On October 16, 1932, at a time when African American nurses were either barred from membership in state and national nursing professional associations or had only limited opportunities to participate in these organizations, a visionary nursing leader named Aliene Carrington Ewell, BA, RN, with the assistance of 11 other founding members, established Chi Eta Phi Sorority, Inc., a national sorority for black professional nurses.
Today Chi Eta Phi is a professional association for registered professional nurses and student nurses–both male and female–representing many cultures and diverse ethnic backgrounds. Headquartered in Washington, D.C., it has over 8,000 members, with more than 90 graduate chapters (for nurses who are already RNs) and 50 undergraduate (student) chapters located across the United States and in St. Thomas, U.S. Virgin Islands.
This October, Chi Eta Phi is celebrating its 75th anniversary. A two-day commemorative event will be held October 15-16 in Washington and will be highlighted by the unveiling of a wax figure in the likeness of Aliene Ewell. After the celebration, the figure will be installed in The National Great Blacks In Wax Museum in Baltimore, which is dedicated solely to the study and preservation of African American history.
Born in Norfolk, Va., Ewell graduated from Freedmen’s Hospital School of Nursing, Washington, D.C., in 1922. She continued to pursue higher education with great vigor, attending several prestigious institutes. She received a baccalaureate degree from the District of Columbia Teacher’s College and also studied at the Catholic University of America and at Columbia University in New York City.
Ewell began her career as a staff nurse for the Instructive Visiting Nurses Association and the District of Columbia Public Health Department. In 1957 she became the executive director of the Ionia R. Whipper Home, a maternity home for black unwed mothers, and worked there for 10 years until her retirement in 1967. She died on January 23, 1997.
These facts depict the professional life of an extraordinary woman who was a leader among minority nurses. Lillian Stokes, PhD, RN, FAAN, the current president of Chi Eta Phi, met Ewell several times in the late 1970s. “She was a dynamic leader, a lady, very elegant. Her [exuberant leadership radiated from her] and her presence made such a big difference,” says Stokes, who was elected to her second term as Supreme Basileus in July.
The 12 original sorors “were visionaries,” she continues. “They were leaders. They were professionals. They were committed to service. They saw a need for the organization because back in 1932 minority nurses could not belong to the majority organizations. They saw the need for an organization [that would provide opportunities for] African American nurses to come together and network, share their talents, develop leadership skills, provide service and connect with each other.”
“These women were looking for someplace where professional nurses of color could get together as a group to look at the issues that were affecting health and [how] nurses could deal with [those issues],” says Chi Eta Phi first vice president Mildred D. Fennal, PhD, RN, CCRN. “[The sorority] evolved from that.”
“Service for Humanity”
Membership in Chi Eta Phi is by invitation and is both active and honorary.
“If someone expresses interest in [joining] the sorority, what we try to do is make them understand that we are a professional service organization, not a social organization,” says Stokes, who has been a member of Chi Eta Phi for over four decades. “[That way,] if they decide to join they are not disappointed. We are about working and serving and those are the things that are stressed.
“Nurses want to be a part of an organization that is professional,” she adds. “They want to help make a difference in their communities. One of the other areas we [emphasize very strongly] is fellowship. It is a way of networking and interacting with other nurses who [share the same beliefs and goals]: to try to provide service to the community.” Chi Eta Phi Sorority as it exists today has five stated purposes:
To encourage continuing education among members of the nursing profession.
To have a continuous recruitment program for nursing and the health professions.
To stimulate a close and friendly relationship among the members.
To develop working relationships with other professional groups for the improvement and delivery of health care services.
To constantly identify a corps of nursing leaders within the membership who will function as agents of social change on the national, regional and local level.
The sorority’s motto, “Service for Humanity,” is reflected in a wide range of programs focusing on health promotion and disease prevention, leadership development, mentoring, international development, recruitment and retention of minorities into nursing, and scholarships for nursing students. The organization also publishes the Journal of Chi Eta Phi Sorority (JOCEPS), a scholarly nursing journal published annually.
“The greatest strength [of the sorority] is the services provided to the community throughout the country and abroad,” Fennal says. “Our signature program is hypertension [awareness and prevention].”
Chi Eta Phi has partnered with the American Heart Association and the National Institutes of Health to offer hypertension screening programs that are specifically targeted to the needs of communities of color. Compared with other racial/ethnic groups, African Americans have the nation’s highest morbidity and mortality rates from heart disease, stroke and kidney failure. High blood pressure is a precursor to these conditions.
“Over the years, our major programs have evolved,” says Stokes, who is the director of the Indiana University School of Nursing (IUSON) Diversity and Enrichment Program. “I believe disease prevention and health promotion were probably the early ones, and we [continue to] do health screening and health education. We are working very hard to make an impact in the community and we try to capitalize on the talents in this organization to help increase individual and community awareness about health issues.
“One of the things we would like to do is facilitate a decrease in health disparities. I think we are probably doing that [already]. Hypertension is one of the major ones.” The sorority also has prevention programs that focus on cancer, glaucoma and Sudden Infant Death Syndrome (SIDS).
In these areas, the health disparity gaps between the majority and minority populations are wide. “That is the reason we selected these programs,” says Stokes. “But we don’t discriminate. We will do programs for any [population], but our focus is underserved populations.”
Fennal, who is a professor at Florida A&M University School of Nursing, has been a member of Chi Eta Phi for some 17 years and has taken full advantage of the leadership opportunities the sorority offers.
“It has been a wonderful experience for me. It has given me the opportunity to grow, particularly as a leader,” she says. “When you’re in a job like academia, sometimes you have to stay forever before you get a chance to [move into] a leadership position. So as a nurse you may not have an opportunity to play a leadership role in your job, but if you are [involved with a professional organization like Chi Eta Phi], you can have a leadership position there that will teach you the same things that [a leadership] job would teach. It also gives you the chance to be a national leader where you [have a constituency of] 8,000 people, which is great.”
