by | Mar 31, 2013 | Magazine
In our winter 2012 issue, we called for submissions to our first ever Take Pride Campaign, an effort to recognize those places of employment that went above and beyond regarding encouraging diversity; recruiting and retaining minorities; and creating a cooperative, inclusive work environment. We were so pleased with the response! Nurses, and even teams of nurses, recommended their places of employment to acknowledge such efforts. And the funny thing is, there is no prize. Not for our nominees nor for our nominators. Furthermore, there is no real winner. The only reward, per se, is their inclusion here. Then again, perhaps the reward is inherent—we’re just bringing it to light. We’re so glad these nurses found such inclusive places to call “home” (during their shifts, at least!). We hope the facilities continue to lead by example, and we are proud to recognize them here.
Alacare Home Health and Hospice, Muscle Shoals, Alabama
Nominated by LaConda Davenport, R.N., B.S.N., M.S.N., M.H.A.
In the five and a half years LaConda Davenport has been with Alacare Home Health and Hospice, she has traveled and worked in several of the company’s 23 offices. As she’s moved within the company, she has “witnessed cultural diversity as a top priority,” she says. “Everyone, regardless of race, age, gender, or whatever makes us unique given equal footing to achieve equal status within the company.”
The company makes its position on diversity clear not just in writing (in its diversity statement), but through diversity training, targeted staff education, and recruitment efforts aimed at minorities. Moreover, the company requires its employees to “renew their commitment to diversity” each year, Davenport says. “Alacare fosters an environment of cultural awareness amongst its employees, and everyone has equal opportunity to strive and rise to the top.”
Davenport started as an RN and went on to earn two master’s degrees and eventually became a Hospice Clinical Manager. “I couldn’t have done this without the support of the company I work for,” she says. “Diversity means that I am afforded every opportunity to grow and mature in my profession within an environment that believes in me and wants to see me strive in a positive manner that is beneficial to me and my organization. Alacare has this attitude and that’s why I believe Alacare is diversified and inclusive—they stand not behind but beside their employees.”
Bayhealth Medical Center, Dover and Milford, Delaware
Nominated by Ludmila Santiago-Rotchford, M.S.N., R.N., P.C.C.N., A.C.N.S.-B.C.
Arriving in Dover, Delaware, back in 2000 felt like going back in time to Ludmila Santiago-Rotchford. “It seemed that most people I met had rarely ventured out of the First State and many people had been here for generations,” she says. “Who knew that this state . . . just a few hours away from metropolises of Philadelphia and New York City was where the infamous Mason Dixon line that separated the North from the South was found.”
Along with a colleague, Kimberly Holmes, M.S.N., R.N., P.C.C.N., A.C.N.S.-B.C., Santiago-Rotchford hoped to promote diversity in her health care system. A simple suggestion grew into the Bayhealth Diversity Committee, a multidisciplinary group that meets bimonthly. “For the past several years we have offered Scoop on Diversity sessions where staff can learn about topics of diversity while enjoying a sundae bar,” she says. “Our annual Diversity Cruise attracts many attendees where we employees display information and samplings of food representative of cultures from around the world.”
A busy committee, they disseminate a “tip sheet” each month called Insights on Diversity and recently partnered with Delaware State University for a Celebration of Culture event. Their website includes further resources regarding diversity, as well as a way for staff to leave feedback.
“Our dream has come to fruition in large part due to the support we have received from our committee members,” Santiago-Rotchford says, citing facilitator Marianne Foard, M.S., R.N., and Chief Nurse Executive Bonnie Perratto, M.S.N., R.N., M.B.A.,N.E.A.-B.C.,F.A.C.H.E., specifically.
Frontier Nursing University, Hyden, Kentucky Nominated by Nena Harris, Ph.D., F.N.P.-B.C., C.N.M.
Nena Harris started her journey at Frontier Nursing University
10 years ago as a student, one of three minority women in her orientation session. “The nature of our program, which is distance learning, creates challenges in that there are few face-to-face interactions,” she says. “As a student, I did not engage in attempting to understand the school’s commitment to diversity, but I also did not witness any active display of this commitment in a way that students could recognize.”
Then, when Harris became a Frontier faculty member six years ago, she was the only professor of color. “Since that time, several faculty of color have been hired,” she says. “Also, I have more face-to-face interactions with students on campus and the composition of those sessions has become more colorful over the years.” In that time, Harris says she’s seen the school “develop a passion for diversity.”
A school founded to address the health care needs of the underserved, FNU is well suited to train nurses to go into those communities that continue to be marginalized—often minority communities. “The administration and faculty realize that providing care to diverse populations requires educating nurse-midwives and nurse practitioners who are committed to returning to the diverse communities in which they live and have roots,” Harris says. To that end, the school is working to recruit more diverse students and faculty, in part through its recently launched, multifaceted PRIDE (Promoting Recruitment and Retention to Increase Diversity in Nurse-Midwifery and Nurse Practitioner Education) initiative.
“FNU is a leader because it demonstrates the importance of educating a diverse workforce to meet the health care needs of an increasingly diverse population,” Harris says. “I am very proud to be associated with this institution.”
Grady Health System, Atlanta, Georgia
Nominated by Dennis Flores, B.S.N., A.C.R.N., et al.*
“Inherent in Grady Health System’s tradition of care is over a century’s worth of diverse personnel who advocate for everyone and discriminate against no one,” says Dennis Flores. “As nurses in our white scrubs, we represent a kaleidoscope of ethnic and racial backgrounds that fulfill the promise of nursing in our everyday practice.”
Many of Grady Health System’s clients come from underserved communities, and Flores says they can relate quickly to their providers, as the staff mirrors the diverse population of the Metro Atlanta region. “Nurses and patients speak the common language of a shared history and world-view, one that translates to better patient care,” he says.
