In Oklahoma, the minority population is increasing faster than the majority, but its nursing workforce does not reflect this trend.
In hopes to better mirror the state’s growing Hispanic population, Oral Roberts University places a special emphasis on recruiting Hispanic students.
Dr. Kenda Jezek, Dean of the Anna Vaughn College of Nursing, says the rapidly increasing Hispanic population has made recruitment in this community a priority.
In order to more effectively do so, the University recently opened the ORU Hispanic Center, the first of its kind not just in Oklahoma but at any Christian university in the nation. The center will be a place for Hispanic students, and prospective students in general, to access resources to help them achieve academically at ORU.
In 2009, 31% of the nursing majors were of an ethnic minority. That same year, the School of Nursing celebrated 100% of its 2009 graduating class passing the National Council Licensure Examination for Registered Nurses.
In order to encourage more students to study nursing, ORU is also developing a partnership with local high schools that have high Hispanic and African American representation in their student bodies. As a part of the program, ORU nursing students will teach health services and assist students with lab projects.
Oral Roberts University, as the Senior Educational Partner of the Hispanic Evangelical community, is committed to reflecting the multiethnic culture around them, said Reverend Samuel Rodriguez, President of the National Hispanic Christian Leadership Conference.
ORU believes that increasing diversity and culture on campuses across the country will enrich and empower communities around the world.
For incoming freshmen, attending college can feel like entering a maze. But for first-generation students, that maze can have added twists and turns, as they may not have a role model or rule book to follow when starting out as a first-year student.
In turn, while parents are proud of their college-bound daughter or son, they too are unfamiliar with the road they are about to travel. Yet, parents can still offer ample support for students just by showing up at family orientation events, asking questions from the program staff, and seeking out other parents to share information, guidance, and direction.
In the Rutgers College of Nursing Educational Opportunity Fund (EOF) Program, parents are strongly encouraged to be a support base to their students. The EOF program has a Family Orientation Day where not only parents, but the entire family is invited to attend. Family Orientation Day provides an overview of what students are expected to do in the intensive six-week Summer Readiness Program. The College of Nursing has the only EOF program exclusively for nursing students in the state of New Jersey.
In 2011, parents were given a firsthand account from a parent whose daughter completed the summer program the previous year. She and her daughter spoke to the audience and answered questions. Additionally, the mother stayed through the entire day to privately speak to parents, many of whom indicated this was especially appreciated. Having a parent whose child went through the program offered them a sense of relief and comfort, making it easier to leave their daughter or son on campus.
At the end of the Summer Readiness Program, the students “graduate” to become members of the College of Nursing (Class of 2015). The students participate in a celebration entitled “Culture Kitchen,” where students and/or parents prepare a dish from their culture. It is truly a feast! Students represent many countries, and sampling the cultural cuisine is a cherished memory of the Summer Readiness Program. This past year’s program was especially gratifying because one parent insisted on being a part of the team in setting up the buffet table and working with the students and staff! It was important for her to become actively involved and not sit on the sidelines.
Perhaps the most moving part of the Culture Kitchen program is watching the students reflecting on their summer experience and seeing the proud faces of their parents. Students benefit from their parents’ support and involvement, and parents are encouraged to be a part of the students’ college experience. The EOF Program wants parents to feel welcomed; we understand the daunting process of wanting their child to be educated along with the difficulty of “letting go” so their daughter or son can progress into adulthood and become a distinguished nurse.
In any given year, about one in five Americans is affected by a diagnosable mental illness. Our nation is also seeing a dramatic increase in the number of students with disabilities on college campuses—and especially students with so-called hidden disabilities, such as learning disabilities, attention deficit hyperactivity disorder (ADHD) and psychiatric disabilities.1
In 2002, the American College Health Association reported that 76% of students surveyed felt “overwhelmed,” while 22% were sometimes so depressed they couldn’t function.2 In a 2005 study, the prevalence of depression in a medical college was reported at 15.2%; only 26.5% of the depressed students reported having treatment.3 The effects of depression and other psychiatric disabilities in nursing students have been studied to some extent as well. However, the exact numbers of nurses and nursing students with mental illness are unknown, due to lack of research data coupled with fear of discrimination, stigma or rejection from a nursing program, state licensing board or employer if they disclose their disability.
