Meet a Champion of Nursing Diversity: Dr. Selena Gilles

Meet a Champion of Nursing Diversity: Dr. Selena Gilles

Selena Gilles, DNP, ANP-BC, CNEcl, FNYAM, is a Clinical Associate Professor and Associate Dean of the Undergraduate Programs at New York University Rory Meyers College of Nursing.

She’s also an Affiliate Faculty member of the Hartford Institute for Geriatric Nursing (HIGN), where she serves as Co-Director of the HIGN Scholars Program, an Affiliate Associate Professor at Howard University College of Nursing and Allied Health Sciences, and a Volunteer Associate Professor for the State University of Haiti.

Dr. Gilles is known for creating and implementing nontraditional immersive teaching/learning innovations to address nationally identified nursing education issues that will enhance student learning/program outcomes.

She is regarded as a leader and prelicensure nursing education expert who has implemented curricular innovations that have been evidence-based, creative, and effective teaching strategies that span multiple courses at Meyers and settings outside of Meyers, significantly impacting student academic success and role transitions.

Dr. Gilles’s contributions have helped enhance the nursing curriculum, filling identified gaps and answering the new essentials call for all entry-level professional nurses to have knowledge and proficiencies to practice across various settings in wellness/disease prevention and chronic disease management.

She’s passionate about the management of acute and chronic pain, as well as opioid overdose prevention, and is the Program Director of the Greater NYC Black Nurses Association Opioid Overdose Prevention Program. Dr. Gilles has strong community advocacy and a passion for global health; currently working with organizations aimed to serve the underprivileged and underserved communities in Haiti, Ghana, and Nigeria and has been on six medical missions.

Dr. Selena Gilles is an important nursing leader, and we’re proud to profile her as part of the Champions of Nursing Diversity Series 2024. The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in

Meet Dr. Selena Gilles, Clinical Associate Professor and Associate Dean of the Undergraduate Program at New York University Rory Meyers College of Nursing.

Talk about your role in nursing.

I am a Clinical Associate Professor and Associate Dean of the Undergraduate Program at NYU Rory Meyers College of Nursing. I am also an Affiliate Associate Professor at Howard University College of Nursing and Allied Health Sciences and a Volunteer Associate Professor for the State University of Haiti. I am a certified Clinical Nurse Educator and certified in Critical Care Nursing. As an Adult Nurse Practitioner, I specialize in neuro and pain management, including medical marijuana and opioid overdose prevention.

I have always been passionate about giving back to my community, which often lacks the resources and support to combat health disparities, inequities, and social injustice. With a proven track record of volunteering, my work with nursing organizations and community groups has impacted thousands of students, nursing colleagues, and community members locally and globally. 

My pioneering work has impacted 8,000+ disadvantaged patients in Haiti, Ghana, and Nigeria. As a volunteer Nurse Practitioner for seven medical missions, I have significantly contributed by educating local professionals and providing appropriate patient care while mentoring nursing students in global health initiatives. My innovations enhance health professions curricula with local/global community-based experiences, fill international gaps, and prepare nurses to gain essential competencies across cultures and practice settings.

How long have you worked in the nursing field?

I have been in nursing for 18 years. It’s hard to wrap my head around that question whenever I answer it. It feels like it was just yesterday when I graduated from nursing school. I have been a nurse practitioner and nurse educator for 13 years.

Why did you become a nurse? 

My grandmother migrated to Brooklyn in 1969 from North Carolina with her three daughters at a time when being black in the South was still dangerous. My grandmother struggled with heart disease and diabetes and suffered a stroke, as do many African Americans in underserved communities. Seeing her severely ill is what sparked my interest in a healthcare career.

