Five years ago, an African-American student at The University of Texas at Austin School of Nursing was feeling lonely, socially isolated and academically frustrated. She had no friends on campus; she was failing her courses and did not understand why she was receiving such low grades on tests and assignments. There seemed to be nowhere for her to turn—she felt there was no support on campus, no one to talk to and no way to develop the skills she needed to improve her academic performance.
This was the situation presented to me as one of the school’s two African-American faculty members. I knew this student had the potential to succeed, and I knew I needed to do something to help her and other minority students who were in the same situation.
Our nursing program had a Learning Enhancement Center that offered many resources to help students, such as providing tutors and mentors to help students improve their study skills, writing skills and test-taking skills. But we had noticed that very few African-American students were taking advantage of the center. Clearly, for any program to succeed in improving the academic performance of minority students, it had to make them feel comfortable using such resources.
Together with the coordinator of the Learning Enhancement Center and the student, we worked out a concept for a more culturally sensitive alternative: a support group for minority students. The objectives for the group, which was called the African-American Nursing Students Association (AANSA), were to:
1. Provide a comfortable environment where students encourage each other to develop interpersonal skills, good study habits and academic savoir-faire.
2. Encourage students to integrate themselves into the academic and social life of the university.
3. Increase the number of minority students entering and graduating from the School of Nursing.
Creating a Network of Support
To ensure a large turnout for the support group’s first meeting, we scheduled it for a time when most minority students were on campus and sent out announcement notices. But the primary reason for so many students showing up was the persistence of the student who originally came to me in need of support. She urged many of the African-American nursing students to attend our first meeting.
During the first three meetings, students were reluctant to communicate. Again, it was the enthusiasm and urging of the original student that eventually motivated the group to talk openly with each other and with the faculty advisor about their experiences and concerns.
They began by expressing their feelings of isolation. Many of them were shy and hesitant to participate in classroom discussions, yet they did not go to the faculty advisor for assistance because they felt asking for help would be admitting weakness. They saw the university and the school of nursing as an unfriendly environment that did not include them, and they did not feel connected to the social or educational resources of the university.
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The first meetings were unstructured: the students concentrated on sharing their experiences. Eventually they began talking about practical concerns, such as professors and classes, their study problems, their test-taking abilities and where they could go for help. After establishing a habit of communication and accepting the value of participating in a group, the students and faculty advisor developed a more structured format to help veteran students progress and beginning students become integrated into the group.
One hourly meeting was scheduled each month. The group members appointed the original student president, and she consulted with the faculty advisor and the Learning Enhancement Center coordinator to set an agenda. Generally, the group focused on a formal topic for the first half hour, such as the resources available for developing writing skills. Speakers often made presentations at this time. The president used the next 15 minutes to pass along timely information, such as news of an upcoming conference. During the last 15 minutes, students talked informally among themselves, often staying after the meeting to continue their conversations.
Achieving Success–Together
In the beginning, I expected that once the minority student support group had achieved its goals, the members would no longer continue it. I assumed they would come to participate in the general nursing student group, the University of Texas Nursing Students Association (UTNSA), and would have no further need for the AANSA.
After participating in the support group, many students did begin taking advantage of the benefits offered by the university and the school of nursing. They were more comfortable expressing themselves in class and more inclined to make friends with students from all backgrounds. They participated more in the general student organizations and began working with the faculty and staff on volunteer projects. Their grades improved because they were no longer afraid to use resources like the Learning Enhancement Center. But the AANSA did not go out of existence.
Currently, the group consists of 14 students, all of whom are female. Members are actively involved with other campus groups, and there is an AANSA representative on the UTNSA board. In addition, the AANSA students are actively working in the minority community. They have organized a program called “Operation: Grow a Nurse” to tutor and mentor middle-school students. They help the students with their schoolwork and encourage them to think about furthering their education at professional schools, such as a school of nursing.
AANSA has given students and faculty the opportunity to interact with each other in an informal setting, allowing them to move beyond the formality of the academic setting. The group has also changed the way faculty members work with students. They taught us that it was all right to approach a student who was doing poorly and suggest that he or she come in for help. The group helped orient the faculty toward the needs and learning styles of minority students, which in turn encouraged instructors to adapt their teaching styles to help students succeed.
And finally, now that the group is cohesive and functioning well, it is time, based on students’ requests, to focus on career development.
Tips For Organizing Your Own Support Network
We learned seven main lessons from our experience with the AANSA group that will benefit other nursing schools interested in forming a minority student network.
1. There must be at least one student who is enthusiastic about the group, who urges others to participate and who takes responsibility for keeping the group active.