The cost of untreated mental illness in college students is enormous. In one recent study of undergraduate students, diagnosed depression was associated with nearly a half point decrease in grade point averages; conversely, receiving treatment for depression was associated with a protective effect of approximately 0.44 points.4 In another cohort, academic impairment—manifested as absenteeism from class, decreased academic productivity and significant interpersonal problems at school—was seen in 92% of depressed students.5 Still other reports suggest that stigma resulting from society’s negative perceptions about depression and its treatment may contribute to the 30,000 suicides committed annually in the United States.6
The Decision to Disclose
If you are a current or prospective nursing student living with mental illness, one of the most important decisions you will have to make is whether or not you should disclose your disability to admissions committees, nursing program administrators, faculty members, classmates, potential employers and others. As the following examples show, there are advantages and disadvantages to “going public” with your disability.
In her 1997 autobiography An Unquiet Mind: A Memoir of Moods and Madness, Kay Redfield Jamison, a professor of psychiatry at Johns Hopkins University School of Medicine who lives with bipolar illness, contemplates disclosing her disability. “I am tired of hiding, tired of misspent and knotted energies, tired of the hypocrisy and tired of acting as though I have something to hide,” she writes. “One is what one is.” Years later, Jamison admitted that while her decision to disclose her illness publicly has had consequences, she would choose to do it again.
Additional Online Resources Disability and Higher Education: Association on Higher Education and Disability (AHEAD) www.ahead.org “Students with Disabilities Preparing for Postsecondary Education: Know Your Rights and Responsibilities” www.ed.gov/about/offices/list/ocr/transition.html U.S. Department of Education, Office of Civil Rights – This site explains how to report educational discrimination, access civil rights regulatory and policy documents, and request information on civil rights compliance programs. www.ed.gov/about/offices/list/ocr/index.html U.S. Department of Labor Job Accommodation Network (JAN) www.jan.wvu.edu Mental Health Advocacy Organizations: National Alliance on Mental Illness (NAMI) www.nami.org Depression and Bipolar Support Alliance www.dbsalliance.org National Alliance for Research on Schizophrenia and Depression (NARSAD) www.narsad.org Boston University Center for Psychiatric Rehabilitation www.bu.edu/cpr/ Nurses in Recovery www.brucienne.com/nir
Now consider the example of Lynne, a pre-nursing student in California who also has bipolar disorder. Because of her disability, she was initially afraid to pursue her dream of choosing nursing as a second career. She had known three health care professionals who had suffered damage to their careers as a result of employers and co-workers knowing about their mental illness. They felt they had become defined by their illnesses. A simple argument at work became suspicious hostility; an error raised questions of poor judgment, faulty cognition or side effects from medication.
With the help of family, friends, her mentor and a discussion board at ExceptionalNurse.com, an online community for nurses and nursing students with disabilities, Lynne applied to and was accepted by several nursing schools. Once at school, she found a therapist and psychiatrist, visited the campus Office of Disability Services to have documentation of her illness placed on file, and designated her academic advisor as a source of confidential support, but kept her illness a secret to all others on campus.
Several months into the school year, Lynne became increasingly aware of the distance and disconnect she felt from her classmates. She also felt that she had to leave her “real self” at the door when she entered the classroom. While assisting with on-campus activities for Mental Illness Awareness Week, she shared her frustration with a trusted professor, who encouraged her to share more of herself with others, at her own pace. A year later, Lynne enjoys planning activities with her campus mental health advocacy organization, giving talks, and participating in panel discussions about mental illness. She has also founded an informal support group for nursing students with mental health issues.
Other than being known to some people on campus as “a person with bipolar disorder,” Lynne has experienced little stigma in her nursing program. The few instances of bias she has encountered have been subtle and came from people who meant well.