Aside from my grandmother, my parents have been very influential in my career. My mom grew up in a very disadvantaged neighborhood. She spent her early years in a housing project. She worked for over thirty years as a certified nursing assistant. My father, a Haitian immigrant who came to America at age 20, instilled in me early on that I’d have to work twice as hard to get the same opportunities as my counterparts. I didn’t grow up in the best neighborhoods. As a latchkey kid who grew up in the NYC public schools, I knew I had to make it out of areas where most lack the resources to succeed. These are places where community members didn’t have the best healthcare access or all the resources required to live a healthy life, like safe areas to play or exercise or even grocery stores with fresh foods. That taught me about the impact of the social determinants of health and how I could serve as a community advocate to combat health disparities and inequities. 

What are the most important attributes of today’s nursing leaders? 

Compassion, emotional intelligence, collaboration, resilience, determination, flexibility, innovation, critical thinking, problem-solving, diligence, not being afraid to challenge the status quo, advocates, and being a team player.

What does being a nursing leader mean to you, and what are you most proud of?

Positions are temporary. Ranks and titles are limited. But the way you treat people is what will always be remembered. I am passionate about helping the underserved and will prioritize doing all I can to help those in need. As an award-winning expert clinician and community leader, I’ve launched effective models that bring under-resourced communities access to healthcare and education while creating nontraditional community-based immersive learning/interprofessional experiences for NP students. My groundbreaking contributions enhance the knowledge/competencies of 40,000+ healthcare professionals across community settings worldwide. I’ve secured corporate and community-based sponsorship for multiple community health initiatives and established an NP-led COVID-19 vaccine clinic that delivered 28,000+ vaccines to vulnerable people. As a volunteer NP, I have immersed nursing students in seven international medical missions, providing care to over 8,000 vulnerable patients and promoting health equity in Haiti, Ghana, and Nigeria. My innovations enhance health professions curricula with local/global community-based experiences, fill international gaps, and prepare nurses to gain essential competencies across cultures and practice settings

Tell us about your career path and how you ascended to that role.

At some point in our careers, we’re all asked how we accomplished our goals. All of our stories are unique. When reflecting on my journey and my road to success, I’ve realized that all paths are not a straight line. My path had many bumps, obstacles, twists, and turns, and I’ve met many people. Often, when we think of education, we think of it in the traditional sense, whatever we’ve learned in school. Of course, as nurses, degrees earned ultimately shape our careers regarding the type of healthcare provider we become and the setting in which we practice. I’d say that my identity as a nurse started to develop way before I entered nursing school. I credit a lot of who I am as a nurse to all of the many experiences I’ve had along the way.

We are a product of our society and our parents and their struggles. It began with seeing my grandmother struggle with chronic illness and seeing my mom work long hours at the hospital. My parents couldn’t afford to send me to the best schools, reinforcing the importance of hard work and dedication. It gave me my drive, made me more ambitious, and taught me not to take no for an answer. This led me to continue to pursue higher education and seek a terminal nursing degree

I am the daughter of a Haitian immigrant. A father who told me I could have anything that I ever dreamt of if I just worked for it. He’s a huge part of where I get my work ethic from. Some may call me a latchkey kid, as my mom worked very hard at a Community hospital to provide for me. That experience taught me to be independent, self-sufficient, and hardworking. I learned that sometimes, you must sacrifice for the greater good. We’ve all made sacrifices for our patients

I think about my experiences in public school, where I didn’t have a lot of teachers who looked like me. You can’t be what you can’t see. In my third year of nursing school, I was exposed to two doctorally prepared women faculty of color. They gave me something to aspire to. It was at that moment that I realized that anything was possible. That my career in nursing could be whatever I wanted it to be. That shaped who I would become as a nurse in academia. So, I pay it forward by being that example. I wish I had more of this when I was pursuing my education. To look at my surroundings and advocate for more diverse faculty so that the diversity in leadership mirrors the diversity of our students and the patients we care for. To ensure our curriculum is diverse and inclusive, we are preparing culturally competent and aware nurses who can provide culturally appropriate care to all patients. This is the change I wish to see in the world. 