Flores commends a number of things illustrating the facility’s commitment to diversity, including minorities in various leadership positions, cooperative decision making at all levels, an endorsement from the Human Rights Campaign as a Leader in LGBT Healthcare Equality, and even a multicultural Nurses Week ad campaign. “Not only is [the ad] a tacit endorsement of the variety that makes up the staff, but it wisely capitalizes on our strength: Grady’s diversity,” he says.
“The culture here allows for us to thrive and newer staff members soon become acculturated to what fierce advocacy is all about,” Flores says. “We are blessed to be working here and we take exceptional pride in representing Grady Health System.”
* Dennis Flores is joined by the following in nominating Grady Health System: Lillian Bryant, L.P.N.; Patrice Henry, L.P.N.; Luis Lopez, B.S.N., R.N.; Marie Lotin, R.N.; Andrea Mayo, R.N.; Njorge Ngaruiya, B.S.N., R.N.; Faith Works, R.N.
HCR Homecare, Rochester, New York
Nominated by Yvette Conyers, M.S.N., R.N., C.T.N.-B.
“Since I first walked through the doors of HCR Homecare, almost five years ago, I felt the culture of inclusion and diversity,” Yvette Conyers says. By meeting the need for more nurses, particularly Spanish-speaking nurses, to serve the many Hispanic patients in the area, the institution has demonstrated an ongoing commitment to diversity.
“The mission and vision of HCR Homecare supports diversity and values its employees considerably,” Conyers says. “The name HCR rings loud in a small community where everyone talks, and comments are always positive.” She cites the facility’s research into the needs of Hispanic patients, such as 2008’s Exito, which tackled reducing health care disparities through improved access and culturally competent care. HCR Homecare has also extended its efforts to improving care for African American, Russian/Ukranian, and various refugee populations. They do so, in part, through partnerships with many local agencies, such as the Rochester Housing Authority.
“Training in cultural competence, specifically transcultural care, has been implemented and is constantly being upgraded to provide better patient care and decrease hospitalizations rates, creating trustful relationships and addressing the overall disparities our nation faces,” Conyers says. Certified nurses lead training sessions and help ensure continued efforts to improve cultural competence. “The constant changes and increased number of minorities both on a national and local level support the need to have an agency that is caring, diverse, and is inclusive of the clients they serve,” Conyers says. “I take pride in my organization!”
Seton Healthcare Family, Austin, Texas
Nominated by Cindy Ford, R.N., B.S.N.
Cindy Ford can name a litany of programs that make Seton Healthcare Family an admirable force in the promotion of diversity. And with 35 years of service to the organization, she would know. “During three decades, I have witnessed Seton lead medical, nursing, and technology advancements; become nationally respected for evidence-based practices; and progress as a leader in diversity.”
The faith-based collection of facilities includes 11 hospitals and 80 other various offices, and Ford says Seton is committed to “improving the diversity and inclusion of staff…by reflecting the communities we serve.”
That started with Seton’s Diversity Leadership Initiative, which “identified the challenges in reflecting the demographic makeup of the community,” Ford says. From those efforts came the hospital system’s Office of Diversity and Inclusion, established in 2006 to meet the needs of the growing populations of African Americans, Latinos, and Asian Americans in Texas. “Programs were developed to meet leadership initiatives,” she says, including diversity/cultural competence workshops, awareness events and cultural celebrations, an interpreter program, and a recruitment team committed to diverse hiring. Seton has also adopted Cincinnati Children’s Hospital’s Project SEARCH, a hiring initiative aimed at young people with developmental disabilities.
University of Wisconsin Hospital and Clinics, Madison, Wisconsin
Nominated by Tracey L. Abitz, M.S., R.N., C.T.N.-B.
From Tracey Abitz’s description of the University of Wisconsin health care employee benefits and resources, it seems like a great place to work, regardless of whether you’re a minority or not! But those employee benefits and resources also reveal a determination to recruit and retain minorities, as well as provide culturally congruent care for diverse patients.
“There is a commitment to diversity and cultural competence to community groups and partners by reaching out to the community with the assistance of the director of community partnerships,” Abitz says. For example, the University of Wisconsin system offers a wide array of language and interpretation services, including those for the deaf or hard of hearing, as well as 32 languages through face-to-face interpreters and over 250 by phone.
Abitz describes the hospital system’s many employee resources, from child and elder care to tuition reimbursement, and the facility has also partnered with a credit union to offer free tax services to employees in a lower income bracket. “There is ongoing review of recruitment and retention data of minority groups with increased efforts to try to diversify the recruitment pool for positions at the hospital, especially leadership positions,” she says.
The nursing staff in particular has served as advocates of diversity, including their use of the Purnell Model for Cultural Competence to assess patients and family needs, Abitz says. The nurses even designed an internal diversity website with resources for clinicians.
“A new interdisciplinary resource group led by nursing has been designed to have a group of champions interested in learning more about culture and diversity with the goal of raising awareness and knowledge, allowing them to be a resource to their colleagues,” Abitz says. “There is continual reflection and commitment to always strive for improvement.”
by | Mar 30, 2013 | Magazine, Nursing Students
Q: I am a Muslim nurse who wears a religious headscarf (hijab). I would like to bring to your attention two negative experiences that happened to me while taking the exams for LPN and RN licensure in the state of New York. The incidents occurred at two different Pearson Professional Centers (PPC) testing sites. PPC is the organization that is contracted to conduct the NCLEX® licensure examinations on behalf of the National Council of State Boards of Nursing (NCSBN) across the United States.
