25 and Counting
“In 1975, the world was a very different place,” Carmen Portillo, PhD, RN, FAAN, immediate past president of the National Association of Hispanic Nurses, told NAHN members at the opening ceremony of the association’s 25th Annual Conference last summer. “The war in Vietnam finally ended; the International Women’s Year Conference adopted a 10-year plan to improve the status of women. Congress repealed the Taft-Hartley Act, giving nurses the right to collective bargaining. In 1975, the world held 4 billion people—but no personal computers and no cell phones. The world had not yet heard about AIDS.”
Back then, the world was also a dramatically different place for Hispanic nurses. There were very few nurses of Hispanic origin in the nursing work force—even though the nation’s Hispanic population was growing rapidly. With very few exceptions—most notably, Ildaura Murillo-Rohde, PhD, RN, FAAN—there were virtually no Hispanic nurses working in academic settings, doing research on Hispanic health issues or advising federal policy-makers about the health care needs of Hispanic people.
What’s more, back in 1975 there was no national organization serving the professional and leadership development needs of Hispanic nurses. There was no unified voice to speak up in advocacy for the unique cultural concerns of Hispanic nurses and the communities they served.
“I began to realize that something had to be done about this,” recalls Murillo-Rohde, dean emeritus and professor emeritus at SUNY Brooklyn. “I saw that I was the only Hispanic nurse who was going to Washington to work with the federal government, review research and education grants, etc. There was nobody else. I looked behind me and thought: ‘Where are my people?’”
This determination to “do something” to increase the representation of Latinos in the nursing profession led Murillo-Rohde to create the organization known today as the National Association of Hispanic Nurses. Last year, NAHN proudly celebrated its 25th birthday as the nation’s voice for Hispanic nurses and Hispanic health. With more than 30 local chapters across the United States and in Puerto Rico, NAHN currently represents the interests of more than 40,000 Hispanic nurses coast to coast.
Today, at the start of the 21st century and the new millennium, America’s Hispanic population is growing faster than the U.S. population as a whole, creating a huge and urgent demand for more Hispanic nurses who can meet this underserved ethnic group’s need for culturally and linguistically competent care. In light of this, NAHN’s original mission statement seems even more relevant today than it was a quarter century ago:
• To serve the nursing and health care delivery needs of the Hispanic community and the professional needs of Hispanic nurses;
• To work toward improvement of the quality of health and nursing care for Hispanic consumers; and
• To provide equal access to educational, professional and economic opportunities for Hispanic nurses.
Like the National Black Nurses Association, NAHN began as an ad hoc minority nurse committee within the American Nurses Association that eventually broke away to go solo. “We felt that we really didn’t have a place within ANA,” explains NAHN’s 1984-1988 President, Henrietta Villaescusa, RN, FAAN. “We had special issues and problems that we felt were unique to Hispanic nurses and were not being addressed. We needed to be accepted as part of the nursing profession; we needed people to understand that Hispanic patients had special cultural needs.”
Adds Mary Lou de Leon Siantz, PhD, RN, FAAN, a founding member of NAHN who is now the association’s current president, “In 1975, many of us were feeling isolated. There were so few Hispanic nurses in the country—and, especially, very, very few in academia. There was little available in terms of mentorship and networking with other Hispanic nurses. Back then, it was a time when ‘minority’ wasn’t a buzzword and the isolation was very acute.”
Following the 1975 ANA annual conference, a group of about 15 nurses, led by Murillo-Rohde, received approval to form a completely new association devoted exclusively to serving the needs of Hispanic nurses. Originally called the National Association of Spanish-Speaking/Spanish-Surnamed Nurses, the fledgling association met in New York City in space donated by the New York State Nurses Association. In 1979, the group was renamed the National Association of Hispanic Nurses and is now headquartered in Washington, D.C.
As the association’s first president (serving from 1977 to 1980), Murillo-Rohde continued to be the driving force behind NAHN in its early years, even using her own money to fund the organization’s growth. “That was because there was no money to do anything,” she says. “For the first four years, I was the chief cook and bottle washer for NAHN. I promoted the association, I put out the newsletter, I did everything.”
Triumphs and Challenges
The National Association of Hispanic Nurses today is a very different organization than it was in its infancy and toddler days. Since the formation of the group’s first local chapter in New York in 1983, the aggressive development of a network of NAHN chapters throughout the country has fueled steady membership growth. It has also provided opportunities for many other Hispanic nurses to serve in leadership roles in the association. “It has been the chapters, working with the communities and the nurses, that have shaped the growth of NAHN,” Murillo-Rohde asserts.
While the association has evolved tremendously since 1975, Antonia Villarruel, PhD, RN, FAAN, the group’s 1996-1998 president, believes NAHN’s fundamental goals have not changed. “We continue to be advocates for Hispanic communities and Hispanic nurses,” she says. “We believe Hispanic nurses can provide unique leadership in the nursing profession, because of our bilingual, bicultural skills. I think we have become more savvy and more powerful as our membership has grown and we continue to attract Hispanic nurse leaders.”
Identifying barriers to quality education for Hispanic nursing students and working toward recruitment and retention of Hispanic students in nursing education continue to be high-priority goals on NAHN’s agenda. Says Portillo, “Given that Hispanic high school students have such a high drop-out rate, we are already at a disadvantage. Those who do make it into nursing school often do not have the appropriate tools to be successful academically. They may drop out or will not pursue higher educational degrees. The majority of our nurses are prepared at the associate-degree level.”
