As increasing numbers of patients don’t speak English as their first language—or at all—the health care field is taking action. Here’s what’s happening and how you can become involved.
Imagine if you were in a hospital in a country where no one spoke English. Being in a strange hospital or other health care facility can be scary enough, but if you had no idea what was going on, it would make you more stressed—possibly making your health worse. You would feel incredibly vulnerable, as not knowing what was happening to you or if the workers could help you would be terrifying.
There was a time in the United States when that could happen. Although it shouldn’t happen, legally, anymore, as Allison Squires, PhD, RN, FAAN, explains, there is still a need for more bilingual nurses. “All health care facilities are required by law—including the Civil Rights Act and updated regulations in the Affordable Care Act—to provide patients who do not speak English with an interpreter,” says Squires, an associate professor at the New York University Rory Meyers College of Nursing. “The interpreter can be an in-person interpreter or a telephone or video interpreter to meet the requirements of the law.”
According to Squires, the increase in patients who haven’t developed English skills comes from two situations: the post-WWII legacy in which U.S. citizens came here as immigrants, and the most recent wave of immigration, which has matched or surpassed the immigration numbers of the early 20th century. “According to the Pew Research Center, one in five households in the U.S. speaks a language other than English at home. More communities are also becoming refugee resettlement cities across the U.S., which means increasing linguistic diversity in places that have historically only had English speakers,” says Squires. “The demand for nurses who speak another language is at an all-time high.”
Location, Location, Location
While all the sources whom we interviewed agree that Spanish is the most prevalent second language needed for patients, they also say that other languages are vital as well, depending on your region of the country. “Spanish is the priority language nationally. Other languages depend on where you live and who is migrating there,” says Squires. “For example, in the New York City and New England regions, there are now large numbers of Russian speakers. These individuals often come from former Soviet Union states where Russian was the official language. Other parts of the country, like Texas and Louisiana, have large numbers of Vietnamese speakers who came to the U.S. as refugees or immigrants. Other than Spanish, language demand is often specific to a local health care service area.”
“Spanish is the language in highest demand, particularly in Texas, California, Florida, and Illinois. In California, bilingual skills are needed for Spanish, Chinese, Vietnamese, and Russian,” says Terry Mort, who is manager of talent acquisition for VITAS Healthcare, the nation’s leading provider of end-of-life care. In the 14 states and the District of Columbia in which they provide care, VITAS Healthcare has also found the need for Mandarin, Cantonese, Tagalog, Hmong, Korean, and Creole.
“We constantly have to look at demographics of the communities we serve and pay attention to how they’re changing over time,” explains Mort. “Take California as an example. At one time, South Central Los Angeles was primarily an African American community, whereas today it’s predominately Hispanic. And as our services move into outlying areas of Los Angeles County, our needs change again because we encounter more families that are Filipino, Asian American, or Hispanic American.”
Currently, in South Florida, several VITAS hospice teams are solely Spanish speaking to appropriately serve their patients’ and community’s needs. “In California, a trilingual nurse—someone who speaks English, Spanish, and other language—would be in high demand,” says Mort.
Although particular languages may be needed to serve certain populations, there are also instances in which unexpected languages may also be required. For example, when there was a recent influx of patients from Puerto Rico at the University of Maryland Baltimore Washington Medical Center who needed health care after Hurricane Maria, there were more Spanish-speaking patients, says Edith Lopez Dobbins, RN. Dobbins is a JET Nurse, which stands for Just Excellent Timing and means that she is a full-time nurse who serves as supplemental staff for different nursing units throughout the hospital. As a result, she has noticed an overall increase in patients who speak Hindi and Korean as their first language.
“In the hospice profession particularly, we also have the challenge of end-stage dementia patients, who may revert to their language of origin as their disease progresses. We had a Russian patient who reverted to speaking Russian, but the family indicated he had not conversed in that language for more than 20 years. If that happens, it requires us to update our care plan so that our nurses and staff members can communicate effectively with these patients in a language they understand,” explains Karen Peterson, senior vice president and chief nursing officer for VITAS Healthcare. “The more languages our staff members can speak, the easier our job is.”