Some of the sorority’s newer programs are designed to assist the members in developing effective leadership skills. The leadership development programs include member development, officer development, the Leadership Fellows Program and the professional development program.
“We are working very hard to develop new leaders, not only to serve Chi Eta Phi but also to serve other organizations and to serve in the community,” says Stokes. “About three years ago we developed [the Leadership Fellows Program] to offer opportunities for members who are interested in holding national leadership positions or holding positions on a regional level. [The program gives them the opportunity to] work with a mentor for a year to develop in whatever area they are interested in.” The program also provides funds that enable Fellows to travel, attend conferences and meet with their mentors.
Support for Students
Chi Eta Phi Sorority awards $50,000 annually in nursing scholarships, including the national Aliene Carrington Ewell Scholarship for undergraduate students and the Mabel Keaton Staupers National Scholarship Award, for students pursuing bachelor’s, master’s or doctoral degrees. Other scholarships are available at the regional and local levels.
“One of the main [barriers to] education for minority students in nursing is [lack of] money,” Stokes says. “We are [especially] pleased that we can be part of supporting students while they are getting their undergraduate degrees.”
The sorority supports student nurses in every aspect of their lives, says Shakyra Stanfield, BSN, who recently graduated from Howard University and is now working at Yale New Haven Hospital in Connecticut.
“With school being the top priority when you are [Chi Eta Phi members] at the undergraduate level, [the RNs in the sorority provide assistance to] make sure we pass all our classes,” she explains. “We get a lot of support from our graduate chapter, which is like our parent chapter. They provide a lot of information and financial resources. If we need to take a class to help us prepare for the NCLEX®, they might fund us in those types of situations. When we were having some problems in one of our classes, members who had graduated from our [student] chapter came back and gave us lessons on how to study, on test-taking skills and how to prepare for exams.”
Stanfield joined Chi Eta Phi at a time when she had just changed her major to nursing. “One of the members of the organization came to our class and gave us information about the sorority,” she recalls. “Joining a nursing organization while in nursing school seemed like it would be a good idea.”
It turned out to be a wise move for this dynamic young leader, who currently holds the position of third vice president on the sorority’s national Board of Directors. Stanfield has forged strong friendships with other sorority members and has stayed in touch with other former student members as they have gone out into the professional world and become nurses.
Chi Eta Phi’s mission of providing community service is clearly evident at the student level as well. “Because we are a nursing sorority, we–of course–focus a lot on health. [Student members] go out into the community and do a lot of screening for chronic diseases or [other health problems],” Stanfield says. “Our chapter has also helped different kinds of populations at various events. We have gone to a senior service agency and delivered food for Thanksgiving. We also did some beautification projects at a local elementary school. We do many things in the community for the overall improvement of the general population.”
Fennal encourages undergraduate students to get involved in Chi Eta Phi because it gives them the opportunity to start their professional network while they are still in college. “The sorority gives them access to all of these [minority nursing leaders] who have done all the contributing before them,” she says. “As a student, that immediately puts you in touch with people who have done work in nursing across the country. It is an excellent professional development opportunity for these young women, mostly, but also young men, to be mentored by people who have been in nursing for a while.
“We have a great undergraduate chapter here at Florida A&M,” Fennal adds.
Keeping the History Alive
Betty Smith Williams, DrPH, RN, FAAN, president of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), is an honorary member of the sorority. She sees the support network offered by organizations like Chi Eta Phi as a very positive opportunity for nurses of color.
NCEMNA President Betty Smith Williams, DrPH, RN, FAAN, is an honorary member of Chi Eta Phi.
“A support system is very much a main thing one gets out of this type of organization–the chance to meet colleagues with the same basic interests,” she says. “Since 90% of nurses are not nurses of color, [minority nurses] can be very isolated. This support system is very important to help you grow as an individual, develop and build [professional] relationships and have the opportunity to mentor [or be mentored by] other people who are doing something to create a lifeline for [minority] individuals in nursing.
“[Today] the problems of segregation, discrimination and racism [still] exist,” Williams continues. “When [nurses of color] come together, you have more opportunities to shape your environments, shape policy and do some things to strengthen your position.”
Stokes agrees with that assessment. “We are a professional organization,” she stresses. “We bring a group of nurses and student nurses together who are dedicated to service, and with that commitment we are able to implement our national programs that have some impact in communities throughout the country.”
The 12 founding members of Chi Eta Phi who made history 75 years ago are all deceased, but they are far from forgotten. “Throughout the intake process , we learned [the founders’] names and we know where they [were] from and when [the sorority] was founded,” says Stanfield. “We cherish our founders. Their families still come to our events and are a part of the organization. [The history] is not lost at all.”
Jewels in the Crown: Chi Eta Phi’s Founding Sisters
Along with Aliene Carrington Ewell, 11 other courageous and visionary African American nurses helped found Chi Eta Phi Sorority in 1932. Like Ewell, they were all graduates of Freedmen’s Hospital School of Nursing, a diploma program for black nurses in Washington, D.C. The sorority refers to the founding sorors as its “Jewels.”
Soror Clara E. Beverly was the first black nurse to receive a BSN degree from the Catholic University of America (in 1944). She went on to pursue graduate studies at the University of Chicago. Returning to Washington, she worked at Freedman’s Hospital as a supervisor/instructor and then became director of nursing at the Veterans Administration Hospital in Tuskegee, Alabama. Beverly also served in the Army Nurse Corps and the U.S. Public Health Service School of Practical Nursing in Fort Defiance, Arizona. As the director of nursing education for the Tubman National Institute of Medical Arts School of Nursing in Monrovia, Liberia, West Africa, she was decorated by William V.S. Tubman, president of Liberia, as Knight Official of the Order of African Redemption. She died in 1978.
