Minority Nurse Magazine (Fall 2014)

The Career and Education Resource for the Minority Nursing Professional • FALL 2014

WHAT RECRUITERS WANT

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Choosing a Nursing Specialization HANDLING RACIST PATIENTS TACKLING STUDENT LOAN DEBT

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Table of Contents

In Every Issue

Cover Story

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Editor’s Notebook

4

Vital Signs

24

7

Making Rounds

By Julia Quinn-Szcesuil

52

Highlights from the Blog

Find out what recruiters across the country say it takes for a new

56

Index of Advertisers

BSN grad to get noticed

Academic Forum 37

The Life of a Humanitarian Relief Nurse

By Archana Pyati Step into the shoes of a humanitarian relief nurse and discover your passion for helping the most vulnerable among us

What Recruiters Want: How a BSN Can Help You Land a Job

Features 8

Affirmative Action and College Admissions

By Terah Shelton Harris Experts weigh in on the latest court cases and what they mean for future college students

Second Opinion 41

Keeping an Open Mind: My Brief Career as a Certified Home Health Agency Registered Nurse

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Steps to Choosing a Nursing Specialization

By Brandon Archer, RN, BSN

By Jebra Turner

A recent grad shares an important life lesson learned when the job market is tough

Not sure which specialty is for you? Follow these steps and heed the advice of three nurses who share their journeys to specialization

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Nursing and the Table of Brotherhood and Sisterhood

By Latoya Lewis, RN, MSN

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The Impact of Racist Patients

By Robin Farmer

Could enriching mentorship programs be the key to increasing diversity?

Learn how nurses of color handle racist patient encounters and what you should do if you find yourself in a similar situation

Degrees of Success 45

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An Effective Teaching Method: Double Testing

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Tackling Student Loan Debt

By Annie M. Clavon, ARNP, PhD, MS, CCRC

By Denene Brox

A nursing instructor makes the case for double testing to enhance adult student and teacher interactions

Discover how to be financially savvy and avoid mountains of debt

Minority Nurse | FALL 2014

while pursuing an expensive degree

®

Editor’s Notebook:

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Keeping an Open Mind

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e’ve all heard the expression, but what does it mean to you? If you’re a new graduate, it could mean exploring all available career options—and not just the most popular specialty. Ambition in health care is important, but flexibility and adaptability are arguably even more so. When faced with a tough job market, the successful nurses will be the ones willing to follow the ebb and flow of careers in high demand. That could mean stepping outside a hospital to gain experience, as many experts suggest in our cover story. We asked recruiters across the US what they’re looking for in BSN grads to give you insider tips on landing that first job. Read more to find out how you can stand out in an increasingly competitive job market.

Having a hard time choosing a specialty? While it’s important to keep your options open, there are some steps you can take to help guide your decision. Jebra Turner offers some sound advice on exploring which path may be right for you. Whichever specialty appeals to you, don’t worry about being pigeonholed; the days of a nurse spending her entire career bedside are long over.

Whether it means exploring different specialties or having an open dialogue with colleagues about controversial issues such as racism or gender identity, the importance of keeping your mind open can’t be overstated. Racism in particular is still prevalent in this country, unfortunately, and it’s often the elephant in the room. Even nurses—who play a crucial role in the life or death of a patient—have been subjected to another’s intolerance. Robin Farmer explores the impact of racist patient encounters and offers young nurses guidance on how to handle racism in the workplace.

Affirmative action is yet another topic that’s still hotly debated. As support wanes, many believe that this could mean the end of affirmative action as we know it. But what impact will it have on minority enrollment in universities? States that have already banned affirmative action are exploring alternative methods to help increase diversity. Is it enough? Terah Shelton Harris reviews the latest trends and asks experts to weigh in on what these court cases could mean for the future.

As nursing school becomes more expensive and advanced degrees become the norm, it can be increasingly difficult to obtain a degree without falling into insurmountable debt. The good news: you don’t have to fall into the student loan trap. There are alternatives available for those who take the time to do their research and weigh the pros and cons of a particular school and/or degree. Denene Brox teaches you how to be financially savvy and obtain that degree without added interest.

Keep your mind (and your options) open and investing in your future doesn’t have to come with a hefty price tag.

— Megan Larkin

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Vital Signs

New Data Brief Reveals Characteristics of Uninsured Minority Men A data brief released by the Office of Minority Health at the US Department of Health and Human Services during Men’s Health Month last June examined the characteristics of uninsured adult males by race and ethnicity, using the most recent data from the 2012 American Community Survey (ACS). Findings from the survey, which include information on social and economic factors such as poverty and education level, that influence insurance coverage, should be considered in developing strategies to increase insurance coverage and access to care for minority adult males.

T

he survey findings provide additional information on the patterns of uninsurance among non-elderly males prior to the establishment of the Health Insurance Marketplace and the expansion of Medicaid eligibility under the Affordable Care Act (ACA).

Highlights of the survey findings include: • Among uninsured adult males, ages 19-34, Latino and African American males exhibited the highest estimates of uninsurance.

• More than 70% of African American and white uninsured adult males and nearly 60% of Asian and Latino uninsured adult males have a high school diploma.

• A high proportion of uninsured adult males across all racial and ethnic groups reported family incomes at or below 100% of the Federal Poverty Level (FPL).

• A high proportion of uninsured Latino adult males (81%) report having a fulltime worker in the household.

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• Uninsured African American males reported the highest proportion (60%) of family income at or below 100% of the FPL. • A high percentage of uninsured adult Asian (28%) and Latino (24%) males also reside in a limited English proficient household.

• A lower percentage of uninsured Latino (6%) and Asian (5%) males experience disability (versus 12% of white and 11% of African American uninsured males).

While data from the 2012 ACS survey show disparities among uninsured males, through the ACA, progress has been made in increasing access to affordable health care coverage: • Over the course of the first Health Insurance Marketplace enrollment period, more than 8 million people were enrolled as part of the ACA. • New data from the Kaiser Family Foundation show that as many as six in 10 people who purchased

health insurance through the Marketplace were previously uninsured.

• Accordingly to recent Gallup data, the most dramatic drops in the insured rate were among African Americans, Latinos, and low-income Americans.

This type of data and knowledge about uninsured minority males can help inform targeted interventions and outreach efforts to improve enrollment opportunities for

minority men in health insurance coverage.

Over the past several decades, our nation has made vast improvements in scientific knowledge, public health, and health care. The health status of racial and ethnic minority men still lags behind the general population. Increasing insurance coverage of minority males is critical to their ability to access health care systems, reduce preventable illnesses, and improve their health outcomes.

Vital Signs

NSAIDs May Lower Breast Cancer Recurrence Rate in Overweight and Obese Women Recurrence of hormone-related breast cancer was cut by half in overweight and obese women who regularly used aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), according to data published in Cancer Research.

“O

ur studies suggest that limiting inflammatory signaling may be an effective, less toxic approach to altering the cancer-promoting effects of obesity and improving patient response to hormone therapy,” says Linda A. deGraffenried, PhD, associate professor of nutritional sciences at The University of Texas at Austin.

