From diversityinc.com

In the fall of 2005, Alister Martin seemed the most unlikely candidate for Harvard Medical School. Laid up in the hospital with “my face so swollen my mother didn’t recognize me,” he says, the high-school senior was recovering from a brutal gang attack. The situation had escalated to a point that law enforcement advised Martin’s mother, a Haitian immigrant, to pull her son from Neptune (N.J.) High School to avoid further trouble.

So Martin’s mom secured a $15,000 loan and sent her son to the private Bollettieri Tennis Academy in Florida, where he completed his GED online while practicing 16 hours a day. Martin’s drive and unwavering desire to become a physician pointed him to Rutgers University’s Office for Diversity and Academic Success in the Sciences (ODASIS), whose Access-Med program prepares promising Black, Latino and other undergrads from underrepresented and economically disadvantaged groups for careers in medicine.

Four years later, Martin graduated from Rutgers with a 3.85 GPA and will begin Harvard Medical School this fall. “A miracle happened,” says Martin.

Each year, ODASIS serves roughly 500 at-risk undergrads, and nearly 800 of them have graduated since the program’s founding in 1985. Among the ODASIS class of 2009, 86 percent were accepted to medical school, up from 70 percent in 2007.

Still, Black, Latino and American Indian med students are rare. Three years ago, more than 40,000 people applied to medical school in the United States, with Blacks, Latinos and American Indians making up only about 15 percent of the applicant pool, reports the Association of American Medical Colleges (AAMC), while comprising about one-third of the population. That same year, only 8.7 percent of doctors were from these underrepresented groups, according to a study published in the Journal of Academic Medicine.

The latest AAMC data shows only slight improvement: Among the 42,269 med-school applicants in 2009, only 16 percent were Black, Latino or American Indian. And this disparity extends beyond the potential physician pool—a mere 6.9 percent of people from underrepresented groups ended up as dentists in 2007, only 9.9 percent were pharmacists and just 6.2 percent were registered nurses.

But it’s critical that people from underrepresented groups be recruited into healthcare and other science, technology, engineering and math (STEM) fields because it will increase the quality of care for those groups and spur innovation. Black, Latino and American Indian/Pacific Islander physicians are nearly three to four times more likely than whites to practice in underserved communities, reports the AAMC.

The dearth of diversity in all STEM professions is what inspired the launch of ODASIS. In 1986, when the initiative first began, only one Black student from Rutgers was accepted to medical school, and he eventually became a radiologist.

STEM-Enrichment Success

ODASIS is a rigorous program that offers four years of step-by-step supplemental instruction, academic enrichment and career advice designed to increase the pipeline of underrepresented talent in all STEM fields. The program is managed by Trinidad native Dr. Kamal Khan, a tireless instructor and caring mentor. He ensures that a four-year academic plan is developed for each incoming freshman so he/she stays on track and pursues the appropriate opportunities.

As a result, these students, often the first in their families to attend college, gain self-confidence. Before ODASIS, says Martin, “I never really believed in myself.”

Academic customization and an integrated-learning approach have helped make ODASIS a success. As part of the Access-Med program, for example, Khan formed collaborative relationships with local healthcare institutions to provide students with research training, professional learning and hands-on experience. Most unique to this pipeline program is the seven-month MCAT (Medical College Admission Test)/DAT (Dental Admission Test) prep course.

Khan often starts working with students who have been identified as having an interest in the sciences the summer prior to their first semester at Rutgers. To facilitate the transition for these incoming freshmen, Khan developed a five-week summer prep program to expose students to basic math and chemistry that allows them to earn college credits toward their degree. This summer, with financial support from Merck & Co., Khan and his team are working with 25 students to help hone their basic math skills “so they can hit the ground running” when they enter college.

“Students were coming in not prepared to take science courses,” he says. “They didn’t have the basic college math to take a college science course. So [we'd have] to support them in the basics. And then by the time they finished the basics, they were in their second year and would say, ‘I don’t want to take the sciences. I’m going to be here forever.’”