In July 2004, I went to the Pearson VUE testing center in Lower Manhattan to take the NCLEX-PN exam for LPN licensure. Upon signing in, I was asked to remove my headscarf “for identification purposes,” even though I had presented my N.Y. state driver’s license, which has my photo with my scarf on. I explained to the Pearson staff that because I am a Muslim, my head covering is a religious mandate that has been routinely accepted by all other authorities without a single objection. I pointed out that all of my photo IDs picture me with my scarf on and that all NCLEX candidates are fingerprinted, which is another official identification method.
The testing center staff insisted that I remove my scarf, arguing that I might be hiding audio equipment or notes under it. In response, I volunteered to be searched by a female staff member in a private place; the staff declined my offer. I refused to take off my head covering, because I did not want to compromise my religious beliefs and because I felt that, as an American citizen whose freedom is protected under the Constitution, I had the right to keep my scarf on. The staff then informed me that if I attended the examination with my scarf on, they would file a report with the NCSBN documenting my refusal to remove my scarf.
I took the examination with my scarf on, worrying about the possible outcomes of being reported and whether the anxiety I was now experiencing would affect my performance on the exam. You can imagine my condition after spending a very stressful 20 or 30 minutes struggling to enter the examination room just because of my scarf!
When I inquired about the results of my exam several days later, I found out that my result was unavailable. After making numerous phone calls over the next two weeks to Pearson and the NCSBN, I finally learned what was causing the problem. The “Incident Report” that the Pearson center staff had sent to the NCSBN documenting my refusal to take off my headscarf was causing the delay, because this report had to be reviewed by the New York State [Education Department’s] Office of [the] Professions before my examination result could be released. I also learned that the incident report would be a permanent part of my file at the NCSBN. Needless to say, this situation affected me personally, because it caused a delay in receiving my license and being able to seek employment as a nurse.
Thankfully, my efforts ended with good news. I passed my LPN board exam and was finally granted the N.Y. state nursing license. Initially, I decided to ignore this unpleasant experience, thinking that it was probably an isolated case. Perhaps the staff of this particular Pearson center was not culturally sensitive or was being affected by the post-9/11 negative public sentiment toward Muslims.
However, in April 2005 I went to take my NCLEX-RN examination. I purposely selected a different Pearson’s testing center in Islandia, N.Y. to avoid the problems I had experienced the last time. But after checking in and providing my photo ID that showed me wearing my headscarf, the exact same thing happened again. I reacted the same way: I refused to remove my scarf. The center’s staff refused to accept my offer to undergo a body search.
This time, I requested to speak to the center manager. The manager threatened me, saying that he would write an incident report to document my refusal to remove my scarf. Once again I refused to give in and I proceeded to take the exam with my scarf on.
After this second negative incident, I was angry. I was determined to speak up about what I had experienced. Immediately after finishing the exam, I called the NCSBN and explained what had happened. They were very understanding and I was promised that nothing would block the release of my examination result. Later on, I was surprised to receive a phone call from the NCSBN offering their condolences for what had happened to me!
I also decided to do some research to see if the NCSBN has any formal written policy on this issue. I went back to my copy of the NCLEX Examination Candidate Bulletin, where I found the following statements:
• (On page 10, under the heading “Test Center Regulations”): “Hats, scarves and coats may not be worn in the testing room or while your photograph is being taken.”
• (On page 11, under the heading “Grounds for Dismissal or Cancellation of Results”): The third bullet states: “Failing to follow testing regulations or the instructions of the test administrator.”
This makes it clear that the “no scarves” policy originates with the NCSBN, and that the Pearson centers’ role is to enforce the NCSBN’s policy. I find it amazing that the NCSBN failed to consider any religious or health reasons that candidates may have for wearing a head covering and that it refuses to make any exceptions in these special cases.
Today, every profession, including nursing, is required to be culturally sensitive. However, the policies that govern the nursing licensure examinations apparently are not. Therefore, I am writing to you, as an expert in the field, to bring this situation to your attention so that other Muslim nurses taking a career examination will not have to go through the anxiety and discrimination that I encountered. I am also planning to send a letter to the NCSBN and I have already contacted the Council on American-Islamic Relations (CAIR) asking them to look into my case. Hopefully, one day we will all be more tolerant of each other’s cultural differences.
–Nicole Berti, RN, LPN
A: I am very sorry to hear about what happened to you at the test centers, especially since sitting for a licensing examination is a stressful enough experience in itself. I strongly believe that this situation should have never been allowed to happen to you, or to any other Muslim candidate. I admire your strength and courage in fighting for what you believe as well as taking the risk of possibly having to give up your dream of becoming an LPN or RN. In fact, I consider you a leader and a pioneer for all Muslim nurses as well as anyone else who believes they have the right to practice their own religious faith in this free country.
I notice that in the 2006 NCLEX Examination Candidate Bulletin (which can be viewed online at the NCLEX candidate Web site, www.pearsonvue.com/nclex), the dress code policy under the “Test Center Regulations” heading now states only: “No hats or coats.” The reference to “no scarves” has been removed. So congratulations! By standing up for what you believe and by having the courage to speak out about the unfair treatment you received, you have actually made a difference in helping to change this culturally insensitive policy.
While I am sure the original policy did not intend to deliberately discriminate against Muslims, I certainly believe that what you experienced at these two NCLEX testing centers was discrimination, whether intentional or not. For example, I am questioning why you and your headscarf were singled out for the accusation that you might be hiding audio equipment or notes. Any candidate can hide many things under their long sleeves, pants, shirts, necktie, etc. Singling out Muslims–or any other religious, cultural or ethnic group–is unacceptable and should not be tolerated in this day and age. There is no question that the staff at these testing centers were lacking in cultural sensitivity and in need of diversity training to increase their awareness and understanding of cultural differences.