Benefits to Being Bilingual
Bilingual nurses on staff help open everyone up to another world as well as another set of patients to care for, says Vivian Carta Sanchez, DNP, ARNP, from Tenet Florida Physician Services. “Nurses who are bilingual can also serve as translators to communicate very important information from physicians who do not speak the language,” says Sanchez.
Squires says that if you work in a hospital, home care, long-term care, or rehabilitation, there are four key times when interpreters are needed—admission, patient education, consent, and discharge. “Using an interpreter during these times can help reduce your patient’s risk for readmission and complications,” explains Squires.
Having a nurse who is bilingual, rather than using a family member to translate, can be crucial. “Let’s say that I take five minutes to explain something in detail to a patient, and the family member who translates what I said to the patient takes about 30 seconds. I can tell that my patient isn’t hearing the same thing that I said—and that’s a risk to the patient, because they’re not getting complete information,” says Peterson. “It’s one of the reasons we prefer not to use family members as translators because they are part of the unit of care and also dealing with psychosocial issues associated with end of life.”
Another advantage to staffing or being a bilingual nurse is that when you are speaking the same language as a patient, the work you are doing will take the same amount of time that it does as when you are talking with an English-speaking patient, says Squires. There’s no need to be concerned about waiting for an interpreter to arrive or to have to deal with any issues that can occur when using an interpreter by phone. In addition, communicating with family members may also be easier. “That being said, as a bilingual nurse, if you are the first language nurse to work with the patient when they access health services—be they in the hospital, home care, or primary care—sometimes you spend more time with them initially because the patient is so happy to have someone who speaks their own language,” states Squires. “You find out all this other stuff that the patient held back because of the language barrier or issues with interpreter services. Another advantage of being a bilingual nurse is that you can quality check video or phone interpretation.”
Culture Comfort
Speaking to patients in their native language isn’t only about the words; it’s also about their culture. Dobbins says that while they use “language phone-lines” to keep at patients’ bedsides so that they, their families, and the health care workers can communicate—which is certainly helpful—the phones can also make talking more impersonal. “It makes patients and their families uncomfortable—possibly because it’s not just about language, it’s about culture. Most of the time, we use peers in the health care team who speak the same language as the patient for better communication and overall quality of care,” says Dobbins.
“Bilingualism is even more imperative in the hospice profession because there’s a lot of emotion and psychosocial aspects of language surrounding the dying process. Each person might have a different opinion or thought process around the issues related to dying. It’s unique in that people may have difficulty conveying their thoughts and feelings, even in the same language, simply because it’s about death,” explains Peterson. “Some patients or family members can’t even say the word ‘hospice,’ so they find a way not to say it. But when our nurses, families and patients understand each other’s language and cultural nuances, we’re more confident that patients are making the right decisions and receiving the best possible care because everyone understands each other.”
Knowing about patients’ culture has become so important that the Chamberlain University College of Nursing began offering a Hispanic concentration on its Phoenix, AZ campus in May 2016. Pam Fuller, EdD, MN, RN, the Phoenix campus president, states that this concentration doesn’t aim to attract Hispanic nurses, but rather to appeal to nurses who want to care specifically for this culturally diverse group. This concentration is offered to anyone who is enrolled in the university’s pre-licensure BSN program. Because of its ability to logistically provide clinical experiences for students who are enrolled in the Hispanic concentration, the Phoenix campus volunteered to pilot it. “The local hospitals and health care centers currently serve Hispanic patients and families every day, and Chamberlain helps provide nurses and care to these local communities,” says Fuller.
“Providing nursing care requires not just an appropriate educational degree and a license, but also crosses boundaries of human dignity and respect. Many, if not all, hospitals and care centers are challenged to communicate more effectively with their patients, regardless of cultural background. Chamberlain specifically launched the Hispanic concentration based on information from hospitals in our local markets,” explains Fuller. “When a patient is in pain or in need of health care, they tend to revert to what is comfortable to them, culturally. If you are culturally more comfortable with your own language and traditions, if there is someone who can speak—at least a little bit—the language you speak, it makes the care that much more effective and personal.”