But thanks to the support of local organizations, the Educational Opportunity Fund Central Office and Johnson & Johnson, Khan is creating a feeder pool of potential ODASIS students by working with local students as early as ninth grade. The goal: to provide laboratory exposure, SAT-prep instruction, college-admissions counseling and career advice. This year, more than 300 12th-grade students attended the ODASIS Saturday Scholars Academy, one of four separate college-prep programs Khan oversees.

“We also do workshops with parents,” he says. “We get parents very involved.”

What motivates ODASIS students to succeed? Setting high standards and being held accountable for their actions, says Khan. “If you walk into class late or you miss a session and get three red flags, you’re out of the program,” he says. “Why so strict? If you want to be a doctor and you miss the operation, someone dies. So we try to teach them to become mature at a young age.”

In addition to their regular coursework, ODASIS students are required to attend roundtable-style academic support sessions, study halls (up to 9 hours a week for freshmen), testing, motivational workshops and more. They also meet one-on-one with advisers twice a month to review their progress.

“If you’re not doing well, they will call your family,” warns Mekeme Utuk, an ODASIS graduate who just completed her first semester at Harvard Medical School.

In exchange, the students, who often come from economically disadvantaged backgrounds, appreciate the support and opportunity. “All that I could take tutoring for, I took. I thought, ‘Why not? It can’t hurt; it’s just extra practice,’” recalls Utuk, whose parents are Nigerian immigrants.

The program also teaches undergrads how to study, critical for challenging courses such as organic chemistry. “I really didn’t know how to study. In high school, I would just cram for exams. But I didn’t know how to break down a chapter and take good notes … and learn through repetition,” says Utuk. “ODASIS made me a better thinker.”

The Nontraditional Career Resource Center encourages students to look beyond gender when choosing a career.

At a middle school in Brick Township, N.J., two eighth-graders developed a presentation that expressed the joys and hardships of their lives in immigrant families. At a high school in Marlboro, N.J., a young woman started a project to help kids in India whose parents are incarcerated. And at a school in Bergen County, N.J., a student started an intramural club for classmates who weren’t on any sports teams.  

Three projects. Three distinct visions of compassion and social justice. One common source: the Nontraditional Career Resource Center at Rutgers University.

The center, a state-funded program and part of the School of Management and Labor Relations, worked directly with those students, and others, to help them develop social-action projects.

Located in the Center for Women and Work, the NCRC’s principal mission is to raise awareness about career paths that are considered nontraditional—those jobs in which one gender comprises 25 percent of the workforce or less. The center employs a range of outreach efforts—guest speakers, workshops, partnerships with employers and educators, and programs for students in grades 7 through 12—that allows it to reach many different audiences.

“What we want people to understand is that at the heart of it all, choosing a career should not be based on your gender,” said Glenda Gracia-Rivera, associate director. “Girls may not be encouraged to go into the sciences or building trades because those are defined as male jobs. Boys may not be encouraged to become nurses or teachers because they are not considered nurturing enough.”

One of the center’s hallmark programs, the Career Summer Institute, began July 11 and brings 90 high-school students to Cook Campus at Rutgers for an intensive, one-week residential program that will focus on how to go about choosing a career. Students will learn about various careers, participate in workshops, and receive leadership training, all geared to developing their decision-making abilities. And like their predecessors, they’ll be encouraged to develop social-action projects so they can take the values they learn during the week back to their communities. The projects, which are called Step Up!, aim at addressing inequities in the students’ schools or towns.

“The kids come out super energized,” Gracia-Rivera said. “So we help them come up with an issue. We tell them, ‘you don’t have to change the world, you just have to address something at the local level.”’

Indra Murti, who attended the institute two years ago and is now a Rutgers undergraduate student, came up with a project that went far beyond the local level. During a visit to India in the summer of 2008, she became aware of a residential school for children of parents in jail or deceased. After visiting and volunteering at the school, Murti said she was moved to do more for the kids, who are supported entirely by the nuns who run the school.