I also believe that changing the clothing policy to just “no hats and coats” is a good start, but it does not go far enough. What about candidates who wear other types of religiously mandated head coverings that could be defined as “hats”–such as Orthodox Jews who wear yarmulkes, Sikhs who wear turbans or nuns who wear habits? What about individuals who have to cover their heads for medical reasons, such as having a thick dressing as a result of head surgery or injury, cancer patients who lost their hair because of chemotherapy, or persons with an infectious head or scalp disease? In my opinion, the NCSBN needs to further broaden its policy by adding language such as “no hats and coats except for those worn for religious or medical reasons.” As long as this rigid policy continues to be applicable to all candidates without any exceptions, the potential for more discrimination, such as the situation you experienced, will continue.
Finally, I believe the NCSBN and Pearson Professional Centers need to improve their incident reporting and complaint filing procedures to make them more fair and open to examination candidates. Specifically, I am suggesting that:
1. If any incident report is filed against a candidate at a Pearson testing center, a copy should be given to the candidate before sending it to the NCSBN. The candidate must have a fair chance to know what was documented against him or her. In America, even people who are arrested have the right to know the charges against them. Why shouldn’t professionals taking a certification exam have the same right?
2.
3. NCLEX candidates must be provided with clear guidelines on how to submit a complaint if they believe they have been treated unfairly. The current 2006 Candidate Bulletin contains virtually no information about this process. It would also be helpful for these guidelines to clearly explain to candidates how the complaint review process works, including the time frame for receiving a response and resolution from the NCSBN or PPC. It may even be beneficial for the NCSBN to create a standardized complaint form or checklist to help candidates focus on the facts, with room for writing in additional comments. The complaint process guidelines should clearly state that this form is available to candidates on request.
As nurses, we have an obligation to ensure not only that all patients we care for are treated with cultural sensitivity and respect but also that our fellow nurses–especially those who are entering the profession–are treated fairly and equally, regardless of their race, ethnicity, religion, gender, age or cultural background. I encourage every nurse who is concerned about fostering diversity, inclusion and respect within the nursing profession to write to the National Council of State Boards of Nursing (NCSBN)–and secondarily, to the corporate headquarters of Pearson Professional Centers and to your state Board of Nursing–about the need for NCLEX testing policies that are more inclusive and sensitive to cultural differences.
Specifically, we should urge the NCSBN to carefully review its current testing center regulations in order to identify and eliminate any potential for cultural bias (citing specific examples such as those mentioned in this article). We should also encourage both NCSBN and Pearson to recognize the need for testing center staff to be culturally aware and sensitive to the needs of examination candidates from diverse backgrounds, and to provide appropriate cultural competency training where needed.
It is time to recognize that America today is a truly multicultural society. We are also a country with a severe nursing shortage, and we need all the licensed nurses we can get. Now is the time for the nursing profession to re-examine our old, outdated, rigid policies and make sure they are sensitive to the cultural needs and basic civil rights of all American nurses.
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by | Mar 30, 2013 | Magazine, Veterans in Nursing
Some of us, for one reason or another, want to be leaders. Whatever it is that motivates us, whether it be power, wealth, position, fame or glory, we strive to climb the ladder of success. The time, energy, and effort you invest is worth it all when you are recognized for your milestone of achievement. But then what? What next? Another goal? A different motivator? I am reminded of the great American motivational speaker Zig Ziglar’s trademark quote: “You can have everything in life that you want if you will just help enough other people get what they want.”
Over the course of my long career in the military, I have found that helping others along the road to success is the greatest achievement of all. With success often comes a platform, an opportunity to further a cause. My own personal cause is breast cancer. I choose to be an advocate beyond the call of duty for breast cancer awareness, prevention and treatment.
During my deployment to Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) from March 2003 to March 2004, I had the privilege of serving as a nurse at the Landstuhl Regional Medical Center (LRMC) in Germany. I provided care to wounded soldiers from the OEF/OIF battlefront as well as serving the health needs of military families in the European theater. Regardless of the day’s duty, a pink ribbon always adorned my uniform to spread the message of breast cancer awareness. As an officer in the Army, people look to me for leadership. The position requires it; the chain of command demands it.
While serving at Landstuhl, my nurse colleague, Major Shirley McKellar, and I recognized a need for a comprehensive breast cancer facility for our soldiers and their families stationed abroad. I assisted Major McKellar in establishing the first-ever breast cancer clinic at LRMC. The Landstuhl Comprehensive Breast Cancer Center proudly opened its doors during my term of deployment.
Major McKellar and I developed all the required activities for the clinic, including organizing a survivors’ luncheon and fashion show fundraiser to increase community awareness of our newly offered services. Our fashion show models were military personnel and cancer survivors/patients. Major McKellar and I also provided breast cancer screening and education seminars and organized a continuing education luncheon.
In addition to being a leader during OEF/OIF, I was also a follower. A follower is someone who recognizes the goals and achievements of others who have performed worthwhile endeavors. A follower sees merit in those same goals and adopts a similar work ethic, building upon the success of those who have gone before. By choosing to use my deployment as an opportunity to promote breast cancer advocacy, I was following in the footsteps of all those who have made a difference in the fight against this deadly disease.
Advocates Against Inequity
My military career has also allowed me to cross paths with another remarkable individual who is making a difference in that common fight. Linda Martin is a beautiful lady with a wonderful message. I met Linda through the honor of knowing her husband, SFC Craig Martin, Linda’s greatest fan. SFC Martin is one of the hardest workers and most professional soldiers at the 94th Combat Support Hospital (CSH) in Seagoville, Texas, where I am currently stationed as an Army Reserve nurse.
Linda is nationally recognized as an author, minister and Christian recording artist and she was selected as Mrs. Plus America 2005. This is a recognition designed to honor full-figured women whose accomplishments have made outstanding contributions to the community. Most important of all, Linda is an advocate for people with cancer. In 2002, she created the “Blessing Bunny,” a stuffed animal that she says brings comfort to all patients undergoing cancer treatments and hospitalizations. She actively uses her platform of visibility to speak about breast cancer.