“Chamberlain’s Hispanic concentration is not a language program. This concentration exposes students to the Hispanic language and culture and allows for 25% of their clinical experience to be placed with a Hispanic patient. This gives them real-time experience in serving the Hispanic population,” says Fuller. “Any student—regardless of their personal cultural background—may enter this concentration…The goal of the Hispanic concentration is to educate students and expose them to the culture and language of the Hispanic community to provide an improved level of care to this population.”
Attracting Appropriate Personnel
How can facilities go about recruiting bilingual nurses? Squires believes that a combination of actions could help. Nursing schools need to recognize local demand for bilingual services and restructure curricula to help ensure the success of English as a Foreign Language (EFL) students, says Squires. “Even now, EFL students have lower pass rates on the NCLEX-RN exam, and that’s not helping to meet our need for more bilingual nurses. Schools need to change how they teach and support EFL students so they have the same success rates as English speakers,” Squires says.
“Organizations should give bonuses to people who are bilingual to encourage better communication,” says Sanchez.
As for becoming bilingual, Squires says that to achieve the level of fluency to be able to effectively and safely communicate with patients about health issues, nurses would be required to undergo years of study or at least a six-month immersion in a country where the language that they want to learn is spoken. “Having just a few words or phrases can be helpful for recognizing when a patient is in pain or [has] toileting needs, but when it comes to the complex communication needs that go with admission for services, patient education, consent, and discharge, you really need to have what’s called sociolinguistic competence in a language. That’s something that your employer should help you certify or do it on your own to make yourself more marketable,” says Squires.
At the end of the day, being bilingual or having bilingual nurses on staff is all about patients’ safety and comfort. “As a nurse, many of my most rewarding moments have to do with going the extra mile to help a Spanish-speaking family during their hospital stay,” says Dobbins.
The end of the year was dreamlike. Not only was I accepted into an accelerated nursing program, the school also selected me as a recipient for a prestigious scholarship award. The honor of being among an elite group chosen to represent the ideal future “face” of nursing leadership was an incredible sensation. But those exciting days quickly spiraled into a nightmare.
Many of us belonging to ethnic and racial groups experience disturbingly disparate health, educational, and economic outcomes, and we have committed ourselves passionately to improving the well-being and quality of life of individuals from populations from which we ourselves are drawn.
My faculty advisor for the scholarship program was so impressed with my curriculum vitae and scholarship application essay that she strongly encouraged me to pursue scheduling a meeting with the director of the Ph.D. program to discuss a seamless progression from a B.S. to an M.S.N. to a Ph.D. One week later, I met with my faculty advisor again to discuss some initial temporary feelings of anxiety I had about the program. I sought to proactively inquire about accessing resources and strategies to succeed in the program, with my diagnosis of depression and anxiety disorder. The next day, in a meeting with my advisor and one of the school’s deans, I was urged to voluntarily withdraw my admission and cancel my acceptance.
The experience was unfathomable; literally within a week, I went from being encouraged to complete all levels of nursing education at the school to being told “this is a very intense program,” “we want you to be well,” “there are other seconddegree programs,” and “when one opportunity closes another opens.” A week after the scholarship orientation and on the fourth day of classes, they concluded that I lacked the emotional fortitude to handle the rigors of the intense, accelerated program. Additionally, when I called several weeks later to honor my end of the scholarship contract with the organization, I was informed that the school had already contacted the organization the day after my withdrawal and requested that the scholarship funds be given to another fi nalist. Along with the frustration inherent in the situation, I was very disappointed with the enduring stigma of mental illness, so pervasive that my health condition superseded the accomplishments that resulted in my selection as a prestigious scholar.
About a month after the experience, I traveled overseas for a service mission trip. An uncanny experience served to maintain my resolute desire to be a nurse, in spite of the indignant and vilifying event.