Returning to Marlboro High School, she formed a student club devoted to maintaining a relationship with the school in India. The American students and the Indian students became pen pals.

“When I saw the kids (in India), and I felt their enthusiasm, it made me really want to help them,” Murti said.

Two eighth-graders in Brick Township, meanwhile, who attended the center’s program for younger students, The Academy of Leadership and Equity, came up with an idea that inspired everyone in their school. The students, one of Indian descent and the other of Mexican origin, worked with their ESL teacher, Theresa Ryan-Botello, to develop an oral presentation that expressed their hopes and fears as immigrants in America.

“They felt they were misunderstood by teachers,” Ryan-Botello said. “So our approach was: ‘Instead of complaining, let’s do something positive.’”

The presentation, “Many Worlds into One World,” told of the students’ ethnic background, examined the demographic changes in the middle school, and offered gentle tips on how to foster respect and greater communication within the school.

“They spoke from their heart, and that was really touching,” Ryan-Botello said. “Many of the teachers were in tears.”
 
All told, 10 students attending programs at the NCRC completed social-action projects, prompting the center’s staff to hold an awards dinner for the kids and their families last spring at the Labor Education Center. The students received certificates and other prizes.  

“Here are young people doing amazing things,” Gracia-Rivera said. “I felt like they needed to be honored and recognized for their efforts.”

Reprinted from Rutgers Today – RutgersToday.rutgers.edu.

11:10AM EDT October 5. 2012 -From USAtoday.com

As Baby Boomers age into retirement by the millions each year, their growing health care needs require more people to administer that care.

That makes fields such as nursing one of the fastest-growing occupations, and hospitals are hiring now to prepare for what's to come.

Central Florida Health Alliance has 140 to 170 open positions a week, and almost 90% of them are for jobs that include registered nurses, pharmacists, physical therapists and pharmacy technicians, says Holly Kolozsvary, human resources director.

The two-hospital system based in Leesburg and The Villages is hiring for its peak season from January to April, when many retirees seek winter refuge in the Florida sun. But it's also managing a trend that requires it to employ more people year-round: More retirees aren't leaving at the end of spring, Kolozsvary says.

"It's kind of a domino effect," she says. "They move here, they're well, they get sick, they're left here through their cancer or heart disease, and we have to take care of them."

Job postings on Monster.com for positions including registered nurses, physical therapists and physician assistants rose 13% from June 2011 through June 2012, according to a 2012 health occupational report by the job site.

The additional demand could be due partly to hospitals preparing for the retirements of many older nurses as the economy gets better, increasing the need for new skilled workers. Scripps Health, a group of five hospitals and 23 outpatient facilities in San Diego, plans to hire about 400 nurses a year over the next three years but might need to increase that by 200 annually because of retirements, says Vic Buzachero, senior vice president for human resources. About 30% of the hospitals' nurses are older than 50.

Jamie Malneritch applied for a part-time job as a registered nurse with Scripps in March and heard from the hospital the same day she submitted her application. She started working a month later.

The 31-year-old, who has worked as a nurse for four years, says the job security and growth opportunities were primary drivers in her decision to go to nursing school in 2006.

"It seems like we always need more hands," she says. "Nursing is flourishing."

With an average salary of $64,690 a year, according to 2010 data from the Bureau of Labor Statistics, registered nursing may be the more desired profession, but lower-paid home health aides are actually in higher demand.

An industry shift that puts more emphasis on outpatient care and home health services makes home health and personal care aides two of the fastest-growing occupations in the country. Employment in both positions, which have an average salary of about $20,000 a year, is expected to grow by about 70% by 2020, BLS data show. Registered nursing is expected to grow 26%.