As women of color, Linda and I have the opportunity to make an even greater impact as advocates in the fight against breast cancer, because of the racial and ethnic disparities that exist with this disease. The statistics reveal that minority women are more likely than their white counterparts to be diagnosed with breast cancer when it is in an advanced stage and are less likely to survive a bout with the disease.
African American women have an average survival rate of only five years after being diagnosed with breast cancer. Hispanic women face cultural and language barriers to screening and treatment; this may account for the fact that they have a lower incidence rate of breast cancer than white women but a higher mortality rate. These inequities are becoming increasingly critical in light of America’s rapidly changing demographics–e.g. population statistics now show that in Texas Hispanics are the majority group rather than a minority.
The first step in the fight against breast cancer disparities is cultural competence. Cultural competence is the capacity to understand, evaluate and overcome cultural barriers to achieving an acceptable standard of care. According to the National Center for Cultural Competence at Georgetown University (http://gucchd.georgetown.edu/nccc/framework.html#lc), cultural competence requires that health care organizations:
• Have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.
• Have the capacity to:
1. Value diversity;
2. Conduct self-assessment;
3. Manage the dynamics of difference;
4. Acquire and institutionalize cultural knowledge; and
5. Adapt to diversity and the cultural contexts of the communities they serve.
• Incorporate the above in all aspects of policy making, administration, practice and service delivery, and involve systematically consumers, key stakeholders and communities.
In conclusion, as you too take your steps up the ladder of career success, look around and take a stand for someone or something other than yourself. I encourage you to join us in the fight against breast cancer. Be a follower who carries forward the work that other minority nurses have done; be a leader and blaze your own trails forward to advance the cause. The task is too large for us to accomplish as individuals, but as a team we can build upon each other’s success to truly make a difference.
by | Mar 30, 2013 | Magazine, Veterans in Nursing
Among various assignments as a U.S. Navy nurse, Commander Ava Abney has practiced in a pediatric outpatient clinic in Puerto Rico, run an obstetric services department in Guam and cared for service men and women aboard an aircraft carrier. Spanning the globe on land and at sea, the African-American nurse’s 18-year career in the military has given her opportunities she never would have had as a civilian.
“It’s so wide open,” says Abney, who now heads up quality management at the Naval Hospital in Pensacola, Florida. “And it’s still very exciting.”
Few institutions can match the career diversity offered by the military, where nurses are groomed for leadership from day one and have wide-ranging opportunities for training and advancement.
“We’re all about leadership,” agrees Lieutenant Commander Select Darnell Hunt, an African-American Navy nurse who is a medical officer recruiter in Kansas City, Missouri. “If you follow the career paths, you’re able to progress to whatever level you choose.”
Endless Opportunities, Unbeatable Benefits
Even before the global war on terrorism and Operation Iraqi Freedom, demand was heavy for nurses to serve in the Army, Navy and Air Force. Nurses work in a variety of specialties in the military, including OB/GYN, community health, mental health, pediatrics and critical care.
The Army is focusing its current recruiting efforts on operating room nurses, medical/surgical nurses and nurse anesthetists, although it continues to recruit nurses from other specialties as well, says Colonel Ann Richardson, chief, Army Nurse Corps Division of the U.S. Army Recruiting Command. As for the Navy, Hunt says the greatest needs now are for generalists, med/surg nurses and critical care.
To join the military nurse corps, nurses must have a BSN degree from an accredited nursing school, be in good physical condition and have an RN license in any of the 50 states. There are also age limits–under 35 years old for the Navy and Air Force and under 47 for the Army–although older applicants can apply for age waivers. Nurses who join the military enter as commissioned officers and begin their military careers as leaders from the very beginning.
Military pay is comparable to that of civilian nursing jobs, especially after promotion, officers say. The military also offers signing bonuses of $10,000. Benefits include opportunities for graduate education and other training, full medical and dental coverage, up to 30 days paid vacation each year and a 20-year retirement potential.
Military nurses care for active-duty and retired personnel in military hospitals as well as serve in the field during emergencies and war. They also work in research, education, management, recruitment and training. The opportunities are almost endless.
Developing Leadership Skills
“As nurses, we are on the rise,” says Commander Select Richelle Kay, division officer of an oncology ward at Portsmouth Naval Hospital in Virginia. After serving a three-year stint in the Navy as a staff nurse out of college, Kay went on reserve status and worked as a civilian nurse in a trauma center. It wasn’t long, though, before she yearned to return to the Navy, where she says the level of professionalism and job satisfaction among medical staff can’t be beat.
Her first assignment after returning to active duty was in Oceanside, Calif., where she worked in operational management–planning and coordinating medical training to make sure the Navy was ready in case of military conflict. The experience enabled her to step away from the bedside and develop strategic leadership skills. “That gave me a bigger picture of what Navy medicine was all about and why we [nurses] are such a critical component,” she notes.
Later, Kay, an African American, became one of the first minority Navy flight nurses and was stationed on Diego Garcia Island in the Indian Ocean. Kay and another nurse developed and ran wellness programs for U.S military personnel stationed there, provided acute care and, when necessary, flew with critical patients to Singapore to keep them stabilized during the five-hour flight.
Lieutenant Colonel Yolanda Ruiz-Isales also has had many opportunities to hone her leadership skills all over the world. Her Army career highlights include an assignment as head nurse in the triage section of a MASH unit in Seoul, South Korea, and an assignment as one of three team members sent to the Czech Republic to help it establish a nursing corps similar to that of the U.S. Army.
“If you are a person who wants to remain stagnant, this is not the place to work,” Ruiz-Isales emphasizes. She joined the Army after working in a civilian hospital in Puerto Rico, deciding that the military would offer greater opportunities and compensation for her work. Now, 18 years later, she remains satisfied with her decision.