As the service team of approximately 60 volunteers waited to begin our five-day service mission, the warm community residents greeted us individually. One young girl caught my attention, as she was wearing a bright pink shirt, decorated with the word “princess” (printed in English) and a rhinestone-studded tiara. It reminded me of something I would have worn at her age. Speaking in Spanish, I said, “I really like your shirt.” She tilted her head, her eyes downcast. Her facial expression indicated that she heard me, but she didn’t respond to my compliment. I then proceeded to tell her how pretty it was and called her Princess. Again, I received no response and little eye contact. I finally asked her if she understood me, as I didn’t rule out the possibility that my Spanish was rustier than I realized, but she answered “yes.”
When I walked off I watched the young girl and noticed she was aloof from the other girls and women who were waiting to enter the clinic area. I had two initial thoughts: first, this young girl needs to see a provider and feels shame or embarrassment, or she is extremely shy. Several hours into the afternoon, I saw her again and asked her age. She clearly responded with her head lifted, making eye contact: “16.” Then she became reticent to speak again, and I watched her from a distance and noticed that she remained aloof.
I asked one of the missionaries of a partnering organization about the average age of parity and the familial structure. He said couples are usually partnered anywhere from 12 years to adulthood. I asked our pharmacy manager if we had pregnancy tests. We didn’t.
I saw the Princess again for the third time in the late afternoon but didn’t find an appropriate opportunity to speak with her in an inconspicuous manner. The next day, I spoke with the pediatrician about my assumption, and when I spotted the young lady, I discreetly pointed her out. My hope was that she could be examined and referred to the permanent clinic, about a 30–40 minute walk, to receive the care I believed she needed. A few minutes prior to leaving for my service project worksite, I greeted her with a wave and a smile and it was reciprocated with a partial wave and smile. The next day, I discovered that a teenage girl was seen by one of our providers and that she indeed thought she might be pregnant but was afraid her mother was unaware of her potential pregnancy.
I shared my experience with my student mentor assigned to me at the time of my admission offer to the scholarship program. She expressed her concern about the information I revealed and reasoned that as a black female ostensibly entering a predominately white women’s profession, disclosing my mental health condition might not have been the action of my better judgment. I respectfully, wholeheartedly disagree.
Not only does concealment fuel stigma, but carrying this unnecessary burden hinders one’s ability to achieve a complete and whole state of wellness. Additionally, I candidly shared with her that my father was a physician, trained in the ’70s, who labored under the stigma and shame of his depression for 30 years, unbeknownst to most of his colleagues. Out of fear of losing his medical license and the respect of his colleagues, he concealed his illness and failed to receive the appropriate level of treatment he needed during a crisis episode. As a result, his lifelong battle with depression ended in suicide. His family, friends, colleagues, fellow community members, and former patients were absolutely devastated and angry that he never reached out for adequate help.
My very considerate and compassionate student mentor addressed a relevant and poignant concern, one I also believe has been inadequately examined in society: in a country that professes a desire for diversity, but where racial prejudice still exists and opportunities to render a racial/ ethnic minority as incompetent can be exploited, how does one handle a having a mental illness?
While this question should by no means be ignored, I’ve debated my decision to disclose my mental health history and the physical manifestations that I experienced. My conclusion? I unequivocally have no regrets. One of the main roles of a nurse is to be a patient advocate. I believe that if I can effectively advocate for myself, I’m well qualifi ed to be a uniquely effective advocate for a patient.
Finally, to my father, I’m so very proud of you for dedicating your life, service, and passions to helping others, even as you did your best to address your own struggles and challenges. Thank you for giving me the resiliency and courage to pursue my passions and dreams amidst obstacles and adversity. I love you.
If you are struggling with depression and/or anxiety, we encourage you visit the National Alliance on Mental Illness website at www.nami.org or the National Institute of Mental Health at www.nimh.nih.gov.
Hospitals For Humanity (HFH) is a registered nonprofit organization with 501(C) 3 status in the United States. The organization provides health care for people living in the least developed countries of the world. Their goals include providing health assessments and treatment for local citizens; updating existing medical facilities, assisting in the construction of modern hospitals, and providing training to local physicians; improving regional health and sustaining the quality of care through partnerships with local government; and responding to special cases of chronic illness and diseases through evaluation, diagnosis, and patient referral.
