What do you get when you bring together the National Association of Hispanic Nurses (NAHN), which represents Hispanic and Latino nurses coast to coast, and LatPro.com, the leading jobs/careers Web site for Hispanic and bilingual professionals? A new Online Job Center and scholarship program designed to fill the nation’s acute need for more multicultural, Spanish-speaking Hispanic nurses, that’s what.
In January, NAHN and LatPro formed a strategic partnership coinciding with the redesign and expansion of the nursing association’s Web site. The partnership’s centerpiece is an integrated health care Job Center on the site, powered by LatPro.com. The trilingual Job Center (English, Spanish and Portuguese) leverages LatPro’s extensive recruiting database to let nurses access a variety of clinical, academic and managerial job listings and create personalized email “job agents.” In addition, health care employers can post job openings and perform advanced database searches to find highly skilled bilingual and bicultural nursing professionals.
President Rudy Valenzuela, MSN, RN, FNP-C
To help address the severe shortage of Spanish-speaking students choosing health care careers, the NAHN-LatPro partnership has also launched a LatPro-sponsored scholarship program that will provide financial assistance to Hispanic students pursuing nursing degrees. (NAHN already offers several scholarships of its own, through both the national association and its local chapters.)
“We are very pleased to have developed this relationship with a company like LatPro that understands the needs of our unique membership,” says NAHN President Rudy Valenzuela, MSN, RN, FNP-C. “Our combined efforts will bring employers and bilingual nurses together, helping to address the need for qualified Hispanic health care professionals.” For more information, visit www.thehispanicnurses.org, or contact Liana Eagle at (202) 387-2477.
They make up significantly less than 1% of the registered nurse population, but their numbers are increasing and the demand for them is growing. “They” are Hispanic nurses who happen to be men.
Even though they are one of the most underrepresented populations in nursing, that hasn’t deterred them from contributing to the profession by carving out leadership roles and serving as mentors to other Hispanic men who may want to pursue a nursing career but are unaware that it’s a viable option for males. Nor do their small numbers diminish their desire to provide quality health care, especially to Hispanics, who are one of America’s most medically underserved populations.
In 1996 there were an estimated 5,064 Hispanic men in nursing, according to the National Sample Survey of Registered Nurses, issued approximately every four years by the Health Resources and Services Administration (HRSA), Bureau of Health Professions, Division of Nursing. The most recent (2000) survey places the number of nurses who are Hispanic men at 6,227 (out of a total Hispanic RN population of 54,861). Although that’s a nearly 23% increase from 1996, Hispanic men still make up less than a quarter of 1% of the approximately 2.7 million total RN population in the United States.
“There has been an increase in male Hispanic nurses, and males [in nursing] in general, over the past 30 years,” agrees Hector Hugo Gonzalez, PhD, RN, a past president of the National Association of Hispanic Nurses (NAHN) and current chief executive officer of NAHN’s San Antonio, Texas chapter. When Gonzalez first graduated from nursing school in 1962, male students were so rare that the school he attended didn’t even have a restroom for men.
Things have improved a bit since then, of course. Today nearly 14% of the graduating class at the nursing school at San Antonio College, where Gonzalez serves as professor and chairman emeritus, is male. Of those, approximately 40% are Hispanic, he adds.
Hispanic First, Male Second
A primary reason for the increase in Hispanic nurses who are men is that health care facilities are now required by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) to provide culturally and linguistically competent care that is sensitive to the needs of America’s ethnically diverse population. For many health care employers, hiring bilingual Hispanic nurses who have firsthand knowledge of Hispanic culture is a move in that direction—and the gender of those nurses is not an issue.
“Hospitals want me because I can speak Spanish and I know the medical jargon,” says Felipe Gutierrez, MSN, RN, FNP, an advanced practice nurse at Scripps Mercy Hospital in San Diego, who estimates that at least half of the patient population he cares for is Hispanic. When people are sick, they tend to revert back to the language with which they are most comfortable, Gutierrez explains. Furthermore, even though many of his Hispanic patients can understand and speak English, they prefer speaking Spanish, he says.
