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TESS VIGELAND: The job picture in this country isn't getting a whole lot better. The unemployment rate went down in January, but in a separate survey, 20,000 jobs dropped of the nation's payrolls. We're used to hearing that a good education is a ticket to a good job. But millions of Americans are stuck in what they feel are dead-end jobs, because they can't afford a good education. But now, in a few places around the country, labor and management are working together to lift entry-level workers into skilled jobs.

Laurie Stern of American Radioworks has the story of one program in Washington state.

Laurie Stern: In suburban Seattle, Candace Picazo is a part-time housekeeper at a big hospital.

Candace Picazo: I like to have things very organized, and I'm just really kind of a, kind of a neat freak.

She starts each day in the basement laundry room arranging her cart. She picks just the right rags from a bin and folds them neatly. Three days a week, six hours a day, she'll dust, wipe, make beds and empty trash.

Picazo: Housekeeping.

Candace is 26. Her parents have factory jobs; her husband works in a restaurant. In her family, graduating high school was a big accomplishment. Until recently, Candace never thought in terms of a career.

Picazo: I started working, and I met my husband and we had our baby. And then my husband was goading me to, to get into a hospital, like, "I'd love to see you as nurse." And I'm like, "Well I guess we can try and get my foot in the door, you know at least."

So as a part-time housekeeper, Candace has her foot in the door. And in lots of hospitals it would be stuck there. The better jobs are taking care of patients, and they require skills Candace doesn't have. She could learn them at community college, but she can't afford the tuition.

Laura Chenven: In this country, we're used to thinking that everybody has a chance to make it. But we aren't always used to thinking that everybody deserves a second chance to make it as well.

That's Laura Chenven with the Healthcare Career Advancement Program, or H-CAP. H-CAP works with unions, employers and states. The partners all put up cash and bend their rules a little so that health care workers like Candace can advance in their careers.

Chenven: I think a lot of us when we get to work, we kind of grow up there. We begin to see what we do and don't want to do. You know, what do I want to be when I grow up? Don't we ask ourselves those questions all throughout our life? People need a chance to go back to school and to get that second chance.

For Candace, the second chance came about a year ago in a notice stapled to her paycheck. It said she could become a personal care assistant by taking free college classes at the union hall and doing on-the-job training where she already works.

Picazo: We go get vitals for our patients, and then pass ice water, help them wash up for breakfast, order breakfast and feed those who can't eat themselves, you know.

Hospitals have learned that it's better to promote from within, because more than a third of recruits, who come fresh from nursing school, end up quitting in the first two years. Existing staffers like Candace are a better bet, because they are used to the intensity of hospital work.

H-CAP runs programs in eight states and says the labor-management/college idea is gaining ground, despite the recession. Part of the impetus is that hospitals still need nurses. Jaime Garcia of the Washington State Hospital Association says many nurses are nearing retirement age -- just as hospitals brace for an increase in demand.

Jaime Garcia: You have the fist wave of the baby boomers beginning to retire. Well, as the boomer generation ages, people over 65 use three times the amount of health care. That's why you still see towers being built at hospitals, in spite of the recession. Because they have to get ready for the wave of people coming out.

Garcia says hospitals will get bigger and need more skilled workers, including nurses, than they can find. The hospital where Candace works is a good example. It's opening a new wing this winter.

Announcer: I would like to call Norma Sanchez.

At a party at the union hall last summer, Candace Picazo and about 80 others celebrated the end of their first year of health care training.

Announcer: And Candace Picazo.

Candace's little daughter danced in the aisle and her mother, Maria Hamshaw, sat beaming. Hamshaw never finished high school. Now, her daughter is a college student.

MARIA Hamshaw: We're just very excited for her, that she's gone through this program and succeeded. And she's doing the right kind of job for her, because she's so caring and loving and helpful and wants to help people all the time. So she's in the right field.

In September, Candace passed the certification test to become a personal care assistant. She'll be on the short list for one of eight new full-time PCA jobs to be added when the new wing opens. If she gets the job, she'll also get a hefty raise and health insurance for her family. And she'll continue taking classes towards her goal of becoming a professional nurse.

I'm Laurie Stern for Marketplace Money.