Efforts are currently focused on communities in Haiti, Nigeria, and the Philippines. HFH’s total patient population is over 65,000 and includes general surgeries, ophthalmic surgeries, dentistry, emergency medical services, and more.
HFH is looking for compassionate volunteers who desire to enroll in the organization, including CRNAs, NPs, PAs, RNs, optometrists, pharmacists, MLTs, EMTs, surgical techs, and physicians of all specialties. Currently, two Medical Mission Initiatives (MMIs) remain for 2012: one in Okija, Anambra State, Nigeria, from October 12–19, and one in Ijumu Land, Kogi State, Nigeria, from December 1–12.
If you are interested in learning more or applying for a Medical Mission Initiative, visit www.hospitalsforhumanity.org. You can view an informational video, look at pictures from past MMIs, and submit an application. Questions not answered on the website can be directed to Adrian Johnson, Director of Recruitment, at [email protected] or 224-577-5479.
A career in pediatric nursing offers an abundance of opportunities for personal fulfillment. Many nurses choose to work in pediatrics because they have a deep passion for helping children; others did not originally set out to work with kids but later chose to focus on pediatric care. But no matter how a nurse becomes interested in this specialty, the rapid growth of America’s racial and ethnic minority population means that minority pediatric nurses and nurse practitioners are needed now more than ever in a variety of health care settings, from hospitals to schools to daycare centers.
According to Gloria Jones, MSN, RN, manager of clinical operations at Connecticut Children’s Medical Center in Hartford, nurses of color are severely underrepresented in the pediatric nursing workforce. “Overall, only about 2-3% of all [pediatric] nurses are minority. It’s a very, very low representation,” she says.
Another reason why culturally and linguistically competent minority nurses are so urgently needed in pediatrics is that caring for children often means caring for the child’s family, too.
“The one thing I’ve found with pediatric nursing is that you treat the whole family. The parents and extended family are also considered your patients because they’re going to be in the room with that child,” says Angela Bryant-Curry, RN, who works in the Kohl’s School Nurse Liaison/Consultant Program at Children’s Healthcare of Atlanta. “With 90% of the kids who are in the hospital, there’s going to be an adult—or we hope there will be an adult—who will remain in the room with that child. So that person becomes your patient as well.”
Making a Difference
Ask any pediatric nurse what they love most about their chosen specialty and there’s a good chance the answer will be: “the opportunity to make a difference in children’s lives.”
Association of Pediatric Hematology/Oncology Nurses (APHON) Beena Mathew, RN, a nephrology nurse at Children’s Medical Center Dallas, was inspired to pursue a career in pediatric nursing after hearing a speech by Mother Teresa at her college in India. The lecture was about finding your focus in life, serving humanity and using your unique qualities to find a profession that is also a passion. Mathew decided to focus her passion on helping others by becoming an educator and a nurse. Since immigrating to the U.S. in 1994, she has dedicated her career to working with children.
Although most nurses don’t have the opportunity to be personally inspired by someone like Mother Teresa, many find that working with children as a pediatric nurse brings tremendous personal rewards.
“I chose pediatric nursing because even as a teenager I wanted to make a difference in the life of a child,” says Bryant-Curry. “My mother is a registered nurse and so my summers were spent at the office with my mom, where I had a chance to interact with nurses and patients early on.”
“During my clinical rotation I really loved working in the labor and delivery unit and working with the babies specifically. I just gravitated toward pediatrics,” says Valerie Caraballo Perez, MSN, RN, BS, senior research coordinator at the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention. “It’s nice that we can have a hand in helping kids get better and also working with the parents so that they understand what they need to do to keep their kids safe. That’s what I got interested in.”