2. Initially, the students in the group should be close enough in culture and experience that they feel comfortable talking with each other and sharing their feelings. This group was African American, and the student interaction might not have jelled if other minorities had participated, because the shared experiences would not have been there. After the group became established, it was easier to bring in students with different racial and ethnic backgrounds.
3. The group’s purpose was to integrate students into the university community. This process, however, takes several years and must be given time to achieve momentum. Students see other students benefiting from the group and become more interested in joining. It is only recently that the AANSA students have become involved in the larger student organization.
4. It is important to have a faculty advisor who guides the group and with whom the students feel comfortable.
5. These students have commented that they would like the group to focus more on their unique cultural background and the contributions they can make as a group to the university and the community. Since these are professional groups, it is important to balance this desire with the needs of the public at large.
6. The participating students and I, as the faculty advisor, continue to see the group as filling a need, even though the students are beginning to successfully participate in the general academic and social life of the university.
The author (far left) and her medical team cross a creek by ferry in rural Belize.
In October of 2001, when I was a master’s degree student in the Family Nurse Practitioner program at Prairie View A&M University, I had the opportunity to experience the adventure of a lifetime. I was part of a team of health care professionals who traveled to the Central American country of Belize for a one-week medical mission.
I believe traveling must be in my blood. My mother is a world traveler. She once told me that her dream was to visit every continent in the world, and today she has nearly accomplished that goal. My own desire to travel began in kindergarten when my teacher marveled on and on with such excitement about her trip to Hawaii. For every birthday, I would ask to go to Hawaii as a present—and on my 13th birthday, my dream came true!
So when my dentist approached me about the possibility of traveling to Belize, that adventurous feeling returned.
My dentist is part of a missionary group from our local Woodlands United Methodist Church that travels to Belize about twice a year to spread the word of God and provide free dental and medical care to school-age children in this impoverished Third World country. For some reason, she couldn’t make this particular trip and asked if I could possibly go in her place.
I drove home from my dental visit wondering what I could offer the Belizeans. I was only a nurse practitioner student with over a year of training still to be completed. I discussed the idea with my husband, who has always been very supportive. He said that if I wanted to go, he would hold down the fort at home with our three children.
Before I knew it, I had received my passport and immunizations. I withdrew some retirement savings and was making travel arrangements. When I mentioned my upcoming adventure to some of my colleagues, friends and family members, I received responses like: “Girl, you can’t speak Spanish,” “You could get killed or raped,” “Don’t you remember September 11?” “Aren’t you scared?” and “What about your family?” But when I called my mother, she was elated. The next thing I knew, I was boarding the plane with my passport, traveler’s checks, bottled water, mosquito repellent and Bible at my side.
Rich in Culture, Poor in Health
Belize (formerly British Honduras) is located in the eastern part of Central America, bordered on the northwest by Mexico and on the southwest by Guatemala. It is a country rich in natural beauty, culture and history. However, Belize is poor in health care resources. Its rural villages are desperately in need of access to quality medical care.
Belize is a multiracial melting pot of cultural mixing. According to the U.S. State Department’s Bureau of Inter-American Affairs, in 1998 there were approximately 170,000 people living in Belize. About 44% of the population is made up of mestizos (people of mixed Mayan Indian and European descent); 31% are Creole (African and Afro-European ancestry); about 9.2% are Mayan and about 6.2% are Afro-Amerindian (Garifuna). The remaining population is of European, East Indian, Chinese, Middle Eastern and North American origin. English is the official language, and the language of instruction in schools.
Our group’s destination was Corozal Town, which is located within the Corozal District of Belize. This area has a population of about 10,000. Our assignment was to work in the rural villages of Copper Bank and Chunox that surround Corozal Town.
From the plane, I could see miles and miles of moist, fresh green mountain peaks and aquamarine bays. They looked like they had been sculpted by hand. I thought to myself, “I must be in heaven.” The scenic view was breathtaking.
A hut-style home in the rural fishing village of Copper Bank. The roof and walls are made of palm leaves.
When we arrived at the airport, I was mesmerized by the sight of the jubilant people who greeted us. With so many different shades of brown skin, it was like a candy store filled with flavors of caramel, honey, butterscotch, maple syrup, dark brown sugar, light brown sugar, deep chocolate, fudge and peanut brittle. Then my ears caught the musical sounds of whistling languages—Creole, Caribbean, Spanish, German, Chinese and, of course, our familiar English spoken with a slight twist. Some of the Belizean women and children had their hair braided like mine. But there were variations in the texture of their hair, ranging from shiny, fine-textured black and brown to coarse like lamb’s wool to curly like a newborn’s molded head.
