Nursing a Career

Dressed in plaid pants and a gray sweat shirt that says INDEPENDENT, Maryam Sindi, 19, is standing inside her old Prince William County high school, staring at a rubber mannequin and clutching a notepad. Even though she already graduated in the spring, here she is again, back at Osbourn Park Senior High School in a new class, pretending that the mannequin is a human patient, and that she is the licensed practical nurse.

"Hi, Mrs. Jones," Maryam says to the mannequin, fingering the raspberry-colored stethoscope around her neck. "I'm going to be your nurse, and I am going to be performing your exam. Do you have any questions?"

"No," says Tammy Dean, her instructor, speaking for the mannequin.

"Are you in pain?" Maryam asks.

"Not at the moment," Dean replies.

"On a scale of 1 to --" Maryam says, halting, before realizing her mistake. "Oh, I guess, I don't have to do the scale if you don't have any pain."

If all goes according to her rough plan, Maryam, who graduated from Osbourn Park near Manassas with a 4.0 grade-point average, will become a licensed practical nurse after she finishes the Prince William program and passes an exam. While working part time as an LPN, she plans to enroll in nearby George Mason University next fall. There she would earn a college degree in nursing, then become a registered nurse and eventually go abroad to do relief work for the impoverished.

In her ambitions, Maryam represents the latest breed of student participating in high school "career courses," also known by the somewhat outdated term of "vocational education." Many students continue their education beyond a high school diploma -- hence, a "Law and Action" course where future lawyers in Fairfax County can learn the difference between criminal and civil cases, and a menu of technical drawing classes for future architects in Prince William. Practical nursing students such as Maryam, who used to go straight into the workforce, are more likely to go on to earn an associate's or bachelor's degree in nursing so they can become a registered nurse, a more advanced job with higher pay and more responsibility.

"The requirements for the job market have really changed," says Kathleen Kunze, the director of the Prince William County school system's career and technical education department. "Most jobs require the equivalent of a two-year degree, something beyond high school."

Virginia is one of just a handful of states in which students can still pursue a nursing license beginning in high school. Out of 33 states that responded to a recent questionnaire from the Illinois-based nonprofit National Council of State Boards of Nursing, only 11 reported that they had practical nursing programs at public secondary schools. Many school districts are phasing out such programs because not enough of their students are passing the national licensing exam, says Dawn Kappel, NCSBN's communications and marketing director.

In the Washington region, the only high school programs are in Northern Virginia -- in Prince William, Fairfax and Loudoun counties and the city of Alexandria. Admission is by application only. (And, at least in Prince William's program, students can get kicked out if they continually get C's or lower in courses.)

High schoolers typically begin the practical nursing program as an elective during their senior year, as Maryam did. If they want to become eligible to take the national licensing exam, they must return for a postgraduate year, which is divided between lectures and working in a hospital or a nursing home. Adult career switchers also participate in the two-year program and tend to outnumber the students fresh out of high school during the second year.