Upward Mobility
Mobility in the military isn’t just about moving physically from one place to another. It also means moving up in rank to positions of higher responsibility and pay. Opportunities for promotions are many, says Major Darlene Foley, an American Indian nurse who is from the Lower Brule Sioux reservation in South Dakota and now oversees OB/GYN outpatient clinics at Wilford Hall Medical Center at Lackland Air Force Base in Texas.
“In the 10 years I was a civilian nurse, I saw that people stayed in the same positions for years,” she recalls. “In the Air Force, I came in as a clinical nurse and started off as a lieutenant. Now I’m a major and OB/GYN flight commander and I oversee 100 people. I see a lot of minority nurses do very well in the military.”
Major Yolanda Bledsoe, an African-American flight commander and chief of group education and training at Wilford Hall, says advancement in the military isn’t about race. “It’s about how I get my job done, how I communicate with people and how I mentor people. No matter where you go, if you bloom and do a good job, the sky’s the limit.” Each assignment brings new challenges, Bledsoe adds, but “I have learned so much outside of my comfort zone.”
Ava Abney agrees. She remembers the awesome responsibility of caring for ship personnel aboard the Navy aircraft carrier. “That was when I really grew up,” she asserts. “Out on that huge boat as one of two nurses for 5,000 people, what you say goes. You become very aware of how important nurses are.”
Work/Life Balance
While the mobility of military life can provide stimulating opportunities and career advancement, it can also bring personal challenges, especially for people raising families.
Lieutenant Maria Millsap says the military works with officers as much as possible to accommodate their work/life needs. Millsap, who is of Filipino descent, joined the Navy out of high school in 1979 and served as a hospital corpsman–similar to a civilian LPN. Then she used Navy tuition benefits to attend the University of Washington in Seattle, graduating with her bachelor’s in nursing in 1996. Not wanting to move her family since then, she has managed to stay in the region, although she has held different assignments, first at the Naval Hospital in nearby Bremerton and then as a nurse recruiter in Seattle.
Although it’s possible to stay in one geographical area for more than a few years, nurse officers have to keep in mind that the military’s needs sometimes supercede their own, especially during wartime. Air Force Captain Luis Perez, nurse manager for the internal medicine clinic at Wilford Hall Medical Center, had just been transferred to San Antonio, Texas, in September 2002. Then he received word that he would be deployed to Germany for five and a half months to help expand a hospital for service men and women wounded in Afghanistan and Iraq.
Military nurses must have the support of their families to cope with the stresses of possible deployment, says Perez. “It’s a different mindset. You can be here one day, then at night the phone rings and you have to leave. Your life has to be very flexible and your family has to be the same way.”
Despite the challenges of sudden deployment, Perez recalls serving in Germany as a rewarding part of his career. He will never forget the determination of the patients and how they cared for one another.
Says Bledsoe: “I have my bags ready to go at any point in time. We have to realize we’re officers first. When you come into the military, it’s almost like you’re answering a higher calling.”
That sense of a higher calling is one of the intangible rewards of military service, nurse officers agree. Abney feels it every day as she watches the color guard raise and lower the flag and thinks about how the service men and women overseas see the same ceremony each day, too. “It puts things in perspective,” she says. “It leaves me with a great feeling–that I’m serving my nation.”
Opportunities for Learning–and Teaching
Opportunity for continued education and training is still another benefit of military nursing. All three military branches offer educational benefits through scholarships and tuition assistance programs, which can pay up to 100% of tuition costs in exchange for service commitments.
Kay, for instance, earned her master’s degree in community health at the University of North Carolina under the Navy’s Duty Under Instruction program (DUINS), which pays the full cost of tuition and fees and provides full pay and benefits for qualified applicants to attend graduate school full time.
Military nurses can also branch out beyond health care. Bledsoe earned her master’s in adult education–which enabled her to teach professional military officer courses–by taking classes at night. She paid 25% of the cost and the Air Force picked up the remainder of the tab.
Another advantage of working in the military, nurses say, is the camaraderie among medical staff. Nurses and doctors work together as peers, a relationship that gives nurses more empowerment than they would typically have in a non-military setting.
“In the military, the partnership is more evident than in the civilian world,” Foley says. “There are better team-building opportunities than in civilian life.”
Doctors and nurses go through weapons training together, for instance, and practice setting up field hospitals with one another. In some cases, nurses even outrank doctors.
The military, of course, is not for everyone. But minority nurses who are flexible, enjoy leadership challenges, like to travel and want to grow professionally and personally might want to consider serving, nurse officers say.
If you are interested in a military nursing career, Kay suggests researching and comparing all three branches to see which one best matches your needs. Then talk to recruiters in your area. Ask as many questions as possible, Kay advises, and take a friend or family member along to ask questions, too.
“After you decide which branch you want to join, ask to speak to some nurses,” she adds. “You need to know day to day what it’s like being a nurse in the service.”
The “War at Home” Needs Nurses
As the global war on terrorism places increasing demand on the military medical community, new opportunities are opening up for civilian nurses interested in working for the U.S. Army. The Army is now recruiting civilian nurses for assignments of one to four years to backfill positions held by active duty and reserve personnel who are currently deployed overseas. Civilians are needed to work in army hospitals as well as at demobilization sites all over the country to screen soldiers before and after they return from deployment.
Benefits include working in state-of-the-art medical facilities, training, 13 to 26 days of vacation time per year, 10 paid holidays, sick leave of up to 13 days and group life and health insurance. The Army’s goal is to recruit 250 RNs, 700 LPNs and 100 nursing assistants. “We think it will be a continuing need for the next several years,” says JoAnn Robertson, human resources director for the U.S. Army Medical Command.