I started wanting to be a pediatrician after doing an externship in the pediatrics unit at the hospital where my mom worked as a teenager. That was my first taste of healthcare. I double majored in college because I didn’t come from money and knew medical school was expensive. I was premed with nursing as my backup. Seeing the great care my grandmother received from her ICU nurses at the end of her life, coupled with my early clinical experiences in nursing school, solidified that a career in nursing was best for me. After completing my degree and passing my licensing exam, I worked in a Med Surg unit for a year and then transferred to the medical ICU because I aspired to become a CRNA. At the same time, I enrolled in a master’s program to get a head start on core courses. I ultimately did not get into the CRNA program I applied to and ended up finishing my master’s and becoming an Adult NP. Upon graduating, I had difficulty finding a job as an NP. You did not see many working in the hospital at the time. One day, while working a shift in the ICU, I ran into a former colleague from my previous Med Surg unit. She had been working as an adjunct clinical instructor at my current institution and thought it would be a perfect fit for me. It wasn’t something I intended for myself, but I decided to try it, and the rest is history. The first and only hospital I’ve ever worked at now became the place where I would educate nursing students. Eventually, I secured a position at this same hospital as an NP in outpatient neurosurgery. Realizing I had a newfound love for nursing education, I began precepting NP students once I settled into my role. This led me to achieve my terminal nursing degree to pursue nursing education full-time. In my 13 years at NYU Meyers, I have strategically moved through the ranks. It feels like just yesterday when I was a clinical instructor. After completing my DNP, I advanced to clinical assistant professor, then a clinical associate professor seven years later. I have been active in the community locally and globally, taking on many leadership roles inside and outside my institution and spearheading many initiatives to advance health equity. In 2020, I was inducted as a fellow in the NY Academy of Medicine. In 2023, I was inducted as a fellow in the American Academy of Nursing and the Academy of Nursing Education.

What is the most significant challenge facing nursing today?

Historically, the image that comes to mind when people think of nurses is the caregiver at the bedside, following orders, administering medications, or being hands-on with their patients. They think of Florence Nightingale. Frankly, the first image is not likely of a person who looks like me. There is so much more work to do to improve diversity in nursing so that the nursing workforce mirrors the patient population they care for. There is still work to address diversity, equity, and inclusion issues in the profession and healthcare. To dismantle the structural and systemic racism that unfortunately exists within our profession. We need more nurses and other healthcare professionals to keep our ever-changing healthcare systems functioning. We need providers who are not only culturally diverse and aware but committed to advancing the profession and working towards eliminating health disparities and inequities.

As a nursing leader, how are you working to overcome this challenge?

Nurses should have a seat at every table, and if we don’t, as Shirley Chisholm says, pull up a chair. We are here because of pioneers like Sojourner Truth, Madame CJ Walker, Andres Fernandez, Mary Mahoney, Teresa Urrea, Mary Secole, Beverly Warne, Kay Fukuda, Junta Sotejo, and countless other nurses of color. I believe it’s important for nurses to have a seat at the table. Because of this, I prioritize dedicating my time to serving on boards of organizations that advance nursing and provide spaces for nurses of color to thrive and advocate for health equity. I am so grateful to DNPs of Color for creating a space where we can all come together, support, and encourage one another. Truly change the game and forge a new path through networking, mentorship, and advocacy. I am proud to serve as their Vice President.