Soror Lillian M. Boswell did postgraduate work at Columbia University in New York City, the Catholic University of America and the Peter Bent Brigham Hospital in Boston. She was a staff nurse and operating room supervisor at Freedmen’s Hospital, where she received many awards for exemplary performance of duties. Boswell was held in high regard by the hospital’s administrators, surgeons and nurses for her expertise in operating room administration and for the instruction and guidance she gave to the medical and nursing staffs. She served as treasurer of Chi Eta Phi’s charter chapter, Alpha, from 1932 until her retirement in 1958. She died in 1986.
Soror Gladys Louise Catchings pursued postgraduate studies at the Catholic University of America, the District of Columbia Teacher’s College and New York University in New York City. She worked in private duty, hospital, geriatric and school nursing. After retiring, Catchings divided her time between Chicago and her birthplace, Georgetown, Georgia. She passed away in 1992.
Soror Bessie Foster Cephas worked in school nursing in Virginia and in Beaver Falls, Pennsylvania. On May 1, 1949, she organized the sorority’s Kappa Chapter in Pittsburgh. Soror Cephas died in 2000.
Soror Henrietta Smith Chisholm received her BSN degree from the Catholic University of America and worked in public health nursing. She held many national and local leadership positions in Chi Eta Phi, including national Tamiochus, Headquarters Trustee and Alpha Chapter Basileus, Anti-Basileus and Tamiochus. She died in 2006.
Soror Susan Elizabeth Freeman engaged in postgraduate studies at Columbia University, Howard University and the Catholic University of America. She worked at Freedmen’s Hospital in a variety of positions. During World War II, Freeman joined the Army Nurse Corps, serving as chief nurse at Fort Huachuca, Ariz., and chief nurse of the 25th Station Hospital in Liberia, where she commanded the first unit of black nurses to serve overseas. She was the first black Army nurse to be promoted to the rank of captain and she received many commendations, including a citation as Knight Official of the Order of African Redemption from the Liberian government. In 1945, she was honored with the Mary Mahoney Award from the National Association of Colored Graduate Nurses. She passed away in 1979.
Soror Ruth Turner Garrett graduated from Freedmen’s Hospital School of Nursing in 1922. After her death in 1943, the sorority’s Alpha Chapter established the Ruth Garrett Memorial Fund in her name to recognize her work in ensuring that sorors who were ill received appropriate nursing intervention and care. This fund is still used today to pay for nursing services for ailing Chi Eta Phi members.
Soror Olivia Larkins Howard graduated from Freedmen’s Hospital School of Nursing in 1930 and embarked on a career in public health nursing. She was an original signee of the Articles of Incorporation for Chi Eta Phi Sorority on February 5, 1943. Soror Howard died in 1963.
Soror Mildred Wood Lucas did her postgraduate studies at Howard University, the Catholic University of America and the Medical College of Virginia in Richmond. Her career encompassed hospital nursing, public health, nursing education and school nursing. She served as a special services nurse for the American Red Cross in Louisville, Kentucky during the Great Ohio River Flood of 1937. In Chi Eta Phi, Lucas held the position of Grammateus in 1932 and served as national Tamias from 1945-1951. She was instrumental in stimulating interest in the sorority in Baltimore, where the Gamma Chapter was organized, and in her hometown of Hartford, Conn., where the Chi Chapter was established. She died in 1999.
Soror Clara Belle Royster pursued postgraduate studies at Howard University, the Catholic University of America and Columbia University. She was employed by Freedmen’s Hospital until she retired, serving in obstetrics and administration. She passed away in 1995.
Soror Katherine Chandler Turner received her bachelor’s degree in nursing education from Columbia University, then went on to do graduate studies at Wayne State University in Detroit and at Columbia University. Her professional career was in public health nursing, and she was the first black nursing supervisor in the Washington, D.C. metropolitan area. Turner served Chi Eta Phi as national Headquarters Trustee from 1976-1978. She was also active in professional and civic organizations, including the National Organization for Public Health and the American Red Cross. She died in 1991.
Correction: “First Generation Education,” a feature published in our fall 2010 edition, referenced Glen G. Galindo as CAMP’s Executive Director. He is the Executive Director of CAMP’s alumni association, an independent organization. For more information on CAMP, visit www.hepcamp.org.
With college costs constantly on the rise, there’s no denying that pursuing higher education is a massive undertaking—the academic, financial, and emotional elements strain not only students, but their parents and guardians too. So how big of a dent can $750 make in a $10,000 tuition bill? How about a few hours of academic counseling in a jam-packed class schedule? For first-generation students, it makes all the difference in the world.
The College Assistance Migrant Program, or CAMP, is a government-sponsored college outreach and scholarship program for students from migrant and seasonal farmworking backgrounds. Established in 1972, a product of President Johnson’s War on Poverty campaign, it has grown from five school branches to 38, with a multimillion dollar backing. From advice on admission and navigating financial aid applications to transitional counseling, CAMP supports students who often cannot turn to their families for help. The program focuses primarily on helping students get into college, but they also offer mentoring through the college years. About 2,000 students benefit from the program each year, joining an alumni network of well over 20,000. Executive Director of CAMP’s alumni association Glen G. Galindo reports a college freshman retention rate of approximately 90%.
Galindo was recruited to CAMP as a freshman at California State University in Sacramento in 1986. Since then, it seems he’s held practically every position in the organization, from student assistant to his current role. He speaks quickly and passionately about the organization and what it does.
