Immigrants and refugees now account for nearly 1 in 5 workers (18.1%) in the U.S. In a moment of seemingly endemic labor shortages that have left companies struggling to fill nearly 4 million job openings, this growing segment of the workforce holds profound and often untapped potential. Making good on that potential can be a challenge when just 4% of adult English language learners have access to the instruction they need to fulfill their career aspirations.
Like many health systems across the country, Atrium Health is grappling with critical staffing shortages. In response, we are reimagining how we invest in often overlooked talent pools, including our front-line staff, many of whom are immigrants, refugees and speakers of other languages. Atrium Health is the third-largest nonprofit health system in the country — and we’ve now joined other major companies like Amazon and Walmart in offering industry-aligned “English upskilling” to equip adult learners with the language skills they need to connect with careers in high-demand fields in health care and beyond.
Here are three ways English language instruction is helping expand the health worker talent pool and build a more representative, inclusive workforce.
Addressing Staffing Shortages
The worker shortage is hitting health care especially hard. Hospitals, doctor’s offices and other providers are struggling to find qualified workers to fill critical positions, from physicians to registered nurses to surgical technicians. By 2033, the state of North Carolina, where Atrium Health is headquartered, is projected to be short 12,500 nurses. One study predicts the United States will be short 450,000 nurses in just the next two years. Study after study confirms that fully staffed health workforces are linked to improved patient outcomes.
That’s why at Atrium Health, we are working to hire 20,000 workers by 2025. To reach this ambitious goal, we are proactively connecting with previously overlooked pools of talent, including health workers from immigrant and refugee backgrounds. This has meant increasing outreach and going to greater lengths to advertise our training programs. It has meant more than doubling our minimum wage in recent years. It has also meant providing workers with the right kinds of training needed to succeed in their new roles. Importantly, that includes English language instruction.
As nearly 1 in 10 working-age adults in the U.S. are considered limited-English proficient, English language instruction is becoming one of the most crucial upskilling opportunities a workplace can provide.
Building a Multilingual, Culturally Competent Workforce
Very few health care workers are multilingual, with surveys suggesting less than 10% of providers are specifically seeking to train and hire employees who speak languages other than English. With the linguistic diversity of the United States rapidly increasing, the need for building a multilingual workforce is urgent. North Carolina’s Spanish-speaking population, for example, has grown from 40,000 to 800,000 in four decades.
Language barriers result in low patient satisfaction, poor health outcomes, longer hospital stays and more medical errors — and language dissonance is often compounded by limited cross-cultural competence, restricting providers’ ability to understand and address cultural and religious perspectives on medications, diet, gender roles and more. One study found that language and cultural discordance greatly hinders nurses’ ability to provide “adequate, appropriate, effective and timely care.” While many providers do have access to medical interpreters, research has unfortunately shown translation is only a partial solution to delivering linguistically and culturally appropriate care.
By hiring more speakers of other languages from the outset and providing them with personalized, context-based English language instruction, we are creating a health care workforce that can better address the linguistic and cultural needs of the people we serve. It’s an approach other sectors would do well to consider, as well.
Promoting and Advancing Careers
Connecting our employees with opportunities for English upskilling doesn’t just benefit Atrium Health’s business bottom line, it also advances the careers and economic mobility of our workers and their communities. About 2 million college-educated immigrants and refugees are unemployed or underemployed, the result of multiple systemic factors, including English barriers. Adults who are still learning English earn as much as 40% less than their workers who speak the language proficiently.
We’re committed to closing this wage gap by offering an online, on-demand, English upskilling platform to staff our 40-hospital system and hundreds of additional care sites. Career-aligned courses like “English for Certified Nursing Assistants” and “English for Patient Care and Support” connect learners with language and job skills to help them advance to high-demand roles. While Atrium Health lends laptops and iPads to its workers to help with any technology gaps, the program can also be easily done on a smartphone.
Research shows that contextualized English language instruction is associated with job promotion and increased wages, making career-aligned English upskilling a sound investment into health care and beyond.
Offering English language instruction as an upskilling opportunity available to our workers is transforming how we hire talent, interact with our patients and serve our communities. At a time when 20% of the country’s workforce are now immigrants, it’s a strategy that could serve as a blueprint for other workforce leaders looking to address staffing challenges, while creating more equitable career outcomes for all who now call this country home.