We arrived in Copper Bank about 9:00 am. The villagers, who are primarily fishermen, lived in one-room tin-roofed shacks and huts made of palm leaves. They walked on cement or dirt floors in their homes. At night they slept peacefully snuggled together in hammocks. Their homes lacked running water, electricity and bathrooms. Hand-washed clothes hanging outside to dry were a common sight, as were nude toddlers playing in the dirt roads.
The villagers commuted along the roads by walking barefoot. The lucky ones rode bicycles. A crowd of women at the bay washed clothes on rocks while their children bathed in the water. Other women traveled down the road carrying baskets on their heads filled with clothes, food and other essentials.
In Copper Bank there was only one telephone for the entire village. The lines of communication are kept open through word of mouth and honking car horns. When a honking car drives through the village, the villagers run and gather around the car to hear the latest news report.
Pediatric Care, Belizean-Style
In addition to myself, our medical team consisted of a pediatrician, Dr. Shehaz Jacob; a family nurse practitioner, Susan George; a dentist, Dr. Gary Ricketts; two dental hygienists, Nellie Soria and Patricia Bissia; and an interpreter, Monroe Taylor. Our makeshift clinic was located in a dwelling with no air conditioning, electricity or plumbing. The doors and windows were open and there were no screens to prevent flies and mosquitoes from entering. The only protection we had from the tropical sun and occasional showers was a roof over our heads.
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I came prepared with latex gloves, antibacterial hand gel, bottled water, stethoscope, penlight, otoscope and ophthalmoscope stuffed in my fanny pack and pockets. My job consisted of triaging, diagnosing, prescribing medications and performing pediatric assessments.
When we arrived at the clinic, the Belizeans were already waiting for us in a single line that stretched for about half a mile. The temperature was approaching 98 degrees. Smiling brown-skinned children with large brown oval-shaped eyes arrived barefoot, toothless and sucking their thumbs. Other children stood holding onto their mothers’ skirt tails, dressed with pride in their Sunday best. Their freshly washed, braided hair was styled with bright rainbow-colored bows and they smelled like a newly opened bar of soap.
The women were sitting and standing, openly breast-feeding their infants while their other children remained at their side. Stray dogs were roaming through the crowd. Chickens were marching about to their own musical parade.
The villagers continued to wait patiently to have their children examined at the clinic. They stood in the long line for hours, never complaining and seemingly impervious to the mosquitoes, flies, chickens and stray dogs, as well as the hot sun, rising humidity and sporadic showers. The Belizeans kept coming in droves. Most of them had large families, each with at least five to ten children.
As I worked, the villagers observed me closely, their oval brown eyes following every tedious fine movement and gesture I made. I was often addressed as “Doctor.” Even though I was only a student nurse practitioner, to the Belizeans I was considered a highly qualified medical professional.
A Journey to Ethnic Pride
To say that my experience in Belize changed my life may sound like a cliché, but in my case it is literally true. For the first time in my life, the color of my skin had become a positive attribute. My African-American heritage, spanning the generations from slavery to freedom, was viewed as special by the Belizeans. They admired my cornrowed hair and I gave them permission to touch it. One little village girl of Caribbean descent came over to me and smiled, then exclaimed, “You are just like me!” I felt so proud to be an African-American professional nurse.
A young patient in the village of Chunox clings to his mother as Robbie Taylor-Simon listens to his lungs.
This brief moment made all of the struggles I had experienced back in the U.S. suddenly seem worthwhile. I remembered the many occasions when patients had informed me that my services were not wanted, due to the color of my skin. But in Belize, the color of
I view my journey to Belize as a blessing and a spiritual rebirth. This trip allowed me to set aside any feelings of negativism, hatred, guilt and distrust I had accumulated as a victim of racial prejudice. The acceptance I experienced in Belize was an affirmation of my faith. As an African American coming from the United States, a society too often filled with an overabundance of intolerance, my experience in Belize was a breath of fresh air that helped cleanse my soul.
Belize is a country that has poverty from sea to shining sea, but has no color preferences, no cultural boundaries and no limits on personal acceptance. For one week, people of different races came together, broke bread, shared, listened, gave, cried, laughed and loved. I learned more from the Belizeans in one week than I would ever learn in a lifetime, and I received more from them than I gave. I found love, tolerance and peace of mind.
Because of my experience in Belize, I now look at life from a new perspective. In the future, I shall return to Belize for another mission. Because every now and then, we all need to be recharged with love.
Author’s Note:
I would like to thank the following people for their encouragement and assistance: Jo Ann Blake, RN, PhD, professor at Prairie View A&M University College of Nursing, for serving as my instructor for the independent study in Belize; Dr. Sandra Carrier, my dentist, who gave me the idea of traveling to Belize; Cameron Collins and the missionary group from the Woodlands United Methodist Church in Woodlands, Texas, for giving me the opportunity to be part of their medical team; and Dr. Shehaz Jacob, my preceptor for this international clinical experience.