For example, while discussing her history with a supportive faculty member, Lynne was told, “Oh, we’ve had people with bipolar in this program before. I’m sure you’ll do fine.” Lynne had not indicated a need for reassurance and wondered why it had so suddenly and spontaneously been offered. Another instructor suggested that Lynne lead a life full of activities because her “high mood” enabled this. Lynne asserted that, for her, hypomania was uncomfortable, frustrating and not at all productive, and that she felt her other qualities and accomplishments were being overlooked.
Tools for Wellness Your mental illness may be with you for a long time, so consider not only accepting it but making friends with it. Think of a wellness plan not as “treatment” or simply medication and therapy (which are important!) but as part of a healthy way of life. Here are some strategies that other nursing students with psychiatric disabilities have found helpful:
Develop a strong, collaborative alliance with your health care providers.
Become educated about your illness, be a proactive health care consumer and take time to educate others.
Learn good coping skills, such as healthy eating, sleeping and exercise habits.
Make social time with friends and family a priority, as well as relaxation time.
Activities or hobbies that you enjoy will give your life balance.
At home and at school, consider asking a good friend, mentor or family member to help you monitor yourself. Even those of us with the best insight may be helped by a gentle nudge and some outside perspective from someone we trust.
For students who have to finance their education by working while they attend school, flexible scheduling is helpful. However, if you find that work stress is interfering with your studies and quality of life, look into alternative sources of funding. Contact your state Office of Vocational Rehabilitation to find out about options and solutions.
Finally, be especially honest with yourself about whether or not this is really the right time for you to be in school. Will you be able to get through a long clinical day without having symptoms that affect your ability to learn or to provide safe nursing care? If you have doubts, be kind to yourself and make wellness your first priority. Nursing school will still be there for you when you are feeling healthy enough to fully benefit from the experience and give your best.
Sources of Support
Having a strong support system in place can make a world of difference. Recall the story of Lynne, who credited much of her success to her support network of health care providers, academic advisors, professors, family and friends, as well as the online networking resources she found at ExceptionalNurse.com. This nonprofit virtual community is committed to the inclusion of more people with disabilities in the nursing profession. The Web site provides contact information for more than 80 mentors, along with a wide range of other disability-related resources and information.
In addition, the online discussion board at ExceptionalNurse.com gives you the opportunity to exchange support and advice with other students and nurses who are dealing with the same issues. Here are some excerpts from recent posts:
“I’m in a BSN program now and have not disclosed my history of major depression with psychotic features. The psychotic part is controlled with meds, and for the most part, so is my mood. I am getting straight A’s in school, but I don’t know if that will be enough to convince a licensing board that I’m stable.”
“I feel your pain. I am bipolar and when I went to nursing school I was terrified that if someone found out I would be tossed out of the program. I waited until I was halfway through nursing school to disclose.”
“I know of professionals who avoid treatment to keep a diagnosis off their records. I also worry a great deal that my illness will interfere with my employment or licensure.”
“I just started nursing school, took me like two years to get in. . .I also have a panic attack disorder that I take medication for. It’s essentially under control, I certainly don’t feel I’m a danger to patients in the least, but we start clinicals next week.”
Students like these share “invisible” disabilities and need the support of the people around them—family, friends, faculty and classmates—to be successful in a nursing program. Nursing educators in particular must serve as a bridge to help students gain acceptance from patients, clinical staff and peers.7
The challenges nursing students with mental illness face are complex and lack “one size fits all” solutions. The only way the stigma will go away is if there are successful, visible role models in the profession—practicing nurses with psychiatric disabilities who are stable, responsible, pulling their own weight and letting others see that it can be done. If you believe you have what it takes to succeed, stick to your guns and fight for your right to become a nurse. Your disability gives you a unique gift of understanding and compassion, and you have an important role to play in nursing.
References:
Wolf, L.E. (2001). “College Students with ADHD and Other Hidden Disabilities: Outcomes and Interventions.” Annals of the New York Academy of Sciences, Vol. 931, pp. 385-395.