The study found that women whose body mass index (BMI) was greater than 30 and had estrogen receptor alpha (ERα)positive breast cancer had a 52% lower rate of recurrence and a 28-month delay in time

to recurrence if they were taking aspirin or other NSAIDs. “These results suggest that NSAIDs may improve response to hormone therapy, thereby allowing more women to remain on hormone therapy rather than needing to change to chemotherapy and deal with the associated side effects and complications,” says deGraffenried. “However, these results are preliminary and patients should never undertake any treatment without consulting with their physician.”

Using blood from obese patients, deGraffenried and colleagues conducted experiments in the laboratory to recreate a

tumor environment containing cancer cells, fat cells, and the immune cells that promote inflammation. They found that the factors associated with obesity initiate a network of signaling within the tumor environment to promote growth and resistance to therapy.

“These studies show that the greatest benefit from aspirin [and other NSAIDs] will be in those with a disease driven by inflammation, and not just obesity,” DeGraffenried explains.

Researchers used data from 440 women diagnosed with invasive, ERα-positive breast cancer and treated at The University of Texas Health Science

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Center and the START Center for Cancer Care clinic, both in San Antonio, Texas, between 1987 and 2011.

Of the women studied, 58.5% were obese and 25.8% were overweight. About 81% took aspirin, and the rest took another NSAID. About 42% and 25% took statins and omega-3 fatty acid, respectively.

There was an indication of protection from aspirin and other NSAIDs even after controlling for statins and omega-3 fatty acid use, which also have anti-inflammatory effects.

This study was funded by the US Department of Defense, the Breast Cancer Research Program of the Congressionally Directed Medical Research Programs, and the National Cancer Institute.

To learn more, visit http://cancerres.aacrjournals.org.

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Vital Signs

Study Finds Youth Who Have Used E-Cigarettes are Almost Twice as Likely to Intend to Smoke Conventional Cigarettes

More than a quarter of a million youth who had never smoked a cigarette used electronic cigarettes in 2013, according to a Centers for Disease Control and Prevention (CDC) study published in the journal Nicotine and Tobacco Research. This number reflects a threefold increase, from about 79,000 in 2011, to more than 263,000 in 2013.

T

he data, which comes from the 2011, 2012, and 2013 National Youth Tobacco surveys of middle and high school students, show that youth who had never smoked conventional cigarettes but who used e-cigarettes were almost twice as likely to intend to smoke conventional cigarettes as those who had never used e-cigarettes. Among nonsmoking youth who had ever used e-cigarettes, 43.9% said they intended to smoke conventional cigarettes within the next year, compared with

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Minority Nurse | FALL 2014

21.5% of those who had never used e-cigarettes.

“We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes, or other tobacco products. Not only is nicotine highly addictive, it can harm adolescent brain development,” says Tim McAfee, MD, MPH, director of the CDC’s Office on Smoking and Health.

There is evidence that nicotine’s adverse effects on adolescent brain development could result in lasting deficits

in cognitive function. Nicotine is highly addictive. About three out of every four teen smokers become adult smokers, even if they intend to quit in a few years.

“The increasing number of young people who use e-cigarettes should be a concern for parents and the public health community, especially since youth e-cigarette users were nearly twice as likely to have intentions to smoke conventional cigarettes compared with youth who had never tried e-cigarettes,” says Rebecca Bunnell, ScD, MEd, the associate director for science in CDC’s Office on Smoking and Health and the lead author of the study.

The analysis also looked at the association between tobacco advertisements and smoking intentions among middle and high school stu-

dents. Students were asked about whether they had seen tobacco ads on the Internet, in magazines and newspapers, in retail stores, and in television programs and movies. Consistent with previous studies, this study found that youth who reported exposure to tobacco ads had higher rates of intention to smoke than those who weren’t exposed to such ads.

The researchers also found the greater the number of advertising sources to which young people were exposed, the greater their rate of intention to smoke cigarettes. Thirteen percent of students who said they had no exposures to such ads had intentions to smoke, compared to 20.4% among those who reported exposures from one to two ad sources and 25.6% among those who reported exposures from three to four of the sources.

More than 50 years since the landmark Surgeon General’s Report linking cigarette smoking to lung cancer, smoking remains the leading cause of preventable death and disease in the United States. Smoking kills nearly half a million Americans every year. More than 16 million Americans live with a smoking-related disease. Each day, more than 3,200 American youth smoke their first cigarette. The Surgeon General has concluded that unless the smoking rate is rapidly reduced, 5.6 million American children alive today—about one in every 13— will die prematurely from a smoking-related disease.

Making Rounds

October 15-17

The American Assembly for Men in Nursing 39th Annual Conference St. Louis Union Station Hotel St. Louis, Missouri Info: 215-243-5813 E-mail: aamn@aamn.org Website: http://aamn.org/conference.shtml

16-18

American Academy of Nursing Annual Policy Conference Grand Hyatt Washington Washington, District Of Columbia Info: 202-777-1170 E-mail: conferences@aannet.org Website: www.aannet.org/2014

14-16

29-November 1

Association of Rehabilitation Nurses

National Organization for Associate Degree Nursing

40th Annual Conference The Disneyland Hotel Anaheim, California Info: 800-229-7530 E-mail: info@rehabnurse.org Website: www.rehabnurse.org

2014 Annual Conference Hyatt Regency St. Louis at the Arch St. Louis, Missouri Info: 877-966-6236 E-mail: noadn@dancyamc.com Website: www.noadn.org

31-November 3

Society of Urologic Nurses and Associates

15-19

45th Annual Conference Disney’s Contemporary Resort Lake Buena Vista, Florida Info: 888-827-7862 E-mail: suna@ajj.com Website: www.suna.org/event/2014-annualconference

142nd Annual Meeting and Exposition New Orleans Convention Center New Orleans, Louisiana Info: 202-777-2742 E-mail: comments@apha.org Website: www.apha.org/meetings/annual

American Public Health Association

22-25

Transcultural Nursing Society 40th Annual Conference Charleston Marriott Downtown Charleston, South Carolina Info: 888-432-5470 E-mail: staff@tcns.org Website: www.tcns.org

22-25

American Psychiatric Nurses Association 28th Annual Conference JW Marriott Indianapolis Indianapolis, Indiana Info: 855-863-2762 Website: www.apna.org

24-27

American Association of Nurse Life Care Planners 2014 Annual Conference Westin Buckhead Atlanta, Georgia Info: 801-274-1184 E-mail: denise@aanlcp.org Website: www.aanlcp.org

February

November

25-28

7-8

Southern Nursing Research Society

Aging and Society 2014 Interdisciplinary Conference Manchester Conference Centre Manchester, United Kingdom Info: 217-328-0405 E-mail: support@agingandsociety.com Website: http://agingandsociety.com/theconference

29th Annual Conference: Conducting Research in Difficult Times: Come Revitalize your Research Spirit Saddlebrook Resort Tampa, Florida Info: 303-327-7548 E-mail: info@snrs.org Website: www.snrs.org

7-9

International Society of Nurses in Genetics 2014 Annual World Congress Doubletree by Hilton Paradise Valley Scottsdale, Arizona Info: 412-344-1414 E-mail: isongHQ@msn.com Website: www.isong.org

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BY TERAH SHELTON HARRIS

Affirmative Action and College Admissions Affirmative action has been a hot topic for decades. Since its tumultuous inception almost 50 years ago, affirmative action has been applauded, argued, and scoffed at as an answer to racial inequality.

