As Black History Month closes, Minority Nurse interviewed Martha Dawson, DNP, RN, FACHE, and assistant professor in the Nursing and Health Systems Administration at the University of Alabama at Birmingham School of Nursing (UABSON). Dawson is also director for the Nursing Health Systems Leadership (NHSL) Division at UAB. The NHSL division includes nursing administration, clinical nurse leaders (CNL), and nursing informatics students. She is also the historian for the National Black Nurses Association.
Dawson, who knew early on that nursing was her path, earned her doctoral degree in nursing after many of her colleagues encouraged and prodded her to advance her studies. The challenges she faced, the experiences she had and her determination will resonate with many minority nurses.
“As I would mentor younger nurses and encouraged them to continue their education to the doctorate level many would say, ‘But, you don’t have a doctorate,’” says Dawson. “I knew then that I had to be the role model and earn a doctorate so I would not become a barrier to young nurses seeking higher education. I have always enjoyed learning and sharing my knowledge.”
The following is our Q&A with Dawson.
Why did you choose to become a nurse?
Becoming a nurse was just something I wanted do from a very young age because I could help people from birth to end-of-life. I can recall telling my father that I wanted to be a nurse. When he asked me repeatedly what type of nurse, I kept replying an RN—I had no idea about the vast career options at such a young age.
I can recall begging my mom one Christmas for a doll that had a medical kit including syringe, stethoscope, bandages, clutches, and arm and leg casts. Nursing provides me with so many career options from providing hands-on care, teaching, mentoring, research, and leadership, and most importantly paying it forward to help others become nurses. Then, there were the times when I took care of my grandmother when she broke her knee and my father when he burned his back. I can also recall when my brother dislocated his leg and I my big toe—mom reset or aligned them using wood splints without us going to a doctor. I was impressed and hooked on being a nurse.
How did you choose your path?
For me this a limiting question because nursing offers pathways, not just a path. Currently, I guess one would say that I am an educator.
I am a planner and strong believer in career mapping and progression. My current educator role is the result of taking a systematic approach to my nursing career by setting short- and long-term goals. I decided early in my nursing career that I wanted to teach, but only after I acquired the expertise to share both lived experiences and book knowledge—in short, I wanted to walk in the shoes of those I would be educating. Therefore, my nursing career started as a BSN nurse in a cardiovascular open-heart intensive care unit where I provided direct care and worked as relief charge nurse and then charge nurse.
Then, like many nurses, after transferring to a pre- and post-cardiovascular unit, I was asked to step into the nurse manager role with no preparation. Management and leadership came naturally to me, but I knew that I needed business and organization skills and knowledge. Therefore, I completed a dual master’s as a cardiovascular clinical nurse specialist (CNS) and in nursing administration that required completion of a 10-month hospital residency certificate program.
By the time I started the nursing administration studies, I had become hooked on leading and influencing change, plus being a voice for nursing both internal and external to the organization. Nursing administration became my passion, and I committed myself to learning as much as I could. I have held positions at the director level, associate chief operating positions, chief nurse, and executive VP level in practice setting, mostly academic medical centers. These roles provided me with the experience to teach the next generation of nurse leaders. I am still growing and determining the next chapters in my career.
I am a life-long leader and forever a student of our great profession.
What kinds of challenges did you face in your career and how did you overcome them?
My challenges would fill a book. There were very few minority students in my school, and it was rarely that more than two of us would be assigned to the same clinical group. In addition, there were very few African American faculty. During my BSN and MSN studies, I did not have a faculty member of color from any ethnicity. Most of the time, I felt the grading was fair, but then I had experiences where I would receive a B on a paper with no correction or remarks only the letter grade. Yes, I did follow up with the faculty and administration as needed.
My advice, and what helped me, is that challenges are there to overcome and to be used as stepping stones. When someone said that I could not do something or advance my career, I felt that it was my God-given right to prove the person wrong. My faith has made and kept me strong. I really try to set my goals and pathways in life and not allow others to determine my destiny. I know and respect that this approach and mental model will not work for everyone. Therefore, I try to help others find their voice.