Gutierrez also understands the importance of family in Hispanic culture and the need to have many relatives nearby when someone is ill. “Every time my great grandmother went to the hospital, five of us would sit around her bed,” he recalls. But he also remembers that when he was working as a tech in the emergency room, only one family member, if any, was allowed to accompany the patient. That was a difficult rule to enforce with Hispanic patients, knowing the emphasis they place on family, he says.
Similarly, many hospitals allow only two visitors at a time in a patient’s room. Although Salvador Alonso, BSN, RN, house supervisor at Yuma Regional Medical Center in Arizona, doesn’t suggest breaking the rules, he does sometimes bend them. When two patients are sharing a room, Alonso always asks if the other patient minds if more than two visitors stay. “If [they say yes], then I just allow two visitors at a time,” he says. “Otherwise, there may be four or five people.”
This Hispanic cultural tradition of having many family members present is something that many Caucasian nurses complain about, he adds. Not long ago, Alonso’s grandfather passed away and approximately 35 relatives were in the hospital waiting room. “Fortunately, I worked there, so they gave us a private room,” he says.
Nurses like Alonso and Gutierrez are also highly attuned to other Hispanic cultural practices relating to health and illness, such as the use of home remedies or hanging up a cross on the wall. Alonso usually lets patients tape the cross on the wall or affix it to a bulletin board. “I try to accommodate these and other customs,” he says, “but some nurses don’t.”
Alonso has found that understanding the importance of cultural identity in the Hispanic community has given him an appreciation for other cultures and languages. “Knowing my culture makes me appreciate others,” he says. “[For example], we get some female Muslim patients who don’t want to be cared for by a male nurse. I’m not offended. You have to respect their beliefs.”
Perceived Authority
While both male and female Hispanic nurses are equally skilled at establishing culturally knowledgeable relationships with Hispanic patients and their families, there are some areas where Hispanic nurses who also happen to be men do seem to have an advantage. For example, when speaking with Hispanic patients, male nurses may be perceived as more authoritative than their female counterparts.
Alonso has noticed that when he talks to Hispanic patients about Do Not Resuscitate (DNR) orders or palliative care, they seem to accept the information more readily than if a female nurse talks to them. He cites several occasions when, after a female nurse discussed DNR orders, the family was opposed. But when Alonso explained it to them afterwards, they changed their minds.
Rudy Valenzuela, MSN, RN, FNP, director of clinical services and health promotion at the Regional Center for Border Health in San Luis, Ariz., often discusses the impact of diabetes with male Hispanic patients. He notices that the patients are not only more willing to discuss certain aspects of the disease process with another man, they are also more likely to follow his advice.
“The reception of my teaching to a male Hispanic patient is more effective,” explains Valenzuela, who is also the newly elected president of NAHN. “They perceive the information coming from a male nurse more as an order. When it comes from a female nurse, [they see it as] more of a suggestion.”
The same goes for discussions about sexually transmitted diseases or hypertension with Hispanic male adolescents, he adds. “[In those situations], that paternalistic machismo pervasive in the Hispanic culture has something to do with your relationship with the patient.”
Because of the culture’s emphasis on male authority, Hispanic nurses who are men are often mistaken for being the doctor, even after they identify themselves as the nurse.
“When I was an emergency room nurse and often the first person the patient saw, they automatically assumed I was the doctor,” recalls Rick Martinez, BSN, RN, president of San Antonio-based MedTrust, a healthcare staffing company that specializes in placing nurses. “When I told the patient I was the nurse, the dynamics in the room suddenly changed.”
Education Comes First
Some young Hispanic men who want to go to nursing school must do so over the objections of their fathers, who perceive their career choice as “woman’s work.” But because their culture values the importance of education, many other male Hispanic nursing students receive full support from their families to obtain a college degree as a means to entering a respected occupation.