“CAMP will provide students with assistance during the application process and support during their freshman year in college. But, ultimately, preparation during high school is a student’s best friend,” he says. “All high school students greatly improve their chances of reaching their educational goals if they earn a high GPA, take the correct college preparatory courses, and take their SAT/ACTs more than once. Unfortunately, most first-generation students lack in one or all of these key points.”
CAMP is not a political organization, Galindo says. It’s funded by federal grants; as such, it can only support U.S. citizens and legal residents. “We would like to see the Dream Act legislation pass so as to give greater opportunity for youth to pursue higher education,” Galindo says. “CAMP students typically have parents with an elementary-level education. Most are U.S.-born citizens, and as first-generation students, simply need guidance and mentorship to reach and succeed in higher education.”
What follows are the stories of three CAMPers. Each student is the first in his or her family to attend college, but the similarities don’t end there. They all appreciate their families and their education. They know they are role models, and they take that responsibility seriously. They understand they’ve been given an opportunity that’s not to be squandered.
Ana Laura Meza
Born in Jalisco, Mexico, Meza moved to Oregon with her family about 15 years ago. She spends her time outdoors, when the Northwest weather allows, and she loves being with her family, listening to her parents’ stories or playing what must be a massive game of Uno—she’s one of seven children.
Meza discovered CAMP as a volunteer at a Cesar Chavez Workshop in Independence, Oregon when the program offered a class that caught her interest. “I did not know much about what I was going to do financial-wise to pay for school,” she says. A CAMP representative named Isabel met with her to explain the program and what she had to do to apply. “We got a bit side tracked dancing and laughing because of the band that was playing outside,” Meza says. “Isabel not only helped me that day to get the application, but she offered her friendship.”
Meza says CAMP gives students a chance to slowly transition from high school to college. “It gives them a small push of motivation to continue to school, to achieve their goals.” Whether it’s a little extra money or life-changing mentoring, CAMP provides essential support at a key transitional point in students’ lives.
“I loved everything about CAMP, from the borrowing of books for your classes to the mentors who kept you updated every week, and the field trips to the local universities,” Meza says. “But the most memorable thing is the people that you meet along your first year.” They bonded over potluck dinners each Wednesday, she says. “The bonds you make with other CAMP students and staff you will keep for the rest of your life.”
Meza faced a number of obstacles in achieving her education, including the price of tuition. “Every person attending college knows that books and tuition are expensive and being unemployed does not help at all,” she says. While the lack of money is a common problem for students from all walks of life, first-gen students also deal with some lesser-known, unique obstacles at home. Never having experienced college or dealt with a child in higher education, Meza’s parents did not always understand all the things she had to do to get good grades, she says. “But no matter what they were always supportive.
“I want my parents to be proud of me, see that I am taking the opportunity of living in the U.S. and not just throwing it away,” she says. “I also want to be a role model for my younger brother who is in high school. I want to show him that if I can do it, so can he.”
Meza just started her second year at Chemeketa Community College in Salem, Oregon, but she hopes to transfer to Western Oregon University in the spring and work toward her bachelor’s degree in nursing. “When I was a little kid. I always enjoyed playing ‘doctor’ with my dolls, setting up scenarios where I had to fix their broken leg, or they were sick and they needed some soup,” she says. “I remember cutting my old shirts and using them as bandages or pencils as needles. As I grew I still had the interest to help people out, and what better way than to be a nurse.”
Jump at the chance to become a CAMPer, Meza advises students considering the program. “One thing for sure is do not take this opportunity for granted, because so many students who live here in the U.S. don’t have the same opportunity as we do,” she says. “Chances like this might only come our way once.”
Health care translators bridge the language gap during some of life’s most difficult and stressful moments. In the public health sector, it’s especially trying work, but it’s Arrezola’s passion. CAMP played a prominent role in getting him there.
Arrezola had already participated in a high school program geared toward migrant children before he learned about CAMP. When he discovered there was a similar program at CSU Fresno, he made an appointment to meet with the director and soon found himself involved as a CAMPer. “I read and learned a great deal about CAMP, and it made a significant impact in my life. I say this because right then I learned that I was going to be part of a group of students that were migrant like me and that also shared many cultural practices like mine,” he says. “That made me feel like I was going to have a family away from home.”
The eldest of five siblings in a family from Amacueca, Mexico, Arrezola came to the United States at 17 years old. He did not speak English, but he learned during night classes after full days at high school.
He credits his parents for their constant support and motivation, but he also struggled to relate the college experience to them. “Because I am of a migrant background and my parents did not go to school, they do not understand the educational system,” he says. “My parents always knew that school will prepare their kids for a better future, but it is not comprehensive.” He says he’s met many other CAMPers with similar problems. “Unfortunately, for various reasons, our migrant parents are not educated about the school system, whether it was poverty, machismo, lack of guidance, or role models.”
Another all-too-common barrier was money. His parents couldn’t afford his tuition, but with financial aid, determination, and help from CAMP, he was able to obtain his bachelor’s degree. “[My parents] did not have the opportunity to go to school like I did. It is my priority to also be a role model to my younger brothers and sisters, because I would also like for them to have a life full of opportunities to enjoy life to its fullest extent.”
Arrezola says college was always part of his plan; he didn’t consider it “optional.” “I was going to be one of those individuals that was going to have guidance in school and also was going to represent the minority in our community,” he says. “Education for me has been my inspiration to make a positive impact in the life surrounding me. I have always believed that an educated community cannot become perfect, but an educated community for sure can make better choices and make a difference.”
Arrezola is currently pursuing a master’s degree in public health at California State University, Fresno. “I always knew that I wanted to stay in the medical field,” he says. “After I graduated from college and became a health educator, I saw the necessity and the need to educate our communities about preventative care.” At 30 years old, he’s already worked as a bilingual health educator, leading one-on-one and group sessions throughout California, particularly in rural areas, for United Health Centers, and he’s served as the Administrative Leader of HealthCare California. As a volunteer, he’s worked as a bilingual spokesperson for the American Cancer Society. “This experience has given me the option to understand that, in our society, we have different groups of the population that need a lot of help finding guidance to medical access,” he says.