While NAHN’s membership outreach has helped make inroads in increasing the number of Hispanic nurses in the RN population, “the recruitment and retention challenges have been constant as well as the growth,” Villarruel feels. “I think it’s a crime that Hispanic nurses still account for only 1.6% of the nurse work force. People will play games with the numbers and say there’s been an increase, but the fact is, the number of Hispanic nurses has not grown proportionately to meet the health needs of our people.”
In the National Spotlight
Ask the association’s founders and leaders what NAHN accomplishments they’re most proud of after 25 years and you get many different answers. For Founder Emeritus Murillo-Rohde, it is NAHN’s success in encouraging Hispanic nurses to move beyond associate-level education and earn advanced degrees.
“High school counselors would try to railroad Hispanic students into the AD nursing programs,” she explains. “I’m proud of the fact that we’ve been able to push more of our nurses on to earn doctoral degrees. We now have a number of Hispanic doctoral nurses who are very good at research and have been recognized worldwide for their studies. For example, Mary Lou de Leon Siantz has done work with Mexican migrant families that was truly ground-breaking.”
Portillo is excited about the fact that “in the last 10 years, NAHN has really risen to a different level—one of national recognition as well as local recognition. There has been great enthusiasm from people who see the need for this organization—including nursing schools, private industry and community health organizations—because they see our members as the connection to the Hispanic community they need to serve.”
Much of this national recognition is due to NAHN’s efforts to bring more Hispanic nurses to the federal health care policy-making table, an achievement Villarruel is particularly proud of. “We now have Hispanic nurse representation on important government boards, such as the Division of Nursing and the National Institute of Nursing Research,” she points out. “I think we’ve been instrumental in moving the agenda for [Hispanic] nursing forward, and in that sense, moving our community forward.”
The association regularly submits the names of Hispanic nurse leaders when positions open up on health policy committees, according to NAHN Vice President Rose Gonzalez, RN, MPS, who chaired the group’s Policy Committee for the last four years. “For instance, Carmen Portillo was appointed to serve on the NINR’s national advisory committee,” she says. “Prior to that, Mary Lou de Leon Siantz served on that committee. Patricia Montoya [RN, MPA], commissioner of the Administration on Children, Youth and Families, is a long-time NAHN member. We sent a letter of recommendation on her behalf for that position, along with the ANA.”
For Siantz, the association’s most worthwhile accomplishment is the creation of a vital and growing national network of Hispanic nurses, eliminating the isolation that existed in the past. “Hispanic nurses need to communicate with each other,” she emphasizes. “Through our networks, Hispanic nurses have their hands on the pulse of the Hispanic community. This enables us to give national, regional and community leaders the message that they need to work with us, because we know about Hispanic people’s health needs more than anybody else does.”
Building Future Leaders
By the year 2050, Hispanics are projected to become the nation’s largest minority group, comprising nearly a quarter of the U.S. population. Will the nursing profession be able to provide enough Hispanic nurses to meet this exploding need for culturally sensitive care? With this challenge at the top of its agenda, the National Association of Hispanic Nurses plans to be a very busy organization as it gears up for its next 25 years.
“We have done a lot but we need to do more,” Murillo-Rohde believes. “We want to continue to increase our membership. As I travel, I still hear Hispanic nurses saying, ‘I didn’t know that we had [an organization like NAHN].’”
Siantz would like to see NAHN representing 100,000 Hispanic nurses in the United States and Puerto Rico by the year 2025. “One thing we’ll be focusing on during my presidency is expanding the student portion of our membership. As the association grows, I’d also like to see us have the capacity to reach out and mentor Hispanic boys and girls who are interested in health care careers.”
But the ultimate goal, NAHN’s president emphasizes, is to continue Murillo-Rohde’s legacy of not just increasing the number of Hispanic nurses but also developing more Hispanic nurse leaders. “NAHN has established a venue for developing Hispanic nursing leadership that simply didn’t exist 25 years ago,” Siantz says. “One of our key strengths is the ability to mentor—in government, academic and community settings. I want NAHN to continue that mentorship with the new students who are coming in. We now have the wherewithal to help Hispanic nurses develop their careers in whatever direction they want.”
How Much Do You Know About Hispanic Nurses?
Test your knowledge with this quiz:
1. How many Hispanic nurses are currently practicing as RNs in the United States?
2. Today more than 10% of the total U.S. population is Hispanic and that figure is expected to rise to at least 22% by 2050. What percentage of the current RN population is Hispanic?
3. True or False: Hispanic nurses are older on average than other RNs.
4. Where in the U.S. would you find the greatest number of Hispanic nurses?
5. True or False: Hispanic nurses are more likely to enter their nursing careers through associate degree programs than nurses of other ethnic/racial backgrounds.
6. What percentage of Hispanic nurses hold advanced degrees (master’s or doctoral level)? How does this compare with nurses from other ethnic/racial backgrounds?
Answers to Hispanic Nurses Quiz
1. As of March 1996*, approximately 40,600 of the 2,559,000 individuals with current licenses to practice as registered nurses in the U.S. were of Hispanic background.
2. Although Hispanics account for more than 10% of our nation’s population, less than 2% of the RN population is Hispanic. You do the math.
3. False. The average age of Hispanic nurses is 41.1 years, compared to 44.3 years for the RN population as a whole.
4. Seventy-five percent of the Hispanic nurse population is located in the western and southern regions of the U.S.—specifically, 38% in the West and 37% in the South.
5. True. As of March 1996, about 53% of Hispanic nurses entered the profession through associate degree programs, compared to about 37% of the RN population as a whole.
6. About 7% of Hispanic nurses hold master’s or doctoral degrees, compared to about 10% of Caucasian nurses and 12% of African-American nurses.
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