“[In many Hispanic families], the fact that you’re going to college is more important than the fact that you’re choosing what may be considered a non-traditional career for males,” explains Valenzuela, who graduated from nursing school in 1991. “You would think because [ours] is a paternalistic, macho culture that a nursing career would not be seen as desirable , but often that’s not the case.”
Gonzalez concurs. “I received a lot of support from my family because education is so highly valued within the culture,” he says. Unfortunately, he adds, the number of Hispanic college graduates in the U.S. currently doesn’t reflect that commitment because too many Hispanics still live in poverty or lack the economic resources to send their children to college.
Martinez says that in his family’s eyes, getting a degree after fours years of college added a sense of professionalism to his chosen career. But even though he wasn’t questioned about going into a female-dominated profession, he was often asked when he was going to become a doctor, as were many of his male nursing colleagues. “Nursing was almost seen as a stepping stone to medical school,” he relates.
Today, Martinez notices more nurse recruitment ads that feature men, many coming from the military. “They’re trying to let the public know that it’s an acceptable career for men,” he says.
Family Pressures
Ironically, while relatives may offer support and encouragement, Hispanic culture’s deep-rooted emphasis on family can add extra stress in the life of a Hispanic nursing student who is often too busy studying to maintain those close family ties.
Alonso, who graduated with his BSN in 2000, recalls that nursing school was a struggle because he was married with a three-year-old and holding down a full-time job. One day, his son told him that he wasn’t his best friend anymore because best friends are supposed to play together. “It broke my heart,” says Alonso. That prompted him to settle for some Bs instead of pushing for all As, in order to spend more time with his family. “They knew I was in school and working, but they still demanded my time,” he says of well-meaning relatives. “They don’t realize they’re doing it.”
When he was an assistant professor in the nursing program at San Diego City College (he is now an adjunct professor), Gutierrez received positive feedback from Hispanic students grateful for a male Hispanic teacher. “They would tell me, ‘You understand that we have family issues.’” That was true not only for male students but also for female students, whose relatives would tell them that they don’t need to go to school and should be at home taking care of their kids, Gutierrez adds.
“The culture does put a lot of emphasis on family responsibilities,” Valenzuela agrees, “but out of that comes the push to improve your life.” Most wives or relatives of male Hispanic nursing students are willing to accept the temporary disruption in family life for a few years because a nursing career will allow the men to better support the family, he says.
In recent years, the nationwide nursing shortage has created more job security and higher wages for nurses, making the profession more appealing to men. “It’s important to relay that information to Hispanic males, because they’re predominantly the breadwinners,” says Gutierrez.
Building Up the Numbers
All of the nurses interviewed for this article would like to see more recruiting efforts aimed at bringing young Hispanic men into the nursing profession. “Nursing schools are paying a lot of lip service about recruiting minorities and males, but [to a large extent] it hasn’t happened,” believes Gonzalez. He points to the example of medical schools, whose student population now consists of 50% women as a result of aggressive efforts to recruit more female students.
“I think nursing schools mean to do it, they’re just not sure how,” Gonzalez continues. He suggests such strategies as conducting public awareness campaigns to publicize the fact that men can be sensitive caregivers, and tapping into the pool of individuals pursuing second careers.
Increasing the number of male faculty in nursing schools would help as well, by providing role models and mentors. “[Men who want to go into nursing] don’t have that many role models in academics,” says Valenzuela. “Nursing schools and hospitals need to target the male population at large, especially Hispanics, to portray nursing as a career that improves your life, academically and financially.”
Meanwhile, many Hispanic men in nursing have become involved in grass roots efforts, such as career fairs at local colleges, as a means to get the word out to young Hispanic males. As President of NAHN’s San Diego chapter, Gutierrez makes it a point to go out into the community with the recruitment and retention committee. “I try to encourage male students to go into nursing,” he says. “Many of them have never seen a man who is a nurse.” He hopes to coordinate a program between his hospital and local schools that will enable students to shadow the nurses at work.
What advice do these veteran nurses have for other Hispanic men who are interested in pursuing a nursing career? Get yourself into a nursing education program and ask about financial aid, Gonzalez recommends. “Hispanics are very reluctant to ask for money,” he says. “They feel ashamed to be poor. But I tell them the government gives financial aid to students because the government considers it an investment. Payback time will come.”