Arrezola has seen the health disparities in rural communities with limited access to health care. “I felt a close connection and could relate to the concerns of these individuals from personal experience,” he says. “I also felt the need to promote awareness about cultural sensitivity because there are a great deal of barriers, such as language, religion, and communication, etc., that retain people from seeking medical care.” He plans to finish his master’s degree and pursue a doctorate in public health with an emphasis in education.
To Arrezola, if any program can help students through the college experience, it’s CAMP. “I am still involved in the program because I see that new students have the same questions that I had when I was beginning my education at the university, and I want to be able to help them in the same way that program helped me,” he says. “I am proud to say that I am still a good friend with many of the students that I met at the CAMP program. Now a lot of them are professionals in the workforce, and the network that we have built has been a great help to continuously grow in our careers.
“I would like to tell students to take advantage of a program such as CAMP,” Arrezola says. “Be serious about wanting to pursue a college education and not feel discouraged.”
“My parents are from Jalisco, Mexico, and although I was born in San Diego, I’m proud to say I’m from Jalisco, Mexico, too,” says Flores. Now enrolled in her fifth year at California State University, San Marcos (CSUSM), she first learned of CAMP as a senior in high school, after being accepted to the University. “I had heard the program would help me in my first year at CSUSM,” she says “Students need someone to guide them throughout the first year of college. It’s wonderful to know someone out there cares and wants you to succeed.”
Flores also came from a low income family. Her father and brother shared the family car, and she had trouble getting to her college classes. “I desperately needed a job to cover my expenses, which included my textbooks for college,” Flores says, so she got a job as a tutor at her old high school and took their bus. “At times it was embarrassing, since students that knew me would ask, ‘Didn’t you graduate already? What are you doing here?’ But being embarrassed was nothing compared to my determination to overcome financial and transportation obstacles.”
Flores wrote about her dreams of becoming a doctor when she was a little girl, she says, but she decided she wanted to become a nurse in high school. “Sometimes I would fake being sick because I wanted to go ask the school nurse about nursing,” she says. “Volunteering at Palomar Hospital for two years helped me notice the great satisfaction I would feel when I would receive a smile from the patients I helped. I realized how privileged I was to be able to help the less fortunate.”
And, like the other CAMPers, Flores credits CAMP for providing the support necessary to not only attend but thrive in college. “I thank the CAMP staff for the help they gave me through these past years; if it wasn’t for them, my path in school would have been full of obstacles,” Flores says. “Once you become part of the CAMP family, they guide you through your college years and the road to success becomes more visible.”
*Correction: This article originally referenced Glen G. Galindo as CAMP’s Executive Director. He is the Executive Director of CAMP’s alumni association, an independent organization. For more information on CAMP, visit www.hepcamp.org.
In the growing sea of nursing specialties, critical care is actually one of the oldest. It was established in the 1950s and 1960s as the specialized care provided for the first intensive and cardiac care units. Seriously ill patients with complex health issues needed qualified nurses with unique skill sets. The same remains true today.
Critically ill patients who were once mostly cared for in ICUs can now be found throughout health care facilities, in emergency departments, post-anesthesia recovery units, interventional radiology, cardiac catheter labs, pediatric and neonatal intensive care units, burn units, progressive care units such as step-down and telemetry units, and even inpatient general care areas.
“The needs of the patients and their families determine whether they require a critical care nurse. It’s not based on the name of the unit or its location,” says Reynaldo Rivera, D.N.P., R.N., C.C.R.N., N.E.A.-B.C., A.N.P. Among his responsibilities as Director of Nursing in Medicine Services at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York, Rivera works with recent nursing graduates as they transition into their first professional role. “People are admitted into the hospital with more serious conditions and complex co-morbidities than patients in the past. The role of the critical care nurse continues to adapt to meet the challenges of a changing health care system,” he says.
More than half a million acute and critical care nurses comprise this specialty, which continues to grow. These nurses also teach, research, manage departments, and lead in the quest to create a health care system that is driven by the needs of patients and families.
A career in critical care has taken Cuban-born and U.S.-educated Maria Shirey, Ph.D., M.B.A., R.N., N.E.A.-B.C., F.A.C.H.E., from an internship program for new nurses at the Baptist Hospital of Miami to educator, manager, and executive positions in Florida, Texas, Louisiana, and Indiana. She is now an associate professor in the Doctor of Nursing Practice program at the University of Southern Indiana‘s College of Nursing and Health Professions in Evansville. “I have been a nurse for 33 years, and the skills gained at the bedside have been useful at every stage of my career,” she says. “Critical care nurses must make quick decisions constantly, and those decisions need to be based on evidence and data. You have someone’s life in your hands, and that’s not a responsibility to be taken lightly.”
Nurses may enter critical care immediately after licensure, or they transition into the specialty after gaining experience in other areas. Patients depend on these highly knowledgeable and skilled nurses to make accurate assessments, prioritize needs, and recognize the difference between an exception and a problem.
Linda Martinez, M.S.N., R.N., A.C.N.S.-B.C.-C.M.C., says critical care nurses begin with the basics, but soon realize textbook cases exist only in the classroom. A critical care nurse for 31 years, she works as a clinical nurse specialist for Presbyterian Heart Group at Presbyterian Hospital in Albuquerque, New Mexico. “First you learn the basics. Then, you learn the exceptions. As nurses gain experience, they start to individualize normal by putting into context what’s going on with each patient,” she says. “Assessment skills have to be very sharp in critical care. You have to be able to quickly assess a patient’s situation in case there’s a life-threatening change. You put everything you’ve learned into context.”