I’m a founding member of the Greater New York City Chapter of the National Black Nurses Association, whose mission is “for the greater good.” The genesis of the Greater New York City – Black Nurses Association, Inc (GNYCBNA) was forged out of the need for a progressive and innovative chapter that addressed healthcare inequities in communities of color. The chapter was founded in 2017 and grew quickly. Through our various initiatives, we strive to positively impact the communities where we live, work, and play. The GNYCBNA’s mission and vision is to U.N.I.T.E. NYC: uplifting neighborhoods through innovation, teaching, and engagement. The cornerstone of GNYCBNA is innovative community service, focusing on health education, improving health, and building and strengthening the community. Through stand-alone efforts or collaboration with local, regional, and national community and professional organizations, GNYCBNA hosts and participates in at least 20 events each year. Committed to addressing health inequities, I spearheaded a strategic partnership between a federally qualified health center (FQHC), Stop the Spread, the Greater NYC chapter of the National Black Nurses Association (GNYCBNA), New York University (NYU) and Long Island University (LIU) Colleges of Nursing to establish four FEMA vaccination sites delivering 28000+ COVID vaccines (70% Black/Hispanic) during the height of the pandemic. As lead Community Liaison, I co-launched an NP-run vaccine clinic in an African-American church accessible to 180,000+ community members, providing access to vital healthcare services. I leveraged this collaboration to offer a semester-long immersive learning experience for 100+ pre-licensure nursing students working with medical students and registered nurses under the supervision of NPs to administer vaccines and provide health education to under-resourced communities disproportionately affected by COVID.

As the founder and inaugural Director of the GNYCBNA’s Opioid Overdose Prevention Training Program (designated by the NYC Department of Health and Mental Hygiene{DOHMH}), I was instrumental in addressing rising NYC opioid overdose death rates in communities of color. We provide annual training to 400+ undergraduate/graduate nursing students through a multi-university collaboration. We also developed an innovative partnership with national music artists, DJs, and an LGTBQ+ clinic, allowing us to create a community coalition delivering ongoing naloxone training to over 400 clubgoers, owners, and personnel within the LGBTQ+ community. Because of the success of our program, I collaborated with the DOHMH on their 2023 Overdose Awareness Media Campaign. As the only NP featured in the campaign, my ad highlighting the use of naloxone for overdose prevention has been placed around NYC in train and ferry stations, neighborhood businesses, and online (in English and Spanish). Banners can be found on the DOHMH website, and the videos are accessible on their  YouTube page.

I think about all of the mentoring I have received throughout my career. I gained all the knowledge from seasoned nurses, all of the great times, and, yes, even the challenging times. I sought out mentors because of their stellar leadership or outstanding accomplishments, as well as those who saw something in me that could develop into something even more significant and wanted to play a part in my professional development. They have helped me grow personally and professionally in so many ways. I’ve gotten so many opportunities from mentorship or simply connecting with different people I’ve met. Because of this, I pay it forward and mentor the next generation. I encourage others to pay it forward, mentor and support nurses of color, and do their part in diversifying our nursing workforce and combating health inequities.

What nursing leader inspires you the most and why?

To know where we are going, we must understand where we came from. Black nurses can be found throughout U.S. history, but they faced racism on all fronts. It took dedication and perseverance to obtain an education and recognition. They had to fight to progress and pave the way for more nurses. Without them, there is no me. I think about Mary Eliza Mahoney, the first Black American to earn a professional nursing license, dedicating her life to increasing access to nursing education for people of color. I think about Estelle Massey Osbourne, the first Black American to earn a master’s degree in nursing. Because of her work, more nursing schools began to admit Black students. I think about Hazel Johnson-Brown, the first Black female brigadier general in the U.S. Army, in charge of thousands of nurses. I think about Eddie Bernice Johnson, the first nurse to win a national office, elected to serve the 30th Congressional District of Texas (1993). I think about Ernest Grant, the first black American Nurses Association (ANA) male president spearheading their Racial Reckoning. I think about living legend C. Alicia George, educator, practitioner, community activist, and the creator of the National Black Nurses Association’s (NBNA) annual Day on Capitol Hill. I think about Beverly Malone, ANA’s past president and chief executive officer of the National League for Nursing. They have truly paved the way for people like me to succeed. I stand on the backs of my ancestors, and I am committed to pulling up others as I climb.

What inspirational message would you like to share with the next generation of nurses?