If you need to get into the workforce right away, he adds, you should attend a two-year program and continue your education while working. If you can attend a four-year program, then go for it and get the BSN degree. While in school, concentrate on your education, Gonzalez suggests, even if that means postponing getting married or having children if you’re already married.
NAHN President Valenzuela has the last word. “I would encourage any male Latino to join the nursing field,” he says, “because it will allow him to take care of his personal needs and the needs of the population at large, by improving the health of the communities where he lives and works.”
Both Hispanics from Caribbean countries and African Americans are more likely to develop Alzheimer’s disease than Caucasians, according to a new study, “Incidence of Alzheimer’s Disease in African Americans, Caribbean Hispanics and Caucasians in Northern Manhattan,” recently published in Neurology magazine.
This area of research is particularly important because the number of Caribbean Hispanics and African Americans who are 65 and older in the U.S. is currently increasing more rapidly than the number of elderly Caucasians.
The study, conducted over a seven-year period by the New York State Psychiatric Institute and Columbia University, examined 1,072 New York residents between the ages of 75-90.
“We are continuing this study and exploring reasons for the differences in rates,” explained Richard Mayeux, PhD, one of the lead researchers from the Gertrude H. Sergievsky Center at Columbia University. “So far, no risk factors completely explain the differences [in Alzheimer’s rates] between the ethnic groups.”
A particularly important finding for all sufferers of Alzheimer’s disease, regardless of race or ethnicity, was the presence of the APOE-e4 gene in persons more apt to develop Alzheimer’s. However, Mayeux adds, “Among the 70% of the population without the APOE-e4 gene, the risk [of developing the disease] is two to three times higher for African Americans and Hispanics than for whites.”
Another factor that increases people’s risk of developing the disease is their education and employment level. According to previous studies, the risk for developing Alzheimer’s is twice as high among those with low-income occupations and less than eight years of education. While this finding does not directly correlate to an ethnic disparity, statistics show that blacks and Hispanics often have lower education and income levels than Caucasians.
Alzheimer’s researchers believe their findings indicate a need for more research into the correlation between race and Alzheimer’s and for increased distribution of information on mental health issues to elderly Hispanics and blacks.
The start of my junior year medical-surgical rotation began the same way it usually does for many other nursing students–with a feeling of nervousness due to the uncertainty of how my first day on the clinical unit would evolve. Upon receiving my patient assignment, I realized my day would be unlike that of my classmates, because my patient could only speak Spanish. My clinical instructor had made the assignment based on my Hispanic background and my fluency in Spanish.
I received the nursing report, which was limited to the physical assessment because of the nursing staff’s inability to communicate with this gentleman. No admission information, health history or personal information about the patient had been obtained, because he had been dropped off at the Emergency Department with no one to help interpret for him. The admitting diagnosis was kidney failure with a secondary diagnosis of cirrhosis. Laboratory values and diagnostic tests were conclusive with the diagnoses.
When I entered my patient’s room, I immediately noticed the fear and pain in his eyes. He was grimacing and teary-eyed, which broke my heart. I was sure the language barrier must have created feelings of loneliness and fear. When he heard my Spanish greeting, his whole appearance changed. He smiled and asked me if I spoke the language, and I answered “yes.” He said, “Hay, gracias,” which means thank you, with a sigh of relief.
The patient was able to talk to me about his abdominal pain and his arrival at the ED. He explained that his boss, who did not speak Spanish, had brought him to the hospital and immediately left. When I asked if there were any friends or family members who could assist him with his communication needs during his hospitalization, he replied “no.” He told me that he lived with a group of other migrant workers and that they were unable to leave work.
I realized at this point that he was completely alone, with no one to help him with his medical, legal and emotional needs. In the back of my mind I knew that meeting the needs of this patient was going to be a significant challenge for me, a student nurse. But I was keenly aware of the impact my nursing interventions could make. I put my nerves aside, gained my confidence and told myself that I was there to help this patient receive the medical care he deserved.