Spring is the season for awards shows—the Academy awards, the Tonys—every time you turn on the television there seems to be another glamorous star stumbling through his or her lengthy acceptance speech. While actors and musicians entertain us, the real heroes in our society—those truly deserving of recognition—are often overlooked. Nurses, who do everything from performing necessary medical procedures to educating patients about health risks to even saving lives, are the real-life heroes, truly deserving of an awards show all their own.
In a special ceremony each year, the National Black Nurses Association (NBNA) does just that by recognizing one exceptional nurse as Nurse of the Year. The award is given to a NBNA member who has made a significant contribution to the nursing profession by promoting educational opportunities for African Americans, performing community service and promoting health policies. This year, Evelyn C. Gardner, RN, BSN, MSN, ARNP, was recognized for her outstanding achievements as a nurse, an educator, a mentor and a health care advocate.
Wanting to Know it All
Gardner, who is the founder and immediate past president of the St. Petersburg, Fla., Black Nurses Association, has been helping minority nurses in one way or another since the beginning of her career. The importance of encouraging other nurses was a lesson she learned before she even became a nurse; while working at a hospital as a clerical supervisor, Gardner was encouraged by the nurses there to go into nursing. They mentored and supported Gardner because they saw in her the potential to become an outstanding nurse. “Those nurses saw something in me that I did not see in myself,” she remembers.
Gardner started out her nursing career in the ’70s as an LPN. She quickly found herself performing many of the same tasks as the RNs but without receiving the same recognition. But it wasn’t the desire for a more prestigious title that motivated Gardner to continue her education; rather it was her drive to learn everything she could about nursing. Not long after receiving her LPN, Gardner went back to school and received an AS from St. Petersburg Junior College and then her AA. She later transferred to the University of South Florida where she received her bachelor’s degree. But Gardner was not content to remain at that level either. After receiving her bachelors, she went on to receive a master’s degree in nursing and an Advanced Registered Nurse Practitioner degree in gerontology.
“When I reached each level, I would stop and think, okay, what’s next? I am an eager learner; I’m self-motivated and I truly love the profession of nursing. I don’t know what it is about nursing—once you get started you just want to know it all!”
Creating a Community Through Education
Not only does Gardner have an insatiable thirst for knowledge, she also has an endless drive to help other minority nurses. Early in her career, Gardner realized that the African-American nurses in her area needed an organization of their own–so she decided to do something about it.
“After I received my masters in nursing, I was working in my community, and I realized how many nurses were in need of professional advice—a lot of them did not know how to access resources. I love to share knowledge, and I wanted to contribute what I had learned in order to benefit my peers,” she explains.
In 1989, Gardner and three of her nursing-friends decided to organize a nursing association—not knowing that they would later connect with the National Black Nurses Association. Gardner was the leader and the motivator of the group. Each time they met, members would bring a friend, and the next time, those friends would bring their friends. Soon they had enough people to organize a charter [to the NBNA??].
“Our association was motivated by the desire to share knowledge and to serve as support for other minority nurses. As a result of being organized, we have accomplished many things.”
Under Gardner’s presidency, an international student exchange program was founded that promotes nursing education to 60 Haitian students, and the St. Petersburg NBNA was awarded the Key to the City for its tutoring and mentoring programs and for the community health fairs it sponsored.
While Gardner’s efforts to help other nurses may seem exceptional, she explains her motivation very simply. “I am a very busy person, but I like helping and learning. Whenever an opportunity presents itself where I can pass my knowledge on to someone else, I am the first one to get involved,” she says.
On top of her many accomplishments, Gardner has also been instrumental in improving nursing education. As the program director for the Practical Nursing and Patient Care Technician program at Pinellas Technical Education Center, she initiated the Senior Citizens Nursing Assistants Home Health Program—a program that teaches nurses how to care for seniors in nursing homes and private residences. Gardner created this program because she saw a need in the community for increased senior citizen care, and she knew she was in a position to help provide it.
“[When creating the program], I looked for those nurses who could be helpful to the community—those who could provide direct quality health care. The nurses I work with [at Pinellas] are some of the most disciplined nurse assistants that you can find—they have all the work ethic, it’s a beautiful group of people to work with.”
