has two courses.

“One course is designed for students that complete our highest level of English. And they’re ready to dive right into the Nurse Aide Training content. The other course that we have is designed for intermediate level speakers of English. And that course, we have paired up a nurse with an ESL instructor, so that the content is made more accessible to the students. The curriculum is the same in terms of the content, but the way it is delivered to the students is done at a different pace.”

Designing an ESL nurse aide training program

Before starting an ESL NAT class, Tatton-Harris recommends looking at other programs for ideas.

“Look at what other schools are doing. Learn from the road that they've walked. The things that we learned were really important for us. We went to programs in Washington State where they are doing these types of training situations with an ESL instructor side by side with a content instructor. It’s called IBEST, in Washington State they developed that model. IBEST stands for Integrated Basic Education and Skills Training. And it’s a model that is becoming more and more adopted around the U.S. So you have two instructors teaching what they know best.”

Tatton-Harris says the ESL instructor plays a very important part in the program.

“When you are bringing a career training program down to a level, and helping students at a lower level of English prepare for a career training situation, it’s really important to bring in the expertise of an ESL teacher in that picture, [because] that ESL teacher really knows how to make that content accessible to the students. We find that our content teachers do a great job with teaching the content. They don’t know what they don’t know, about where the students are with their comprehension…”

Highly motivated students

Laurel Anderson is the ESL instructor for the intermediate-level NAT program at Carlos Rosario. She says that the students are different from a usual class of ESL students.

“I would say that I’m seeing a difference in the level of motivation - knowing that there is this big Red Cross board exam coming up at the end of the course is really motivating to them. We’ve gotten near perfect attendance; every single day I’ve got 100 percent of my students here. That’s different from other ESL classes that I’ve taught where the stakes aren’t quite as high. So, there’s an aspect of bringing in the real world here - taking this exam, getting a job after that, that is very, very motivating. So, yeah I would say that’s a difference from a straight ESL class.”

Practical training

Students in the NAT class practiced feeding a patient. Next to their classroom, there is a room that looks like a hospital room. Students learn how to raise and lower the bed with electrical controls. A teacher assistant checked each action the students made during the practice.

Back in the classroom, the NAT content teacher, Arlene Venable, taught students the correct way to move a heavy object. Nurse aides sometimes move patients and supplies. They have to know how to do it without causing injury to themselves.

Adjusting the teaching materials

ESL Instructor Anderson says the ESL NAT program has required some important changes to the earlier course design. One is the level of the textbook.

“Learning how to modify this textbook for different students. We have a couple of students that are struggling with this textbook. Last week we contacted the publisher and [found] there is a more basic version of the textbook. So we are going to bring that in and see if that makes it more accessible.”

Language teaching in the program also changed. Anderson says the course started with an importance on the students’ speaking skills. The idea was that the students should be able to speak clearly to patients and fellow staff members.

“… that was a big focus when we started out. And then learning along the way that reading comprehension was also a big, big part of what I need to be focusing on. So we have adjusted there - more reading strategies and comprehension activities to help them process all of this material - that has been a bigger focus this semester.”

Tatton-Harris says the ESL NAT program also had to change the timing of presenting new material.

“I think pacing was one thing that we learned, in terms of how quickly, and/or how much time needed to be spent on certain topics.”

Using technology in the program

Tatton-Harris adds that the ESL NAT program has been learning better ways of showing student progress.

“We also learned to keep track of where students are in their learning better. We're capturing more data about how they are doing on their quizzes, how they are doing in the lab, how we use technology to capture that. So we record our students by video and they can reflect on what they see in their own recording as well as the teacher can watch them do skills through that recording and evaluate that. So all of these things we are sort of learning through experience.”

In the next Education story, we introduce two students in the Carlos Rosario Nurse Aide Training program. Other stories will present the school's culinary arts program.

I’m Jill Robbins.

Dr. Jill Robbins wrote this story for Learning English. Caty Kelly Weaver was the editor.


Words in This Story

outsource - v. to send away (some of a company's work) to be done by people outside the company

nurse’s aide - n. (medical) a person who is employed to carry out basic tasks in the care of patients, such as bathing and feeding, making beds, and transporting patients, under the supervision and direction of a registered nurse

content - n. (in education) the body of knowledge and information that teachers teach and that students are expected to learn in a given subject

intermediate - adj. relating to or having the knowledge or skill of someone who is more advanced than a beginner but not yet an expert

accessible - adj. easy to appreciate or understand

expertise - n. special skill or knowledge

motivation - n. a force or influence that causes someone to do something

aspect - n. a part of something

textbook - n. a book about a particular subject that is used in the study of that subject especially in a school

focus - n. a main purpose or interest

adjust - v. to change (something) in a minor way so that it works better

strategy - n. the skill of making or carrying out plans to achieve a goal

semester - n. one of two usually 18-week periods that make up an academic year at a school or college (compare to term, quarter, trimester)

pace - n. the speed at which something happens

deliver - v. to present (a speech, statement, etc.) to a group of people

integrated - adj. having different parts working together as a unit

adopt - v. to begin to use or have (a different manner, method, etc.)

patient - n. a person who receives medical care or treatment

curriculum - n. the courses that are taught by a school, college, etc.

practice - v. to do something again and again in order to become better at it

Now it’s your turn. What field do you want to work in? Is there training available near you for that field? Is English needed for a job in the field? Write to us in the comments section or on our Facebook page.

Read More About Working as a Nursing Assistant

How much do Nurse Assistants earn?

What does the future look like for this career?

How do you become a Nurse Assistant in the United States?

Becoming a Certified Nursing Assistant

Training Materials and Vocabulary

American Red Cross Nurse Assistant Training Manual

Vocabulary for Nursing Assistants


Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2016-17 Edition, Nursing Assistants and Orderlies,
on the Internet at