Communication and Comfort
I proceeded with my nursing assessment, gathering and writing down as much information as possible. I provided the patient with information about the daily routine of the hospital, such as what to do when he had pain, how to use the call button and when meals were served.
I asked if he knew why he was in the hospital. He didn’t exactly know what was wrong with him. He acknowledged that he was in pain and said he needed pain relief so he could go back to work. He complained of generalized right quadrant pain and stated that this was not the first time he had experienced this type of pain. My physical assessment revealed a distended abdomen that was tender to palpation.
After I gathered my assessment and provided comfort to my patient, I returned to the nursing station to talk with his primary nurse. We discussed his medical and personal situation. It was necessary for this man to understand his medical condition and his need for urgent treatment. It was also necessary for the hospital to obtain legal documents such as a living will, power of attorney and a phone number for notifying his next of kin.
I returned to the patient’s room and explained to him that he was very ill and would not be going back to work anytime soon. I educated him about his disease. I asked him if he drank alcohol and he replied that he did drink every day but not in large quantities. I explained that his kidneys were failing, his liver was seriously diseased and that it was necessary for him to avoid drinking alcohol.
I could see the fear in his eyes, and his skin color changed. His closed his eyes and began to cry. I tried to comfort him. He continued to cry, asking how this could have happened to him and what was he going to do, because he couldn’t lose his job. He spoke about his family who lived in Mexico and how he wished he could see them. He said he came to America for a better job and sent the money he earned to his family, but was never able to contact them. He sent letters to his wife and daughters but never knew if they received them. He confided that it had been 10 years since he had seen or spoken to his family. He started crying with such intensity that it broke my heart, and I cried with him. I remember holding his hand, feeling helpless as he sobbed that he wanted to see his family.
At the end of the day, I finished by reviewing the information he needed to know about his hospitalization and medications. I told him how important it was for him to stop drinking alcohol and to take all medications prescribed to him.
When I entered his room one last time to say good-bye, he told me how grateful he was that I had been his student nurse. He said, “I felt relieved and less scared knowing that you were able to understand me and explain everything to me.” At that moment I truly realized my potential as a student nurse to make a difference in a person’s life. I remember telling him before I left to “stay positive and take care of yourself as much as possible.”
As I left the clinical unit I felt a sense of satisfaction and honor to have been able to take care of this patient. I came to the realization that I was able to provide this man with some comfort and put a smile on his face during a dark time in his life. By intervening on behalf of this non-English-speaking patient, I had made a difference for him, for the staff nurses and for myself. As a result of this experience, I feel more committed to fulfilling the needs of my patients, and particularly those patients who face barriers to care.
As just about everyone knows by now, Hispanics are not only the largest ethnic minority group in the U.S., they are also the fastest-growing. Yet study after study–from the Institute of Medicine’s 2003 Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care to the Agency for Healthcare Research and Quality (AHRQ)’s annual National Healthcare Disparities Reports–has shown that Hispanics’ access to health care, as well as the quality of care they receive, is severely lacking in comparison with that of the Caucasian majority population.
Gloria Ceballos, MS, RN, CNAA, BC
Other studies, such as the Sullivan Commission on Diversity in the Healthcare Workforce’s 2004 Missing Persons: Minorities in the Health Professions, have strongly suggested that increasing the number of Hispanic nurses in the health care system can help make a profound difference in improving health outcomes for Hispanic patients and communities. In fact, culturally competent, bilingual Hispanic nurses are uniquely qualified to be more than just participants in the effort to close the gap of Hispanic health disparities–they are the ideal choice to lead these efforts.
But in order to have leadership, you must have leaders. The problem is that Hispanic nurses account for only about 2% of the nation’s RN population, which makes for a shallow pool of potential nurse leadership talent. And many Hispanic nurses who want to be leaders may lack the confidence and skills to do so and have few role models to emulate.
