From the time she was a student at Washington High School, Lilli-Anne Mantle knew her dream career would involve caring for others. She had always been drawn to science and took health-related courses in school, so when her paternal grandmother and self-described best friend, Leola Mantle, moved to Cedarcrest Manor in Washington, Mantle got a job as a nurse’s aide to spend as much time with her as possible.
She started at East Central College (ECC) in 2015 — the same year her grandma passed away — with the goal of becoming a nurse, but after juggling classes and playing softball for ECC for a few semesters, she transferred to the college’s EMT program. She later became a certified EMT and found a job at Mercy Hospital Washington. Working with the nurses there reignited her passion, so she again set out to become one of them.
“Working in the ER and watching the nurses do all these incredible things ... they just knew exactly what to do to help people who were sick, and I wanted to do that,” Mantle said.
Mantle is now one of 89 students earning an associate of applied science degree in nursing through ECC. The program is celebrating its 40th year in 2020, and as the COVID-19 pandemic continues to highlight the need for health care professionals, the students say they are more committed than ever to graduating and getting out on the front lines.
Best in the State
ECC’s nursing program was recently ranked No. 1 in the state and No. 4 among 660 associate degree programs for nursing in the Midwest, according to nursingprocess.org, an online educational resource that publishes regular rankings. ECC’s high ranking is attributable in part to its students’ high pass rates on the National Council Licensure Examination for Registered Nurses (NCLEX-RN), a mandatory exam that ECC students pass at rates well above national and state averages.
Recently, the school learned it won a $180,704 award from the U.S. Department of Agricultural Rural Business Development grant program to upgrade the technology available to the nursing and EMT/paramedic programs.
ECC’s program, which has an additional campus in Rolla, utilizes a mix of classroom and clinical training to prepare students for a career. The school partners with six area health care systems and facilities — Mercy Hospital Washington, Missouri Baptist Hospital Sullivan, Phelps Health in Rolla, SSM Health Cardinal Glennon Pediatrics in St. Louis, Cedarcrest Manor and the VA — where students gain real-world experience from their earliest days in the program.
The nurses-in-training begin their first semester in long-term care. Second semester involves learning medication administration and sanitation procedures. By the third semester they’ve started trickling into the ICU and operating rooms to observe, and they wrap up the program honing leadership skills by working with multiple patients at once.
This is essential because many of the students have never worked in health care before. Lisa Heimos, a second-year student, earned a biology degree and had a career with the Missouri Department of Conservation before applying for the nursing program in her 40s.
“I had zero patient care (experience), other than taking care of my own kids,” Heimos said. “I had never stepped foot into any sort of facility in that manner, so it was and still is an extremely daunting task for me to take care of someone else. So the fact that we have clinicals right off the bat gives us that practical knowledge that helps me.”
‘They Rose to the Occasion’
Nancy Mitchell, director of the nursing program and dean of health sciences, said these clinical rotations were the most impacted by the COVID-19 pandemic. ECC made it to spring break before classes went remote in March, so faculty had about two weeks to pivot to 100 percent online instruction.
“We tried to be really flexible with our policies because when you have moms and dads in your class and on the faculty who have kids at home, that was a struggle,” Mitchell said. “But the students rose to the occasion.”
The cohort of students is diverse in age, socioeconomic background and life situation, and each had to overcome different obstacles to keep learning remotely.
At one point, Heimos, who has four daughters, did her classes inside the RV parked in her driveway while her daughters claimed the flat surfaces in their home for their homework.
“If I had any doubts before, this time does solidify how important and rewarding this job is -— and difficult, but doable,” Heimos said. “It’s highlighted how important health-care workers are all-around, from treating ailments to helping patients’ mental health.”
First-year student Charlena Borges has six children under age 8 and one computer in her home. When classes went remote she did much of her homework on her phone, but she was more determined than ever to make it work.
“It may sound weird, but (the pandemic) makes me more excited because I know I can be that person to help someone,” Borges said. “I feel like being in nursing school, I’m not helping yet — but I want to be.”
Another first-year student, James Johnson, was still taking his prerequisites when the pandemic struck last year, but he immediately applied for a job at the hospital. Although the floor he would have worked on was furloughed and he didn’t end up going in, he said he felt like it was his duty to get in there and help people, particularly with the ongoing nursing shortage the country was already seeing.