What I love about the new generation of nurses is their fearlessness and willingness to speak up and to advocate for themselves, their patients, and their profession. For them, that may often seem like a huge weight to bear, but they will be the ones who will push our profession forward. I want them to remember what it took to earn their title. Remember how they’ve triumphed, persevered, been resilient, and supported one another. Remember the challenges they’ve overcome and all that they’ve learned along the way. Remember to be as kind to themselves as they are to others. Remember to care for yourself because you can’t pour from an empty cup. Remember to give yourself grace and that learning is a life-long process. Remember always to do what’s right and prioritize accessible and equitable healthcare. 

Is there anything else you’d like to share with our readers? 

Remember, not every path is a straight line. Our identity as nurses is shaped by our formal education and, more importantly, by the challenges, obstacles, difficulties, opportunities, and victories we’ve experienced. Continue to pay it forward. Be that preceptor, that mentor, that faculty member, that leader you had, or even wish you had. You never know who’s watching and who you’re helping to develop their identity as a nurse. In my circle, we have a saying: Show up, show off, and show out. So show up as your authentic self. Show off all you have accomplished because you never know who you are inspiring. Show them that you are outstanding, even when imposter syndrome is knocking at the door.

Meet a Champion of Nursing Diversity: Fidelindo Lim

Meet a Champion of Nursing Diversity: Fidelindo Lim

Fidelindo Lim, DNP, CCRN, FAANa clinical associate professor at New York University Rory Meyers College of Nursing, has worked as a critical care nurse for 18 years and concurrently, since 1996, has been a nursing faculty member.

In 2013, Dr. Lim conducted the seminal national study of faculty knowledge, experience, and readiness for teaching LGBTQ+ health in BSN programs across the U.S., and the groundbreaking findings of his research on LGBTQ+ health integration in nursing have been cited in six white papers and at least nine LGBTQ+ policy statements by leading stakeholders.

Dr. Lim has published over 200 articles on various topics, including clinical practice, nursing education, LGBTQ+ health, reflective practice, preceptorship, men in nursing, nursing humanities, and Florence Nightingale. He has been designated as a Nurse Influencer by the American Nurses Association’s (ANA) American Nurse Journal. Additionally, Dr. Lim is a Fellow of the New York Academy of Medicine and New York University’s Aging Incubator and an NYU Meyers Alumni Association board member.

In 2021, Dr. Lim was one of four nurses featured in the ANA-sponsored documentary film “American Nurse Heroes,” a multi-channel network television event celebrating the Year of the Nurse.

He’s the faculty advisor to various nursing student groups at NYU Meyers, including the Asian Pacific-Islander Nursing Students Association, Men Entering Nursing, the LGBT Nursing Student Association, and also a founding member of NYC American Association for Men in Nursing, which represents the goals of men in nursing and advancing men’s health. Dr. Lim frequently brings male nursing students to local New York City schools—including an all-boys school—to provide health education, introduce students to nursing as a career path, and have them see male role models. Dr. Lim has fostered salience in nursing education through high-quality extracurricular programming and active learning and is an imitable mentor and coach to countless students and nurses.

Dr. Lim is an important nursing leader, and we’re pleased to profile him as part of the Champions of Nursing Diversity Series 2023.

The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in

Meet Dr. Fidel Lim, DNP, CCRN, FAAN, a New York University Meyers College of Nursing clinical associate professor.

Talk about your role in nursing and how long you have worked in the nursing field.

I have been a nurse for 36 years—nineteen years as a staff nurse on the night shift in the critical care unit. I have been simultaneously teaching at New York University Meyers College of Nursing since 1996.

Why did you become a nurse? 

I got into nursing quite serendipitously. When I was 15 and a half years old, I was sent to Manila by my parents to get a college education. I didn’t know what career to take. I was going with the flow. My sister, who took me to the university to apply for college, was in her last trimester of pregnancy. In those days, college applications had to be done in person. She told me she couldn’t stand in line for long because of her swollen feet. So, I suggested that we go to the shortest line – which was the nursing program’s line.