Mentoring is important for any nurse, but especially for minority nurses. Did you have any kind of mentoring relationship?
I really did not have a mentor(s) early in my career, as I progressed in my career there were leaders that I would say have served as good coaches for me. During my doctorate education, I had my first African American nursing faculty—31 years after becoming a nurse.
Do you mentor young (or new-to-nursing) nurses now?
I mentor everyone that will allow me, from elementary school to doctorate level students. Giving back and investing in others is a personal charge that I have accepted to afford others a smoother path. I mentor nurses, other healthcare professionals and those who aren’t nurses/healthcare professionals. Mentorship is a bidirectional relationship.
However, as a mentor it has to be about the mentee and their career goals. For me as a mentor, the relationship keep me current with professional and society issues, and it improves my listening skills so I can hear and support the mentee. It is key that mentees come to the relationship with a desire to focus and put in the time. Too often, I believe the mentees fail to appreciate the work that will be required of them. However, a good mentor will help mentees step outside of their comfort zones and encourage them to excel beyond the level of the mentor.
True mentorship must include self-assessment, self-reflection, and the willingness to change and reinvent oneself if necessary. It is a learning and growing process that never ends. I encourage my mentees to outgrow me and seek advice from others. In addition, I tell them that if I can only get them to my level of performance, accomplishment, or achievement, then I have failed them because it is not about me, but them. I should help them do more, give more, achieve more, and go further. The mentees help and allow me to sow into their success and support them as I transition into a different phase of my career.
In short, each mentee is a part of my succession plan to ensure that the profession and world are in good hands with the next generations of nurses, nurse leaders, and teachers.
What is the most beneficial outcome of increasing the diversity of the current nursing workforce?
I believe the greatest benefit of having a diverse nursing workforce is the role model and mentoring that can be provided to students of different races and ethnicities to help them enter, matriculate, and graduate from nursing programs. Next, if the profession truly wants to improve population health, then we must have nurses that have lived experiences of the populations we are trying to help.
In the same manner, if we want to create a culture of health, it is important that the owners of culture are engaged on the front end and that the engagers look like them and understand them. There is also a business and economic case to be made that we rarely read about in the literature; nursing is a great profession and one of the few occupations that can continue to earn a livable wage during an economic recession. Nursing as a career can help improve the economic status of families and improve the long-term health outcomes of whole communities for generations. I appreciate diversity at all levels. However, we have to be careful of the global approach to diversity, i.e., where we are counting everything to avoid addressing the real issues of race and ethnicity.
We need more men in nursing but not to just increase the “diversity count.” In other words, I still want to know the breakdown of male nurses by age, race, and ethnicity. Then, we have to address the issue of diversity and inclusivity. Diversity without inclusivity is just a pen, paper, and number game. My motto is that diversity is the quilt that creates a beauty pattern, but inclusivity is like tapestry, many different colors of threads creating a picture. Therefore, an organization has to ask, “Is our vision of diversity a pattern or a picture of interconnectivity?”
What are the biggest barriers for young students of color to become nurses and how can that be changed?
After serving as the principal investigator for two HRSA workforce grants, I am convinced that if we want to increase diversity in nursing and the medical field, we have to start with pre-K through 7th grade.
Nursing is a science-based discipline, and students must be introduced to the profession with the understanding that they have to take the STEM-related courses. The lack of preparation in math and science is the biggest problem facing our students. Prerequisite courses derail many of our pre-nursing students of color. Therefore, they cannot wait to take chemistry, advanced math, anatomy, and physiology, and other related science courses. These courses are needed prior to college entry.
The second major problem is related to high school and freshman counselors. Top performing high school students are receiving information on nursing as a career option. Then many students of color, even some with the GPA, are being mis-counseled and advised against nursing because of the rigor of the program. In addition, many schools of nursing that are concerned about their NCLEX pass rates are growing and holding more and more seats for their “honor programs” thus making it more difficult for that pre-nursing student with an ACT of 20 and GPA of 3.5 to even be considered for the nursing program.