ResCare HomeCare, a national provider and employer of home health and personal care aides, who work primarily with seniors with chronic illnesses or disabilities, has received 32,000 applications this year, a 23.3% jump from last year, and it hired 6,000 of the people who applied, about 5% more than in 2011, says Shelle Womble, senior director of sales.

Home health and personal care aides are generally the same, providing services such as checking vitals, prepping meals and bathing and grooming the patient. But home health aides are funded by Medicare and, in some states, require more training, while personal care aides are funded privately and may require less training, Womble says.

ResCare, where aides make $22,000 to $30,000 a year, is anticipating the need for more workers in the near future.

"Right now, one of our key positions is that we are hiring the talent before we even get the clients so we can be prepared and have the staff available," Womble says of home health and personal care aides. "There's a lot more competition for that type of employee."

Article from http://diversityinc.com

A new study by the Kaiser Family Foundation finds that in almost every state men of color continue to fare worse than white men on a variety of measures of health, healthcare access and other social determinants of health.

The report, Putting Men’s Health Care Disparities On The Map: Examining Racial and Ethnic Disparities at the State Level, documents thepersistence of disparities between white men and men of color—and among different groups within men of color—on 22 indicators of health and well-being, including rates of diseases such as AIDS, cancer, heart disease and diabetes, as well as insurance coverage and health screenings. It also documents disparities in factors that influence health and access to care such as income and education.

This new analysis provides state-level data for men of many racial and ethnic populations that have not been available before. Among the findings:

• American Indian and Alaska native men had higher rates of health and access problems than men in other racial and ethnic groups on nearly all health indicators. They also had the highest poverty rate and second worst educational attainment, unemployment rate and incarceration rate.
• More than four in 10 Latino men lacked insurance (46 percent) and a personal health care provider (49 percent), and more than a fifth (22 percent) had no doctor visit in the previous year due to cost. Latino men also had the lowest median household income, the largest wage gap compared to white men and the lowest educational status.
• Black men had much higher rates of poverty and incarceration and lower rates of high school graduation than whites. The most striking health disparity was that nationally Black men were more than seven times as likely as white men to be newly diagnosed with AIDS, with a rate of 101.5 new AIDS cases per 100,000 Blacks ages 13 and older compared with 13.5 new cases per 100,000 whites. The disparity was even larger in some states, such as Nebraska,Pennsylvania, and Maryland, where the rate of new AIDS cases was more than 10 times as high among black men compared to whites.
• Nationally, Asian American, Native Hawaiian and Pacific Islander men had the lowest rate of health problems and the fewest barriers to access of all subgroups of men, even white men.
• While white men fared better than minority men on most access and social indicators, they had higher rates of some health problems than men of color, such as higher rates of smoking and binge drinking. For example, in Wisconsin35 percent of white men reported binge drinking compared with 20 percent of minority men.
• Some of the states with the greatest access disparities between white and minority men included Connecticut, Maine, New Jersey, Rhode Island and Washington, D.C., all of which also exhibited some of the greatest disparities in income between white and minority men. Several states with relatively large Native American populations—Arizona,North Dakota and South Dakota—also had large disparities in access between white and minority men.

The full report, including detailed state-by-state data tables and related fact sheets, is available online.

A companion report released in 2009 examines similar racial and ethnic disparities among women, and includes state fact sheets and interactive data tables, also is available.

For more on decreasing disparities in healthcare, watch the video below on WellPoint’s innovative Community Ambassador Program:

From http://www.diversityinc.com

Federal healthcare law changes dramatically impact how the  industry—hospitals, health-insurance companies and pharmas—do business today. University Hospitals in Cleveland has been aggressively reaching out to the newly insured, predominantly Blacks and Latinos. University Hospital’s Case Medical Center’s Rainbow Babies & Children’s Hospital, known asUH Rainbow, is receiving a $12.8-million grant to implement a Physician Extension Team, which works to improve the healthcare of about 68,000 children on Medicaid with high rates of emergency-room visits.