Creating new Hispanic nurse leaders is the goal behind the Institute for Hispanic Nursing Leadership, a leadership development workshop that is a collaborative effort between the National Association of Hispanic Nurses (NAHN) and the American Organization of Nurse Executives (AONE). Now in its second year, the workshop is offered free to NAHN members as a special half-day session at the association’s annual conference. The first Institute, held last summer at the 2006 NAHN conference in Phoenix, attracted 40 to 50 attendees, says Gloria Ceballos, MS, RN, CNAA, BC, a former chief nursing officer at Kettering Medical Center in Kettering, Ohio who is now pursuing her doctorate.
Ceballos teamed up with NAHN’s 2004-2006 national president, Rudy Valenzuela, FSP, MSN, RN, FNP-C, to create the Institute after several NAHN members requested information about how to develop their leadership skills.
“Most of NAHN’s members are working at the staff nurse level,” Ceballos explains. “So what we wanted to show them was how they can progress on the nursing leadership ladder. [America] not only needs great Hispanic nurse clinicians, we also need leaders to develop the structure by which nurses can understand the diversity in their patient populations and have a closer relationship with those communities to promote the prevention of disease or to help the patients through their illnesses.”
Ceballos was also a member of AONE’s Diversity Council. “[NAHN] had never done a leadership development program and several members were asking , I saw the opportunity to [capitalize on the expertise of] both organizations and bring them together to see what we could do.”
The response to last year’s Institute was so positive that the second installment will be held this July 17 at NAHN’s 32nd Annual Conference in City of Industry, California. Its theme will be “Leaders and Leadership: Are You the Leaders You Want to Become?” and it will focus on topics such as knowing your leadership style, preparing to become a leader and influencing change. Nursing leaders scheduled to speak at the session include NAHN past presidents Antonia Villarruel, PhD, RN, FAAN, and Carmen Portillo, PhD, RN, FAAN, along with Fortuna “Tuni” Borrego, MSN, RN, president of NAHN’s Broward County (Florida) chapter, and Angelica Millan, MSN, RN, NP, president of the Los Angeles chapter.
“Think About Your Leadership Potential”
By popular demand, the 2007 Institute will feature an expanded format. Feedback from last year’s attendees indicated that they wanted more time, more speakers and, especially, more Hispanic speakers, says Valenzuela, who is now president of Camillus College, a nursing school in Paramount, California.
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“I think most of the nurses who [attended the Institute] were there because they wanted to be there and they wanted to make an impact,” he adds. “I encourage nurses to think about their leadership potential and to grab a hold of it and go with their heart so they can improve their lives, they can improve their careers and, most importantly, so they can improve the health of their communities.”
One of the speakers at last year’s Institute was Maria Warda, PhD, RN, who until June 2007 was dean and professor at Georgia Southwestern State University. She is now director of the nursing program at the University of Tampa in Florida. The 2006 workshop, she says, covered topics such as strategies for success, dealing with discrimination, staying focused and planning educational and career mobility.
Many of the participants were young Hispanic nurses who had either recently started graduate school or were considering it. For the most part, they were searching for role models who could serve as inspiration, Warda says.
“There are a lot of barriers for minorities in America, and certainly for minorities in nursing,” she notes, “because there are so very few of us. There are so few role models in either the service arena or, especially, in the academic arena who can understand the unique strengths and the unique barriers.”
The need for Hispanic nurse leaders is enormous, Warda continues. “We need to recruit more Hispanics into the nursing profession, and beyond that we need to help them continue their educational journey, so we can have future leaders who are also Hispanic. Those few that I know who are deans of nursing or in leadership positions are aging. We are close to retiring and we don’t have the new generation coming in to take our places and to mentor others.”
Leaders Get Involved
Valenzuela believes nurses who wish to become leaders must first get involved–both in their workplaces and in their communities. “Nurses need to come out of their shell and become involved in issues that interest them,” he says. “Attend meetings, speak to doctors, administrators and other nurses about how the quality [of care] can be improved.” He also advises nurses to become advocates and speak up about issues that are important to them, such as making more culturally sensitive care available to Hispanic patients. “We’re never going to make any progress toward improving the health of the community if we don’t speak up for it,” Valenzuela maintains. “[Hispanic nurses] need to be vocal about what is important to them and to their patients.”