“We need more medical professionals,” Johnson said.
Doing clinical simulations online, students and faculty struggled to create the same experiences of working in a true facility. The school was able to use CARES Act funds to purchase digital software the students could use at home. The students are now permitted to enter their partner facilities, except the long-term care facilities.
“We’re very thankful for that because they recognize that nurses need to be educated in live patient experiences,” Mitchell said. “I’m certain the majority of students who graduated in May, or August, and even the ones coming up in December, because they missed out on six weeks of clinical time, are going to be behind.”
The pandemic strains were also felt by the students who work in health care jobs while going to school. Mitchell said some in the cohort work as nurses’ assistants, EMTs and paramedics or LPNs (licensed practical nurses) and suddenly had to balance school work with being on the front lines.
“Many of them said, ‘I’m on mandatory overtime, on mandatory call. I can’t come to class.’ That was a big issue for that cohort of students,” Mitchell said. “I think it’s inherent in health care that you do what you need to do because that’s what you’ve been called to do. (They weren’t) running away from the fire, (they were) running into it. You saw that masses of nurses going to New York, which was the initial hot spot.”
Mitchell said two ECC graduates were among the nurses who went to New York City to help fight the virus there.
A Career in Compassion
Although the students have taken different routes to the program, they share the same goal of wanting to help people.
“I knew I wanted to be a nurse when I was 14,” said Borges, who started prerequisites after high school before taking time off to start her family and returning to college in 2018. “I always wanted to be a mom, and I think nursing and being a mother or father go hand in hand (because of) that caring aspect.”
Her dream job post graduation is in the labor and delivery unit.
Johnson, who was previously a chef at Hawthorne Inn in Labadie and a graphic designer and is a scuba diving instructor in St. Charles, went into nursing as a way to make an impact on people’s lives. He hopes to work in the emergency room and in pediatrics.
Mitchell, who is celebrating 18 years on the ECC faculty, was a nurse for 12 years at Mercy Hospital Washington, formerly St. John’s Mercy Hospital, before joining the college. She always loved nursing, but she began to realize she also loved mentoring the recent graduates joining the hospital staff. She initially joined the ECC faculty as a part-time clinical adjunct. When a full-time teaching position opened at the end of her first year, she couldn’t turn it down.
“I learned to appreciate that I could meld these two loves together, and I can be a full-time nurse educator and still see and care for patients,” Mitchell said.
Part of Mitchell’s role involves identifying students who would one day make good nurse educators and encouraging them to try it out. She calls it “growing her own,” and the strategy has placed several RNs who are ECC alums on the faculty.
She remembers fondly two of her beloved mentors — Pat O’Connor, who was the program director at ECC before moving to Washington state, and Vera Haney, who was a head nurse and worked at Mercy Hospital Washington for 31 years before moving to her hometown hospital in Hermann where she still works.
Mitchell said she tries to emulate them in her interactions with her students. Students also find mentors in the additional seven full-time faculty and eight to 10 adjunct faculty. The intentionally small class sizes mean each student has the chance to develop a close relationship with faculty.
“They’re not only there to guide you and make sure you’re doing well on academics, but they also care about students,” Borges said of the faculty.
Mantle said she can talk to her professors about anything and even had a professor call her during quarantine to talk about an assignment. Heimos said she had one instructor who asked his class every single day, “How are you guys doing?” and he genuinely wanted to hear what they had to say.
“The instructors are extremely open to help me,” Heimos said. “I’ve never found anybody there that wasn’t willing to sit down and help.”
What Comes Next
Mantle’s now lives in Union with her maternal grandmother, Pat Gabbert, who owns Pat’s Family Hair Care Center.
Mantle will graduate in May and hopes to stay in ER medicine, preferably at Mercy Hospital Washington where she said she has grown to love her coworkers.
Gabbert is supportive of Mantle’s goal to be a nurse and said her granddaughter is self-reliant and motivated.
“She does get discouraged sometimes, but she hangs in there.” Gabbert said, adding that Mantle studies late at night and early in the morning.
“I’m excited for her to finish school,” she said. “I always knew she’d be a great nurse.”