Dr. Drew Hertz, medical director for UH Rainbow Care Network and an assistant clinical professor at Case Western Reserve University School of Medicine, was a guest speaker at DiversityInc’s Innovation Fest! event where he explained how this innovative program will provide 24/7 access to nurses and doctors for referrals, advice and healthcare coordination. University Hospitals is one of the 2012 DiversityInc Top 5 Hospital Systems. View the video below.

This is a great snapshot done by CareerBuilder of Diversity in the workplace.

By David Schepp

Growing demand for health services and declining productivity will result in millions more health-care jobs by the end of the decade -- regardless of how the U.S. Supreme Court rules next week on "Obamacare," a new Georgetown University report shows.

The demand for workers within the health-care industry is expected to grow by 3 million to about 13.1 million by the end of the decade, up from slightly more than 10.1 million in 2010.

Adding in "replacement jobs," those left open by retirements, deaths and resignations, Georgetown researchers forecast the number of jobs to grow nearly 30 percent to 5.6 million by 2020.

Despite legal challenges to the the president's health care reform law -- formally known as the Patient Protection and Affordable Care Act -- Georgetown researchers concluded that the law will have a "negligible" effect on the growth in the number of health care jobs.

The study's projections show that health care reform's implementation would "shift some jobs around inside health care," but lead author Anthony Carnevale says that the law's impact on employment levels is likely to be minimal simply because the sector is so big and growing so rapidly.

"It doesn't affect the industry that way," Carnevale told AOL Jobs in an interview.

Where there is likely to be an impact is among those holding or pursuing jobs as nurses.

Other findings from the report:

• Nursing is becoming an increasingly educated profession, especially among younger workers.
• People of color have been well-represented in the sector, but greater educational requirements may result in some minorities being pushed out. The study found 51 percent of white nurses under 40 have bachelor's degrees, compared to only 46 percent of Hispanics and 44 percent of African-American nurses.
• The industry has the largest number and proportion of foreign-born and foreign-trained workers in the U.S. The report finds 22 percent of health-care workers are foreign-born, compared to 13 percent of all workers nationally. Most foreign-born nurses come from the Philippines, India and China.
• White males still hold most of the high-paying jobs. The report found 81 percent of dentists are white men. Just 30 percent of doctors are female.

While most of these occupations have modest educational requirements, only 20 percent of health-care professional and technical occupations earn less than $38,000 a year, and nearly 50 percent earn more than $60,000.

By Genevieve M. Clavreul, RN, Ph.D.

By: Lanette Anderson

In nursing school, we are taught to respect the rights and dignity of all clients. As the “world becomes smaller” and individuals and societies become more mobile, we are increasingly able to interact with individuals from other cultures. Cultural competence and respect for others becomes especially important for us as nurses and patient advocates.

We all begin the process of learning the behaviors and beliefs of our culture at birth. We become assimilated into that culture, and the way that we express it is often without conscious thought. Our culture can have a definite and profound effect on how we interact with others, and also how we relate to the health care system.

Diversity is prevalent in our society and the clients and our co-workers in our health care system today clearly demonstrate that fact. The development of cultural competence first requires us to have an awareness of the fact that many belief systems exist. At times, the healthcare practices of others may seem strange or meaningless. The beliefs that others have about medical care in this country, and sometimes their aversion to it, may be difficult for us to understand. We must remember that we don’t need to understand these beliefs completely, but we do need to respect them.

Barriers to cultural sensitivity can include stereotyping, discrimination, racism, and prejudice. There are situations in which we may portray a lack of sensitivity without realizing it or intending to offend someone else. Simple steps such as addressing clients by their last name or asking how they wish to be addressed demonstrate respect. Never make assumptions about other individuals or their beliefs. Ask questions about cultural practices in a professional and thoughtful manner, if necessary. Find out what the client knows about health problems and treatments. Show respect for the client’s support group, whether it is composed of family, friends, religious leaders, etc. Understand where men and women fit in the client’s society. For example, in some cultures, the oldest male is the decision-maker for the rest of the family, even with regards to treatment decisions. Most importantly, make an effort to gain the client’s trust. This may take time, however all will benefit if this is accomplished. If the client does not speak your language, attempt to find someone who can serve as an interpreter.