“Tell me, Show me, Let me and Praise Me”
As a nurse involved in education, Gardner is keenly aware of the need to improve recruiting efforts of students into the nursing profession. So, what is the best way to encourage young students to become our future nurse leaders? According to Gardner, we need to start recruiting at the grade school level. She encourages minority nurses to go into their communities and be role models for the children. “Spend time in the classrooms and show the children what nursing entails,” Gardner says. She stresses that we cannot wait until the students are ready to go in to college to begin recruiting efforts.
“The majority of the baby-boomers who became nurses in the ’70s will be retiring within the next six years, but the need for quality health care will still be here. If we don’t mentor the new and prospective nurses and teach them leadership skills, I am afraid of where things will lead. Sure, technology is advancing but that will not replace the need for people to provide health care.”
Gardner practices what she preaches. She is involved in mentoring programs at Boca Ceiga High School, St. Petersburg Junior College, St. Petersburg Urban League and the University of South Florida.
All minority nurses should make it a priority to mentor younger nurses, according to Gardner—and not just nurses of their own racial or ethnic minority group. “All nurses need to be mentored. It doesn’t have to be African-American nurses mentoring African Americans, we have to help any one in need,” she says.
“Tell me, show me, let me and praise me—those are the needs of young nurses as they are being mentored. They have to be shown how beneficial they can be as health care providers.”
Clearly Gardner is doing her part to help mentor the new generation of minority nurses, but she is simply doing what was done for her, as a young African-American nurse, years ago. “Back in the ’70s, nurses had many mentors. We had people who really cared about us,” she says. “Even though they didn’t have a lot of formal education to provide, the older nurses offered the wisdom they had acquired through working in the field. I learned from them because I was part of their team, and they were willing to share the knowledge that they had gained.”
Keeping the Ones We’ve Got
While recruiting nurses at an early age is important, according to Gardner, we also need to focus on retaining those nurses once they enter the demanding field of nursing. “Nursing is a tremendously difficult profession. Often the younger nurses don’t realize how grueling it is and how committed one must be in order to be successful as a nurse,” she explains.
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But Gardner believes retention in the nursing field can be improved if older nurses reach back and help younger ones. “We, as nurses, can provide activities that will help them overcome some of the obstacles they encounter at their jobs. We must do anything we can to help them.”
Gardner also believes that nurses at every level need support and encouragement. “I believe whatever level students what to work at is fine. If I have a student who wants to work as a nursing assistant, that’s great; we need people on that level. If I have a student who wants to maintain an LPN license, that’s fine, too, because we need people on that level as well. I let them know how important every stage is—and how important the job of nursing is on any level. However, I do try to motivate students to increase their education if the desire is there.”
What’s Next?
Although Gardner speaks wistfully of her future retirement, when she plans to work as a nursing consultant, she shows no signs of slowing down just yet. In conjunction with the health department, Gardner recently received a grant called “Closing the Gap.” The grant is part of an effort to reduce the health disparities that affect racial and ethnic minorities in Pinellas County. The first effort of the project was to administer pneumonia vaccines to typically underserved populations, which gave her the opportunity to work with people of all different nations.
“There were Asian, Haitians, Cambodians, Philippines and many more. It’s extremely important for those of us in the health care field to come together and work as a nation to deal with health disparities,” Gardner states. “Understanding other cultures specific risk habits and behavior patterns will help nurses prevent diseases, not just treat them. The health arena will be more productive if we look at these issues early—instead of waiting until people are sick.”
Through Gardner’s example, she compels us to work together, using our unique abilities and resources to improve health care for all. As she explains, “Those of us who are educated in health care must come together with different cultures and races and share our knowledge about health. We need to respect the differences within various cultures and communities; we need to work together for the common goal of accessible, quality health care.”
Randolph Rasch, PhD, FNP, RN, is passionate about nursing. And he’s also passionate about teaching.
“When you practice as a nurse, you provide care as an individual. If you teach, you are helping multiply the number of nurses who are able to provide care. Your efforts are multiplied and you help shape the future of clinical practice. That’s very rewarding,” says Rasch, who is a professor and the director of the family nurse practitioner program at Vanderbilt University School of Nursing in Nashville, Tennessee.
Rasch’s love of both nursing and teaching are spotlighted in the current “Nursing
Education…Pass It On” promotional campaign put together by Nurses for a Healthier Tomorrow (www.nursesource.org), a coalition of 43 national nursing and health care organizations working together to address the nursing shortage. The campaign is designed to encourage nurses and students to consider teaching careers in hopes of slowing the country’s growing shortage of nursing faculty.
While Rasch is new to his role as celebrity spokesman, he has long considered it part of his job to look for and recruit future nursing professors–and his efforts aren’t limited to just the university students in his classes. Before accepting his current position at Vanderbilt, he was a faculty member at the University of North Carolina in Chapel Hill, where he was involved in offering continuing education programs for nurses across the state.