Tommy Covington, RN, a hematology/oncology nurse at Childrens Hospital Los Angeles, has been working in pediatrics for nearly 40 years, even though it was not what he initially set out to do. “I was reluctant to go into pediatrics at first, because I had planned to work at the veterans’ hospital after I graduated,” he explains. “I wanted to work with the vets because I was recently out of the Navy. But I gave Childrens a try with their encouragement and have enjoyed my 39 years here. My wife has worked here for 27 years, so we are a Childrens Hospital family now.”
Where the Jobs Are
Whether you’ve always wanted to work in pediatrics or are contemplating a career change, this specialty offers virtually limitless opportunities and practice settings, including hospital pediatric units, children’s hospitals, pediatricians’ offices, schools, daycare centers, community health care organizations, home health care, insurance companies and more.
“We are seeing a great job market for nurses,” says Linda Matzigkeit, senior vice president of human resources at Children’s Healthcare of Atlanta. “There will continue to be sick children who need top-of-the-line care, and that means trained pediatric nurses are in high demand. This includes specialist positions, such as critical care and cardiac, as well as general patient care positions.”
There are also new and emerging career options in which nurses work in a combination of settings to provide care for children. For example, Bryant-Curry’s position combines work with both health care facilities and schools. As a school nurse liaison/consultant, she helps chronically ill children transition from the hospital back into the school setting. The transition process can range from a simple phone call to the school’s nurse or mental health monitor to sharing pertinent medical information about a particular child to conducting a medical in-service to educate school staff, or any other adult involved with the child, about the child’s medical condition.
“I’ve educated bus drivers or any school personnel that will have contact with the child that has been diagnosed with a chronic illness,” says Bryant-Curry. “On the consultant side, school nurses call me for information on a particular disease or health issue related to a particular child.” She currently provides consultation to nurses in eight Atlanta school districts.
In 2008, Bryant-Curry educated 2,200 school personnel on medical conditions such as anaphylaxis (severe allergic reaction), asthma, communicable diseases, diabetes, epilepsy and sickle cell disease. Her role as a hospital/school liaison gives her the opportunity to develop medical presentations for state conferences, serve as a mentor for school nurses and write fact sheets for school personnel on children’s health issues such as allergies versus colds.
Research is still another career path pediatric nurses can follow. Caraballo Perez, who is the current treasurer of the National Association of Hispanic Nurses (NAHN), calls her injury prevention research job the CSI of nursing.
“I work pretty much like a crime scene investigator,” she explains. “We assess children who were injured in motor vehicle crashes. We assess the injuries and the vehicle, and we present the information we gather at meetings, to see how we can use this data to improve things like vehicle [safety] design and the way the physicians treat patients. There is great opportunity in injury prevention education. There are a lot of research positions here at Children’s Hospital for nurses to get into.”
Caraballo Perez, who received her master’s degree in public health nursing in 2004, also conducts community education programs on child passenger safety, as well as giving presentations at injury prevention conferences.
Nurses who are interested in advanced practice careers will find that opportunities for pediatric nurse practitioners are plentiful, especially in emerging practice settings such as retail clinics in pharmacies. But Carolyn Jaramillo de Montoya, MSN, CPNP, immediate past president of the National Association of Pediatric Nurse Practitioners (NAPNAP), emphasizes that traditional basic care for children and their families will continue to be at the forefront of the profession.
“I believe there will be an increased demand for pediatric nurse practitioners who are capable of providing first-line quality care for children and families to help tackle preventable illnesses such as type 2 diabetes, obesity and essential hypertension,” she says.
The Demand for Diversity
Minority pediatric nurses and nurse practitioners can play a vital role in the lives of young patients of color by helping them bridge communication gaps resulting from cultural differences and language barriers. As the U.S. becomes more and more multicultural, minority nurses will be in increasingly high demand to advocate for patients and their families.
For More Information About Careers in Pediatric Nursing Society of Pediatric Nurses (SPN) National Association of Pediatric Nurse Practitioners (NAPNAP) Association of Pediatric Hematology/Oncology Nurses (APHON)
“As the population becomes more diverse, it is important that the health care workforce represents the people they are serving,” says Jaramillo de Montoya. “For example, it is helpful for a child who may only speak Spanish or Navajo to have a nurse who can explain what is happening to them in their own language. Additionally, nurses of color help other nurses to understand their culture, thus improving the care of minority children.”