Finally, we still have the issue of lack of diversity among SON faculty. Nursing must become more committed to developing a diverse academic workforce. A great starting point would be to increase faculty diversity to be 10% higher than the state demographic profile because we have a lot of catching up to do.
I still love nursing and think it was the best choice for me. I am not sure what I will be when I grow up, but it will have something to do with nursing. Oh, not grow up, but when I retire.
February is American Heart Month — what better time to reassess how well you are taking care of your heart health?
Know Your Risk Factors
As a minority nurse, you probably know certain minority groups have higher risks for heart disease. According to the American Heart Association, African Americans, American Indians/Native Alaskans, and Hispanics have an increased risk of heart disease and its associated problems like high blood pressure, heart attack, and stroke.
Other risk factors include hereditary factors (others in your family have heart disease), smoking, obesity, sedentary lifestyle, and poor diet.
Know the Signs
According to the Centers for Disease Control and Prevention, there are a few heart attack signs and symptoms that you shouldn’t ignore.
If you experience any of these symptoms, call 911 immediately.
- Pain or discomfort in the jaw, neck, or back
- Feeling weak, light-headed, or faint
- Chest pain or discomfort
- Pain or discomfort in arms or shoulder
- Shortness of breath
Women also tend to have symptoms that are different from men and, therefore, aren’t always immediately considered as heart trouble.
Watch for these unusual signs:
- Nausea or vomiting
- Extreme fatigue
- Feelings of unease or anxiety
Heart disease isn’t called the silent killer for no reason. If you feel something is off, whether that’s occasional chest pain with exercise or under stress, heart palpitations, or off-and-on chest discomfort, always be cautious and get it checked.
Reduce Your Risk
If you have risk factors for heart disease, you should monitor your blood pressure, your cholesterol, and your blood sugar. Try to reduce your risk by maintaining a healthy weight, getting enough physical activity, being sure to rest, staying connected with loved ones, and trying to keep your stress levels in check.
With the hectic pace of a nurse’s day, getting any time to bring your stress down a notch is a struggle. But one simple way to help with stress reduction is to step outside. Plenty of research backs up the idea that more time outside is better for your health. A few minutes walking at lunch, parking far enough away in a parking lot, or even just getting a few breaths of fresh air on a break can have huge benefits on your physical health and your mental health. Getting into nature can clear your mind, lower your blood pressure, and help you clear out the mental clutter enough to focus better when you come back to work.
Heart disease is the number-one killer of men and women in the United States, so paying attention to your own heart health is one of the best preventative measures you can take.
Keondra Rustan, RN, MSN, PhD(c), visiting assistant professor at Linfield College in Portland, OR, has overcome many challenges in her decade-long career as a nurse and nurse educator. Raised in a single-parent home with limited resources, she discovered how she could channel her interest in science into a nursing career by reaching out to mentors along the way.
Today, she shares her story and offers advice to other minority nursing students and nurses who may face similar challenges in their education and careers.
How long have you been in the nursing field and what has been your career history until now?
I have been a nurse for nine and a half years. I started out working in cardiac health care in Virginia. I did cardiac stepdown, some cath lab work, and I floated to some cardiac ICUs. I then went to the ICU where I learned a great deal and developed some professionalism and leadership traits. I then went on to become an assistant manager of an ICU and IMCU. I finished my master’s degree and became a professor at a private college where I rediscovered simulation and developed a great love for it. I became the simulation lab coordinator and for a time was the interim director of the LPN program, and went on to become the assistant director of the LPN program so that I could make more time for my doctoral schooling.
I am currently working in the dissertation phase of my doctoral program and enjoying my work at Linfield College as a visiting assistant professor working in simulation as lead faculty.
What inspired you to enter the nursing profession?
At first I didn’t want to be a nurse. I went through all of my primary schooling without having the decision of wanting to be a nurse. I wanted to be a scientist at first like those scientists in Jurassic Park.