“I made a point to always tell those nurses where I went to school and all of the different roles I had enjoyed as a nurse,” he says. “I was very honest. I said, ‘I am telling you this because I know that some of you are interested in doing different things as nurses and I want you to see the type of things you could do.’”
Rasch would always stay after these education programs to meet one-on-one with
RNs who were interested in career advice. He gave out his contact information freely. Hearing from some of these nurses years later, after they’ve made the transition to a new career specialty, is still one of his biggest rewards.
A History of Firsts
Rasch is featured in two print advertisements developed by JWT Specialized Communications for the “Nursing Education…Pass It On” nurse educator recruitment campaign. He is shown standing in front of a classroom full of students, smiling. His words urge others to join him in training future nurses. “By sharing my story of nursing firsts, I am able to demonstrate how individuals from a variety of backgrounds can succeed,” the ad quotes him as saying.
Rasch does indeed have a long history of firsts. He was the first African-American man to graduate from the nursing program at Andrews University in Berrien Springs, Michigan. He then became the first African-American male public health nurse (PHN) in his native state of Michigan. He followed that by becoming the first male African American to complete an MSN as a family nurse practitioner (at Vanderbilt in 1979). Finally, he became the first African-American man to earn a PhD in nursing when he graduated from the University of Texas at Austin in 1988.
But Rasch insists he didn’t enter nursing with the goal of being a trailblazer. Instead, he just wanted to provide good patient care.
“I was always interested in health care,” he emphasizes. “I really didn’t know what was involved in nursing, so I originally thought about going to medical school. As I learned more, it was clear that nursing was the right choice for me.”
It was nursing’s holistic approach that appealed to Rasch. “Nursing focuses more on the whole person,” he explains. “You can get to know people and help them improve. You do need to know about diseases and treatment, but you also need to learn who this individual is. You have to know about their lives and families so you can plan care that is appropriate for that person.”
Encouraging Future Faculty
Rasch’s approach to encouraging the next generation of nurses to consider careers as professors is very simple. He does it through one-on-one conversations with students. After all, that was how he himself was recruited into teaching.
“When I first became a nurse, I only saw myself working in a clinical setting,” Rasch recalls. “When I graduated from my undergraduate program, I went to work in a hospital. The director of my program said for me to go ahead and do that, but she thought I would grow to become interested in other things.
“She was right,” he continues. “I did enjoy working in the hospital, but I wanted to do other things. So I went to work as a public health nurse in Benton Harbor, Michigan, went back to school for my MSN and became a family nurse practitioner. Then I wanted to learn how to identify problems and solve them, so I entered a PhD program.”
It was while he was pursuing his doctoral degree that the idea of teaching came up. “Almost all of my classmates were nursing professors,” he says. “Along with the faculty, they talked me into [becoming a professor].”
Rasch believes an encouraging word from a trusted faculty member is often all it takes to cause a nursing student to consider teaching. “Most of the people that I talk to haven’t thought about becoming a teacher,” he notes. “When my professors said they could see me teaching, that was enough reason for me to consider it. It’s very encouraging for someone to say to you, ‘we’ve been watching you and we see what you can do. Let’s talk about this.’”
Rasch is careful never to become too pushy in his efforts to recruit future faculty. “No one ever told me to become a professor, but they did ask me to think about it. That’s what I do with my students now.”
When nurses become professors, he adds, they make a lifelong commitment to learning as well as teaching. That begins with the basics of research. “I never saw myself as a researcher with a big ‘R,’ but it is an integral part of my work.”
Rasch’s research expertise is in HIV/AIDS and men’s health issues. He believes that the ability to read, understand and apply research is becoming more important to all nurses. Future nurses need that interpretive skill, he feels.
“Nowadays, anybody who watches the evening news is constantly hearing about new developments in health care,” Rasch says. “Patients will come in and say, ‘I saw this on the news.’ As a nurse, you need to be able to look into it, find and read some of the most current research and then get a sense of whether a change [in the patient’s treatment] should be made.”
Not Always an Easy Journey
Rasch’s long list of barrier-breaking firsts means, of course, that he was often the only male African American in the class or on the job. Yet he says he didn’t experience the loneliness that some men of color feel in nursing. He credits his outgoing personality with helping him avoid isolation. However, he did experience discrimination, although it wasn’t always intentional.
“Some things happened where I realized that my teachers or fellow nurses were discriminating, but [it was usually because] they didn’t stop to think,” he explains. “Sometimes they would almost try to protect a patient from having a male nurse without realizing that it wasn’t an issue with the patient.”
