Growing up in El Salvador, Ana Ascencio remembers visiting hospitals and jails with her grandmother when she was a child.

โ€œThatโ€™s where I come from โ€” since I was very small, we always took time to visit the sick,โ€ she said in Spanish.

Ascencio lives in Manchester now and is training to become a Licensed Nursing Assistant. As sheโ€™s learning, she hopes to be patient and take time to help others like her grandmother Lucรญa did.

Ascencio is part of a small cohort of students studying to become Licensed Nursing Assistants at the International Institute of New England (IINE). Now in its fourth year, the free program addresses New Hampshire’s statewide nursing shortage and gives immigrants the education they need for better jobs.

Photos of LNA participants in a classroom at the International Institute of New England on Sept. 9, 2025. LAU GUZMAN / New Hampshire Public Radio

Like Asecencio, students live in Manchester but come from all over the world. They graduated from a long series of English classes, and are now tackling a whole new language: medical English. During class, they throw around phrases like โ€œmyocardial infarctionโ€ (a heart attack), โ€œorthostatic hypotensionโ€ (feeling dizzy after standing up too quickly) and โ€œepistaxisโ€ (a bloody nose).

IINE education manager Hannah Granok said the program started in 2021 as a partnership between the International Institute of New England and Manchester Community College. So far, Granok said about 50 students have graduated from the program and passed their licensing exam โ€” and theyโ€™re staying in nursing. IINE confirmed 80% of its students are still working in the field and nearly all eligible alumni renewed their LNA license.

โ€œWe thought, what a win, If we can help these English Language Learners get into this high need career and help them get these jobs that they want to be in,โ€ she said. โ€œIt’s something that’s going to help them and their families long term because these are good paying jobs.โ€

The online salary comparison tool pay scale shows annual pay for an entry-level LNA is about $30,000 and often has flexible hours.

Thatโ€™s what attracted Diana Infante. Sheโ€™s originally from the Dominican Republic and works as a cleaner and a delivery driver. But sheโ€™s training to become a Licensed Nursing Assistant for the better pay and the flexible hours that will help her spend more time with her kids.

โ€œIโ€™m a single mom and I work a lot,โ€ she said in Spanish. โ€œSo I want to have a job that lets me work fewer days earning more money.โ€

Infante went to a career fair with her classmates earlier in the semester. She said there are a lot of openings, but sheโ€™s considering either a job at a hospital or one helping autistic children. Either way, she said itโ€™s a way to help people who need it.

โ€œI prefer to deal with people, probably because theyโ€™re also vulnerable,โ€ she said in Spanish. โ€œI also went through a family situation that made me more empatheticโ€

Programs like this are in jeopardy due to federal funding cuts and a freeze on new refugee acceptance. Ascentria, the other resettlement organization in New Hampshire, laid off staff earlier this year. But IINE is expanding this program after it won a competitive $100,000 grant in March from the NH Health Force Innovation challenge

Anifa Amzati, one of the students from the latest cohort, said sheโ€™s eager to get her certification in January. Sheโ€™s originally from the Congo and wants to help people learn how to cope with trauma by becoming a psychologist. Amzati sees the LNA certification as a way to get a leg up in her career.

โ€œI have a lot of dreams to achieve,โ€ she said โ€œI think by doing LNA, that will get me closer to people. Get to know people better, get to know their stories and get to know where I can start when I start doing my psychology.โ€

As nurses retire and the stateโ€™s population ages, the New Hampshire Employment Security Office found thereโ€™s an increasing need for various nursing roles in the next decade, especially in rural areas. The office estimates turnover and demand will create about a thousand openings for LNAs every year in New Hampshire.

These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.