Celebrating Black Nursing Leaders: Meet Dean Amar

Celebrating Black Nursing Leaders: Meet Dean Amar

Dean Angela Amar, Ph.D., RN, FAAN, is a professor, active researcher, and administrator for the UNLV School of Nursing. This nursing leader is a national expert on mental health nursing, sexual and dating violence, diversity in nursing leadership, and forensic nursing. Her research on dating violence, sexual assault, and mental health responses to traumatic experiences has earned funding from the Robert Wood Johnson Foundation, the National Institute of Child Health and Human Development, and the National Institute of Nursing Research. 

Dean Amar is an important nursing leader, and we’re pleased to profile her as we celebrate Black History Month with the Black Nursing Leaders Series 2023.

The entire month of February, we’ll highlight healthcare leaders who are prominent figures in their organizations and making transformational impacts in nursing.

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Meet Dean Amar, Dean and Professor at the UNLV School of Nursing

Please talk about your career path and how you ascended to your role at the UNLV School of Nursing.

My Dad was very sick and hospitalized a lot when I was in high school. I admired the nurses who took care of him. I’d always liked science and wanted a career where I’d connect with people. Nursing was the perfect choice for me.

What inspired you to become a nurse?

My Dad was very sick and hospitalized a lot when I was in high school. I really admired the nurses who took care of him. I’d always liked science and wanted a career where I’d connect with people. Nursing was the perfect choice for me.

What are the most important attributes for today’s nursing leaders and why?

Nursing and healthcare are in a period of great transition. The nursing leader of today has to be able to respond to the multiple issues confronting the field. Leaders need to make employees feel valued, heard, and respected. Nursing leaders must respond to challenges with flexibility and the ability to change course as needed. Finally, they must be able to communicate a vision, work with others to plot a course, and inspire others.

What does it mean to you to be a nursing leader, and how are you making a difference?

As a leader, I use my voice to help others. My various professional roles have expanded my reach, so I sit at many tables, often as the only nurse or Black woman. In these forums, I speak out on issues and bring the voices of those I represent. Also, I mentor a lot of nurses across the country. I use my experiences to help others and learn from my mentees.

What is the most significant challenge facing nursing today?

In the aftermath of the pandemic, nursing is in trouble. Our nurses are feeling burnout and fatigue. They’re not feeling valued and heard. We are headed for a shortage. Academic nursing is seeing retirements in leadership and senior faculty which makes for gaps in increasing enrollment. Further, COVID-19 exposed health inequities and racial injustice in our society and healthcare.

As a nursing leader, how are you working to overcome this challenge?

As Dean of the UNLV School of Nursing, one of the most diverse universities in the country, we work to prepare students as expert clinicians, scholars, and leaders who are prepared to address the challenges facing the profession. Our school of nursing also works with local nursing leaders to address the problems facing our region. I also work through my leadership in national organizations to make meaningful changes for the nation.

What nursing leader inspires you the most and why?

Just one! That’s hard. In my career, I’ve benefited from multiple mentors. I learn so much and am inspired by so many nursing leaders. Dr. Carolyn Mosely has been my mentor since I was an undergraduate student. She pushes me and many others to be our best. She has led in multiple capacities in universities, nursing and professional organizations, and communities.

What inspirational message would you like to share with the next generation of nurses?

Keep doing the work you’re doing to change the system. We see you. You bring a new and fresh perspective and approach that is so needed in our healthcare system. Change is hard. It gets messy, but the end is worth it. So keep working and keep fighting for change. And keep bringing new insights and perspectives. The profession needs you.

Racism Motivates and Hinders Aspiring Midwives of Color

Racism Motivates and Hinders Aspiring Midwives of Color

Structural and interpersonal racism is blocking aspiring midwives of color from joining the workforce at a critical time for the health of pregnant and birthing people.

The U.S. has alarming disparities in maternal health that will likely intensify following the erosion of reproductive health access in states across the country. Midwifery care and care from providers who share a racial and cultural identity with their patients are proven to improve outcomes for parents and babies. Yet an overwhelming majority of midwives in the U.S. identify as white.

Research from the Abortion Care Training Incubator for Outstanding Nurse Scholars (ACTIONS) program at the University of California, San Francisco, and Commonsense Childbirth found that the high cost of midwifery education and related expenses like loss of income while enrolled in school were major barriers for people of color wanting to enter midwifery education.