Rasch hopes that by featuring an African-American male professor in the campaign, the “Nursing…Pass It On” advertisements will draw nurses from a variety of backgrounds into the field of teaching.
“I think it’s important to have a very diverse faculty,” he stresses. “We each have our own cultural experience. If you just have people with the same experiences, you narrow the perspective. You get people that look at everything the exact same way and there’s no growth. With a diverse group, you can look at things more creatively and come up with a wider range of possibilities and solutions.”
This trailblazing teacher knows the journey from nurse to professor isn’t easy. He offers several pieces of expert advice for minority nurses interested in making the transition from practicing nurse to nursing educator.
“The first thing to do is look at what graduate programs are accessible,” he says. “Look at where the program is located and how it is offered.” Once you’ve narrowed your choices down to two or three programs, get information on the faculty–specifically, find out about their nursing expertise and their teaching philosophies.
Rasch also recommends putting together a portfolio of nursing accomplishments. This will help you document your successes, something that may be needed to impress graduate school admissions officers. “Remember that students and faculty both add something to the learning process,” he points out. “Show the admissions officers what you can contribute as a student.”
Finally, don’t think it’s too late to consider teaching. Rasch himself worked as a nurse for several years before going back to school to pursue an MSN. “If you’ve been out of school for a while, highlight the things you have done in your career” is his advice for nontraditional students.
Entering the patient’s room, I immediately took note of the look on the elderly woman’s face. There was no way I could look past her grimacing. As an African-American male nurse, I had seen this look before and knew it was in response to my gender, my race or both. Pulling away from the side of the bed where I was standing, she demanded: “Where are all the white people?”
Busy and rushed for time as most nurses are, I was not sure how to handle this situation and still get my medication pass done in a timely manner. I did not think therapeutic communication or touch would work in this particular case. She would not let me get that close to her, either physically or emotionally. Acting as if I could not comprehend her, I offered her the medications that were ordered. She looked at the medicine cup and abruptly said, “I’m not going to take that!” Now the dilemma had evolved into how to distribute medication to this patient.
Who knows what was going through this woman’s mind? Maybe she thought that my being alone with her in her room was a perfect opportunity for racial retaliation: Here was this black man who was finally going to pay her back for centuries of racial injustices. More than likely, she felt I was not intelligent enough to follow the physician’s orders and that the meds I was offering her were incorrect. At this point, it was all irrelevant. My intention was to help her, but in her mind I only represented someone from a race she considered inferior and had spent a lifetime hating.
This patient may not have known the date, or what the name of the health care facility was, or even her own name, but she could and did hold on to racial intolerance. Years of other life training may have abandoned her, but the training she had received about race remained intact. I saw in her face what could only be described as a mixture of hate, fear and anxiety. The year was 2004, but in my mind this incident transported me back to our nation’s past and gave me a taste of how ugly and complicated life must have been for past generations of black and white Americans.
Frustrated with my inability to administer medications to this patient, I exited her room and searched for the other nurse on duty. She was also African American, but I thought there was a chance she would fare better because she was female. This nurse was not new to the ward and she was not surprised by the patient’s reaction to me. When I asked her how I should handle this matter, she replied, “She won’t take medications from me either.”
Needless to say, this patient did not receive her medication that particular shift. I documented the incident and continued to care for the patients who would allow me to.
Unfortunately, it seems the only repercussions that resulted from this incident of racism were the painful feelings that have continued to stay with me. Nothing was ever addressed on any other level that I was made aware of. My employer’s apparent reluctance to acknowledge the problem disappointed me. It seems that even the most liberal and up-to-date facilities fall short when it comes to addressing this issue.
“Get Over It”
Another of my notable experiences involving racism in a patient care situation was an encounter I had with a veteran. This incident affected me deeply for two reasons. First, I am a veteran myself, having served eight years in the U.S. Air Force. Veterans usually feel a kinship toward other vets, regardless of their background, branch of service or duration of service. Secondly, I had taken care of this particular patient for some time and thought that our relationship had somehow transcended race. Until this incident occurred, our interactions had always been very cordial and respectful.
This was a patient who needed total care. He was paralyzed on his left side from a stroke and needed another’s help for even his most basic needs. The incident occurred on evening shift. Because of our limited staffing, once the total care patients were put to bed for the night it was our practice to leave them in the bed until morning. But on evenings when bingo was being played, I would help this patient get dressed again, put him in a wheelchair and push him to wherever the game was located.
He was prone to fits of yelling and anger, but in the past I had always been able to calm him down. Entering the room this particular night, I could tell that he was not in the best of moods, but I was not expecting the encounter that ensued. All of my attempts to calm him failed. In fact, they seemed to just heighten his anger. And at the apex of his anger, he yelled, “N- – – – -, get out of my room!”