Rivera serves as president of the Philippine Nurses Association of America, where he advocates for diversity in the workforce, ethical recruitment practices, and professional development and standards. “Nurses in high acuity and critical care must have the competencies and requisite skills to do the job with an underlying sense of compassion and sensitivity. It’s the combination of all these attributes that inspire patients and their families to trust us,” Rivera says. “We practice as whole persons, using our hearts, the mind, and the hands. It’s also the soul of who we are.”
Shirey and Martinez have also become national leaders in nursing and critical care. Martinez serves on the national board of the American Association of Critical-Care Nurses (AACN), the world’s largest specialty nursing organization, representing the interests of more than 500,000 nurses who care for acutely and critically ill patients. Shirey chairs the AACN Certification Corporation, the association’s credentialing arm that certifies bedside and advanced practice nurses in high acuity and critical care. It also certifies nurse managers in a joint program with the American Organization of Nurse Executives.
Desire to learn
Shirey cites complex patient conditions, the fast pace, and pressure-packed environment as reasons why critical care nurses must commit to continuing professional development. “Things happen so quickly that you don’t have time to always research before acting. I either need to know it or know where to turn for help,” she says.
Shirey says she first joined AACN because of her desire to take better care of patients and their families. “I started studying the AACN core curriculum to hone my skills. I then joined AACN so I could receive the journals and earn my CCRN certification. All so I could be the best nurse for my patients.”
Armenian-born Anna Dermenchyan, B.S.N., B.S., R.N., C.C.R.N., agrees. She’s a clinical nurse in the cardiothoracic ICU at the Ronald Reagan UCLA Medical Center and an adjunct instructor at Mount St. Mary’s College, both in Los Angeles. “If we’re not learning, we’re not moving forward. Outdated skills affect patient care, especially with new medications and technology, changing policies, and procedures,” she says. “We have to be the best for our patients. We learn the most from them. Each case presents lessons for the next case.”
Ryan Cavada, R.N., a staff nurse at the UCLA Medical Center Santa Monica campus, says nurses in critical care need strong critical-thinking skills, the ability to work under pressure in a fast-paced environment, and a continual desire to learn. “Critical care is at the forefront of evidence-based nursing practice where we apply new medical research, adapt ever-changing procedures, and use the latest technology. Our patients can’t afford care that doesn’t meet this benchmark standard,” he says.
Advocate for the patient
Patient advocacy is a vital responsibility of critical care nurses, as acutely and critically ill patients often can’t express how they feel or what they need. “As a nurse, I am the main representative for my patients and their families,” Dermenchyan says. “Many times, patients can’t communicate for themselves, describe symptoms, or tell me something is wrong. I need to be on the lookout on their behalf and communicate their needs to the ICU team.”
Martinez adds, “Critical care nurses must hone their communication skills, because a lack of understanding or miscommunication can have life or death implications.” She recalls the night she realized the importance of good communication. “I was speaking with the intern on call about a patient in pain and it hit me that I am the voice of this patient. My role as a patient advocate became crystal clear. If I couldn’t communicate what was needed, that patient would suffer through the night.”
Working as a team
Critical care nurses collaborate with other nurses and health professionals with a single focus on caring for the patient. Filipino-American nurse Cavada points to critical care’s unique intimacy. “We really get to know our patients,” he said. “Nurses are more than an active part of a team. We become the team’s hub. Doctors, nutritionists, respiratory therapists, everyone involved in a patient’s care come to us for the most current information.” He says competent critical care nurses are concerned about their own patients and stand ready to assist their colleagues. “Good teamwork allows more to be done for the patient in less time. In critical care, that can make a big difference; time is of the essence.”
“When we get patients who are extremely sick, we all have to work together. It’s our patient, not my patient. We all want good outcomes,” Dermenchyan says. “Collaboration is key, or patients suffer.” Critical care nursing demands a healthy work environment and true collaboration, in which each professional’s knowledge and abilities are respected.
Collaboration in critical care also goes beyond health care professionals. “Family members are an important element to caring for the patient,” Shirey says. “Critical care nurses learn to integrate them into the care, keep them informed, and we know how to be sensitive to changes in the patient’s condition that might cause turmoil in the family.”
The willingness to work collaboratively toward a common goal has benefits beyond the bedside.
Nurses learn early on how to work well in teams,” Martinez says. “And teams are vital to improving the system of health care, not just in the delivery of care.”
Rowena Elliott, Ph.D., R.N., C.N.N., B.C., C.N.E., is one of those people who make it all seem effortless. She balances teaching and mentoring with research projects and speaking engagements. She has a handful of degress and has held the title of “Director of Nursing” at least twice—it’s hard to keep track. She also has a collection of faculty, nurse, and student of the year awards from a number of organizations, and she was named a Gates Millennium Scholar in 2000. Add to that dozens of ancillary committees.
Yet, it’s her brand-new role as president of the American Nephrology Nurses Association that has people talking. In a time when there seem to be so few “firsts,” Elliott is the first African American to hold the position. And for anyone who believes educators are, or should be, community leaders, her life is a case study of both. “She has been so determined in her professional career and volunteer leadership roles, accomplishing so much,” says Loretta Jackson Brown, Ph.D.-C., R.N., C.N.N. Brown served on the ANNA Board of Directors with Elliott from 2008–2010, where they together made history as two minorities in leadership roles within the organization. Outside the ANNA, Brown is a clinician health communicator with McKing Consulting and the Centers for Disease Control and Prevention. “She is dedicated to improving the statue of others, to including her nursing students, nephrology nurses, nurses in Mississippi, where she is an active member and leader for Mississippi Nurses Association, and many others.