For more information about the Army Medical Command Centralized Civilian Recruitment Program, call (800) 633-3646.
For More Information
U.S. Army Nurse Corps
(800) USA-ARMY, ext. 183
http://www.goarmy.com/amedd.html
U.S. Navy Nurse Corps
(800) USA-NAVY
www.navy.com
U.S. Air Force
www.Airforce.com
by | Mar 30, 2013 | Magazine, Veterans in Nursing
In her mind’s eye, Capt. Mary Lambert can still picture the children walking to school, just as children do in neighborhoods everywhere, talking in small groups as they amble along. Except in this scene, they are walking along streets lined with bombed-out buildings, and at least one child in every group is missing an arm or leg.
Lambert, an African-American nurse and commissioned officer in the U.S. Public Health Service, will never forget this and other surreal scenes captured in her mind from her time in Rwanda. The stark contrasts will stay with her forever: the lush flowers that grew higher than her head and the huge avocados dripping off the trees, versus the devastated cities and war-torn people, many of whom had lost nearly all of their relatives to roving bands of death squads.
“The people we worked with were so gracious and appreciative in the face of their losses,” she says. “When I came back to the U.S., it was probably six months before I felt I could complain about anything.”
But just as the experience made a lasting impression on Lambert, she ¬in turn left an equally indelible mark on Rwanda. In 1995, Lambert and other American health care professionals spent two months working in the civil war-ravaged African nation. Their assignment: to train 500 people to staff the country’s severely depleted clinics. The training was critical because Rwanda had lost an astounding 80% of its health care work force in the genocide the year before.
“It was one of the most humbling and rewarding experiences of my life,” she says of her work there.
Serving in countries like Rwanda is just one of the many and varied opportunities available to nurses who work in the Commissioned Corps of the U.S. Public Health Service. Driven by their passion for public service, these nurses work on the front lines to deliver health care to the people who need it most, in locations ranging from Third World countries to America’s most underserved racial and ethnic minority communities.
Cmdr. Ana Marie Balingit-Wines, CCRN, chief of beneficiary medical programs, calls the U.S. Public Health Service “one of the federal government’s best-kept secrets” because so many nurses are still unaware of the career opportunities it provides. Under the direction of the U.S. Surgeon General, commissioned nurses wear uniforms and serve as officers. They work for local, state, federal or international health agencies in a wide variety of capacities. They help conduct research, design disease prevention programs, develop creative techniques in medical methodology, improve mental health care, expand health resources and much more.
“If you are somebody who wants to contribute to the overall health of the nation, and even the world, the opportunities are endless,” says Rear Adm. Mary Pat Couig, RN, MPH, FAAN, an assistant Surgeon General and chief nurse officer.
Never a Dull Moment
Lambert feels the variety offered by the Commissioned Corps is one of this career’s greatest assets. “It’s not easy work, but the opportunities are just incredible,” she says. Her service in Rwanda is just one slice of her nine-year career in the Public Health Service. For three years, she helped provide care for some 4,000 seasonal farm workers in migrant camps in eastern Maryland and Virginia.
Later, she worked for the U.S. Food and Drug Administration as a consumer safety officer. There she managed the review process for FDA approval of nicotine substitute products, such as the patches that help people quit smoking. She also worked for the Centers for Disease Control and Prevention in Atlanta, where she helped create training programs and educational materials on immunization. Since November, she has been developing policies on military health issues as director of the Office of Military Liaison and Veterans Affairs.
In addition to their regular jobs working for government health agencies, nurses in the Commissioned Corps also can be mobilized in time of war or national and international emergencies. To become a commissioned officer, nurses must have earned at least a Bachelor’s degree. Salaries are determined on the basis of rank, education and experience. The pay is competitive with the private sector, particularly after the first couple of years, and the benefits are generous. They include free health care, military commissary privileges and a fully funded retirement plan that doesn’t require any matching contributions by the employee.
Unlike officers in the Army or other branches of the military, who are often forced to move from base to base, officers in the Public Health Service Commissioned Corps control their own careers. While they tend to be mobile, because promotions often require moving to another government agency, they have the freedom to choose where they want to go and what positions they want to take.
According to Cmdr. Marylouise Ganaway, RN, chief nurse recruiter, the need for nurses is greatest in the Division of Immigration Health Services and the Bureau of Prisons. Bilingual nurses especially are in demand to provide care for recent immigrants. Translators can always be found, but nurses who share the patients’ language and culture can establish a comfort level and provide care that much more quickly.
Although these are the only two areas that are currently experiencing a nursing shortage, there are still plenty of job openings throughout the Public Health Service. As Ganaway puts it, “We can always use more nurses.”
The Right Stuff
Who is the ideal candidate for a nursing career in the Commissioned Corps? The answer is fairly simple.
“A qualified nurse who wants to make a difference in the nation’s health care,” Ganaway says.
“You have to be hard-working,” adds Balingit-Wines, who entered the Public Health Service 14 years ago after serving as a nurse in the Air Force. “You have to make a lot of sacrifices. You have to want to do good.”
In other words, this career is best suited for nurses who have a true passion to serve the neediest of underserved areas and are willing to boldly go to places where other nurses may be reluctant to work—from Micronesia to federal prisons to Mexican border towns.
Ever since she knew she wanted to be a nurse, Capt. Evangelina Montoya, RN, MSN, yearned to use her education and skills to help people with limited access to health care. Montoya grew up in a migrant farming family in Visalia, Calif., and knew first-hand the struggles of those without good medical resources. “I recall, as a child, the isolation and the financial burdens my parents endured,” she says.
After graduating from nursing school, Montoya worked in a hospital on an Indian reservation in Arizona. Despite her nearly lifelong desire to serve, she admits that the adjustment was difficult at first. Having completed her nursing degree in Denver, Colo., she had grown accustomed to the comforts of living in a big city. She also had to learn how to speak the tribe’s language so she could communicate more effectively with her patients.