I

n 1961, President John F. Kennedy was among the first to use the term “affirmative action” as a method to prevent further racial discrimination despite civil rights laws and, essentially, to temporarily level the playing field. Executive Order 10925

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required that government contractors “take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, creed, color, or national origin.”

But it was President Lyndon

B. Johnson who developed and enforced it for the first time in 1965 with the passage of Executive Order 11246.

“This is the next and more profound stage of the battle for civil rights,” Johnson said to a Howard University graduating class in 1965. “We seek…not

just equality as a right and a theory, but equality as a fact and as a result.”

Since then, the debate over affirmative action has grown more and more contentious and problematic as the public— with divided opinions—have weighed in on a complex issue.

Robert A. Schaeffer, the public education director of FairTest, the National Center for Fair & Open Testing, believes that many issues relating to race are highly controversial because critics have been able to define policies as “preferences” rather than “balancing” the playing field.

“Many Americans are convinced that affirmative action creates biases in favor of certain groups,” says Schaeffer.

“Particularly in economic tough times, it is not difficult to fan resentment against any plan that seems to advantage [some] while disadvantaging others.”

Schuette v. Coalition to Defend Affirmative Action In recent months, the battle over affirmative action once again gained momentum in light of the latest Supreme Court rulings. In April, the Supreme Court upheld a constitutional amendment Michigan voters approved in 2006, banning preferential treatment based on race, gender, ethnicity, or national origin in admissions to the state’s public universities.

By a vote of 6 to 2, the court concluded that it was not up to the judges to overturn the 2006 decision by Michigan voters to bar consideration of race when deciding who gets into the state’s universities and made it clear that states are free to prohibit the use of racial considerations in university admissions.

“This case is not about how the debate about racial preferences should be resolved. It is about who may resolve it,”

Justice Sonia Sotomayor, on the other hand, blasted the majority, who she said attempts to “sit back and wish away” evidence that racial inequality exists.

“The stark reality is that race still matters,” Sotomayor wrote in her 58-page dissenting opinion joined only by Justice Ruth Bader Ginsburg. “The way to stop discrimination on the basis of race is to speak openly and candidly on the subject

“The stark reality is that race still matters,” Sotomayor wrote in her 58-page dissenting opinion joined only by Justice Ruth Bader Ginsburg. “The way to stop discrimination on the basis of race is to speak openly and candidly on the subject of race, and to apply the Constitution with eyes open to the unfortunate effects of centuries of racial discrimination.”

Justice Anthony Kennedy wrote in an opinion joined by Chief Justice John Roberts and Justice Samuel Alito. “There is no authority in the Constitution of the United States or in this court’s precedents for the judiciary to set aside Michigan laws that commit this policy determination to the voters.”

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of race, and to apply the Constitution with eyes open to the unfortunate effects of centuries of racial discrimination.”

Moving Forward It is unclear how the decision might move other states.

Eight states, including Nebraska, Arizona, and Washington,

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now have bans on affirmative action. The ruling could encourage other states to join the handful that already have such prohibitions, such as California and Florida.

But what’s worrisome to proponents of affirmative action is the precedent that may have been set with the court’s ruling, potentially, further energizing opponents of racial preferences, who have already outlined plans to put Michigan-style constitutional amendments on the ballot in Utah, Ohio, and Missouri.

A survey conducted by ABC News and The Washington Post last year found that 79% of whites and 71% of non-whites oppose the consideration of race and ethnic preferences in college admissions, suggesting that any affirmative action ballot measures are likely to be voted down.

Moving forward, Roger Clegg, president and general counsel of the Center for Equal Opportunity believes that the court’s decision means that colleges in states that have banned racial preferences must follow those laws and other states without bans should reexamine with current plans.

“It also means that colleges in other states must take into account the fact that their continued use of racial preferences, which is unpopular, should consider getting rid of that policy since it may be banned in their states, too,” Clegg adds.

Quite the contrary, says Michael Olivas, director of the Institute for Higher Education Law and Governance at the University of Houston Law Center. “It hurt the choices that Michigan colleges wanted to make, and this violated their academic freedom.”

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But it need not be a regressive process, Olivas continues.

In Maryland, voters approved resident tuition for the undocumented in a ballot measure, and Colorado voters turned down a Michigan-type measure.

“They are neither good nor bad in and of themselves, except we should not make such

cant drop in the enrollment of black and Hispanic students.

In April 2014, The New York Times published an article examining how minorities have fared in states with affirmative action bans, including California, Florida, and Michigan. At UC Berkeley and UCLA in California, for example, the graphs

A survey conducted by ABC News and The Washington Post last year found that 79% of whites and 71% of non-whites oppose the consideration of race and ethnic preferences in college admissions, suggesting that any affirmative action ballot measures are likely to be voted down. important decisions for colleges by this means,” Olivas adds.

The groups that challenged the Michigan affirmative action ban pointed out the basic unfairness of giving preferences in admission to some groups while banning similar treatment of African Americans, Latinos, Native Americans, and women.

“Michigan higher education leaders and most major civil rights groups reinforced our arguments,” says Schaeffer, who provided expert assistance to the groups challenging Michigan’s ban. “However, the judicial system held that voters could impose whatever distinctions they determined to be reasonable.”

Impact on Minority Enrollment What is not clear is the ruling’s impact on minority enrollment. While the US Supreme Court affirmed Michigan’s constitutional amendment banning race-conscious admissions, states that forbid affirmative action in higher education, like Florida and California, as well as Michigan, have seen a signifi-

showed that 49% of the state’s college-aged residents are Hispanic, though only 11% and 17% of freshmen are Hispanic at those two schools, respectively.

In Florida, 27% of the state’s college-aged residents are Hispanic at Florida State and the University of Florida, yet both universities showed that only 18% of their freshmen was Hispanic.

While the decision didn’t address the constitutionality of race-conscious admission policies, Justice Sotomayor cited student-demographic data as proof that the ban, which went into effect in December 2006, has adversely affected minority enrollment and diversity at the University of Michigan (UM) in Ann Arbor.

“A white graduate of a public Michigan university who wishes to pass his historical privilege on to his children may freely lobby the board of that university in favor of an expanded legacy admissions policy,” she wrote. “Whereas a black Michigander who was

denied the opportunity to attend that very university cannot lobby the board in favor of a policy that might give his children a chance that he never had and that they might never have absent that policy.”

According to the policy brief, “Restructuring Higher Education Opportunity?: African American Degree Attainment after Michigan’s Ban on Affirmative Action,” which Justice Sotomayor cited in her dissenting opinion, the proportion of African Americans who obtained a bachelor’s degree at UM dropped by about one-third after the ban on race-conscious admissions went into effect.

Additionally, The New York Times article revealed that the enrollment of black freshmen

at UM between 2006 and 2011 dropped from 7% to 5%, despite the number of black college-aged persons in Michigan increasing from 16% to 19%.

While Justice Sotomayor argued that the ban on raceconscious admissions might have had a negative effect on the number of minority students who enrolled, it has not necessarily stopped colleges from looking at alternative procedures to maintain and promote diversity.

A 2012 study by The Century Foundation, a nonpartisan group, found that at seven of 10 major schools where racial preferences could not be used, race-neutral alternatives helped maintain or even raise minority representation.