Shea, R.H. (2002). “On the Edge on Campus. The State of College Students’ Mental Health Continues to Decline. What’s the Solution?” U.S. News & World Report, Vol. 132, No. 5, pp. 56-57.
Tija, J., Givens, J.L. and Shea, J.A. (2005). “Factors Associated with Undertreatment of Medical Student Depression.” Journal of the American College of Health, Vol. 53, No. 5, pp. 219-224.
Hysenbegasi, A., Hass, S.L. and Rowland, C.R. (2005). “The Impact of Depression on the Academic Productivity of University Students.” Journal of Mental Health Policyand Economics, Vol. 8, No. 3, pp. 145-151.
Heiligenstein, E., Guenther, G., Hsu, K. and Herman, K. (1996). “Depression and Academic Impairment in College Students.” Journal of the American College of Health, Vol. 45, No. 2, pp. 59-64.
U.S. Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General.
Maheady, D. (2003). Nursing Students with Disabilities: Change the Course. Exceptional Parent Press.
Earning a perfect 4.0 grade point average in her nursing prerequisite courses is an impressive enough achievement all by itself. But that’s just the beginning of what makes Erica Lee, a student in UCSF’s Master’s Entry Program in Nursing, such an extraordinary scholar. Add in her strong research, patient education and community outreach skills and her exceptional commitment to improving health care in minority communities and it’s easy to see what brought her to MN‘s scholarship winner’s circle. After graduating from Scripps College in 2003 with a dual B.A. in psychology and Asian American studies, Erica worked for three years as an HIV/AIDS counselor and health educator at a community-based non-profit organization serving at-risk Asian immigrant youth. Her responsibilities ranged from HIV testing and giving community presentations on HIV prevention to coordinating a peer education teen theater troupe. She also spent a summer working for San Francisco’s Aim High Summer Enrichment Program, where she taught health seminars to at-risk eighth grade students.
In addition, Erica brings a solid research background to her nursing studies. As a Psychology Department research assistant at Scripps, she helped design a study investigating ethnic identity and interracial stress among school-aged children. She also worked on a research project that examined cognitive differences between young people and elders and she spent a study-abroad semester in Milan, Italy.
Erica’s goals for her nursing career include becoming an advanced practice pediatric nurse. “I would initially like to work at a clinic that offers both on-site and outreach care to children and families from underserved populations,” she says. “In this way I can use my training to provide individualized, culturally competent care that focuses on prevention, wellness and patient education.”
ANNA RIOS-SMITH
ANNA RIOS-SMITH
Samuel Merritt College
$1,000 Scholarship
What do peanut butter and jelly sandwiches have to do with Anna Rios-Smith being selected to receive a Minority Nurse Magazine Scholarship? The answer is: They symbolize this outstanding nursing student’s unique commitment to not just participating in community service programs but initiating them.
It all began one recent Thanksgiving when Anna and her fiancé, Bill Doyle, decided to make a bunch of “PB&Js” and drive around their Oakland, Calif., community handing out the sandwiches to hungry homeless people. Soon Anna and Bill were distributing sandwiches every weekend, along with donated clothing, pillows and blankets. Eventually the couple co-founded their own non-profit organization, Paloma Negra, to provide this service on an ongoing basis, as well as other projects like collecting handmade blankets for donation to terminally ill Bay Area children.
In addition to all this, Anna’s academic excellence has brought her National Dean’s List status as well as induction into Phi Theta Kappa, a scholastic honor society for students attending two-year colleges. This January she began the second part of a 2+2 cooperative nursing program between Mills College in Oakland—where she earned a 3.48 GPA in her pre-nursing courses—and Samuel Merritt College, from which she will graduate with her BSN degree in 2009. While at Mills, she participated in a Kaiser Permanente INROADS internship program for minority students, attended nursing leadership seminars and played a leading role in creating a nursing students’ organization on campus.
