Equality First

Erma Willis-Alford, BSN, RN, is quick to say that her experience as the first African American nurse at Memorial Hospital of Southern Oklahoma is “no Rosa Parks story.”

Unlike the late Parks, who became a symbol of courage in the civil rights era for refusing to give up her seat on a Montgomery, Ala., bus to a white man, the 61-year-old nurse says she experienced little prejudice from colleagues and patients when she joined the Ardmore, Okla., hospital in 1966.

Her story, instead, could more aptly be described as the heart-warming tale of an African American woman embraced by a hospital and city seeking to bring about peaceful integration. Anyone who remembers or has studied the 1960s civil rights struggle will remember that integration often occurred only after overcoming violent resistance.

Willis-Alford says her story is quite the opposite. She wasn’t trying to make a statement or become a civil rights pioneer when she applied for a position at the hospital that now goes by the name of Mercy Memorial Health Center. She just wanted a job. She had become impressed with the hospital after visiting a sick cousin who was a patient there. To a small-town girl from Pauls Valley, Okla., the four-story building looked like a gleaming tower dedicated to modern medicine.

Compared with the one-story hospital in Pauls Valley, a city that to this day has a population of only 9,152 people, the Ardmore facility looked like a skyscraper, Willis-Alford remembers. The well-dressed staff appeared so efficient and professional that she yearned to be a part of it all. So she decided to apply for a job there, “not knowing that they did not have a black nurse and had never had a black nurse on the staff.”

“A Beautiful Experience”

Willis-Alford’s interest in nursing started at a young age and seemed quite natural for someone in her family. Her great-great grandmothers and their sisters had all been midwives and her father worked as a scrub tech in a hospital operating room. She began her formal training as a teenager in 1964, when she enrolled in a first aid class. A year later she took a class to become a nurse’s aide and that same year began work at the Pauls Valley State School, a facility for children born with deformities.

Willis-Alford, who says she has worked in every type of nursing except the operating room, isn’t sure what the administration at Memorial Hospital of Southern Oklahoma had on its mind when they hired her. If there was some plan to integrate the hospital and use her as the guinea pig, they never told her. And they didn’t parade her through the facility as some sort of symbol of brotherly love.

They just put her to work, placing her with two other nurse’s aides who taught her the ropes. Later, when she became a nurse, the floor nurses took her under their wings and trained her so she could work on any floor.

“It was a beautiful experience,” she recalls. “I’m sure there must have been some racism, but it wasn’t blatant. I didn’t see it. I was so eager to work and make a good salary.” She had three children at the time (and would eventually give birth to another) and didn’t have time to worry about what people were saying. “I was more concerned about doing my job, doing what the head nurse asked me to do and doing exactly what the physicians wanted,” she explains.

The hospital staff went out of its way to make her feel included, she adds, and she, in turn, went out of her way to get to know people. Although she didn’t drink coffee or smoke, she willingly joined her colleagues on coffee or smoking breaks because it gave her a chance to get to know them on a personal level. “I would stand there and inhale their second-hand smoke and enjoyed every bit of it,” she laughs.

Willis-Alford, who eventually became supervisor of the hospital’s emergency department, says she never received “the dirty end of the stick.” She was expected to do the same work as any other nurse and never felt she was given more work than others.

Community Support

Memorial Hospital deserves much of the credit for Willis-Alford’s career progression from nurse’s aide to licensed vocational nurse and, eventually, to registered nurse. The hospital paid for her to attend a 12-month LVN program at Southern Oklahoma Technology Center in Ardmore. When she graduated in 1968, she became the second African American to complete that particular program, which had been established two years earlier. She received her LVN license in 1968.

Three years later, the hospital again provided financial support that enabled her to continue her professional education. They paid for her to attend a two-year RN program at nearby Murray State College. She became the first African-American to graduate from that program, which was also in its second year. But she would not have achieved that milestone if the Ardmore community hadn’t stepped up to help her during a time of family crisis.

In 1973, an accident left her young daughter severely burned and facing months of recuperation and reconstructive surgery. Willis-Alford’s instinct was to quit school and care for her, and she would have done that had it not been for the wives of Ardmore’s Shriners, who offered to tend to her daughter while she attended school each day.

“[They] told me, ‘Go on to school, you get your lessons and learn to be a nurse,’” she says. Later, when she and her daughter traveled to Galveston, Texas, for reconstructive surgeries, two Ardmore physicians offered to let her son stay with them until she returned.

The Shriners’ wives and the physicians were all white. “They’re just that way,” she says, explaining why people went out of their way to help. “They wanted to do the right thing.”

Oil discovered more than a century ago had brought wealth to Ardmore residents, and that wealth bought more than just the stately mansions that still stand along the city’s Sunset Boulevard. It also helped fund five major foundations and endowments that have brought high standards of excellence in medicine, academics and the arts to Ardmore.