Cultural competence is the ability to provide effective care for clients who come from different cultures. It requires sensitivity and effective communication, both verbally and non-verbally. As a nursing profession, we are far from representative of the populations that we serve. Members of minorities make up only a small percentage of nurses in the U.S. This number has been estimated to be as low as ten percent. The important issues of recruitment into the profession should specifically include efforts to recruit minorities and individuals from other cultures. When working with these individuals, the same principles apply as those listed above. Respect each other as a part of the health care team; we all are working towards the same goals of providing safe patient care.

Cultural sensitivity and cultural competence are an important part of the nursing care that we provide. Respect for others is discussed in our basic introductory courses in nursing school. It may have been a while since we heard how important it is in the development of an effective nurse/client relationship, but unlike some aspects of nursing, this will never change.

By TESS VIGELAND

Published: March 21, 2012

How far would you go for a financial comeback? Heading to North Dakota’s oil boom and other stories of post-recession striving.

IN 2007, Kurt Edwards figured he would be stacking and racking 80-pound boxes of dog food and celery in the back of a grocery store for the rest of his working life. And he was fine with that.

But that June, after nine years on the job, layoff notices arrived on the warehouse floor at the Farmer Jack store in Detroit where he worked. His employer, Great Atlantic and Pacific Tea Company, closed the Farmer Jack chain. Today he still does a lot of lifting, but of people, not boxes. Mr. Edwards joined the ranks of former warehouse, factory and autoworkers trading in their coveralls and job uncertainty for nurses’ scrubs.

At 49, divorced with no children, he now tends to patients on the graveyard shift at Sheffield Manor Nursing and Rehab Center, a two-story, gray brick building in a ramshackle neighborhood on Detroit’s west side. Interviewed last month, he says he is making about $70,000 annually, $20,000 more than he did at the warehouse.

The story of how he made the transition is one that men like him appear to be telling with increasing frequency, and the demand for their services is what is setting so many of them on similar paths.

Hard figures are elusive, but the Michigan Department of Energy, Labor and Economic Growth estimates a shortage of 18,000 nurses in the state by 2015 — and the labor force is adapting.

Oakland University in nearby Rochester, Mich., has established a program specifically to retrain autoworkers in nursing — about 50 a year since 2009. And the College of Nursing at Wayne State University in Detroit is enrolling a wide range of people switching to health careers, including former manufacturing workers, said Barbara Redman, its dean. “They bring age, experience and discipline,” she said.

David Pomerville brings a few more years than Mr. Edwards. A 57-year-old nursing student, he spent most of his career as an automotive vibration engineer, including almost 10 years at General Motors. His pink slip arrived in April 2009.

At the time, Mr. Pomerville was earning almost $110,000 a year at the General Motors Milford Proving Ground in Milford Township, Mich.

But having watched another round of bloodletting at G.M. three years earlier, he had already decided on nursing as his Plan B. “I thought, ‘Well, I worked on cars for this long, now I’m going to work on people for a while,’ ” he said.

A married father of two and grandfather of two, Mr. Pomerville had almost no money saved when he was laid off. But the federal Trade Readjustment Act, which aids workers who lose their jobs as a result of foreign competition, paid for nursing school tuition. His wife is a teacher, and he receives unemployment benefits. He hopes to graduate at the end of this year, and he expects his salary will be about half what he used to make.

Timothy Henk ultimately decided not to try to stick it out as long as Mr. Pomerville did. Mr. Henk, 32, worked for eight years at the Ford Sterling Axle Plant in Sterling Heights, Mich., installing drive shafts in the F-150 truck, and was making about $25 an hour by 2007. With overtime, he earned $70,000 a year.