Later on in high school I decided that I wanted to be a scientist that could help cure diseases and study microbes. However, I lost my grandmother when I was in high school and some of the care that she received wasn’t the best and lacked empathy. I decided that I wanted to help people more directly and show them that they aren’t just a room number but a thriving person who was deserving of care. I wanted to be a person who made a difference in the lives of others.
As nurses we often aren’t remembered individually; but if a patient has less exacerbations and starts feeling better because of your care and the education that you provided, it is very rewarding.
What inspired you to become a nurse educator?
I discovered that I liked teaching by precepting new nurses and nursing students. I enjoyed seeing the potential in them. I loved teaching them how to do things based on evidence and why it was so important for it to be done that way. I wanted to show them how to provide holistic care to patients and help them grow into future leaders.
I also enjoyed telling them stories so they could directly apply the teachings to their practice. Most importantly, I wanted them to have things I did not have prior to becoming a nurse: resources and a mentor. I wanted to apply these principles on a broader and larger scale so I went into the field of nurse education.
I would say the first year or so I was not very good at it. Or at least I did not feel as though I was a good teacher. I did not have a mentor or anyone to show me the ropes so I just taught them the way I was thought, which did not work.
What challenges have you faced in your career and how have you overcome them?
In my career my biggest challenges have come from lack of resources and lack of mentors. I grew up in a low-income single parent home with no vehicle. We did not have the funding or access to resources to get informed about career programs while in high school or even most scholarships. I wasn’t aggressive enough in thinking of my future and did not have enough drive when I was younger to seek those resources.
Once I decided to become a nurse, I didn’t really know how to become one, what nurses actually did, and what type of nurse I wanted to be (even when I graduated I still did not know that part). I had a lot of ideas, but I did not know how to bring them into fruition.
I overcame the lack of resources and lack of mentoring by joining organizations (good old-fashion Google search) based on my interests. When I was obtaining my BSN I got accepted into Sigma Theta Tau (the nursing honor society). Going to those conferences really opened a lot of doors for me. I am so grateful for the aid of the nurses and educators that I have met throughout my nursing career. They were able to point me into a lot of great directions. I am still growing and have a great deal more that I want to accomplish.
What challenges do you see minority nursing students face and what is your advice for them?
I see lack of resources as a big one and lack of mentors. Minority students (and I include males in this) have a high risk of falling through the cracks in nursing school. There seems to be a reluctance to seek aid when dealing with difficulties. It is hard to get over, because typically it is culturally ingrained.
My advice is to seek help right away when you are having trouble. If your school does not assign faculty mentors, seek out an instructor that you feel you can connect with. Shadow a nurse if you are not experienced with the duties of a nurse, so you have an idea of if it is right for you. Don’t be afraid to ask for help; if you do not understand, seek help (think of the patient’s safety).
Most nursing schools have scholarships, open labs, writing labs, and tutors available for their students; make use of these resources and give yourself support. View any setback as a learning opportunity and grow from the experience. Never stop learning even after you are licensed and working on the floor. Google search some nursing organizations (you can even join some as a student for a cheaper price) and they can lead you down some interesting paths. Also, once you obtain your knowledge, pass it on. You never know who you will be helping with your expertise and experience.
Where do you see yourself in 5-10 years?
I see myself with at least 10 articles published and maybe a book, of course having obtained my PhD. I want to still be educating nursing students and maybe have obtained my NP. I want to continue to learn and grow each day to become the best educator that I can be. I want to do more in community and be a greater help to those in need.
Having a strong mentor and academic advisor can make a huge difference in the lives of undergraduate and graduate nursing students. Being that mentor is what motivates Ronald Hickman, PhD, RN, ACNP-BC, FNAP, FAAN, associate professor of nursing at the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, OH.