“Often times people think that a leader of her rank perhaps is unapproachable and not in touch with the real members,” Brown says. “Dr. Elliott can often be found mingling with the members. She is inconspicuous and doesn’t draw attention to the fact that she is the most powerful person in the room.”
A girl from Chicago
Elliott speaks excitedly, quickly, about her life and years leading up to being elected president of the ANNA.
Born and raised in Chicago, Elliott is the second of 10 children, an even split of boys and girls. “I grew up in a household where we didn’t have a lot,” she says. “We were poor.” Elliott says she is fortunate that all of her siblings are still alive, as well as her mother, though her father passed away over a decade ago.
Elliott’s parents, who both left high school before their senior year, instilled in their children a reverence for education. They knew it would lead to a better life and exponentially more opportunities. Through education, they could achieve anything. Elliott took their advice to heart, and now holds three degrees and has been teaching since 1998. Married with two children and two grandchildren of her own, Elliott says, “I try to instill the same thing in them.”
Elliott graduated from nursing school in 1982. She wanted to become a CRNA immediately, but marriage and children postponed her plans. “Life happens,” she says. Fifteen years later, she went back to school for her master’s degree.
“I’ve done a little bit of everything,” Elliott says. As clinical nurses often do in small hospitals, “We did it all.” Juggling the responsibilities taught her to think on her feet, to move quickly, and to not be afraid.
Eventually, Elliott moved into long-term care, but she says it wasn’t her niche. She was looking for new job opportunities when she saw the hemodialysis unit in her hospital needed a director. Elliott applied, even though she couldn’t remember much about dialysis from nursing school. “I probably wouldn’t even recognize a dialysis machine!” she says with a burst of girlish laughter.
To her surprise, Elliott got the job and had a great teacher to guide her through. She says she learned how to prioritize and do things right the first time. “No shortcuts,” she says, suddenly serious. Now she shares the same advice, plus 30 years of lived experience, with her students.
For three or four years, Elliott ran the dialysis unit, and throughout that time, she heard her colleagues say she should become a nurse educator. “I never really thought about being a teacher,” Elliott says. “But I thought, ‘I have the gift to do this.'”
In 1998, she started teaching at Alcorn State University School of Nursing in Natchez, Mississippi. She moved on to her alma mater, the University of Mississippi, in 2001. The entrepreneurial bug bit her in 2005, and Elliott started her own legal nurse consultant business, but the novelty of the business side of nursing eventually wore off. “I started missing my calling,” she says. She belonged in a classroom. So she took a position at the University of Southern Mississippi in 2008, where she teaches today. Elliott is passionate about guiding and being a role model to others, particularly minority nurses and nephrology nurses. She says it plainly: “I love my students.”
As medical director, Elliott required her staff nurses to join the American Nephrology Nurses Association (ANNA), starting a relationship with the organization that has seen her rise through the ranks, from state to regional to national officer and now president.
Elliott, bottom left, and her family in Chicago, circa 1968
At one point, Elliott ran for ANNA national secretary, but lost. She says the election taught her a lot, and when she came back stronger and more prepared, she won the position. Six years later, she was elected president, and on March 29, 2011, she was officially sworn in. “My brother actually calls me Dr. Ro-bama,” she says, again laughing through her words.
“Rowena is very energetic, outgoing, and stylish,” says Sharon Longton, R.N., B.S.N., C.N.N., C.C.T.C., a data manager and transplant coordinator at Harper University Hospital in Detroit. The two met when Elliott joined the ANNA’s Board of Directors as National Secretary. “She works tirelessly to achieve her goals and the goals of the organization. Her personality and laughter draw others in and makes them feel like they belong,” Longton says. “She always recognizes others for what they do, no matter how small or big their contribution may be.
“I also admire Rowena’s style,” Longton says. “Ro loves shoes and Paris. It seems as though she has shoes in almost every color and style available. Her love is so significant that if you were to look closely on the cover of ANNA’s 2011 Fall Meeting program brochure, you will notice a pair of red high heels near the base of a street lamp. These were included in the picture as a subtle representation of something for Rowena. And what can I say about Paris other than it shows how classy and intelligent Rowena is.”
Being a “first”
“I get teary,” Elliott says, less than a month before the swearing-in ceremony. “When I think about it—” Her voice falters and she stops for a minute.
“I’ve come from a family where we had nothing to being the first African American president of this organization,” she continues.
“I do remember when I was a preteen that I had to sit in the ‘blacks only’ section of the local health clinic,” Elliott says. “To go from that to being the first African American to lead this organization is surreal but also warms my heart.”
Although Elliott celebrates her achievement, she does not dwell on it because it’s a part of a greater plan, she says. “I know God wants this position to be an opportunity to let other nurses and nursing students to know that no matter the obstacles and challenges that life brings, your dreams can definitely become realities.”
For Elliott, the role is more meaningful because she’s showing other minority nurses that they can do it too. “If you see something you want to change, you can change it,” she says.
Being the ANNA president was not a lifelong dream for Elliott, she says, but when she saw that Board of Directors, she felt that she just needed to be there. “[They] did not reflect the membership,” she says. Elliott remembers looking at the ANNA’s Board of Directors and asking the then president, “How do you get up there?”
For Elliott, it’s a simple matter of equal representation. “The amount of minorities does not reflect the population that we serve,” she says of the ANNA and her specialty. When you look at the patients nephrology nurses serve, they’re primarily African Americans who experience grossly disproportionate numbers of hypertension, heart disease, and diabetes, which lead to kidney problems and renal replacement. As ANNA president, Elliott wants to increase the number of all minority nephrology nurses, while boosting the number of nephrology nurses in general. “That’s been one of my goals,” she says, and she already has experience, having served on recruitment committees as a university faculty member.