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For example, Texas’s Top Ten Percent Rule—which guarantees admission to the University of Texas (or any state-funded university) to any high school senior graduating in the top 10% of his or her class—helps ensure diverse college student bodies. A combination of measures, including affirmative action based on class, increasing financial grants, and de-emphasizing standardized tests are just a few promising race-neutral options that have allowed minority enrollment to return to pre-ban levels.

“From FairTest’s perspectives, all these initiatives are worthy of consideration,” says Schaeffer. “But none fully replace affirmative action as a tool for

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addressing past and present discrimination.”

Fisher vs. University of Texas at Austin Last June, the justices had a chance to make another big statement on affirmative action with its decision in Fisher vs. University of Texas at Austin (UT Austin). The case was filed by Abigail Fisher, a young woman from Texas who applied to the university but was rejected. Fisher, who is white, then filed a lawsuit, arguing that she had been a victim of racial discrimination because minority students with less impressive credentials than hers had been admitted.

The Supreme Court did not immediately decide the fate of Fisher. Instead, the justices voted 7-1 to return the case to the lower courts to determine whether the use of race is “necessary” and have “the ultimate burden of demonstrating, before turning to racial classifications, that available, workable race-neutral alternatives do not suffice.”

“Strict scrutiny must not be strict in theory but feeble in fact,” Justice Kennedy wrote.

“The reviewing court must ultimately be satisfied that no workable race-neutral alternatives would produce the educational benefits of diversity.”

Only Justice Ginsburg dissented in the decision to send the case back.

“I would not return this case for a second look,” Ginsburg wrote in her dissent. “The University reached the reasonable, good-faith judgment that supposedly race-neutral initiatives were insufficient to achieve, in appropriate measure, the educational benefits of studentbody diversity.”

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The ruling upheld Gratz v.

Bollinger and Grutter v. Bollinger, two cases fundamental in defining universities’ rights to consider race as an admissions factor. Though many argue that the court’s decision preserves the principle that affirmative action is permissible in some circumstances. That, according to Olivas, depends upon the narrow tailoring that the remand requires.

“UT Austin is allowed to

school] population. It does not harm them, nor does the modest affirmative action policy.”

It can be said both decisions illustrate the court’s skepticism about race-conscious government programs. The Schuette v. Coalition to Defend Affirmative Action ruling alone took five separate opinions totaling 102 pages written over six months—a sign of how divided the court remains on the issue and the

The Schuette v. Coalition to Defend Affirmative Action ruling alone took five separate opinions totaling 102 pages written over six months—a sign of how divided the court remains on the issue and the role the judiciary should play in protecting racial and ethnic minorities. use race (by Grutter), and the top ten percent plan—which I helped write—is race-neutral, so Fisher was not harmed. She was simply not admissible,” Olivas argues. “The plan allows in over 50% whites, in a state where whites are only 30% of the [high

role the judiciary should play in protecting racial and ethnic minorities.

To most, the recent Supreme Court’s decision upholding Michigan’s affirmative action ban was far from a shock, but many believe the ruling could

symbolize a steady march to the end of the use of race in higher education.

But, for now, the most recent Supreme Court decision only impacts public colleges and universities in the state of Michigan. The voter-approved Constitutional amendment clearly bars them from considering race, gender, ethnicity, or national origin in admissions and related decisions.

“For higher education institutions in other jurisdictions that are not operating under similar bans [some states, such as California, have their own prohibitions], affirmative action policies that comply with the court’s Hopwood [v. Texas] and Grutter decisions remain legally permissible,” says Schaeffer.

“However, many who closely observe the Court believe that further restrictions on affirmative action are likely as the result of Fisher and other cases, currently moving through the judicial system.”

Terah Shelton Harris is a freelance writer based in Alabama.

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Steps to Choosing a Nursing Specialization

BY JEBRA TURNER 14

Minority Nurse | FALL 2014

Many nurses, once comfortable with the day-to-day practice of nursing, decide that the next natural step is to go the specialization route. The thinking is that nurses who select a specialty will enjoy a higher salary, greater employment demand, and career-long job security than those who don’t. The US Bureau of Labor Statistics reports that registered nurses earn a mean wage of $68,910 annually, while nurse midwives earn $92,230; nurse practitioners earn $95,070; and nurse anesthetists earn $157,690. Not all specialties guarantee increased earnings—a parish nurse, say, is typically unpaid—but the niches that demand additional training, certification, and experience that’s in short supply almost always do.

H

owever, not everyone agrees that specialization is the best approach to navigating a nursing career. “Some nurses start out interested in pediatrics, ER, or labor and delivery, but most don’t,” says Donna Cardillo, RN, MA, a nursing career coach (www.donnacardillo.com).

“Many nurses feel pressured to choose a specialty and feel deficient in some way if they don’t.

That’s an old, outdated model.

Most of us used to work in one specialty our whole career. It’s not like that anymore. We’re going to work in many different specialties and work settings.

It’s common to weave in and out of specialties all the time.”

Cardillo believes the health care landscape has changed and so has the job market. Jobs are moving out of hospitals to alternate inpatient settings— long-term care, inpatient rehab, subacute care, and longterm subacute care.

sionally, rather than ‘choosing a specialty,’” says Cardillo. “But they also have to think about opportunities outside of the hospital. For example, if interested in pediatrics, consider pedi long-term care, pedi home care, [or] pedi rehab.”

Regardless of whether you pursue a specialty or a good opportunity, as Cardillo advises, it turns out that the steps are very similar. It means thoughtful consideration, energetic career exploration, and possibly pursuing more education, certification, and on-the-job training. Here are three simple steps to specialization, plus the career stories of three nurses in some of today’s most popular specialties.

Look Inside One of the best online resources for nurses considering a specialty is at www.discovernursing.com, which is sponsored by Johnson & Johnson. They of-

“New nurses have to think more about the opportunity itself—the support they will get and the opportunity to grow personally and professionally, rather than ‘choosing a specialty,’” says Cardillo.

“New nurses have to think more about the opportunity itself—the support they will get and the opportunity to grow personally and profes-

fer a comprehensive Find Your Specialty quiz that starts with your education and skills (current or projected), then goes on to your favorite work roles and

preferred work environment.

Here are some representative questions and possible answers, slightly modified for brevity:

Q A

What are you good at?

Tech savvy; good communicator; strong leader; compassionate; calm

Q

When it comes to your patients, the best way you can help them is:

A

Face-to-face; managing, training, or teaching nurses; doing research, writing, or advocating

Q

When mingling with colleagues, how do you join the conversation?

A Q A Q A

I lead it; I usually listen at first; I listen At work the perfect pace for you is: Slower; steady; faster Your ideal day at work is:

Pretty much the same; slightly switched up; completely different

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At the end of the test, you’ll get a top recommendation for a specialty, plus two alternatives.

Each one is described in detail and includes a list of advanced training, educational degrees, or certifications required to practice. Finally, there’s a profile of a successful nurse in that specialty to give you a sense of what’s required to find satisfaction on that career path.

Look Outside After self-exploration, it’s time to do some workplace exploration. Nurses get a great deal of first-hand knowledge of various categories of nursing as they do their rotations during nursing school. If you pay careful attention to your “gut level” reactions—to medicalsurgical, pediatrics, obstetrics, or critical care—you will discover which specialties appeal to you at a deeper level. You may want to explore additional specialties through internships, externships, temporary assignments, or PRN work outside your regular work duties.