People also frequently cited the lack of midwives of color to teach and mentor them. Barriers to becoming a midwife were greater among people with lower levels of income or education.

This survey of aspiring midwives of color across the U.S. is the first study exploring a wide range of barriers to entering midwifery education.

“Aspiring midwives of color are motivated to provide care in their communities to counteract the effects of racism on maternal and infant health,” says Renee Mehra, Ph.D., ACTIONS postdoctoral fellow and first author on the paper. “We need them in the workforce, yet the cost of midwifery education and the lack of racial and ethnic diversity in the profession are standing in their way.”

“We must act now to train, diversify and deploy a midwifery workforce that can tackle the persistent maternal morbidity and mortality that disproportionately plagues Black and marginalized people in the USA today,” says midwife Jennie Joseph, Founder and President of Commmonsense Childbirth.

The structural and interpersonal racism that impacts people’s ability to become midwives also motivated them to want to provide this care. The strongest motivating factors in the study were providing racially concordant care in their communities, reducing racial health disparities, and their own prior experiences of discrimination in healthcare settings.

To help aspiring midwives of color meet their goals, the researchers suggest solutions including providing funding for students of color for tuition and other living costs, creating a pipeline for midwives of color by enrolling more students of color, and supporting and hiring more teachers of color, and opening more midwifery schools, especially in Historically Black Colleges and Universities.

Frontier Nursing University Names Dr. Paula Alexander-Delpech Chief Diversity and Inclusion Officer

Frontier Nursing University Names Dr. Paula Alexander-Delpech Chief Diversity and Inclusion Officer

Frontier Nursing University (FNU) named Dr. Paula Alexander-Delpech, Ph.D., PMHNP-BC, APRN, as its Chief Diversity and Inclusion Officer (CDIO).

Previously, Dr. Alexander-Delpech served as the Interim CDIO since January and guided the planning and programming for FNU’s 12th annual Diversity Impact Conference held in June.

Dr. Alexander-Delpech serves as co-chair of the President’s Task Force on Diversity, Equity, and Inclusion (DEI) and the Faculty, Staff, and Preceptor Development and Retention sub-committee of the DEI Task Force.

Performing at the Highest Level

“Dr. Alexander-Delpech has performed at the highest level as our Interim CDIO,” says FNU President Dr. Susan Stone, CNM, DNSc, FAAN, FACNM. “We know she will continue to provide the direction, passion, and leadership necessary to further the essential work of FNU’s Office of Diversity, Equity, and Inclusion. She has tremendous energy and has brought forth a number of new initiatives to build upon our existing DEI efforts, which are so important to the future of healthcare.”

Nurse Educator DEI Faculty Fellowship

Dr. Alexander-Delpech presented “The Development of A Faculty DEI Fellows Program” at the American Association of Colleges of Nursing’s Diversity Leadership Institute. Under her leadership, FNU plans to launch a Nurse Educator DEI Faculty Fellowship program this fall. Eight faculty members will be selected as Fellows and will attend a 12-week DEI training and then be assigned at least four more faculty whom they will coach for 12 weeks.

The Office of Diversity, Equity, and Inclusion oversee the development of five new student interest groups (SIGs), which hold their first meetings in June. The five SIGs are International Students in Nursing, LGBTQIA+ Students in Nursing, Men in Nursing, Military/Veterans in Nursing, and Students of Color in Nursing.

Delivering Equity and Diversity in Healthcare

“It has been a pleasure working with Dr. Alexander-Delpech,” says FNU Dean of Nursing Joan Slager, DNP, CNM, FACNM, FAAN. “She is passionate about creating opportunities for our faculty and our students to grow in their expertise in teaching about and delivering equitable healthcare.”

“I am so honored to accept the role of Chief Diversity and Inclusion Officer at Frontier Nursing University,” Dr. Alexander-Delpech says. “We always think about DEI as it pertains to our curriculum or profession, but when people start talking about it in their personal lives, that means people are making changes. The ripple effect is happening. At FNU, we are ahead of the game. When we talk about DEI work, FNU has surpassed a lot of other universities.”

Nurse Finds Her Passion as Nurse Navigator

Nurse Finds Her Passion as Nurse Navigator

My nursing education journey began when I received my BSN in Nursing at Rutgers College of Nursing in 2011. During my time there, I met some strong, professional women professors. They took such a personal interest in me that, over a decade later, I think of them with much gratitude. Their strength helped me to see myself as a strong but caring nurse.