Dr. J. Diane Jassawalla, who was Anna’s advisor at Mills College, describes her as “a very dedicated student, eager to learn and determined to make a difference in her community. She is an intelligent, ethical, caring person who is committed to becoming a nurse so she can not only offer health care but also help develop health care alternatives for underserved people of color.” This is clearly reflected in Anna’s plans for the future: She wants to establish a clinic for medically underserved minority women.
REBECCA GUIDRY
REBECCA GUIDRY
University of Rochester School of Nursing
$500 Scholarship
Rebecca Guidry describes herself as “a very proud member of the United Houma Nation,” a state-recognized Indian tribe based in southern Louisiana. And Rebecca has other things to be proud of as well. Despite growing up in a small, economically disadvantaged rural community that has a 72% illiteracy rate, she has excelled in her nursing prerequisite courses at Nicholls State University and in her first year as a master’s entry student in the University of Rochester (N.Y.) School of Nursing’s Accelerated Master’s Program for Non-Nurses, where she was named a Helene Fuld Scholar in recognition of her academic achievements and leadership potential.
But what Rebecca is undoubtedly most proud of is the exceptional work she has done to improve health care access and quality in her medically underserved tribal community, which is not eligible to receive federal assistance. After earning a bachelor’s degree in management from the University of Louisiana in 1999, she worked with community groups to develop a health care needs assessment and open a culturally appropriate community clinic that provided care to 1,800 patients during its first year.
This experience eventually inspired Rebecca to pursue a career in nursing. “Opening the clinic for my community was one of the most exhilarating moments in my life,” she says, “but after working to establish this successful program, I realized that I wanted to be more involved with patient care. Working directly with patients gives you a whole other level of satisfaction.”
Rebecca is a student member of the National Alaska Native American Indian Nurses Association (NANAINA). She continues to provide community service by participating in the AmeriCorps program and has volunteered as a victims’ assistance counselor for the Rochester Police Department.
ROSEMARY NUNDU MAINGI
ROSEMARY NUNDU MAINGI
Oregon Health & Science University School of Nursing
$500 Scholarship
Rosemary Nundu Maingi, a senior in OHSU’s BSN degree program, grew up in Kenya “surrounded by human suffering—poverty, famine, disease and natural disasters.” Her experiences of volunteering at a refugee camp in northeastern Kenya and caring for a relative who died of AIDS have instilled in her an unwavering desire to “make a difference in people’s lives, not only by caring but also by being part and parcel of their well-being.”
Nundu, as she is called, is a highly motivated student who has a 3.54 overall GPA and a 4.0 average in her clinical rotations. She speaks six languages, including Spanish and American Sign Language. Nundu is also exceptionally active in community service projects and on-campus organizations. She has helped with relief efforts for victims of Hurricane Katrina and the 2003 Asian tsunami, participated in food drives for the homeless, volunteered at local public health clinics and recently earned disaster response certification from the Emergency Management Institute. “Nundu is a remarkable woman who brings wisdom, compassion and a global view to nursing,” says Donna Markle, OHSU School of Nursing associate professor emeritus. “She is an outstanding student who demonstrates strong critical thinking skills, the ability to readily apply theory to practice and a strong sense of social justice. Nundu enhances her colleagues’ understanding of cultural issues and has made a significant contribution to helping them gain greater cultural awareness. She has a natural ability to provide leadership in nursing.”
What lies ahead for Nundu, who will graduate from her nursing program in June? “My future career plans are to acquire a master’s and later a PhD in nursing [and to work as] a nurse practitioner in community health,” she says. According to Markle, Nundu’s long-term goals “include finding opportunities to return periodically to Africa to help address health care needs in Kenya.”
Hispanics are the largest and fastest-growing minority population in the United States, and their numbers are expected to triple by the year 2050 to constitute a quarter of the total U.S. population. Today, in fact, Hispanics account for 42% of the population in New Mexico, roughly one third of the population in California and Texas and one fourth of the population in Arizona. Yet only 2% of the nation’s registered nurses are Hispanic, and the percentage of Hispanic nurses educated at the baccalaureate level or higher is even smaller.
