A Step in the Right Direction

The patient had a rehab bed waiting. He just couldn't get to it. To qualify for the transfer, he needed to walk 400 feet on his own. After days in bed on a medical-surgical unit at Christiana Hospital, that distance might as well have been a mile. Then Natalee Lynam arrived on his floor. Natalee, a senior at Hodgson Vo-Tech, is one of ChristianaCare's first "mobility interns" — high school students from local vocational-technical schools who spend a paid co-op year on medical and surgical units, walking with patients to help them regain strength and get home sooner. The job is purposefully narrow, and clinically meaningful. "Physical therapists come by and do most of the work, but they're only there for about 20 or 30 minutes," Lynam said. "We're an opportunity for a patient to walk an extra one or two times a day." Over the course of several shifts, she and her intern partner kept their patient moving. At the end of one of those shifts, she got to see him leave for rehab.

The Mobility Intern Program — believed to be the only one of its kind in the tri-state region — launched at Christiana Hospital in July 2025 and expanded to Wilmington Hospital in November. Nurse leaders saw a clinical gap that nurses and patient care technicians know well: even brief stretches of bed rest can take a measurable toll on a patient's function. "You'd be amazed at how much function is lost," said John Dickerson, MSN, RN, CVN, BC, the nurse manager who oversees the program through ChristianaCare's nurse float pool. "As little as 6 to 12 hours on bed rest, and a patient may not be able to do what they did before coming to the hospital."

Nurses and patient care technicians strive to get patients out of bed and on their feet as often as possible, but a busy med-surg unit doesn't always allow it. Physical therapy, when ordered, focuses on targeted recovery rather than sustained walking throughout the day. The mobility interns fill the space in between. The 16 students who started at Christiana Hospital were assigned to four medical units in pairs. They arrive at 1 p.m. and clock out at 8 p.m. Each shift, they receive a list of that unit's patients along with their Johns Hopkins Highest Level of Mobility scores, a clinical tool that rates a patient's functional ability. The interns focus on patients scoring in the higher range — those most likely to benefit from additional walking. Before approaching any patient, they check in with the bedside nurse. Every walk is documented in the medical record. "It's part of a larger system-wide effort to improve mobility for our patients," Dickerson said. "Every extra set of hands matters."

The clinical impact is half of the story. The other half is a workforce strategy that begins before students even graduate from high school.

ChristianaCare's co-op partnership with New Castle County Vo-Tech is in its fourth year. Hodgson Vo-Tech, Delcastle, Howard and St. Georges all feed students into the system through certified nursing assistant, medical assisting and physical therapy aide programs that include paid clinical hours, a major draw for vo-tech students choosing a senior-year placement.

The mobility internship marked a new step in that partnership: the first time vo-tech students were brought into a paid, direct patient-care role inside the hospital. Barbara Feeny, MSN, NPD-BC, RN-BC, HN-BC, nursing professional development manager, helped lead the work to make that happen. She worked closely with Kamela Smith, M.Ed., director of workforce partnerships and engagement, who spent years building the co-op relationship that brought Hodgson Vo-Tech into the ChristianaCare fold.

"We understood that exposure equals expansion, and opportunity changes lives," Smith said. "It helps shift future trajectories, opens doors of possibility and addresses disparities for our scholars." Across all co-op programs, more than two of three students stay with ChristianaCare after graduation, said Dean Byong Yoo, the workforce partnerships and engagement specialist who facilitates the co-op and serves as liaison with the schools.

The mobility internship is on track to build on that record. Of the 32 interns hired across the first two cohorts, several have accepted patient care technician positions at ChristianaCare following their high school graduation in June. They will continue working while pursuing nursing, physical therapy and other healthcare degrees at colleges across the region. "There's so much value in starting with someone this early in their career," Yoo said. "We teach them our values, our behaviors and 'The ChristianaCare Way' from day one." For Lynam, that means continuing part-time on her floor while she begins a pre-physician assistant program at the University of Delaware this fall, working toward becoming an orthopedic surgical physician assistant. Other interns are heading to West Chester University, Delaware State University and Neumann University to pursue nursing, athletic training and kinesiology.

For Lynam and her intern partner, Jasalyn Lopez, the appeal of the hospital was the variety. Many of their Hodgson classmates were placed in outpatient settings, where the work tends to look similar from day to day. "In the hospital, you see everything — any kind of patient, any kind of condition," Lopez said. "People are here for serious issues, and you get to be part of helping them through it."

Lynam said the unit functions like an extension of the classroom — sometimes a better one. "The nurses and the techs are so willing to share with you. Nurses will start explaining things to me and I didn't even have to ask, because they know that I'm a student," she said. "Our physical therapy teacher was a nurse here for 13 years, and she always told us, 'You're going to learn more on the floor than you ever will in the classroom.' That's been proven to us."

Yoo said the transformation is visible across the cohort. Students who were too nervous to find parking on day one now move through the hospital like longtime caregivers. "The confidence, the pride — it's day and night," Yoo said. "They walk these halls like they belong here, because they do."

Patients have noticed too. The interns describe regulars who ask, "Are you coming tomorrow?" At least one wrote down a student's name in hopes of being cared for by her one day. On the units, nurses and patient care technicians have welcomed the additional support, and the energy of younger caregivers joining the team has been, as Yoo put it, "a breath of fresh air."

Forty mobility intern positions have been approved for the 2026-2027 school year, with Christiana and Wilmington Hospitals starting at the same time in July to give both cohorts a full school year together. Union Hospital joins the program this summer. "Programs like this show what is possible when community partners come together," Feeny said. "By opening doors for students and investing in workforce development, we are strengthening patient care today and shaping Delaware's future healthcare workforce."