Elliott, center, with two of her mentees at the Mississippi Nurses Association’s Nightingale Award ceremony
“If you want to make a change, don’t complain about it—take the steps,” Elliott says. “Make the change that you’re trying to see.”
Recruiting is about creating awareness and highlighting the benefits of this niche nursing specialty to make it an appealing path for future generations of nurses, Elliott says. Part of the effort is advocacy and speaking out. Let people know you’re there. Elliott presents at symposiums and writes about the subject at length, detailing solutions for recruitment. She recently spoke at a National Student Nurses Association event to discuss nephrology as a career path. “A lot of them didn’t even realize it was an option,” she says.
Elliott says she sees a lot of nursing students go into the ICU, women’s health, and emergency nursing—the well known specialties shown, and often idealized, on television and in movies. Nephrology needs to take a similar tact, Elliott says, but because getting it into the movies may be a challenge, it’s up to the nurses. “Our specialty is a great specialty. It’s very rewarding and exciting,” she says. “We need to make sure our name is out there.”
Elliott, or “Dr. E.” as she’s known at school, estimates two or three of her students go into nephrology nursing every year. The students tell her they chose the specialty because of the passion she expresses for it in her teaching.
“Her dynamic personality allows her to [be] interactive with individuals across all racial and ethnic groups,” Brown says. “She is infectious in her presentation and you truly are motivated to go out and accomplish more once you hear her speak…She truly epitomizes leadership excellence and encourages the hearts of others.”
Elliott hopes history will remember her for her leadership, not just as the first black ANNA president. “It’s truly an honor. I don’t have the words to express it,” she says. “But I’m ready for the work.”
Elliott credits her parents for always encouraging her to do better, to be better. “I know I’m making history,” she says. “I’m proud.”
“She is just what ANNA needs at this time,” says Donna Painter, M.S., R.N., C.N.N., the exiting ANNA President. “I know that ANNA will thrive.”
Always the teacher, Elliott hopes the next generation of nurses can learn from her nearly three decades in the profession. “Don’t settle,” she advises. “Don’t settle for anything in your personal life. Don’t settle for anything in your professional life.” If you dream about being a nurse educator, press forward until you become a nurse educator. “Stay focused on your goals and make the sacrifices,” she says. “Keep your eyes on the prize.”
It is often said, “We are a product of our environments.” In many respects this is true. In the African American culture, we tend to embrace the habits and behaviors of our surroundings. We don’t think of our childhood or adulthood lifestyles as unhealthy because we tend to repeat the behaviors we have always known.
Fast-paced and stressful workdays, a lack of physical activity, poor nutritional choices, and sedentary downtime are all factors that have led to skyrocketing levels of obesity, but are the norm in the American lifestyle. Consequently, problems like hypertension, heart disease, peripheral vascular disease, diabetes, some forms of cancer, pulmonary disease, depression, and conditions involving the musculoskeletal system plague obese populations. Additionally, the study of obesity reflects underlying economic and income inequalities, community disadvantages, and social class divisions. With the rapidly increasing pace of obesity, the weight of the matter is both individual and societal.
The term “obese” is often confused with “overweight.” We know the difference as health professionals, but the communities we serve may not. Healthy weights are determined using the Body Mass Index (BMI). People with a BMI between 25 and 29.9 are considered overweight. Those with a BMI of 30 or greater are obese.
Obesity has become one of the most serious public health problems of the 21st century, due to its prevalence, cost, and health effects. It cuts from a wide swath of people, spanning all ages and genders, making it a national priority. Obesity has reduced the lifespan of entire communities and dismantled their quality of life. African Americans are killing their bodies when they do not make the connection between lifestyle behaviors and their outcomes.
One effective strategy for solving the obesity epidemic is through educating ourselves. Taking ownership of our bodies, recognizing the problems, and changing our attitudes will help us make knowledgeable decisions about our health. Although countless excuses, from a lack of role models to fast-food conveniences, may attempt to undermine addressing the real issue, the life or death importance of seeking solutions should resonate beyond the perception that fighting obesity is futile.
For the Fort Bend County Black Nurses Association (FBCBNA), the fight against obesity is persistent. This year, FBCBNA is celebrating its 10th anniversary. We challenged our members to lose 10 pounds in honor of the occasion. The National Black Nurses Association (NBNA) awarded the FBCBNA a $1,000 seed grant to fund the initiative and develop strategies to tackle obesity. The grant will be used to introduce interventions, like personal training tips and group exercise activities, as well as community education, such as teaching people how to read food labels.
As nurses, we need to practice what we preach. Fighting obesity from within our local chapter seems like a sensible choice. Nurses do an excellent job giving advice and caring for others, but don’t always do a good job caring for themselves. Reducing one’s BMI requires changing behaviors and making lifelong healthful decisions. The FBCBNA’s obesity initiative is titled “BMI Beware: A Nursing Association’s Strategy for Changing Body Mass Index.”
The pillars of combating obesity are balanced nutritional meals and physical activity. Portion control, knowledge of ingredients, informed reading of food labels, and nutritious food choices are fundamental in changing unhealthy behaviors and developing improved lifestyles. The fight to conquer obesity must have multiple layers of intervention. Aerobic and resistance fitness programs, avoiding fast food purchases, planned healthy meals and snacks, and adequate hydration, specifically water, are all positive ways to intervene in this epidemic.
The goal in all this is to make a conscious assessment of our obesity problem. Personal lifestyle and behavior changes must be developed and then practiced daily to make a real impact. Opportunities to take on new and rewarding lifestyle changes are all around us. We just have to get moving—one day at a time, one step at a time. We owe it to ourselves, our families, and society. The obesity epidemic is serious. As we collectively transition toward healthier choices and better lifestyle routines, sharing knowledge and becoming more educated as health professionals will lead our communities to positive results.