A Strong Caring Nurse

My education gave me the confidence to care for my patients competently. I had a tough clinical practice specialist on the Med/Surg/Tele unit I first worked on. When she asked me questions on the spot, I almost always knew the answer. I credit Rutgers and fellow student nurses who supported each other through nursing school.

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Prisca Benson, MSN, RN is a a nurse navigator for the neuroscience department at The Valley Hospital

While there was a lot to learn on the job, the education I received provided a foundation I used to excel clinically. It was not long before I started picking up per diem job opportunities to explore and broaden my horizons as a nurse. I worked in home care as an intake nurse, home care nurse, and infusion nurse for different companies.

In 2014, I got a job as a neurology nurse at my dream hospital, NYP-Columbia University Hospital. While per diem there, I joined committees I was interested in and disseminated the information to the staff in my unit to improve our practice.

I also noticed that some patients lacked a basic understanding of their medical history and medication. So I used the principles I learned in school to educate them effectively so they could be more knowledgeable about their health and care.

A Life’s Passion Realized 

I soon realized that my passion was teaching.

I began searching for nursing opportunities to give me more time to teach patients. I applied for a position as Neuroscience Nurse Navigator at The Valley Hospital, which allowed me to create and develop the role to support the patients during their admission and help them maintain outpatient follow-up.

This was a dream come true! I finally had the time to sit at a patient’s bedside, teach them about their new diagnosis and answer all their questions.

While working this job, I received my MSN in Nurse Education at Chamberlain University. The modalities taught have allowed me to be a better peer and patient educator. It encouraged me to start with the other person’s understanding as a foundation for effectively educating someone. I participated in my organization’s student nurse externship by teaching skills, theory, and even creating an educational game to increase knowledge retention.

Love and Desire to Educate

My love and desire to educate led me to start a personal finance and health blog, Our Green Life, during the pandemic. The fear and misinformation were very unsettling, so I wanted to provide a reliable but approachable space for information. I use what I have learned through my education and experience to make the information easy to grasp and to demonstrate how it could be applied.

My nursing education helped shape my career, goals, and values, and I will be forever grateful for it.

ANA Issues Racial Reckoning Statement: “We Ask Forgiveness From Nurses of Color…”

ANA Issues Racial Reckoning Statement: “We Ask Forgiveness From Nurses of Color…”

“To begin, we must acknowledge that from 1916 until 1964, ANA purposefully, systemically and systematically excluded Black nurses…”

The American Nurses Association (ANA) is taking a meaningful first step to acknowledge its own past actions that have negatively impacted nurses of color and perpetuated systemic racism. With the release of a formal racial reckoning statement on July 12, ANA is beginning a multi-phase journey of reconciliation, forgiveness, and healing. The Journey of Racial Reconciliation is the name for ANA’s racial reckoning journey as it seeks to address past racial harms from as far back as the formation of the association in 1896.

From the ANA statement:

“Similar to the concerns raised by Black nurses, in 1974, led by Dr. Ildaura Murillo- Rhode, a group of 12 Hispanic nurses who were also members of ANA came together to consider establishing a Hispanic Nurses Caucus within ANA because ‘ANA was not being responsive to the needs of Hispanic nurses.'”

“We know that ANA’s work to reckon with our historical and institutional racist actions and inactions is long overdue. Racism is an assault on the human spirit, and we want to be accountable for our part in perpetuating it. We have certainly failed many nurses of color and ethnic-minority nursing organizations, undoubtedly damaging our relationship with them and in so doing, diluting the richness of the nursing profession. We ask forgiveness from nurses of color as a first step to mend what is broken,” said ANA CEO Loressa Cole, DNP, MBA, RN, NEA-BC, FAAN.

“ANA recognizes that issues of racism persist today and continue to harm nurses of color. Findings from the Commission’s 2021 national survey on racism in nursing (n = 5,600) noted that racist acts are principally perpetrated by colleagues and those in positions of power. Over half of nurses surveyed (63%) said they had personally experienced an act of racism in the workplace with the transgressors being either a peer (66%) or a manager or supervisor (60%). Fifty-six percent of respondents also noted that racism in the workplace has negatively impacted their professional well-being.”

On June 11, 2022, the ANA Membership Assembly, ANA’s highest governing body, took historic action to begin a journey of racial reckoning by unanimously adopting the ANA Racial Reckoning Statement. Please read the entire statement and stay connected with ANA on its journey.