Hickman has been honored with two esteemed awards for student mentorship at Case Western Reserve University: the John S. Diekhoff Award for Excellence in Graduate Mentoring, which is presented to four full-time faculty members who make exemplary contributions to the education and development of graduate students; and the J. Bruce Jackson Award for Excellence in Undergraduate Mentoring, which celebrates faculty and staff who have guided a student in their academic and career paths; fostered the student’s long-term personal development; challenged the student to reflect, explore, and grow as an individual; and supported and/or facilitated the student’s goals and life choices.
“Mentoring has been a cornerstone approach to making a difference in the lives of undergraduate and graduate nursing students,” says Hickman. “The receipt of two of the university’s top honors for mentoring undergraduate and graduate students is a testament to my commitment to making sure that I pay it forward.”
Hickman says the mentorship he received across his undergraduate and graduate studies has been invaluable. “My mentors shared their lived experiences and lessons learned to help me avoid pitfalls and inspire me toward a career in academe. These honors highlight my commitment to mentoring and acknowledge the impact of effective mentorship on the lives of emerging leaders in nursing practice and research.”
However, nursing was not Hickman’s original career plan. “As an undergraduate student, I majored in biological sciences with the intention to attend medical school after graduation.”
He was not admitted to medical school, but upon reflection about potential career paths he decided to pursue nursing because it aligned with his personal philosophy of health. “Although nursing was not my first choice for a career, it was the right choice for me,” he says.
Hickman acknowledges that pursing a nursing career can be challenging for minorities.
“Many minority nurses are the first in their families to attend college and are standouts in their communities,” he says. “When entering the nursing profession, the academic preparation is challenging and, in most instances, the diversity of nursing faculty is often not representative. This can create situations where minority nurses do not wish to speak up and seek help when needed. Whether you are pursuing a nursing degree or transitioning to a new role in nursing, do not suffer in silence. Asking for assistance often facilitates your success and delivery of safe nursing care.”
Another key to success that Hickman recommends for minority nursing students is to find a strong mentor and strongly consider pursing a doctoral degree in nursing.
Hickman is truly paying it forward. “As a nurse educator, I am inspired daily by helping students develop as competent nurse clinicians and scientists,” he says. “Helping others achieve their goals is an invaluable and enduring experience for most educators. The opportunity to inspire and challenge future nurse leaders is a priceless reward.”
Hickman sees himself in a senior leadership position in a school or college of nursing in the future. “My aspiration to secure a senior leadership position aligns with my commitment to help an organization and its’ faculty achieve their goals and impact the health of Americans.”
As Black History Month draws to a close, now is an excellent time to reflect on all the nurses who paved the way for today’s increasingly diverse nursing workforce.
The numbers still don’t reflect the levels of diversity in the country as a whole, or even necessarily in the settings where they work, but African-American and black nurses are entering the nursing profession and earning advanced nursing degrees in greater numbers than ever before.
According to the Bureau of Labor Statistics, the nursing workforce is achieving greater diversity, but there’s still a long way to go. While the 2015 National Nursing Workforce Study stated 19.5 percent of nursing respondents reported a racial or ethnic minority background, the rate was even higher among newly registered nurses.
With a nod to early black nurses like Sojourner Truth or Harriet Tubman, who each paved the way for minority nurses to follow, nurses are expanding into many specializations and gaining higher degrees. With the current push to have 80 percent of nurses educated with a completed bachelor of science in nursing by 2020, higher ed and advanced degrees are an important part of getting ahead in nursing. Of the 176,000 nurse practitioners, 8.5 percent are African-American. And of the 3,102,000 registered nurses, 11.9 percent are African-American.
Minority nurses continue to make big strides in increasing the diversity of the overall nursing population. According to American Association of Colleges of Nursing (AACN) figures, the percentages of black or African- American nurses earning master’s or doctoral degrees has increased significantly in the past 10 years.
In 2006, 10.6 percent of those earning doctoral degrees were African American. In 2016, that percentage jumped to 16.2. And in those same years, the number of those earning master’s degrees also saw a percentage jump. In 2006, 11.3 percent of those going for a master’s degree were black. Ten years later, the percentage was 14.3. Overall, the percentage of minority nurses seeing nursing degrees hovers at about 30 percent of the total.