If an actual, in-the-field trial is not an option, consider going online to learn about other categories. At www.discovernursing.com, there is a database of 104 nursing specialties that you can access in a variety of ways. The specialties cover the gamut, so there’s something for everyone: 34 are outside hospital settings, 68 are research connected, 37 are managerial, and 92 are patient-facing.

One of the best parts of this database is that you can filter it by health care setting, degrees/ certifications required, and job characteristics, so you don’t have to wade through all 104 specialties. The site will “curate” the ones that match your specific requirements.

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One of the key factors that nurses consider when choosing a specialty is employment demand. Many associations survey their members about employment and publish re-

at nursing specialty forums and at networking and social media sites.

So, when pursuing insights about being an OR nurse, for example, ask nurse lead-

Nurses get a great deal of first-hand knowledge of various categories of nursing as they do their rotations during nursing school.

sults. Say that you’d like to be an OR nurse and know that the Association of periOperative Registered Nurses (AORN – online at www.aorn.org) reports that the average age of their members skews high, plus a quarter of OR nurses plan to retire or work part-time in the near future. Those demographic factors may increase job demand—or not. You have to dig a bit deeper to find out.

Now that you’ve chosen a few specialties to explore, it’s time to get out there and do some personal sleuthing. You can attend the professional association meetings near you, go to area conferences, or connect with RNs online

ers what prospective nurses should know about that specialty. Here’s what Deb Cooksey, RN, MBA, MS, CNOR, vice president of nursing at AORN notes: “First, they need to understand that their experience with the patient is very different; it’s very short and concise—probably the biggest difference they would experience. Also, working as part of a team is often a big change; many nurses are used to working autonomously.

Another area where there is a significant difference is in how work is done; in Periop, it’s often multitasking but in a consecutive way. That can take getting used to.”

Next up, arrange one-toone informational interviews with nurses who are successfully working in that specialty to find out more about their individual career path and what they’d suggest to a newcomer. Cardillo recommends asking experienced nurses these questions: • How did you get started in this specialty?

• What do you like most and least about your specialty?

• What are the most important attributes of a nurse in this specialty?

• What trends do you see in this specialty?

“You’ll get your best information from those in the field, but take it with a grain of salt— that’s another reason why you should speak to four or five people,” Cardillo adds, so that nobody’s opinions weigh too heavily on your decision to pursue a specialty. Make a point to ask each person you interview for the names of one or two other nurses, and if they’re willing to make an introduction or let you say they referred you.

Assess Opportunities Take a look at your overall career goals and areas of interest, the type of lifestyle you aspire to, your personality and work style, and the time and other resources required to pursue an avenue.

So, for instance, if you think you’d enjoy independent case management but you don’t have funds available to get a business off the ground (and wait for it to grow to support you), maybe that isn’t a good initial specialty.

Then, of course you’ll want to see what offers you get as a way of determining if your job target is actually viable.

“Whether a new or experienced nurse, you don’t want to stay unemployed for any length of time,” says Cardillo.

“You can continue to pursue your dream job while you’re working. Say you’re interested in pediatrics, but can’t get hired in a hospital on that unit. Maybe you get offered a job on a telemetry unit. You might consider taking that because it’s easier to get transferred into another unit than hired from outside.”

BELOW, THREE NURSES WEIGH IN ON THEIR JOURNEY TO A SPECIALTY, WITH SOME ADVICE FOR OTHER NURSES: Lisa Pacheco

RN, BSN, Director of Maternal Child Services, Children’s Hospital at Nevada University Medical Center, Las Vegas My personal journey I always knew I wanted to help moms and babies, because of a nurse who took care of me when I had my older child. I went into nursing school with the idea of

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Minority Nurse | FALL 2014

maternal care but was advised not to specialize early on so I did medical-surgical nursing, then neuro subacute nursing, then I made a full circle back to my passion, a women’s care unit, and

realized my love of taking care of women and children. It’s a place where I can leave my footprint and make a difference. We’re a voice for families, making sure they’re taken care of. I’ve been

doing this for 23 years. There are so many aspects to this field—antepartum, NICU, women’s care unit, community nursing—it’s so broad so you can really find your niche.

Lisa Pacheco, RN, BSN, Director of Maternal Child Services, Children’s Hospital at Nevada University Medical Center, Las Vegas

Who does well in this specialty Nurses with a passion for taking care of mothers and children do best. Follow your heart, and then even on that hardest day when you don’t think you can come back to work, you will. Find a unit that takes in new grads and trains them. Be careful not to take just anything. You want it to work for your goals.

Having a baby is a dangerous thing. I always say it’s the most dangerous point of a young woman’s life. We triage patients, we have an OR for C-sections. If you work in a birthing center, it’s usually a quiet, beautiful experience. But

ent still, and so is postpartum.

Also, when I started, if you weren’t healthy you didn’t have babies. Now patients can have diabetes, heart problems, and asthma, and still get pregnant. Their health is compromised and their pregnancy is

Follow your heart, and then even on that hardest day when you don’t think you can come back to work, you will.

What might surprise you about this specialty A lot of nurses want to take care of moms and babies, but sometimes there’s disillusion.

if it’s high risk, like here at the hospital, you’ll have your fill of adrenaline. The NICU is differ-

ICU later—with nothing that’s pregnancy related.

Downside of specialization If you do specialize early, you may fear layoffs. If you’ve been a NICU nurse for 15 to 20 years, for instance, those nurses have a really hard time getting another job if we have a layoff.

For more information on this specialty, visit The Association of Women’s Health, Obstetric and Neonatal Nurses website at www.awhonn.org.

high risk. Patients come in by ambulance, very ill, and a lot of moms end up in the

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Erik Meyer,

RN, BSN, Nursing Supervisor, Providence Seaside Hospital, Oregon resses make the best ER nurses.

You know to grab everything you need before leaving the kitchen, then check in on everyone to see how they’re doing and give them the best service possible! The ER is so like the food-service industry.

That’s what I grew up doing— waiting tables.

Job search advice for new nurses

Erik Meyer, RN, BSN, Nursing Supervisor, Providence Seaside Hospital, Oregon

My personal journey I chose ER for selfish reasons—I’m an instant gratification person. In the ER, either we fix them or we send them away. Instant results. We get a go at it, and if they stabilize they go to ICU or another department. When I was in nursing school, I saw a level 1 trauma center in inner-city Detroit. Everything you see on

TV—well, that was that place.

It was just a one-shift visit, but the next day I applied for a two-year internship. There were 500 applicants and they hired 30 of us. It was a freefor-all, fly-by-the-seat-of-yourpants kind of place, but a great place to learn.

I’ve been in the ER at a small, rural, critical access hospital for 18 years, now as a

nursing supervisor. I work two 12-hour shifts; my wife and I are raising four kids and running a coffee business. That’s the great thing about nursing—you can work as much or as little as you want.

Who does well in this specialty It’s so intense and we’re so busy that waiters and wait-

Brittney Wilson,

RN, BSN, also known as “The Nerdy Nurse,” Clinical Informatics Nurse, Georgia My personal journey After my second year of bedside nursing, I knew that I couldn’t do it forever. It’s

backbreaking and emotionally draining. I began searching for MSN programs that would allow me to elevate

my career and stumbled upon something called “Nursing Informatics.” When I read the job description, it was like

Brittney Wilson, RN, BSN, also known as “The Nerdy Nurse,” Clinical Informatics Nurse, Georgia

18

Minority Nurse | FALL 2014

Just keep pushing. Introduce yourself to the ER manager and let them know your goal. Tell them, “If you need help, I’m available.” Keep pushing. When you pass them in the hall, ask “When can I work for you?”