But as he and his wife contemplated having children, he worried that income would not last. So in 2007, he took a buyout, which included $15,000 a year for four years to put toward education. Two friends in nursing — both women — had suggested he look into joining their profession. He researched the demand for nurses in Michigan and used the buyout money to pay his tuition at Wayne State.

The amount of schooling required to be a nurse depends on the level of nursing a student chooses to pursue. Mr. Henk went through Wayne State’s four-year program to obtain a bachelor of science in nursing and then took a licensing exam to become a registered nurse, or R.N. Other levels of nursing include the C.N.A., or certified nurse’s aide, which can require as little as eight weeks of training plus a certification exam, and L.P.N., or licensed practical nurse, which requires one or two years of schooling and a licensing exam.

All of that assumes acceptance in a nursing program. The American Association of Colleges of Nursing said more than 67,000 applicants were turned away in 2010 for lack of faculty or classroom space — not a good sign with a national nursing shortage projected to be as high as 500,000 by 2025.

Mr. Henk now works in the critical care unit at Beaumont Hospital in Royal Oak, Mich. He makes about $50,000 annually for a 36-hour workweek, though Ford’s health insurance was better.

The choice to make this switch was probably least likely for Mr. Edwards, the former grocery worker. He dropped out of college and spent four years in the Army as a paratrooper with the 82nd Airborne Division. He found his unionized warehouse job after a stint working for his father, an accountant.

“You have this plan, this goal,” he said. “I was going to be at this warehouse; all the guys were retiring with great benefits. I was part of the middle class, and I was going to make it.”

When it became clear that he would not make it to retirement there, someone he was dating suggested nursing.

Though he wrote it off as woman’s work at first, he realized he was getting a bit old for manual labor. So he returned to school, living on unemployment checks and occasional groceries from by his mother. He spent the last four months of his L.P.N. training with no electricity because he could not afford to pay any bills except rent.

Once he finished, the Sheffield Manor administrator, LaKeshia Bell, pretty much hired him on the spot. “They are like a hot commodity,” she said. “A male presence actually helps us in the facility.” At 5 feet 9 inches tall and 220 pounds, Mr. Edwards lifts patients as easily as he stacked boxes.

But he still appears to be a rarity. Just 7 percent of employed registered nurses are men, according to a 2008 Department of Health and Human Services survey. It did not count licensed practical nurses. Still, the percentage of people certified in nursing in some way who are men has risen to 9.6 percent since 2000 from 6.2 percent before, according to the department.

Ms. Bell noted that new nurses coming from manufacturing had unusual adjustments to make. When dealing with parts on the factory floor, she said, repetition is a major part of the job. “These are not parts. They’re people, so you can’t just have a set regimen like in a plant setting,” she said.

That cultural shift goes both ways. Mr. Edwards’s supervisor, Yvonne Gipson, provided an example. “I mean Kurt is not an ugly man, O.K.?” she said. “You got all these female workers, and they’re all looking at him like, ‘Oh! Potential husband!’ So, yes, it does change.” Her voice trailed off, erupting into peals of laughter as Mr. Edwards slipped a $20 bill into her pocket.

While these success stories point to opportunity, Michigan’s unemployment rate is still 9 percent. And Nelson Lichtenstein, director of the Center for the Study of Work, Labor and Democracy at the University of California, Santa Barbara, says history is a cruel taskmaster when it comes to struggling industries.

“When one industry goes in decline and another comes to the fore, you don’t have a one-to-one employment replacement at all,” he said. “It takes a decade, two decades. In the meantime, some people find their careers are ended, ruined, and they never get them back.”

For these new nurses, the advantage is the demand in Michigan. Mr. Edwards knows he is lucky. “You know I wake up every day and I’m very proud,” he said. “I’m looking in the mirror. I’m happy. I’m proud. I’m saying, you know, this turned out great. The lights are on!”