Fortunately, nursing schools all over the country are taking action to change that situation. Through innovative outreach and retention initiatives, they are working to recruit more Hispanic and other minority students into nursing programs, guide them through successful completion of their degrees and increase the supply of culturally and linguistically competent nurse leaders who can improve health outcomes in Hispanic communities.
Here’s a look at four successful model programs, all of them funded by federal grants from the Health Resources and Services Administration (HRSA).
Weekend Warriors
Although the Hispanic population in Virginia is growing five times faster than the overall population, less than 1% of registered nurses in the state are Hispanic. Furthermore, Hispanic nurses are less likely to hold bachelor’s degrees in nursing than RNs of other races and ethnicities.
To address these two issues, Virginia Commonwealth University (VCU) School of Nursing in Richmond is recruiting Spanish-speaking RNs to a program that lets them earn their BSN on the weekends while working full time. The recruitment project, called “Public Health for Virginia’s Future, Part Two,” is also designed to increase the number of public health nurses who return to school to get their baccalaureate degrees.
VCU first started its RN-BS Weekend Program in 1989 to provide more convenience for working RNs seeking bachelor’s degrees in nursing. The program is offered at locations across the state and online. Students take classes one weekend a month and can earn their BSN degree in as little as 18 months.
In July 2005, the School of Nursing was awarded a $600,000 HRSA grant to fund a three-year project to recruit more Spanish-speaking nurses to the weekend program. The school hired a full-time Hispanic Coordinator, Milagritos (Millie) Larrauri Flinn, to market the program to the Hispanic community. It also started offering classes on “Spanish Language and Culture for Health Care Providers,” a cultural competence seminar series for students and faculty, and a mentoring program to help retain students.
In its first two years, the project exceeded its recruitment goals and the nursing school is optimistic about the initiative’s impact. “I feel we’re making a huge difference in spreading the word,” says Flinn.
Between the 2005-06 and 2006-07 academic years, the targeted recruitment effort increased Hispanic nurse enrollments in the RN-BS Weekend Program by 75%. The nursing school is now exploring the possibility of offering scholarships for Spanish-speaking students. In partnership with the Virginia Department of Health and the state’s community college nursing programs, VCU School of Nursing is conducting surveys to determine whether scholarships would enable more Spanish-speaking RNs to earn their BSN degrees.
Building community awareness of the program was challenging at first, because the Hispanic population in Virginia is relatively new. Many in the community are the first generation to live in the United States.
Flinn reached out to Hispanic community leaders and made presentations at community organizations, community colleges and hospitals. She also worked with the local English-language and Spanish-language media. Flinn serves as a friendly point of contact for students inquiring about the program and she provides personal attention and support to students, from enrollment through the completion of their studies. Alumni from the RN-BS Weekend Program serve as mentors for students.
The program’s overall goal is to strengthen Virginia’s health care system. Recent studies show a link between the shortage of nurses prepared at the baccalaureate level and patient outcomes. Surgical patients, for instance, had a “substantial survival advantage” if treated in hospitals with higher proportions of nurses holding bachelor’s degrees or higher, according to a study published in 2003 in the Journal of the American Medical Association. A 10% increase in the proportion of nurses with BSN degrees lowered the risk of patient death by 5%, the researchers found.
“Our work in this grant means [there will be] more nurses and better-trained nurses to care for patients most in need,” Flinn says. “Nurses are our first line of health care providers, so strengthening our nursing workforce benefits all Virginians.”
Reaching for STARS
To increase nursing education opportunities for ethnically and racially diverse individuals from disadvantaged backgrounds, including Hispanics, the University of Texas at Arlington (UTA) School of Nursing designed a program that takes a comprehensive approach. The multifaceted STARS for Nursing project ranges from educating high school students about health care careers to providing academic, financial and personal support to help recruit, retain and graduate minority nursing students.
About 4% of RNs in the Tarrant and Dallas counties UTA serves are Hispanic. In contrast, more than a third of the population in Dallas County and almost a quarter of the population in Tarrant County is Hispanic.