“I had never lived on a reservation,” she explains. “Once I got there, I was in culture shock.” Although she believed her nursing education had prepared her to be culturally competent, she soon realized she had a lot to learn about working within a culture different than her own—for example, how to collaborate with the tribe’s medicine man in the treatment of patients.
Another tough challenge in Public Health Service nursing, says Francess Page, RN, BSN, MPH, is “recognizing that you can’t reach [every person in need] all the time, even though you’d like to.” Page, who is African American, entered the public health arena after working as a nurse in hospitals and seeing patients suffering from conditions that could have been prevented.
Driven by a passion to educate people so they can live healthier lives, she has played a major role in national AIDS prevention programs. Today, as director of policy and program development for the Department of Health & Human Services’ Office of Women’s Health, she continues to work on the AIDS awareness front, along with coordinating prevention and education efforts on such issues as lupus, domestic violence and minority women’s health.
Unlimited Rewards
Despite the hard work and the steep challenges, a career in the Public Health Service Commissioned Corps can offer profound rewards—whether they’re achieved directly, by treating patients, or indirectly, by shaping health policy. Page, for example, was instrumental in the effort that led to the creation of a national domestic violence hotline. She also helped establish a national nurses’ summit on violence against women and recently helped put together a national working group on lupus that is providing education about that disease to federal employees and the public.
Montoya, who is now a public health analyst for the Division of Community and Migrant Health, helps develop health care policies for migrant farm workers. She also works in a number of local clinics, to keep informed about what’s happening on the front lines of her field. “I feel I am giving back to the community,” she says.
In addition to her five years of working on Indian reservations in Arizona and New Mexico, Montoya has also served as an occupational health consultant and traveled internationally. In 1995, she went to Mexico as part of a World Health Organization delegation to help that country create a national health care plan. Three years later, she traveled to Chile as part of a delegation on nursing practice models.
Balingit-Wines says her work at the Alaskan Native Medical Center in Anchorage was one of her most rewarding nursing experiences. Many of her patients lived in such remote areas that their only access to health care facilities was by plane. Yet despite the isolation, the population faced growing problems of coronary heart disease and diabetes due to increasingly Westernized diets. Balingit-Wines, who is Filipino, says the fact that she physically resembled her Alaskan Native patients helped establish an immediate comfort level. “Just to hold a hand and see a familiar face meant so much to them,” she recalls.
Capt. Ernestine Murray, RN, BSN, MAS, has worked in a wide variety of positions during her 20 years as a commissioned officer. Murray, who became a nurse after a career in business at Lockheed Martin, worked as a critical care nurse at the Public Health Service Indian Hospital in Tuba City, Ariz., caring for members of the Navajo and Hopi tribes. As a nurse consultant and scientific reviewer for the FDA, she helped develop educational programs aimed at reducing complications associated with the use of medical devices. She also worked as a cardiovascular and surgical intensive care nurse at the National Heart, Lung & Blood Institute.
Currently, she is a senior health policy analyst for the Agency for Health Care Research and Quality. She is involved in the agency’s Center for Practice and Technology Assessment, where she develops and implements clinical practice guidelines and evidence-based reports on health care.
“With each job, I gained valuable experiences and wonderful memories,” Murray emphasizes. As an African American who grew up in Maryland during the time when schools were being desegregated, she thought she had been well exposed to disparities in equal access to basic human services. And yet, she says, the work she did on Indian reservations gave her a new appreciation for the stark needs that still exist.
“America’s health care system cannot be considered effective until those who have the least have the same access as those who have the most,” she maintains. “But through working in the Public Health Service, you feel your input helps chip away at that lack of access.”
Opportunities for students
Nursing students can earn money and get valuable experience through two programs offered by the U.S. Public Health Service Commissioned Corps, as well as a related federal program called the National Health Service Corps.
In the Public Health Service’s Junior Commissioned Officer Student Training and Extern Program (Junior COSTEP), students are commissioned as junior assistant health service officers. Nursing students can earn about $2,300 a month working for public health agencies on assignments ranging from 31 to 120 days. Students are not obligated to go on to a career in the Commissioned Corps after they graduate, but if they do, they receive credit for their time in the program for pay and retirement purposes.
For students in their final year of undergraduate or graduate school, the Senior COSTEP offers a competitive financial aid program in exchange for an agreement to work for the Public Health Service after graduation. As an active-duty officer during their senior year, students are paid about $2,300 a month and receive uniformed services benefits. When they graduate, participants are promoted according to their degree and professional experience. A nurse with a Master’s degree, for instance, would be promoted to a junior lieutenant with a $2,700 monthly salary, plus benefits.
To learn more about these opportunities, go to the student page on the Commissioned Corps Web site. Applications for both programs are available online, or by calling (800) 279-1605; if you are located in Maryland, call (301) 594-3453.
Meanwhile, nurses in certain specialties can apply for scholarships and educational loan repayment assistance through the National Health Service Corps, a program sponsored by the U.S. Health Resources and Services Administration (HRSA), Bureau of Primary Health Care. The program works together with local communities to place health care professionals in rural areas and inner city neighborhoods where the need for health services is greatest. Unlike the Commissioned Corps of the U.S. Public Health Service, however, members of the National Health Service Corps work for the community agencies, rather than the federal government. They are not part of the government’s uniformed services.
The scholarship and loan repayment programs are highly competitive. In exchange for the financial assistance, winners agree to work in two-year residencies in underserved areas.
The scholarship program is open to students studying to become nurse practitioners or nurse-midwives; the loan program is open to primary care certified nurse practitioners, certified nurse-midwives and psychiatric nursing specialists. For more information, see the NHSC Web site, or call (800) 221-9393.