Many emotions ran through me at that moment-certainly too many to count. What I did next escapes me. I assume I must have straightened his blankets and did what I thought would make him comfortable. I do know that I exited his room angry and told the charge nurse about the encounter.
The nurse in charge was totally sympathetic but at a total loss as to how she should handle the situation. I was sitting in the staff break room obviously angry and frustrated, with my arms crossed on top of my chest. She under- stood that she could not just let this incident go without some intervention on her part. Her decision was to call the house supervisor.
I had what I thought was a decent working relationship with the house supervisor, so I was not against discussing this incident with her. When the evening supervisor arrived on the ward, I was still in the break room fuming from the incident. She came in and asked me to explain what had happened; I gave her my interpretation of the incident. Her reply did nothing to soothe my anger. She basically said, “Get over it.”
She then began to relate some incidents of disrespect she had encountered in her own journey through nursing. Being called out of her name, having her level of intelligence questioned and being touched inappropriately were all situations she described. She seemed to indicate that this was part of our job and we had to take it.
I sat there listening, refusing to believe what I was hearing. I also refused to accept her personal doctrine that this type of treatment was “normal” and that nurses should accept it. I sat there respectfully, but her words did nothing to redeem my dignity or help repair my relationship with this patient.
The incident did send some minor ripples toward the higher-ups at the facility. They never spoke to me directly, but their messages found a way to me somehow. The messages consisted of blaming the occurrence on the patient’s condition, saying that stroke patients sometimes react that way. The patient’s medication was also increased, especially his psychiatric medications.
A Gesture of Healing
The one person who truly seemed to understand how much this incident had hurt me was the patient’s wife. His wife, who was a volunteer at the facility, was tireless in her efforts to continue caring for him and many other veterans. She seemed to be his exact opposite in terms of temperament. She volunteered mainly on the day shift, but our paths crossed as the day shift ended and the evening shift began. She too had always been very cordial and respectful to me. The day she confronted me about this incident was no different. I did not intentionally avoid her, but I was not looking forward to encountering her either.
Our discussion took place in the doorway of the patient dayroom. She had always been very direct and that part of her personality was very much in evidence now. She looked me straight in the eyes and said, “I heard about what happened between you and my husband, and I would like to apologize for the awful word he called you.”
I immediately dropped my head and was silent, not because I was ashamed but because I was so full of anger. She continued, “My husband was not a man who used that type of language when he younger, and we did not raise our children to use that type of language either.”
I was still silent, but now we were staring into each other’s eyes. We could both see how deeply this incident had touched me. “I have offered an apology and I can not force you to take it,” she said, “but I hope that you will and that you will continue to care for my husband in the same manner as you have always done.” That was her last statement to me as she gently patted my hand and walked away.
We did speak again after that, but the subject of what happened that day was never touched on. Our conversations were genuine and honest, but I believe we both felt that enough had been said on the subject. Even though I never said anything to her about the incident, she comprehended the depth of the damage her husband had caused by uttering that offensive word.
Emotional Scars
As much as I would like to say that my treatment of that patient did not change, the truth is that it did. I was still very professional and considerate to him. But all of the things one would describe as “extras” ceased. I never got him up for bingo again and my conversations with him held brevity in my tone.
Time passed and I was transferred to another unit at the facility. But I never forgot that patient or that painful incident. Any time I visited that unit to see past co-workers, I would always peek into his room just to see how he was managing.
I began to hear that his health was declining. By the time I had gathered enough courage to actually step into his room, he had deteriorated to the point where he was alert only to himself and being fed by a nasogastric feeding tube. I stood at his bedside and asked him how he was doing, but all he could do was gaze up at the ceiling and mumble incoherent words. He continued to steadily decline until a co-worker notified me of his death.
Later that week I read his obituary. I was surprised at the sterility of the announcement. There he was in an old picture from his military days, hat cocked to the side, smiling. The obituary mentioned a lifetime of loved ones and military service. It was brief and to the point. He existed, but now he was gone.
I was not sure of my feelings then and I am still not sure of them now. All I knew was that he was dead and our joint legacy of pain had died with him. But it still lives in me.
The point of this personal reminiscence is that we in the nursing profession must ask ourselves how to handle the issue of racism in the nursing workplace, and more specifically, how to handle racism when it is expressed by patients. I guess the first step is to admit that the problem exists. Even when they are in a hospital receiving care for the effects of diseases, aging or traumatic physical injuries, there will always be some individuals who will put their racial ideology above anything they are confronted with. That is their right.
But we professional caregivers of color also have the right and the obligation to stand against such behavior and demand to be treated with respect and dignity.