Rudy Valenzuela, FSP, MSN, RN, FNP-C
Tuni Borrego, who is director of nursing for a med/surg and telemetry unit at Memorial Hospital West in Pembroke Pines, Fla., says getting involved helps nurses see an organization’s big picture rather than just their own area of interest. And that’s an important perspective for future leaders to gain.
“Learn how decisions are made, how changes come about and why they come about,” she recommends. “You need to know the ‘whys’ of things before you can understand the ‘hows.’”
Borrego took her first step into leadership by becoming a charge nurse just a few years after beginning her nursing career. “A lot of the other nurses were afraid to do charge or didn’t want the extra responsibility,” she says.
Warda advises Hispanic nurses interested in becoming leaders to first prepare themselves educationally. “No one is going to promote you just because you are Hispanic or intelligent,” she argues. “You have to have a strong education. Pursue graduate education, go as far as you can.”
She also stresses the importance of developing a strong support network of people who are accomplished leaders in the areas you want to pursue. In other words, mentors–and they don’t necessarily have to be Hispanic. Look for a mentor who is committed to diversity and wants to help. “There’s not enough of us [Hispanic nurse leaders] to go around,” Warda points out.
Getting involved also means joining professional organizations, taking advantage of opportunities and being willing to take risks, such as moving to another city or state to pursue career advancement, even if it means being farther away from family and friends.
From a clinical standpoint, Borrego advises new nursing graduates to avoid working in a specialized area right out of school. Many new nurses go straight into specialties like home health, emergency nursing or labor and delivery, where their patient population and/or the conditions they treat are limited.
“If you get your foundation in med/surg first, you can pretty much work your way up and do anything,” she says. “Take at least six months to a year to get your feet on the ground. Get to know the med/surg population and from there you can go anywhere.”
Moving Into Leadership
Another topic that will be covered at this year’s Institute for Hispanic Nursing Leadership is understanding the roles and responsibilities within an organization. Borrego says it’s important to understand this so you know what’s expected of you when you’re given a task. That, in turn, helps you become a better leader. “You can’t really do things if you don’t know what’s expected of someone in that role,” she explains.
Fortuna “Tuni” Borrego, MSN, RN
Warda, whose various career roles over the years have included being a military nurse, clinical nurse specialist and hospital administration executive, used the GI Bill to obtain a master’s in nursing in the late 1970s. Because there were so few nurses with master’s degrees in those days, “that gave me the opportunity to move into a leadership position in nursing.”
She later became interested in pursuing a PhD when her immediate supervisor at the hospital at which she worked enrolled in a doctoral program. This provided a role model for Warda to emulate. “I had never thought of doing that before,” she says. “Because I knew somebody else who was doing it, I decided to apply and I was accepted into the doctoral program at the University of California, San Francisco.”
By her second or third year in the program, Warda knew she wanted to go into academia, so she took a teaching job at San Francisco State University to develop her skills as an educator. Because she had extensive leadership experience, including several years in hospital administration, it was a natural transition when she was offered a job as assistant dean at the University of California, San Francisco.
After three years in that position, Warda was presented with still another opportunity to move up the leadership ladder. “My supervisor, who had been my academic advisor when I was a doctoral student at UCSF, just one day walked into my office and said, ‘I believe you will make an outstanding dean one day and you should consider pursuing that career path.’” That led her to apply for the dean’s position at Georgia Southwestern State.
As Warda’s career journey makes clear, learning to be a Hispanic nursing leader is a continuous, lifelong process. Leadership development workshops like the NAHN/AONE Institute are great, she says, because they energize and motivate participants and give them the confidence they need to work toward becoming leaders. “But unless that is followed up by having a network of mentors who are close to you and can work with you on an ongoing basis,” she emphasizes, “it will be an injection of enthusiasm that will only last so long.”
