FRESNO, Calif. (FOX26) — Hospital staffing shortages don’t just impact patients – they can drive up healthcare costs for taxpayers through higher public spending and insurance premiums.

Now, some hospitals are taking a different approach, training future nurses from within.

“My biggest passion and drive as to why I want to become a nurse is to help people that were once like me,” said Miranda “Lulu” Moitoso, a student at Unitek College, Community Health System.

She was adopted from China as a child, born with multiple health challenges, and spent a decade inside hospitals undergoing reconstructive surgeries.

Now, she’s preparing to give back through the same profession that once helped her.

A process with many challenges, nursing programs don’t accept a majority of applicants.

“I needed to be able to continue to provide for myself while being able to kind of step up on the career ladder,” said Moitoso.

Thanks to the partnership with Community Health System, she began working at Community Regional Medical Center in Fresno.

Through the Unitek Community partnership, students can begin the nursing program after 6 months of employment.

“It allows students to be able to work simultaneously while continuing to go to school full-time,” she said. “I started in housekeeping.”

But her path to nursing highlights a much bigger challenge facing hospitals across the Central Valley.

Mary-Ann Robson, Executive Director for Clinical Education with Community Health System, said, “The nursing shortage in the Valley, and in fact in the nation, really, is becoming more and more severe.”

She says the workforce took a major hit after the COVID-19 pandemic, with 238,000 nurses nationwide leaving the profession.

“Which is a lot of nurses to leave,” she said. “And really, what’s driving it is an aging population together with high retirement rates amongst nurses. And also burnout.”

A 2024 survey from the national nursing workforce showed that about 40% of nurses are looking to retire within the next five years.

Many qualified students face waitlists, lottery systems, and years-long delays before ever getting a seat in a nursing program.

Rochelle Garcia, Unitedk College Assistant Dean for Workforce Development at Community Regional Medical Center, says expanding education pathways is one of the most effective long-term answers.

“I had a student at our last orientation state that she’s been waiting close to ten years to get into a nursing program because of the wait and lottery systems and this is really a reality for a lot of people.”

It’s not the lack of interest in the field. It’s actually the lack of opportunity.

With nurses in high demand, hospitals aren’t just filling open positions — they’re helping train the next generation.

“We’re seeing a lot of students that are qualified, but again limited seats,” said Garcia.

When hospitals can’t fill those roles, they still have to meet strict staffing standards.

That can mean turning to temporary staffing or other costly solutions for healthcare services, hurting patient experience on-site and taxpayers in the long term.

“The more capacity we’re able to create, the more we can directly impact the nursing shortage,” said Robinson.

For Moitoso, that opportunity has already changed her future.

She graduates as part of the program’s first cohort in September.

“A lot of people here in the central valley and in general have a very hard time securing a position being a new grad nurse and that was something that was a huge plus for me was being able to secure a position after the program,” said Moitoso.

A full-circle moment for a former patient now preparing to care for others.

“All that kind of difficulty made me want to give back to others like me,” said Moitoso. I want to be the nurse that advocates for my patients.”

Hospital leaders say nursing pathways in the central valley help strengthen the community as a whole.