ER personnel will respect people who are assertive. If you’re leaning in this direction, start getting your certifications in order and working towards becoming a Certified Emergency Nurse. Get the books and start studying for the test.

For more information on this specialty, visit the Emergency Nurses Association at www.ena.org.

the clouds parted, the sun broke through, the angels began to sing. Most informatics nurses are BSN-prepared. So I decided to pursue the career

Who does well in this specialty

because of this, it can be reFor more information on ally difficult to get your foot this specialty, visit the AmeriOne of the primary parts of in the door. I will say that, at can Nursing Informatics Assomy job is translating the needs minimum, you should be BSN- ciation at www.ania.org. of nurses to IT and the needs of prepared with at least three years of bedside nursing ex- Career advice for any nurse perience. The MSN credential Read nursing blogs! There will certainly be a help, but are many message boards that That’s the great thing about nursing—you can work many organizations also want are filled with negativity and as much or as little as you want. experience, so try to find some lots of complaining. If you way to get IT or technical ex- want to find something more without the MSN in hand to IT to the nurses and other clini- perience. uplifting and connect with see if I got any traction; three cal staff. Sometimes, when nursCertifications do command people who are really passionmonths later, I was hired. Of es and nerds get together, it can a higher salary. According to ate about nursing, then nurscourse, my technology savvy seem like they’re speaking two the HIMSS 2014 Nursing In- ing blogs are where it’s at! as conveyed through my blog separate languages. That’s where formatics Workforce Survey, (www.thenerdynurse.com) were informatics nurses come in.CH059629B the average14salary for an inMINORITY NURSE MAGAZINE 2014 Jebra Turner is a freelance health a big help with that. In my formatics nurse in 2014 is and business writer based in 7 x 4.5 (4c process) AJOHNSON WELLP0003 day job, I get to do what I Job search advice $100,717, while the average Portland, Oregon. She frequently Nursing lovemr/gl/baf/jmg/mr/sc/jb/mr/jb/jb/jb/mr/ every day: combine tech- for this specialty contributes to the Minority Nurse salary for a nurse who is cernology and health care to imInformatics nursing has tified in nursing informatics magazine and website. Visit her prove patient outcomes. become a hot specialty, and is $121,830. online at www.jebra.com.

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Registered Trademark, WellPoint, Inc. © 2014 WellPoint, Inc. All Rights Reserved. EOE. M/F/Disability/Veteran

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THE IMPACT OF

BY ROBIN FARMER

When sick and injured patients arrive at hospitals for treatment, they also bring with them their unhealthy prejudices and biases. On the frontline of health care and healing, nurses may find themselves dealing with patients who prefer a caregiver who is of the same race. Patients—or their loved ones—may express their racial preference with negative comments and intolerant behavior, or directly voice their desire for another nurse. In a perfect world, hospital management would not cater to racially biased requests or demands. But real life is imperfect.

O

ne blatantly racist incident involving an African American nurse made national headlines in 2012 when a white, swastika-tattooed father demanded that no black nurse care for his sick baby at a Michigan hospital. That case served as a springboard for several lawsuits and as a template for health care providers of exactly

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Minority Nurse | FALL 2014

what not to do. Tonya Battle, a 25-year nurse at Flint’s Hurley Medical Center, worked in the neonatal intensive care unit when she met the white parent. After introducing herself, she was told by him to get her supervisor. The father relayed his racial preference to the supervisor, who reassigned Battle.

According to the Lansing State Journal, Battle said that

a note was posted on the assignment clipboard reading: “No African American nurse to take care of baby.” Hospital officials removed the sign from the assignment chart after a short time. Still, black nurses were not assigned to care for the infant for about a month “because of their race,” according to the lawsuit. Battle’s case has since been settled.

While such overt incidents are isolated, no one should be shocked by racist patients, says Roberta Waite, EdD, APRN, CNS-BC, FAAN, associate professor of nursing and assistant dean of academic integration and evaluation of community programs at Drexel University’s College of Nursing and Health Professions.

“Racism is prevalent within

RACIST PATIENTS our society. At times it’s been more covert and other times it has been more overt. It’s much more covert now,” says Waite, although it depends on geographical areas. “The more shocking component is: what do we do about it? How do we talk about it? How do we work with our students if we work with them at all? And how do we have these discussions amongst our colleagues?”

Whatever the solutions may be for patients who discriminate against nurses based on race, physicians need them, too. A 2010 survey of emergency room doctors found

Focusing on caregiving instead of the patient’s name-calling or other forms of intolerance is the best strategy, nurses say. that patients often reject the physician assigned to them and request a doctor of the same race, gender, or religion.

Their requests are routinely accommodated. If the patient request came from someone who was female, non-white, or Muslim, it was more likely to be granted.

“It’s medicine’s open secret,” Kimani Paul-Emile, an associate professor of law at

Fordham University, told The New York Times. Paul-Emile did not respond to Minority Nurse’s requests for an interview but has written extensively on the topic. “The medical profession knows this happens but doesn’t want to talk about it,” she wrote in an article in the UCLA Law Review titled “Patients’ Racial Preferences and the Medical Culture of Accommodation.”

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So, how do nurses of color handle patient encounters they believe stem from bigotry?

For Stephanie Stith, RN, a travel nurse for the past 10 years of her 15-year career, staying calm is a coping strategy. “I just mainly look [at them]. I give myself some time, because it’s not worth losing a job for.” She recalled one experience involving a patient who told her he was a member of the white supremacist Aryan Nation. “He looked at me and said, ‘I hate niggers.’ I said, ‘Good, so do I.’” No other nurse was available to treat him, so she as-

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Carolina G. Huerta, EdD, RN, FAAN

LaDonna Northington, DNS, RN, BC

Roberta Waite, EdD, APRN, CNS-BC, FAAN

sumed her medical duties. As she worked, he continued his racist rant until she reminded him it was not smart to deride the person helping him stay alive. “I wanted him to know that I have the power over your life, and you are calling me names? Not that I was going to do anything; I just wanted him to think,” explains Stith, who says she deals more with slights than outright racism.

For example, patients sometimes assume she is a medical tech instead of a registered nurse because she is black.

Stith also refrains from becoming emotional when responding to racist patients. “I need a paycheck. It doesn’t benefit me to get indignant.

You can call me ‘nigger’ and say whatever you want, but at the end of the week I cash my paycheck. I am contracted to perform a service. I can’t change anybody’s mind or attitude. All I can do is be the best I can.”

Retired nurse Dinah Penaflorida, RN, MPH, MSN, agrees.

Her advice for new nurses dealing with such requests is to remember that “the patient’s comfort and trust comes first.

It is more important to be patient-centered in the care than to take the patient’s request

personally. When the patient is in pain and suffering, it is not the time to talk about race and discrimination.”