Nurse-Midwives Train Doulas to Reduce Black Maternal Health Risks

Nurse-Midwives Train Doulas to Reduce Black Maternal Health Risks

Nurse-midwives and educators from three prominent research universities have teamed up to improve pregnancy outcomes in Black communities by providing specialized training for doulas, persons who support birthing mothers and families through the entire process of childbirth.

The Alliance of Black Doulas for Black Mamas is led by Vanderbilt University School of Nursing Associate Professor Stephanie DeVane-Johnson, PhD, CNM, FACNM, Duke University School of Nursing Assistant Clinical Professor Jacquelyn McMillian-Bohler, PhD, CNM—both graduates of Vanderbilt’s nationally-recognized Nurse-Midwifery program—and University of North Carolina School of Medicine Assistant Professor Venus Standard, MSN, CNM, FACNM. The project leaders are Black, certified nurse-midwives with a combined 60+ years of midwifery experience.

Doulas offer emotional and informational support for pregnant persons and their families. Unlike nurse-midwives, they are not medically trained; however, their help with things like breastfeeding, acupressure, birth plans and postpartum issues can be critically needed, as can their presence as an advocate for the mother.

The three researchers are addressing the U.S.’s Black maternal health crisis. The U.S. has the highest maternal mortality rate among developed countries—and the crisis is even more pronounced for Black mothers. Centers for Disease Control and Prevention statistics reveal disparities between pregnancy complications and risks across different racial groups. Black women are approximately twice as likely to have a moderately low birthweight child and three times as likely to have a very low birthweight child than white or Hispanic women (https://www.cdc.gov/nchs/products/databriefs/db306.htm). Black women are also more likely than white or Hispanic women to die from pregnancy complications—almost 67 percent of which are preventable.

Having a trained and trusted professional who can help parents-to-be make healthy decisions and choose proper prenatal care can make a difference in maternal health and birth outcomes.

DeVane-Johnson, McMillian-Bohler and Standard worked together to write and fine-tune a plan to train and provide Black doulas to help Black families, with hopes of mitigating the high Black maternal and infant mortality rate. In 2020, the doula project was funded by a $75,000 award from UNC, the Harvey C. Felix Award to Advance Institutional Priorities and the group trained its first 20 doulas. In 2021, they received a $545,000 Duke Endowment grant, which will fund the program for three years beginning in May 2022.

Nurse-midwives Jacquelyn McMillian-Bohler, Venus Standard and Stephanie DeVane-Johnson.

Nurse-midwives Jacquelyn McMillian-Bohler, Venus Standard and Stephanie DeVane-Johnson.

The main program goals are to: decrease Black maternal mortality and morbidity; improve patient experiences; provide doulas for free to families; and help those interested in becoming doulas build critical skills and later use those skills to earn wages. The program’s goals align with the 2021 Black Maternal Health Momnibus Act, which “directs multi-agency efforts to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations,” states congress.gov (https://www.congress.gov/bill/117th-congress/house-bill/959).

“The training is more than about labor and birth,” said McMillian-Bohler, who teaches the mindfulness curriculum. “We also introduce the doula to general stress-reduction techniques such as mindfulness and acupressure. Although evidence suggests these techniques are helpful, they are often not accessible to the Black community.”

DeVane-Johnson works remotely as the community engagement liaison for the program, which is housed at UNC Family Medicine in Chapel Hill, but the doulas will be serving families in Durham, Wake and Orange counties in North Carolina. Devane-Johnson hopes to receive funding to expand this program to Black pregnant persons in Nashville, TN.

“The strength of the program is the expertise of the entire team and the integration of the expertise,” said Standard, who connects families with doulas from the program and is currently teaching the third cohort of Black doulas. “Although each university could independently support the doula program with its hospital system and academic affiliation, a collaboration between the three universities positively impacts the project as a whole.”

Doula training applicants attend information sessions and are screened to make sure they will be successful in the program and that they will enjoy the work.

According to McMillian-Bohler, the program’s doula/family partnerships offer racial concordance, which can increase trust and understanding.

“I think the fact that we are able to come in and talk about some of these health resources and, I hope, remove some of the stigma, opens up a whole area of health care and wellness to people who desperately need it, who maybe didn’t feel like it was for them,” McMillian-Bohler said.

The doulas recognize that birthing parents have the right and need to speak up for their own bodies and health, and help them build the confidence and ability to do so.