Perhaps the fact that the city operated, at least to some degree, on a “higher plane” led Memorial Hospital to integrate so easily and to support Willis-Alford’s aspirations to become a nurse. Or maybe the hospital simply valued her work. “I was told that I gave excellent care,” she says. “I pride myself on doing the right thing for my patients.”

At first, some of the older patients had trouble adjusting to having an African American nurse care for them. Willis-Alford says some used what she calls “the ‘N’ word” to refer to her. She didn’t like the word then any more than she does now.

“But I did not take it out on them, because that’s how they were raised,” she says. “They didn’t know any better. Why would I fight with someone who was ill? You don’t do that. But eventually they would say, ‘Have the black girl come in’ [because I provided such good care].”

Another major step forward took place a short time after Willis-Alford’s arrival at the hospital. Until then, the patients had always been segregated, and minority patients were sometimes placed in hallways and treatment rooms. Suddenly, the hospital staff started placing patients in rooms without regard to race. In a subtle way, her presence was again making a difference.

Encouraging Others

Erma Willis-Alford paved the path for other nurses of color in Oklahoma to follow. Although she was the only black RN in Ardmore for 15 years, other African Americans were hired by Memorial Hospital to work as nurse’s aides and LVNs.

“I think my presence and the road I took stimulated others to want to do the same things,” she says.

Eventually, more African American RNs began working in Ardmore. Willis-Alford estimates that approximately 15 black RNs work in the city today. More are needed, she says, adding that she hopes more African American men and women will enter the profession.

“We do need more and more and more [minority nurses], because sometimes [minority patients are able to relate better to caregivers who share their race or ethnicity],” she says. “Sometimes another person of their race may be able to get them to speak up and explain the problems that they have.”

Why are African Americans and other people of color still so underrepresented in nursing? Willis-Alford believes that sometimes the barriers to progress come from inside rather than from others.

“I think a lot of it has to do with self-determination and controlling your own environment,” she explains. For example, some minority students look at the rigorous coursework needed to become a nurse and red flags of self-doubt pop up. She feels it is crucial for parents and educators to work together to encourage and prepare young people of color to pursue health care careers–for example, by making sure they take science and math classes from an early age. “By the time they are ready to graduate from high school, it is too late to begin to take those classes,” she asserts. “[For students who don’t have that preparation,] college will be an uphill struggle.”

She speaks highly of a national training initiative called the Area Health Education Center (AHEC) program, designed for underrepresented and disadvantaged students from underserved urban and rural areas who are in the seventh grade and higher. The federally funded program, established in 1971, enables students to shadow someone who works in the health care field. AHEC also hosts a summer camp that allows students to gain hands-on experience in health care-related activities.

Still Spreading the Message

Willis-Alford eventually left Memorial Hospital in the 1980s for a better-paying job at Presbyterian Hospital in Oklahoma City, where she worked on the cancer floor. She became certified in chemotherapy and worked with bone marrow transplant patients.

She is now semi-retired, although it’s hard to tell. She lectures once a month at the Ardmore Senior Citizens Center, serves on various boards, reviews grants for the federal government, helps organize health fairs and works in youth camps each summer. In November 2003, she was part of a U.S. medical delegation that traveled to Cuba through the People to People Ambassador Program, an international exchange program established by President Dwight D. Eisenhower in 1956.

Willis-Alford is also involved in many preventive education activities aimed at fighting health disparities in the African American community. She provides information on diabetes, chronic kidney disease, cardiovascular disease, cancer, obesity and HIV/AIDS. Some of this information isn’t readily available at community health clinics, she says.

“Certain chronic diseases may not be prevented, but they can certainly be delayed,” she emphasizes. “That is the message I try to get out. People should not wait for signs and symptoms to appear before they seek medical help. We are now in the era of prevention.”

Not surprisingly, three of Willis-Alford’s four children work in the health care field–her youngest daughter became an RN exactly 20 years after she did–and one of her 12 grandchildren is studying to become a physician. These days, she says she can’t maintain the pace she did years ago and has no interest in working the “long hauls” that one has to endure as a floor nurse. But that doesn’t mean she plans on retiring to her rocking chair any time soon.

Her next major goal is to earn a graduate degree, preferably a doctorate in health education and leadership. She’s considering schools in Oklahoma City and Denton, Texas, that offer doctorates with classes structured in such a way that she won’t have to attend school five days a week.

This remarkable nurse may not be the Oklahoma equivalent of Rosa Parks, who died in October 2005 at the age of 92. But when the history of Ardmore, Okla., is written, there will no doubt be a page devoted to Erma Willis-Alford.