USC Lancaster Pathway Program Works to Fulfill Student and Community Needs
When a certified nursing assistant (CNA) walks into a patient’s room, they’re often the face of care: steady, compassionate, and familiar. For many, it’s also the first step toward a larger calling. The University of South Carolina Lancaster CNA to BSN Pathway Program is turning that calling into reality by helping CNAs in rural South Carolina advance their education and move into nursing leadership roles.
Dr. Courtney Catledge’s connection to this work began long before the Pathway Program existed. Raised in rural Tennessee, she went on to earn a Bachelor of Science in Nursing from Clemson University and later completed dual master’s degrees in nursing and public health. After teaching in USC Upstate’s BSN program for several years, she was recruited to USC Lancaster, where she helped establish the collaborative BSN program with USC Columbia and eventually helped launch the USC Lancaster CNA to BSN pathway. In May, Catledge became the permanent campus dean. While the role has shifted her away from hands-on nursing work, her leadership continues to shape and strengthen the Pathway Program’s future.
Catledge describes how the program came to be, commenting on how it aims to alleviate student stress, increase student competencies and employability, and meet greater community needs.
“We discovered that there was this transition stress that students were experiencing from going from didactic or lower division nursing to upper division nursing where we’re throwing them into clinical,” She explains. “All of a sudden they were obsessing and stressed out about the physical acts of clinical: blood pressure, taking pulses, talking to patients.”
When assessing how best to help students in their transition stress, Catledge says the University turned to CNA training. She describes how by serving as a CNA, BSN students are able to gain experience and skills to better prepare them for clinicals in addition to giving them the opportunity to have a paid position while pursuing their degree.
The program has been a success in alleviating stresses on students as they transition into clinicals, and Catledge cites student testimonies saying they feel more prepared and ready as they enter upper division. Clinical instructors have also taken note of this career readiness.
She explains: “We’ve also had clinical instructors say the [students] working in the field or who have the training [we] provided, they exhibit more confidence and take on more leadership roles when it comes to their clinical experiences.”
The Pathway Program has also worked to foster relationships between nursing students and faculty, creating another resource to minimize stress around clinicals. Students now have the opportunity to build strong relationships with faculty earlier, and with that they are able to establish a foundation of trust and comfortability with someone who can serve as a resource during upper division.
Catledge also describes how the Pathway Program has helped create a backup plan and ensure employability for students who may not transition to upper-division nursing.
“What are they going to do when they really want to care and be in the healthcare field, but completing the BSN degree is not an option for them? We wanted them to have a marketable skill en route to whatever’s next for them.”
The Pathway Program allows students to have a safety net. If they do not transition into upper division, they may still pursue a healthcare job that will allow them financial independence.
“They’re meeting a need in our community,” Catledge says. “But they’re also meeting a need in their own personal lives to be able to have a pretty good paying job, to be able to sustain themselves.”
The final reason behind the Pathway Program, according to Catledge, is the opportunity the program has to fill a greater community need. She explains the drought of healthcare support happening in Lancaster, and how USC Lancaster has been able to alleviate some of these issues.
“Our community says we need more certified nursing assistants,” Catledge says. “We need more support in our hospitals, and we want to support people, especially people who want to continue on to get their bachelor’s degree in nursing. So, maybe we could establish a culture that would serve as part of a recruitment process. Then they would want to stay as nurses as well, because we know there’s a shortage in that.”
Catledge explains their partners’ appreciation for the program and how it has helped fill gaps in their healthcare facilities.
“Our partners love it, too, because our local hospitals and our local long-term care facilities now have a steadier stream of CNAs that can come in there and meet the needs of their organizations.”
She describes the diverse profile of students in the program, especially in terms of their motivations to pursue nursing. Catledge attributes financial security and employability as major draws to the profession, as well as the opportunity to care for others and help their community.
Another pull towards nursing, according to Catledge, is the diversity of paths within the field. She describes how students can pursue work in different environments, such as schools or hospitals, along with the opportunity to specialize in a variety of different disciplines. Catledge explains that one additional benefit of the Pathway Program is the opportunity it gives students to know which nursing field is best for them before they graduate.
“[Students] may discover that they don’t like medical surgery, or they love medical surgery, or they don’t like this, or they love this,” Catledge says. “They have some experiences to build upon so that they can make their best choices once they graduate with their nursing degree, rather than starting in a location or an environment that is not a good fit for them.”
The Pathway Program is not stopping with its current successes, as they hope to amend another issue in healthcare work accessibility: CNA certification testing sites.
Catledge explains: “We can provide the education, we can get the students, they can complete the clinical hours, but after that, they have to go through the state and take the test. Well, there’s a shortage of testing sites. [...] The challenge of finding a testing site, having to drive hours to a testing site, and having to wait months for a testing site has been a little bit of a deterrent for some people completing their certification.”
She went on to describe how USC Lancaster and the Pathway Program hope to remove this barrier by working to become a testing site. Catledge details renovations to the current campus space that would allow for a testing space for anyone wanting to pursue their CNA certification test.
Catledge attributes the Pathway Program’s influence and success to the Center for Rural and Primary Healthcare (CRPH). She says the Center’s support helped them start the program, which helped them further identify gaps in Lancaster healthcare education. She also discusses the other benefits of being a CRPH program.
“I went and was able to serve on a panel at the last CRPH Collaborative Meeting, and you just learn a lot from what others are doing. I think the network of that is really powerful,” Catledge describes. “The financial support [from CRPH also helped] to equip us to be able to add this course, recruit, and help to cover some faculty costs for that and equipment costs.”
When it comes to rural health as a whole, Catledge says that, to her, rural health means meeting people where they are.
“In South Carolina, so many of our community members live in very rural spaces, and, you know, the idea that everyone has the capacity to travel to city centers and urban areas for care is unrealistic. Coming from a rural background myself, rural means meeting people where they are and having those needs met, no matter where you’re located.”
