Nina Cox cultivates compassion.

The nursing instructor shows her students at North Side High School how to interact with people who are decades older than them and who have dementia. Cox reminds her class not to use modern slang, like bussin, a word her students often use to describe a good situation, around their residents. Learn their slang and use it to communicate, she advises.

“You have to use their words. You have to use cool and swell and peace, man — stuff like that. You can’t play your music for your residents. You have to play their music,” Cox said.

All of this goes a long way toward becoming a compassionate medical worker. That is Cox’s most important goal as she leads a new program between her employer, the James L. West Center for Dementia Care, and Fort Worth ISD. The program is aimed at building up a medical workforce that can properly navigate and care for a growing aging population in Fort Worth.

The partnership is the first between a school district and a post-acute care organization in the state, according to officials from both organizations. The partnership launched in August when the current school year kicked off. It is part of the district’s Pathways in Technology Early College High School initiative, or P-TECH, that allows students to earn a tuition-free associate degree in one of eight areas. 

In August, the school board formalized the partnership. Trustees signed off on a three-year budget of $112,074 to certify up to 75 students as nursing assistants. The program is part of the district’s effort to ensure students are ready for post-high school success.

‘A lot of possibilities’

The James L. West Center sees this specialized P-TECH program as developing the local workforce. The center has offered certified nursing assistant programs in the past, with Cox leading them. But being embedded into a high school like this is new.

Jaime Cobb-Tinsley is the vice president of dementia and caregiver education at the West Center. The specialized training students are receiving is key as dementia has become a public health crisis, Cobb-Tinsley said.

An estimated 6.5 million Americans older than 65 are living with dementia, according to the Alzheimer’s Association. That number is expected to more than double to 12.7 million by 2050. 

Cheryl Harding, president and CEO of the West Center, pointed to another pressing issue fueling the need for its partnership with Fort Worth ISD — a shortage of employees. Harding’s industry faces a lack of employees ranging from direct care all the way up to management, she said.

Caring for older people is a viable career path for young people, Harding said. This is a field that will stay around even as the economy changes. The problem, though, is they may not know much about it. The dementia P-TECH program changes that.

“Our society doesn’t always put a lot of value in caring for older adults, but those are the folks that have cared for us,” Harding said. “It’s really exciting that we’re getting to work with students so early on and give them a marketable skill. At the end of the year, they’ll be able to get a job as a (certified nursing assistant).”

That means those who finish this class could start getting real world experience working for an employer such as the West Center — all before they even earn their high school diploma.

However, students are encouraged to not stick with being a certified nurse’s aide as their future career. This is a starting point, or, as Harding puts it, the spark that ignites a newfound passion for students.

“Working with older adults is wide open. There are all kinds of jobs from administrative, finance, all the way through to the direct-care group. There’s just a lot of possibilities for folks working with senior adults,” Harding said. 

‘You have to feel something’

Students Kayla Orona, Jose Cardona and their classmates spent a recent Thursday morning learning how to make a bed, a mundane task they may not do at home sometimes but will be necessary for creating a comfortable atmosphere for their future patients. 

This is just one of many skills Kayla and Jose have been learning in the dementia care nursing class. 

The class is split into two halves. The fall semester is focused on students learning the skills they need to care for residents in a classroom setting. In the spring, they will put their skills to use at the West Center and help care for residents. Kayla, 16, is excited to help people in a few months.

“It makes you feel like I’m actually doing this. It just makes it more real for me,” she said.

Both juniors have long wanted work in the medical field. Jose’s cousin, who works in medicine, inspired him to enroll in the medical P-TECH program at North Side High School. But they have deeper reasons for why they wanted to get on the path toward becoming a certified nursing assistant.

“I’ve been interested since I was little to help people,” Jose, 17, said. “I don’t want to see them suffer. I want to help them feel better.”

The dementia-focused class is important for Kayla. She knows older people and those with dementia are sent to unfamiliar places for others to care for them. She wants to help them feel comfortable and ensure they have someone who cares for them. 

Part of how Cox ensures her students properly care for their future residents is by requiring them to try their skills on each other. Sometimes she encourages her students who are playing the resident role to be more difficult. Other times, they are easier. Students have to be prepared for whatever may happen.

Regardless, Cox’s point is that students need to clearly communicate to residents. 

“My name is Nina. I’m your (certified nursing assistant) today. May I come in?” Cox said, recalling a recent lesson.

If a resident does not answer, Cox told her students to ask again and check for any nonverbal responses, like a nod. If they do, students should tell their residents why they are there and how they will help. It all comes down to confirmation. 

“It’s a circular thing, going round and round,” Cox said. “If any of those are not properly done, the communication isn’t effective or broken.”

Kayla can feel how much Cox cares for her residents through her lessons. One commonality ties every lesson in Cox’s class — compassion.

“She always says that it’s not something that you can just learn — it’s just a quality that you have to have,” Kayla said. “You have to feel something for the person that you’re caring for.”

‘They have ambitions’

Cox had a question for her students on the first day of class: What do you want to be when you grow up? Some said they wanted to be doctors. Others wanted to be pediatricians. One wanted to be an anesthesiologist, and another said neurosurgeon.

Only four wanted to be nurses. 

This was surprising for Cox. She had previously taught classes for adults, all of whom were preparing to become nurses. But this broadness was motivating for her to learn.

“They’re going into it because they love health care, and they have ambitions in health care,” Cox said.

Kayla, a student, is unsure of what she wants to do after high school. She has narrowed her options down to two: Go straight into college or take a year off and work as a certified nursing assistant in a one-year internship then go into college.

Kayla recognizes what she is doing is unusual for a 16-year-old. At home, her step-mother also is training to be a nurse. They’re both doing the same thing, and sometimes help each other with their studies.

Cox sees Kayla, her classmates and anyone else entering the medical field as wanting to care for people. That want is beneath every job and area in medicine, she said. In fact, caring is a requirement for Cox.

“You have to care first. I can’t teach them how to care, and that’s what I told them,” Cox said. “I can only teach you how to show you care.”

Jacob Sanchez is an enterprise journalist for the Fort Worth Report. Contact him at or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Jacob SanchezEnterprise Reporter

Jacob Sanchez is an enterprise reporter for the Fort Worth Report. His work has appeared in the Temple Daily Telegram, The Texas Tribune and the Texas Observer. He is a graduate of St. Edward’s University....