All that good news helps patients who say they want to see a diverse workforce in the healthcare professions. Many patients feel comfortable with someone who looks like them, but, more importantly, a diverse workforce helps spread culturally competent nursing practices. The entire nursing staff may not represent the ethnic diversity in a given setting, but they can learn from those who might understand certain cultural traditions, languages, or practices. All that understanding makes for better patient care and outcomes and an especially effective nursing staff.
So as Black History Month draws to a close, take a few moments to reflect on how far African-American and black nurses have come and the essential care and understanding they provide to the public. And take a moment to take pride in being part of that.
During this year’s CRNA Week (#crnaweek), there are many nurse anesthetists who are remembering why they got into the profession, and even more are reflecting on how the face of the profession is changing.
John Bing, BSN, CRNA, American Association of Nurse Anesthetists (AANA) Region 6 director, and national AANA board of directors member, says one of his steadfast missions is to make sure the field continues to attract top nurses, but that it is especially welcoming to aspiring minority nurse anesthetists.
Bing knows first-hand how hard it is being a minority in the field. When he first started out, he was often the only African American in the OR, he says. At times, people assumed he was part of the housekeeping staff. Although he laughs about it now, Bing has made it a direct part of his mission to attract more minorities into this field.
He even takes on leadership positions with the primary goal of making sure he is representing the minorities in the field. “You need to see that in leadership,” he says. “If others don’t see that, they won’t see a place for them. I make sure they see it.”
“Many times you would go in and you were it,” he says of when he started out. “Maybe you were the only one in the hospital or the department. Now you go in and you see a fair amount [of minorities].”
As a president of the Diversity in Nurse Anesthesia Mentoring Program, Bing also makes sure his students know why he enjoys this profession so much.
One of Bing’s specific approaches is to make sure he talks to patients as the anesthesia takes effect. He finds out what they like so they can chat about it—sports, cooking, books, kids—anything that helps them relax. “That’s like a sedative,” he says. “It calms them down and they remember that.”
And while he’s monitoring a patient, Bing does exactly what he teaches his students—he assesses his patient over and over and over. “You must rely on your instinct,” he says. During travels with students to countries like Nicaragua, Bing teaches students that not every machine is calibrated the same or even correctly.
“The machine is a guideline,” he says. “You are ultimately responsible for anything that happens. You can’t blame the machine for anything. Look at the patient.”
Bing says that while he’s checking blood pressure every five minutes or so, he is constantly “circling the block,” as he calls it. All the machines are incredibly helpful, but they should only confirm what a nurse anesthetist is seeing, hearing, smelling, and touching.
And getting stale in this profession is not an option, he says. “I say to my students, ‘Tell me how this patient could die today,’” he says. That forces students to look at the big picture and not just look for complications, but to look for other factors that could impact that patient on that day.
Bing clearly enjoys working with his students, but he understands first-hand how sometimes they are not the ones who chose the profession. “The last thing I thought I would be was a nurse,” he says with a laugh. As an African-American, there were few role models that looked like him.
A chance look at a jobs list that revealed six pages of nursing jobs, convinced Bing, an athlete in high school and college, to take a look. Bing says he turned to his buddy he was working out with and said, “We get to be around girls and have a great job!” But he still didn’t expect to land in this field. Eventually, nurses in the recovery room where he worked nudged him to give it a try.
Now, Bing’s mission is to attract minorities into nurse anesthesiology. He speaks to kids in schools, paying special attention to making the field appealing to boys and young men. As it is, 49 percent of nurse anesthetists are male, he says, which is a high number considering less than 10 percent of all nurses are male.
But Bing lets kids know that there are chances to be out on a helicopter go team or even in the midst of trauma situations. “Men like that kind of stuff,” he says and it certainly gets the attention of younger kids who don’t know those possibilities exist.
Add in the good salary, the camaraderie, and the fair amount of autonomy, says Bing, and a career as a CRNA shows kids who might not initially consider a nursing career that the path is open to more possibilities than they ever imagined.