The three-year, $728,000 HRSA grant that funded the STARS project ended in July, but the initiative has been so successful that the school plans to continue it, says Mary Jane Ashe, MN, APRN, RN, assistant director of undergraduate student services.
STARS stands for:
Stimulating interest in nursing
Tutoring and mentoring students
Assisting with career and financial resources
Recruiting and retaining pre-nursing and upper-division nursing students
Strengthening the health care community with BSN-prepared nurses from diverse backgrounds.
STARS for Nursing comprises three programs: Aspiring STARS for high school students, Emerging STARS for pre-nursing students and Shining STARS for junior and senior nursing students.
During the grant period, Aspiring STARS adopted six high schools where Hispanics and African Americans make up the majority of the student population. Representatives from UTA School of Nursing made presentations at career days and college nights and led classroom activities focusing on cultural diversity, career guidance, college admission and succeeding in college. The high school students also had the opportunity to tour the School of Nursing and attend a two-day nursing summer camp, where they took classes, met nursing students and faculty, practiced hands-on skills in the university’s “smart hospital” and visited area hospitals that partnered with the program.
The ultimate goal of Aspiring STARS was to recruit these students into the UTA nursing program. Part of the recruitment process included sponsoring events for families so parents would understand the demands and benefits of attending nursing school. For Hispanic students, families play a central role in their lives. “It’s not only the potential student you have to consider,” Ashe says.
The Emerging STARS program set up “freshman interest groups” for pre-nursing students, to create a sense of community and provide help with time management and study skills. Older nursing students served as peer mentors and counselors. Research shows that students are more likely to complete school when they are part of a learning community, Ashe says, particularly those who are the first generation in their family to attend college. In addition, the School of Nursing hired a fourth full-time advisor to provide support and monitor the students’ progress.
To help retain and graduate upper-division nursing students, Shining STARS provided a variety of support services, including RN and peer mentors and tutoring available in a learning center. A faculty member served as a student success coordinator and was available for any students who needed extra help with study skills, test-taking skills and preparation for the NCLEX-RN® exam. Local chapters of minority nursing organizations, such as the Dallas chapter of the National Association of Hispanic Nurses and the Lambda Eta Chapter of Chi Eta Phi sorority, partnered with the program to provide RN mentors from their memberships.
Going forward, the STARS for Nursing project plans to set up a mentor program for high school students and restructure an RN mentor program for college students, Ashe says.
Supporting Success
Thanks to a program at the University of Texas at El Paso (UTEP), a Hispanic-Serving Institution located on the U.S.-Mexican border, nursing students who otherwise might not have pursued their bachelor’s degrees got the support they needed to graduate, and thousands of students from grade school to college learned about nursing career opportunities.
Funded by a three-year, $674,394 HRSA grant, the Recruitment & Retention of Hispanic Nursing Students Program was designed to increase Hispanic enrollment and graduation from the university’s School of Nursing and to help meet the growing need for culturally sensitive health care in the Border region. The grant ended in July, but the school plans to apply for an extension, says project director Velma McInnis-Edmonds, DNS, MSN, RN.
As part of the project’s recruitment component, School of Nursing staff visited elementary, middle and high schools to speak to children and teens about the nursing profession. UTEP also hosted a summer day camp on campus for high school students interested in nursing careers. Other outreach efforts included working with local community colleges to hold pre-nursing workshops to recruit students and help them make the transition into UTEP’s School of Nursing. The workshops provided information on topics like how apply to the university and how to access financial aid.
The retention side of the project focused on ensuring that the Hispanic students had the resources, support and skills needed to successfully complete the BSN program. The School of Nursing provided financial assistance through scholarships and stipends, as well as individual attention and support to retain students through graduation. The school also partnered with an economic development initiative called Project ARRIBA (Advanced Retraining & Redevelopment Initiative in Border Areas) to provide case management and social services to students.
