Nursing and Education Combine to Create Nation’s First Nursing-Focused Charter School

Pamela McCue and Colleen Hitchings
Pamela McCue, left, and Colleen Hitchings

Rhode Island Nurses Institute Middle College developed in answer to some pressing problems: the underachievement and under-education of poor urban students and the lack of diversity — which contributes to health disparities — in nursing.

With these problems in mind, and with the support of the Rhode Island State Nurses Association and Rhode Island Department of Education, nurses and educators completely rethought and reimagined secondary education. The result? The nation’s first public high school focused exclusively on nursing and the health professions.

At a time when many educators are tweaking curriculum with an eye on college- and workforce-readiness, Rhode Island Nurses Institute Middle College (RINIMC) stands out for its bold approach. The school opened in 2011 and currently serves approximately 200 students, ages 15-20, from 19 school districts. Students enter at grade 10 and spend their first two years at RINIMC completing a challenging high school course while developing healthcare skills. During grades 12 and 12+, students take a combination of high school and college courses. Upon graduation from RINIMC, students are prepared to enter college at the sophomore level.

We recently spoke with Pamela McCue, RN, M.S., chief executive officer, and Colleen Hitchings, B.S., M.Ed., chief academic officer, to learn more about this innovative school.

Nursing and education seem like strange bedfellows. What was the thinking behind the formation of Rhode Island Nurses Institute Middle College?

Pamela McCue: The consensus in professional nursing is that a more diverse nurse force will be more culturally competent and sensitive, and help us eliminate many of the health disparities related to race and ethnicity. .At the same time, secondary education has been realizing the need to do something different in education because students from disenfranchised or impoverished backgrounds are not making it through college. The graduation rate is low, and attrition rates are very high.

So nursing and secondary education reformers came together, and said, we think we can do something different.  

The question we started with was, how do we take kids from communities in which we know that they’ve been underserved and really prepare them academically, socially, and emotionally for college?

We do that with good old-fashioned academics in a college-prep curriculum. We integrate nursing knowledge, experiential learning in hospitals and healthcare facilities in the community, and kids take college courses while they’re here with us.

Tell us about the process of going from an idea to an actual school.

Pamela: Our vision is what really brought all of us together. Once the vision and mission were clear, people bought into that. How you operationalize that is something we’ve learned as we’ve evolved over these four years.

We learned we need nursing leadership to know where we need to go and to keep that nursing healthcare vision in place. We also need education expertise and leadership to help you run and operationalize a school.

We have very unique educators who have been attracted to what we’re doing here. Colleen’s first career was as a clinical lab scientist. We have a guidance counselor who spent eight years working as a pediatric emergency nurse.

What binds us together is that the essence of nursing and of education is a holistic, comprehensive approach.

You created a unique curriculum that’s aligned to the Common Core State Standards, Next Generation Science Standards and National Education Technology Standards, with courses such as American Literature: Exploring Topics in Healthcare, Sociology: Global Health Issues and Art in Medicine. How did you craft your curriculum?

Colleen Hitchings: It took a very committed, motivated, and talented team to make this happen. A lot of time, energy and passion went into merging urban education and nursing into the curriculum.

We looked at the standards and tried to figure out how to cover the standards via nursing concepts. Then we realized we could broaden nursing into healthcare — anything that has to do with medicine, the human body, the development of human beings.

Pamela: We needed content experts in social studies, English and math, and it was a challenge for them to integrate some of the nursing and healthcare topics, because that’s not their area of expertise. So we utilized the professionals around us and my contacts and did professional development.

How else do you support student development and learning?

Colleen: We support every aspect of student development, and I think that’s one of the crucial things in our model. We support them academically. We support them behaviorally. We support them socially and emotionally. Anything that they need, we meet the individual where they are.

We have a lot of specialists on staff. We have a director of special education and a special educator on staff. We have two literacy specialists. We have a numeracy specialist. We have an ELL specialist, a social worker and health services on staff. And our guidance counselors really focus on providing social and emotional support in addition to academic guidance.

Pamela: Every kid has an individual learning plan. On that individual learning plan are what academic, social and emotional supports we’ll use with this student and what strategies work best for him or her. We bring in the student and the parents, and they contribute to the plan.

Because we’re a charter school, we’re small and we have autonomy. We have a board of directors for governance, but we don’t have all the central-office bureaucracy. If our kids need something, we can put the resources where they need to be. And if something doesn’t work, we come together as a team, brainstorm and try something different.

Have you dealt with any criticism from people who think that age 15 is too young to decide on a career path?

Colleen: We haven’t had any criticism at all; all we’ve been receiving is very positive feedback about this model of education.  But we do have some students who eventually decide they don’t want to be nurses. They may decide they want to do something else in healthcare or that they want to do something totally unrelated. We support that as well.

Our mission is to promote nursing and healthcare as much as we possibly can, but we also understand that students may find it’s not for them. We give students enough experiences to know what nursing is about so they can decide at an early age whether or not it is something they want to pursue.

Right now, there’s so much discussion within education about college and career readiness. What can other educators learn from your approach and experience?

Pamela: You need strong academics, social and emotional support, and a culture that promotes confidence, resilience, nurturing and care.

I’d been living in the world of nursing and healthcare for a long time, but when I came into education and started to really work very closely with secondary educators, I realized that there’s not much difference between nursing and education. We’ll all doing the same thing: We are focused on meeting the unique needs of others. We may use different terms, but we’re all very student-centric and patient-centric.

Colleen: It seems like this approach is natural, that this is the way education should be. But we know that the only way it can happen this way is through a lot of extremely hard work.

Jennifer L.W. Fink is a freelance writer who frequently writes about education, health and parenting. See her work at and

Learn More: Click to view related resources.