Doula students learn to use use birthing balls to help relieve pain and pressure during pregnancy and during birth.To receive help from a doula in the program, a person must be Black, pregnant and planning to deliver at a University of North Carolina-affiliated hospital.

“By having a culturally concordant doula, the patient has a personal advocate, educator and support person to help guide and navigate the system as a Black person, whose needs are often dismissed or ignored,” Standard explained.

“Our hope is that by selecting doulas, who are gatekeepers into various aspects of the Black community, and by giving them tools to share with families, we create a community project that helps birthing families and doulas, said McMillian-Bohler”

The program offers doula training that is expanded to accommodate the specific needs of Black women, covering topics like reproductive justice and the “superwoman schema,” which says that many Black women care for others at their own expense, increasing stress during a pregnancy.

“The goal is to help mitigate Black maternal and infant mortality rates,” DeVane-Johnson said. “Doulas stand in the gap. Sometimes, Black women bring things up to their health care providers and are not taken seriously, or the provider does not talk at a level that the patient and family can understand. The doula is there to bridge that gap and potentially interpret information.”

DeVane-Johnson also serves as the facilitator for breastfeeding lectures. She studies the history of breastfeeding and presents lectures to doula-trainees to help them understand the hurdles faced by those they are trained to help. The doulas use this training to support Black women who want to breastfeed and connect them with lactation consultants, as research indicates that breastfeeding decreases cancer risks in mothers and improves health outcomes for babies.

“Black women have the lowest breastfeeding rate out of any race,” DeVane-Johnson said. “When variables such as socioeconomic status, education and marital status are controlled for, similar positioned white women still tend to breastfeed at higher rates.”

Doulas help solve communication issues and offer consistent labor support for those who don’t have it, something that has been shown to decrease time in labor and the need for pain medications.

“We hope to create opportunities for Black women to find their voices and be empowered to ask questions,” McMillian-Bohler said.

“Doulas are there to empower, uplift and elevate birthing families,” she continued. “If something doesn’t feel right, the doulas help them recognize that they need to speak up and keep speaking until their voice is heard.

The doulas are trained to recognize preterm, term and postpartum warning signs that may otherwise go untreated, leaving parent and baby at risk.

They train over the course of seven weekends. While on-call with patients, they assist with birthing plans, help pack bags for the hospital and even attend appointments, depending on how much support the birthing parent needs. Once trained, a doula is paired with three Black families who receive assistance for free.

DeVane-Johnson says program applicants need to be Black, have a passion for birth work and have a desire to support women in labor. In the past, applicants may not have been financially able to secure training, but thanks to the grants, training is free.

Applicants are screened to make sure they have reliable transportation, a job that’s flexible enough to allow them to leave to attend a birth and are vaccinated against COVID-19.

According to DeVane-Johnson, the most important qualification is “a passion to help support Black families in the community.”

“Being a doula often is different than what many people imagine,” said McMillian-Bohler. “They may have a romanticized notion of what the job is like. Babies come all the time, anytime, and doulas have to be able and willing to drop whatever other things they may be doing to come to a birth.”

The program benefits go beyond those received by the birthing family.

“Doulas are marketable and can hire out their services after they work with their first three families through the program,” DeVane-Johnson said. “This training will help them bring in money for their families and provide an important service.”

The program supports workforce development, DeVane-Johnson said, as the new doulas have sustainable jobs and develop entrepreneurial skills.

With many interested in training and families lining up for the service, the program is poised to make a difference in communities and in Black maternal health—and the leadership team envisions it as something that can go even further.

“Our goal with this program is to create a doula training model that can be tailored for birthing people with disabilities, those in the LGBTQ+ community, making things culturally relevant to whatever specific marginalized population that is birthing, because it’s these marginalized populations that have the worst birth outcomes,” DeVane-Johnson said.

At this time, the program has one year of data and the group looks forward to evaluating the incoming qualitative and quantitative data, something the new Duke Endowment grant will help them do over the course of the next three years.

DeVane-Johnson, McMillian-Bohler and Standard also hope to see the program expand beyond the borders of North Carolina.

“We want to disseminate this program throughout the country,” Standard said. “We want to reach out to other academic hospital-affiliated institutions and integrate this program into their maternal care systems.”

If the program receives additional funding, Standard said they plan to increase compensation to the doulas and faculty, and hire additional staff to support an expansion to help more families.

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