The Recruitment & Retention of Hispanic Nursing Students Program also provided services such as tutoring and counseling. Educational outreach manager Hilario Monreal met weekly with students to help them stay on track to reach their goals and address any obstacles to their success. Once a year the students attended workshops on study skills, computer and library research skills and time management.
Meanwhile, the program also sponsored workshops for nursing faculty to help them understand and be sensitive to the Hispanic students’ cultural needs. Instructors were encouraged to make themselves available to students.
Program statistics for the third year of the grant are not yet available, but in its first two years the project exposed more than 2,000 potential students to nursing opportunities and recruited 43 Hispanic students into UTEP’s nursing school. Almost all of these students have completed their BSN degrees or will graduate within four years of enrolling in the School of Nursing. Many of the students were single mothers with English as a second language, and they started college with doubts about whether they could make it.
“Most [of the students] probably wouldn’t have gotten their bachelor’s degrees if it weren’t for [this] program,” Monreal says. “They all said the greatest thing the program did for them was provide support and encouragement. Because they were determined and passionate, they did well. I’m very proud of the students and glad we were able to help them fulfill their dreams.”
McInnis-Edmonds agrees. The program, she says, helped provide a caring and nurturing environment for students, giving them the confidence and support they needed to succeed.
A Ladder to Licensure
Internationally educated nurses are the focus of the Enfermeras en Escalera (Nurses on a Ladder) Program at Mesa Community College in Mesa, Arizona. The program, also known as E3, prepares immigrant nurses for licensure as RNs in the United States and helps them transition into jobs in the U.S. health care system. Ultimately, E3’s goal is to help address the nursing shortage in Arizona and increase the supply of bilingual, bicultural nurses in the state.
The program, which enrolls 15 students a year, is the only one of its kind in the United States that is based in an academic center. Initially targeting Spanish-speaking students, E3 has grown more diverse to include nurses from Africa, Eastern Europe and the Middle East as well as from Mexico, Puerto Rico and Central and South America.
Although living here legally, many of these students who were practicing nurses in their countries of origin haven’t been able to navigate the system to get licensed in the U.S. The Enfermeras en Escalera Program provides a “nurse refresher” curriculum, including a clinical rotation at local hospitals. It also helps students strengthen their English skills and cultural competence, prepare for the NCLEX-RN licensing exam and transition smoothly into nursing practice in the United States. The program provides tutoring and counseling, and local hospitals and health care systems provide scholarships for students.
So far, 56 nurses have enrolled in the program and 19 have passed the NCLEX-RN.
“We have [internationally educated] nurses out in the workforce [here in Arizona] who thought they’d never be able to practice their profession again,” says Bertha Sepulveda, BSN, RN, director of special projects for the Mesa Community College Department of Nursing.
A team from the college and the local Valle del Sol chapter of the National Association of Hispanic Nurses developed the program and wrote the grant proposal. The Arizona Community College Association provided $144,000 in funding and the Arizona Hospital and Healthcare Association provided $30,000 for the first year. The program was then awarded a three-year, $487,000 HRSA grant.
With the critical need for more bilingual nurses who can communicate effectively with the nation’s rapidly growing Hispanic population, internationally educated nurses living in the U.S. are a rich yet largely untapped resource. In addition to passing English and licensing exams, they must prepare for a work environment that is different from that of their native countries. Nurses in other countries often don’t have as much responsibility as those in the United States because doctors in those countries take care of the more complicated procedures, Sepulveda explains.
The E3 Program can be completed in three semesters and includes 31.5 credit hours. The nurse refresher curriculum helps students develop skills in critical thinking, pharmacology and medication, patient management, delegation and working as part of the health care team.
“The biggest challenge for these nurses hands down is language,” Sepulveda says. Although many of the nurses speak English fluently, some need formal language courses to prepare them for passing the reading and writing portions of the English proficiency examination.
Sepulveda and her team are working on a plan to sustain the program at Mesa Community College after the grant period ends. “It’s been so satisfying [to see] these nurses out in the workplace,” she says. “It’s certainly improved the quality of their lives, and overall it’s improving the quality of life in our community.”
