The Exec: HCA Healthcare Aims to 'Change the National Statistics' With Aggressive Nurse Education Strategy

Galen College of Nursing has multiplied its campuses nearly fourfold since HCA's acquisition 3 years ago. 

When HCA Healthcare acquired a majority stake in Galen College of Nursing, one of the nation’s largest private nursing schools, in early 2020, the nursing school consisted of a handful of campuses.

Since the HCA acquisition, Galen has expanded to 19 campuses nationwide, plus an online program, with an enrollment of some 12,000 students. The newest campus, announced in April, will open in the latter part of 2023 in Salt Lake City, Utah.

Partnerships between hospitals or health systems and schools of nursing are becoming more common as healthcare leaders search for creative ways to bolster the number of nursing students, and thus, their nursing pipeline.

Sammie Mosier, DHA, MBA, BSN, NE-BC, CMSRN, HCA’s senior vice president and chief nurse executive, spoke with HealthLeaders about the health system’s supercharged approach to educating future nurses amid a national nursing shortage.

Sammie Mosier, SVP and CNE, HCA Healthcare / Photo courtesy of HCA Healthcare

This transcript has been lightly edited for clarity and brevity.

HealthLeaders: What have been benefits of HCA’s acquisition of Galen College of Nursing?

Sammie Mosier: Not all healthcare providers can offer degree programs like we can with our nursing school. One of the obvious opportunities is to ensure that we have a Galen College of Nursing in our markets, and that does a couple of things.

It introduces a supply of nurses and so it's an opportunity for us to recruit those nursing students early. Also, we have a nurse extern program that allows our nursing students to come into the hospitals and participate in that program. It gives them hands-on experience and exposure to healthcare, which has been something we've been challenged with over the last couple of years with some of our students. They have gotten out of school, and they passed their NCLEX but they didn't necessarily get a lot of hands-on training in their programs, so this is mitigating that barrier.

We have more than 5,500 nurse externs in our hospitals and that is allowing them to get hands-on opportunities with our patients, but then it also gives them exposure to different care areas so that they’re a little more familiar with the hospital environment and they also can determine which specialty they want to go in when they graduate. So, they're interviewing us just like we're interviewing them.

HL: How has Galen grown, and in what ways, since it became part of HCA?

Mosier: We’ve more than doubled in footprint. We're currently at 17 schools [Editors’ note: Two more campuses have opened since this conversation]. When we purchased Galen, it had four campuses and, I believe, was getting ready to open a fifth, so we’ve definitely helped expand that, and that's been based on market needs.

The school has about 12,000 students enrolled. We look at that and determine how many more schools of nursing we need. We do have some expansions planned over the next three years based on the enrollments that we're seeing, so Galen definitely has not been short on gaining students in every one of our markets. They actually have exceeded enrollment expectations, which emphasizes that it's not that people are not interested in nursing; it’s that there's a barrier for them getting into nursing school, so Galen is opening that up.

NCLEX testers since 2019 in the U.S. have numbered about 149,000 to 150,000 testers each year, and as we expand Galen, that's going to put more students with the ability to test, so we'll change the national statistics as we grow this program.

HL: You referenced barriers, and one barrier is that nursing schools don’t have enough instructors. How is how is Galen doing in filling those seats?

Mosier: This is where we have a really good partnership with Galen. They have a good culture with a positive and supportive environment, so they're able to attract talent. They have created a pathway that takes nurses who are passionate about education, and they teach them how to teach. They have unique training, where they take new faculty members and do extensive individual orientation with them that lasts about 12 months. Then they have additional programs and separate tracks so that those nurses who are becoming faculty continue to move from a novice to expert just like our nurses do.

We also have benefit where together we created a program for their master's program. They have a master's in education, and they have a master's in leadership. With the master's in education, they can build their instructor gaps with that, and the master's in leadership is where my pipeline comes into play as far as directors and ACNOs and CNOs for the future. So, there’s a good partnership there.

Galen also has invested heavily in resources to establish a common curriculum and assessment, so those 17 campuses don't look different. They're able to leverage the size and scale of Galen, to be able to help support their educators.

HL: How has the pipeline benefited HCA regarding filling staffing gaps? What percentage of Galen graduates go on to work in HCA facilities?

Mosier: We’re starting to get that data now because a lot of the programs that we opened are just starting to graduate students, so we'll have better statistics in the future to report on that. We're starting to see that, and that nurse extern pipeline is helping us think about the potential conversion rate there, too.

Obviously, our goal is to get them to convert to full-time nurses. I tell everyone that it's not a short-term strategy; it’s a long-term strategy when it comes to the Galen. Within the next year, we'll really start seeing the benefit of that in the markets that opened earlier and then that will continue to build.