Penaflorida was born and raised in the Philippines. At 16,

says Deborah Bowser, RN, who has a master’s degree in health services administration and is a practice administrator in Richmond. “Most of my instructors were nurses of color

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For any young nurse of color who encounters such patients, “carry yourself with pride and get a mentor to help you,” Bowser advises. she received an American Field Service Scholarship to spend a year in Hutchinson, Kansas. As a staff nurse at Kansas University Medical Center in the 1980s, she encountered a few patients who requested a Caucasian nurse instead of her. When it occurred, she went to the charge nurse to comply with the request to “create a more comfortable environment for the patient to heal.” She left those experiences behind her when she moved to the West Coast. “Working in California was different. I did not experience that,” says Penaflorida.

Focusing on caregiving instead of the patient’s namecalling or other forms of intolerance is the best strategy, nurses say. “l always keep in the back of my mind that I had the best training going because I am a nurse of color,”

and they dealt with worse situations than I have. They always instilled in us that ‘you will be judged by the color of your skin and it will be assumed you are not a RN, and you do not have the experience.’ They took no slack from us. We were the best of the best.”

Bowser recalled being rebuffed by two white patients during her 43-year career.

Both incidents happened in New York during her night shift. Each time, her supervisor told the patient she was one of the best nurses.

“One patient decided they did not want to be treated by me because I was black, so I informed my supervisor. The patient was extremely ill, so I said, ‘You have a choice; let your prejudices go by the side and let me take care of you.

I know what I am doing.’ In

one incident the patient said ‘yes,’ and in another the patient said ‘no’ and did not get care for a very long time because there was no other nurse who was Caucasian who could care for that patient.”

Bowser says she would like to think in this day and age that race-based requests would be nonexistent, “but you are going to have people who do not want people of color touching them” regardless of their expertise. For any young nurse of color who encounters such patients, “carry yourself with pride and get a mentor to help you,” she advises.

Racist patients can overwhelm young nurses, says LaDonna Northington, DNS, RN, BC, professor of nursing and director of traditional undergraduate studies at the University of Mississippi Medical Center (UMMC) School of Nursing. “A young nurse would probably be intimidated and wouldn’t know what to do but leave out of the room, so they have to find a mentor to help them... problem solve through a situation like that. A seasoned nurse is able to take a high road. If you try to take care of the patient, they can call it assault,” so a nurse must learn how to accommodate a patient from a legal standpoint, she explains.

“For a young nurse, they should get their charge nurse or head nurse to intervene. It’s a tough call,” says Northington, who has not dealt with a racist patient during her 35year career.

“I can’t recall an incident when I was on the floor taking care of patients where I felt like a patient did not want me to take care of them because I was black...and you would

think if it was anywhere blatant, it would be in the South where we are. I haven’t heard the students talk about it. It could be in pockets [of communities] or people deal with it in a different way.” The UMMC School of Nursing addresses sensitivity and cultural awareness and understanding, she says, adding it’s possible that black patients may reject white nurses. “An elderly black person who has never trusted white people because of Tuskegee and those kinds of things and Mississippi history” may request a black nurse.

Discussing race makes many people uncomfortable, but nurses say it’s part of the solution. “When you are talking about the elephants in the room, we talk more openly about religious differences... and gender or sexual orientation, but when you get to race, there is so much more hostility and changing the subject,” says Waite. “It’s not talked about openly... oftentimes not at all. I’m not shocked that those incidents occur; I am actually surprised it doesn’t occur more often.”

Waite uses a social justice framework to talk about such topics as power, privilege, oppression, “and every ism” in a leadership course she teaches all undergraduate health profession students, including nurses. “I explicitly talk about it. However, most often within nursing clinical courses the topic is called ‘cultural competence.’ That’s the catchall phrase that overlays issues of culture and diversity. That phrase is probably in everybody’s syllabus; however, how each person operationalizes what they do in teaching their students will vary,” she says. It

will come down to how comfortable that faculty member is in guiding or leading or discussing issues regarding race, she adds.

At the University of Texas-Pan American nursing department, the curriculum emphasizes culture and cultural differences among people, says Carolina G. Huerta, EdD, RN, FAAN, nursing department professor and chair. In one required course, undergraduate students spend at least two weeks listening to lectures and discussing the impact of culture on nursing care, with particular attention paid to debunking stereotypes and focusing primarily on each person’s uniqueness. The course aims to sensitize students to issues related to racism and stereotyping.

“Once admitted to our program, every student must address cultural implications of their nursing care following each of their clinicals,” explains Huerta. “There is a section on their assigned clinical paperwork that must be turned in that deals strictly with cultural implications of care. The students are asked to reflect on the patient that they cared for and address any cultural implications, whether these deal with the foods the patient ate, religious affiliations, overt or covert racism, family issues, et cetera.”

While some patients will always express a racial preference for nurses, what matters most is how the institution and administration respond to such requests. “If you cater and say ‘no black people will work with you,’ that’s the problem,” Waite argues. “A patient has the right to decide who will care for them, but they can’t do

it in a discriminatory manner.

Instead, the response could be ‘Everyone here is competent to take care of you. If you choose to [reject care from a specific

spectrum,” says Waite. “All of us continuously struggle to deal with prejudice and bias because no one is perfect.

When trying to understand

While some patients will always express a racial preference for nurses, what matters most is how the institution and administration respond to such requests. nurse] that is fine, you can go to another hospital.’”

Most of the hospitals that have been in the news “gave in” to racial preferences, Waite notes. Hopefully, most hospitals have a statement within their policy on how to engage and work with clients if anything like this surfaces. Talking about these issues is key, she adds.

“I think oftentimes today, people think either you are racist or not. It’s not that you are racist or not; racism is a

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where these thoughts come from and not feed into it, we move society forward. And it’s going to move forward as we are able to have these open and authentic conversations with one another.”

Robin Farmer covers health, business, and education as a freelance journalist. Based in Virginia, she contributes frequently to Minority Nurse magazine and website. Visit her at www.Rob-

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What Recruiters Want

How a BSN Can Help You Land a Job

BY JULIA QUINN-SZCESUIL With the increasing demand for more highly educated nurses and many hiring requirements now mandating a BSN, the nursing job market is in the midst of a massive shift.

T

he BSN figures prominently in the nursing field, especially since the Institute of Medicine’s report The Future of Nursing called for 80% of nurses to have a BSN by 2020. More nurses are attaining the degree, but many of them wonder just what advantages the BSN can bring.

According to recruiters, a BSN automatically raises both your professionalism and your marketability.

Recruiters, who act as a link between job seekers and the organizations looking for staff, also say a BSN is only one piece of the professional package needed to land your first job out of school.

“More and more, a BSN is becoming the minimum requirement, as opposed to the preferred idealistic requirement,” says Amanda Bleakney, senior managing director of health services operations with The Execu|Search Group. In fact, many top-tier hospitals won’t hire a nurse without a BSN. “Nurses who aren’t getting a BSN are ruling themselves out of job opportunities,” she says.

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What Is a Recruiter Looking For? Recruiters can help new grads find a job, but as a job seeker, you still have work to do. Recruiters want a BSN backed up by experience, but they also want to hear about any special skills you might have. They are trying to keep their clients happy and send them candidates they need, so the more precise and polished you are, the better the fit will be.

“Anything we can use as a selling point to the client helps,” says Bleakney. “When it comes to the candidate side, we always have a selling point.” So if you’re looking for a job in the Bronx and you speak Spanish, you might be more valuable than someone who has a little more experience, but isn’t bilingual.