What are the most important attributes of today’s nursing leaders? 

Inspiring others (subordinates, peers, colleagues, students) to achieve their level best is one of the true marks of a leader. It seems rare to find this attribute these days. We have plenty of managers and taskmasters but only some true leaders.

What does being a nursing leader mean to you, and what are you most proud of?

I am proud to have mentored many students over the past two decades. Being a leader means modeling the behaviors you want others to manifest or emulate. A leader must be sincere and intentional in making authentic relationships, not fake camaraderie.

Tell us about your career path and how you ascended to that role.

My first job out of nursing school was as a public health nurse for the Philippine National Red Cross. The bulk of my role was conducting health education training for local villagers. I was particularly amazed to discover that I was comfortable standing in front of an audience, having fun connecting with people, and enhancing their health literacy. This inspired me to pursue my master’s in nursing education at New York University. I was fortunate to be taught by leaders in nursing education and practice. I was like a sponge. I soaked up every bit of inspiration, wisdom, technical and relational skills, emulated my betters, and made these my own. When I graduated from NYU in 1996, I was offered a job as an adjunct faculty member, and in 2008, I transitioned to a clinical assistant professor. Currently, my title is Clinical Associate Professor.

What is the most significant challenge facing nursing today?

The nursing profession’s most significant challenge is keeping nurses at the bedside where they are most needed. The staff nurse turnover is very high. Bedside work has now become a short stop for many new grads on their way to a career as advanced practice nurses and nurse practitioners. There was a time when there were much fewer career choices for nurses. So, nurses stayed on their jobs much longer or held the same job until they retired. Nursing has become the most flexible and dynamic role; the work choices are endless. There is an internal brain drain within the profession.

As an educator, one of the most significant challenges for me is the burgeoning technology, the latest of which is ChatGPT. Appraising students’ learning is much more complicated nowadays if we rely too much on writing assignments. There is also a big disconnect between how we train nurses and the real-time demands of the job. The nursing school focuses on layering facts on the student’s already full plate but is very lean on providing clinical experiences with actual patients. Competency is more important than comprehension.

As a nursing leader, how are you working to overcome this challenge?

Like any complex issue, the challenges in the nursing profession require collaborative solutions from various stakeholders. For example, hospitals should invest (financial and material) in enhancing the clinical experience of student nurses to transition them into the role. Providing opportunities for advancement within the institution is another solution.

As a nursing faculty, I am constantly reading and teaching myself how to hone my skills in teaching, managing large classes, crucial conversations with students, and mentoring others. I remind myself that nursing education should not only teach how to save lives but also how to live.

What nursing leader inspires you the most and why?

I am an avid fan of Florence Nightingale. I have read her most famous book, Notes on Nursing, many times. Nightingale’s erudition and no-nonsense approach to the challenges she faced is what I try to emulate. Her stamina for hard work was a wonder. She was the first and true nurse influencer. She did not depend on how many “likes” she got; she wanted to do what was right for the patient.

What inspirational message would you like to share with the next generation of nurses?

In nursing school, you get the lessons first and then get tested. In real life, you get the test first; then, you learn the lesson. In and out of nursing, you will discover many tedious things you will forget. But it is better to have learned and lost than never to have learned at all.

Is there anything else you’d like to share with our readers? 

Have a growth mindset and be patient. Nursing education is different from what it used to be. But then, again, what is?

Nursing Homes Serving Black Residents Have Greater Hospitalizations, ED Visits

Nursing Homes Serving Black Residents Have Greater Hospitalizations, ED Visits

Nursing homes with the highest proportion of Black residents have the greatest number of hospitalizations and emergency department visits, according to a new study led by researchers at NYU Rory Meyers College of Nursing.

Staffing levels likely drive the differences in hospitalizations and emergency department visits among nursing homes, the researchers report in the Journal of the American Geriatrics Society.