To effectively address the needs of the changing communities that hospitals serve, nurses should know the dynamics of that community, believes Caraballo Perez. “Minority nurses bring rich experience and knowledge of their own communities,” she says. “[We come from communities that] have vibrant traditions, histories and cultural beliefs. To influence change in health care and advocate for our minority pediatric patients, minority nurses must recognize these attributes and move into positions of leadership [so we can] have a place at the table where decisions are being made.”
Diversity in the pediatric nursing workforce becomes even more important when the unique challenges of treating the ever-increasing population of minority children are factored in. Today, one third of all Americans under the age of 18 are classified as a racial or ethnic minority, creating a high demand for knowledgeable nurses who understand the health disparity issues these populations face. For example, minority children are more prone to conditions such as obesity and type 2 diabetes. They are also more likely to be without health insurance, resulting in lack of access to important preventive care and treatment.1
“It is simply a matter of time before the U.S. develops some strategy for dealing with the 47 million Americans who lack health insurance,” says Jaramillo de Montoya. “Within this number of uninsured there are approximately 8 million children. The current workforce of primary care providers is insufficient to meet the demand for providing care to these children.”
Seeing the Big Picture
Jones notes that many nurses in general—both minority and majority—are reluctant to pursue careers in pediatrics. “I’ve been talking with minority nurses since 1999 to find out why [so many of them] are not interested in pediatric nursing, especially after I came here [to Connecticut Children’s Medical Center],” she says. “I would say 96% of the 40 to 50 nurses I’ve spoken with say they just felt that they didn’t want to work with sick children or that they couldn’t manage working with children.”
The most common reason for this resistance to working in pediatrics, Jones adds, is that many nurses find it heartbreaking to see children who are sick and in pain. But pediatric nurses who are passionate about their specialty argue that having the opportunity to help sick kids get well and live healthier lives outweighs the negatives and truly makes this career worthwhile.
While working with children can be emotionally difficult at times, Bryant-Curry remains focused on the larger picture. “It is emotional and sometimes you feel like you’re doing things that are painful, such as giving a child an immunization,” she says. “But that’s only going to be 30 seconds of pain to prevent a life-threatening disease.”
References
1. Hockenberry, M.J., Bryant, R. and Rodgers, C. (2006). “Pediatric Nursing: Recent Changes and Current Issues.” Current Issues in Nursing, Seventh Edition, Cowen, P.S. and Moorhead, S. (Eds.), pp. 204-211. Elsevier Health Sciences.
In New York City, an innovative community-based cancer prevention initiative that utilizes bilingual “patient navigators” to guide participants through the process of receiving a colonoscopy is achieving remarkable results in increasing rates of colon cancer screening and early detection among the city’s minority populations.
According to a report in the June 6 edition of the New York Times, the New York Citywide Colon Cancer Control Coalition—a group of physicians, city health officials, union workers, hospital administrators and insurance providers—launched the program five years ago to improve the low rate of colonoscopy screening among New York residents ages 50 and older. The patient navigators’ role is to call people to encourage them to make a colonoscopy appointment, and then guide them through the process to make sure they actually receive the screening. To increase compliance and reduce no-shows, the navigators provide a variety of support services, from explaining how to prepare for a colonoscopy to arranging transportation.
Between 2003 and 2007, the navigator program has helped increase colonoscopy rates by about 50%, while dramatically reducing the no-show rate from 67% down to 10%, the coalition reports. Specifically, among New Yorkers age 50 or older:
64% of blacks received a colonoscopy in 2007, compared with only 35% in 2003.
63% of Hispanics received a colonoscopy, up from 38% in 2003.
53.6% of Asians received a colonoscopy, compared to 25% in 2003.
62% of whites received the procedure, versus 48% in 2003.
Because of this success, the program is now operating in 16 hospitals in the city and is starting to expand into other areas, such as diabetes prevention.