Studies show that nursing homes serving high proportions of Black residents may experience poor healthcare outcomes. To better understand nursing homes’ environmental and structural characteristics that may lead to these outcomes, the researchers examined data from 14,121 U.S. nursing homes using national datasets from 2019.

They found that, compared to nursing homes with no Black residents, nursing homes with at least 50% Black residents had lower ratios of registered nurse (RN) and certified nursing assistant (CNA) hours per resident per day and greater ratios of licensed practical nurse (LPN) hours per resident per day. As the proportion of Black residents in nursing homes increased, hospitalizations and emergency department visits also increased.

Nursing homes serving Black residents were also more likely to be located in urban settings, for-profit in the South, and have more Medicaid-funded residents.

“As lower use of RNs has generally been associated with increased emergency department visits and hospitalizations of nursing home residents, it is likely that the relative scarcity of skilled workers largely drove the differences in hospitalizations and emergency department visits in nursing homes with greater proportions of Black residents,” says Jasmine Travers, PhD, RN, assistant professor at NYU Rory Meyers College of Nursing and the study’s lead author.

“Staffing is a modifiable area in which federal and state agencies should take action to eliminate disparities in quality of care among nursing homes,” adds Travers.

Angela Amar Named Dean of NYU Rory Meyers College of Nursing

Angela Amar Named Dean of NYU Rory Meyers College of Nursing

Angela Amar, PhD, RN, FAAN, a forensic nurse and leader dedicated to enhancing diversity, was named dean of the NYU Rory Meyers College of Nursing. She begins her new role on August 1, 2023.

Dean Amar is an accomplished leader, advanced practice psychiatric nurse, and researcher studying sexual and dating violence. She joins NYU from the University of Nevada, Las Vegas (UNLV) School of Nursing, where she has been dean and a tenured professor since 2018.

NYU Welcomes Dean Amar

“Angela Amar comes to NYU’s Rory Meyers College of Nursing with an outstanding reputation as a researcher, a nursing educator, and an advocate for the profession. She particularly impressed us with her distinguished record of leadership, not only at UNLV but also at Emory and Boston College, and especially her focus on advancing diversity and inclusion in the profession, her concentration on student success, and her attention to faculty development, “ says NYU President Andrew Hamilton. “We were struck, too, by how strategically she was able to transform her vision, ambitions, and goals for UNLV’s School of Nursing into reality, with improvements in research funding, publications, student success, and faculty hiring.”

Before her tenure as dean of the UNLV School of Nursing, Dean Amar joined the faculty of Emory University’s Nell Hodgson Woodruff School of Nursing in 2012, where she served as an assistant and then associate dean between 2013 and 2017. She developed forensic nursing programs for Emory, Boston College, and Georgetown, establishing a nationwide educational model on forensic nursing for nursing schools. Dean Amar’s scholarship on sexual and partner violence focuses on improving care and support for survivors of violence and trauma when they enter the healthcare system. 

Dean Amar is a widely published author. Her books, articles, and book chapters include A Practical Guide to Forensic Nursing (2015, Sigma Theta Tau International Honor Society of Nursing; with Sekula); “Gender Violence Prevention in Middle School Male Athletics Programs” (2020, JAMA Pediatrics, with Laughon); “Bullying Prevention: a Summary of the Report of the National Academies of Sciences, Engineering, and Medicine” (2016, with others); “Administrators’ perceptions of college campus protocols, response, and student prevention efforts for sexual assault” (2014, Violence and Victims; with others); and “Gender Differences in Attitudes and Beliefs Associated With Bystander Behavior and Sexual Assault” (2014, Journal of Forensic Nursing; with others). She is the recipient of numerous honors and awards, including receiving the 2022 Nursing Leader Award from the Asian American Group and Las Vegas India Chamber of Commerce; being selected for the American Association of Colleges of Nursing Wharton Executive Leadership program; and receiving the 2017 Lillian Sholtis Brunner Award for Innovative Practice in Nursing, Alumni Award, from the University of Pennsylvania’s School of Nursing. She is a fellow of the American Academy of Nursing, a Distinguished Fellow of the International Association of Forensic Nurses, and a Fellow of the National League for Nursing’s Academy of Nursing Education.

She earned her BSN (1987) and MN (1992) from the Louisiana State University Medical Center’s School of Nursing and her PhD from the University of Pennsylvania (2003), and is licensed as an RN in several states, is a board-certified advanced forensic nurse, and is certified as an adult psychiatric and mental health advanced practice nurse.

Language Is a Factor in Readmission Risk

Language Is a Factor in Readmission Risk

A recent study in the International Journal of Nursing Studies shows a direct correlation between a patient’s language preference and the risk of being readmitted to the hospital from a home health care environment.

Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: A retrospective analysis shows that when a patient in a predominantly English-speaking hospital or healthcare facility had a language preference that differs from English, the risk for being readmitted within a 30-day period increased. Although the reasons behind the finding are varied, the overall study offers a warning about language barriers being an additional risk factor for poorer health outcomes.

“Part of the issue with readmission is that it is always complicated,” says Allison Squires, PhD, RN, FAAN, associate professor at NYU Rory Meyers College of Nursing and the study’s lead author. Often, the outcome comes down to how well the language barrier was handled in a healthcare encounter, she says. If the patient has complex health issues or is sent home too early, language barriers will only make things more difficult.

When patients don’t have a needed interpreter, they likely won’t have a good enough explanation of services. “First and foremost, is there proper implementation by language services,” says Squires. Nurses must also be given the proper time to work with a patient, especially if extra time is needed for an interpreter’s services. “If you have to be in the hospital these days, you have to be pretty sick in general,” she says. “A language barrier makes it even trickier.”

Squires says that while many in the medical community have known about this problem for a long time, this is the first study to actually show the direct link. The best way to help take steps to lessen this effect is for healthcare workers to ensure a patient’s language preference is accurate and listed in the medical records and that interpreter’s services are available.

For instance, if a patient visits a primary care physician and speaks a little English, they might be listed as an English speaker, even if they don’t speak it well. Without the accurate language preference on record, it might look like the patient doesn’t need an interpreter when in fact they do, says Squires.

Attentive nurses can change that when they first encounter a patient (although in an emergency situation, that might not be possible) so they can record the patient’s language preference with accuracy. They can also document every time an interpreter is used–whether by phone, video or in person. It’s important to also note when an interpreter was expected but didn’t show up when they were supposed to. This isn’t to get anyone in trouble, but shows that a discharge might have been delayed because of that and nurses didn’t want to rush the process.

The potential for language misunderstandings is profound. Patients could have difficulty communicating when they are hungry or in pain or even if they need to use the bathroom. A patchwork of hand gestures is also difficult to interpret and could open the door for some serious cultural miscommunication, says Squires.

And the stopgap method of pulling in a nurse who speaks the patient’s language isn’t the best practice. The nurse might speak the language, but that doesn’t mean they can read or write it fluently enough to give the patient accurate medical information. And the practice isn’t helpful for the patient’s transition to home care.

Healthcare organizations are moving to correct this issue, says Squires, and it takes a comprehensive effort. Sending care instructions home in the patient’s language and in their caregiver’s (both a home health care provider and a family member) language is necessary to prevent any mix ups. And ensuring the patient has access to an interpreter or a care provider who speaks the same language is important for accurate care and for positive outcomes.

Although Squires says the study’s findings weren’t unexpected, there was a finding that surprised her. “Russian speaking patients have the second-highest risk for readmission,” she says, blasting the stereotype that only people of color speak a different language and need interpreters. The more it is recognized and mitigated, that patient is less likely to return to the hospital with an often-preventable readmission. “A language barrier is a language barrier,” Squires notes, “and it ups your risk of readmission.”