However, no matter how great your experience is, it means nothing if you don’t present yourself well. A recruiter can open the door for you, so it’s just as important to show them your best, most professional self.

“A recruiter is a gatekeeper,” says Terry Bennett, president of the National Association for Health Care Re-

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cruitment. “Recruiters are helping to screen candidates the managers will then interview.

Where graduates can present their best selves is by helping to qualify what they will bring to an organization.”

want to highlight, such as your bilingual skills, your experience with specific populations, or your electronic medical record training, should be at the top.

“Bad or poorly formatted resumes will rule nurses out of a

According to recruiters, a BSN automatically raises both your professionalism and your marketability.

Your resume is your first introduction, so use it to tell your story. “Tailor your resume,” Bleakney advises. Anything you

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job,” says Bleakney. Even if a nurse hires a pro to craft her flawless resume, Bleakney says it shows that she is someone

who cares about presentation and likely has strong administrative skills, too.

Recruiters want candidates whose preparation and professionalism will shine a light back on the recruitment firm. “We want to send the highest quality, top candidate as we can because that candidate stands out for us,” says Bleakney. Very often, an initial phone screen will be followed up by an inperson meeting to go over all the candidate’s qualifications and background checks.

If you have anything that

could be interpreted as even slightly negative, be upfront with your recruiter, suggests Bleakney. “It’s always best to disclose something,” she says, or it can cost you a job instantly.

“Reputation is everything,” says Brenda Fischer, PhD, RN, MBA, CPHQ, FACHE, senior director of clinical education programs with AMN Healthcare, a workforce solutions firm, so watch your social media posts and appearances carefully. “Employers can be very selective,” says Fischer,

know if they do that to me, they will do that to my clients.”

When you advance to an interview your recruiter sets up, do your research. “Know about the organization,” advises Bennett.

“For the unit, what types of pa-

of nursing is with a BSN,” says Julia Taylor, a BSN grad who works at Memorial Sloan Kettering Cancer Center on an inpatient gastrointestinal surgical oncology unit. “You’re more of a well-rounded nurse and will

“Reputation is everything,” says Brenda Fischer, PhD, RN, MBA, CPHQ, FACHE, senior director of clinical education programs with AMN Healthcare, a workforce solutions firm, so watch your social media posts and appearances carefully. tients are there?” Make sure the organization knows why you want to be on that unit, with that manager, with that organization, and why you are the best person for the job, she says.

What Does a BSN Do for a Nurse’s Career?

and they will look at a candidate’s online information.

Recruiters want people who represent them well, and they use your first meeting to assess how you will present yourself to a client. Although it’s not an actual job interview, it is your first step in getting a job.

Don’t be late, dress professionally, and bring your resume and any other requested documents, recommends Bleakney. “Half of getting a job is showing up and being prepared,” she says. “If someone cancels continuously or is a no-call and no-show, I

“Students should realize what they are getting from a BSN that is special,” says Hayley Mark, PhD, MPH, RN, an associate professor and the director of the baccalaureate program at Johns Hopkins School of Nursing. “The degree means they have the ability to think critically. They can evaluate evidence and apply it, and that skill is critical.”

Critical thinking means a nurse can assess the quality of care, says Mark. “It goes beyond the skills,” she says. “A BSN gives a system-wide perspective and helps nurses look beyond the one-on-one.” For instance, if there’s ever a medical error, a nurse can gather the reasons why it happened, can use that information to understand why it happened, and will then take that knowledge to implement changes to make sure it doesn’t happen again.

A BSN also opens doors for other prospects. “The future

have more opportunities down the road to pursue a master’s or doctoral degree.”

When you are interviewing, highlight not just your BSN but also the knowledge that comes with it. As with any education, a BSN gives you more in-depth nursing knowledge, but the specific training from a BSN also means you know how to look at the whole system and you have the skills to work in a leadership role across all systems, says Mark. “Generally, if a company is comparing a BSN nurse to a less educated nurse, they will hire [the one with] the BSN,” she says.

When a nurse looks at the industry systemically, issues such as cost effectiveness, pa-

How Does a BSN Translate to Real Work?

The BSN degree prepares students for the broad thinking required of future nurse leaders, but any hands-on experience a new grad has or can get makes recruiters take notice. Many organizations are looking for a couple years of experience, says Bleakney, but are willing to consider new grads who can demonstrate how their clinical—or even their volunteer work—prepared them best.

A practicum in a similar unit will increase your chances as you will gain similar skills, says Bennett. But even work outside of health care is helpful if you frame it right. Did you manage a restaurant? Then you have great customer service skills, says Bennett. Did you head up an Eagle Scout group? You also fine-tuned your leadership skills in the process.

As a minority nurse, you can also highlight your diversity skills. In most organizations, the ratio of cultural diversity with patients and providers is not representative of the population. If you are a minority nurse looking for a job, recruiters in certain locations want to see your resume because health

When you are interviewing, highlight not just your BSN but also the knowledge that comes with it. tient centeredness, communication skills, awareness of the latest in patient safety, and familiarity with information technology are most pressing, says Fischer. That scope often mirrors an organization’s approach as well, so hiring nurses who think that way benefits the entire company.

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care organizations are seeking a more diverse staff. “I would use that in crafting my resume and present it as a strength,” says Fischer.

Farzana Abed, a recent graduate of the Johns Hopkins School of Nursing, chose a BSN program for the breadth of the studies, but her own back-

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ground offers employers a valuable perspective. “A BSN offers a more comprehensive program with the social, cultural, and political aspects of nursing,” she says. Combining her education with her life experience as

for a job. Get in touch with people through your alumni network or call a nurse manager or a nurse recruiter and impress them. “Every opportunity for volunteerism or professional development helps,” says Fisch-

If your cultural or racial background gives you a better understanding of what minority patients might need or how they approach health care, your life experience combined with your BSN is going to be a sought-after skill. an immigrant from Bangladesh who knows the challenges of language barriers, financial difficulties, and even racism makes her very aware of the challenges some patients face.

If your cultural or racial background gives you a better understanding of what minority patients might need or how they approach health care, your life experience combined with your BSN is going to be a sought-after skill. If you understand various cultural traditions surrounding health choices or if you are bilingual, let recruiters know those skills up front.

What Can You Do? “Get any work experience on the unit and do the job well,” advises Mark. A shadowing experience also helps you boost your knowledge and get yourself noticed, she says. Bleakney suggests seeking out professional organizations that mirror your ideal job, whether that brings you to the Case Management Society of America or with the Nurse Practitioner Association of New York State, so you can meet leaders and connect with others in the field.

Networking, although it can be difficult for some, is a vital step when you are looking

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er. “Build every relationship through your clinical experience or through your school.

Use every experience to form good relationships.”

Fischer acknowledges the special barriers of nurses who are going back to get a BSN after several years on the job. Unless they have actively worked at keeping their industry networks vibrant, it’s going to be harder for them to get out there and make the connections. They likely have pressing family obligations or more job responsibility than a new grad and less time for networking. “Make your own network,” Fischer advises, saying a group of colleagues can give specific career advice and family and friends can help out.

Where Are the Jobs?

The need for BSN nurses is great and will continue to rise as tougher standards are adapted. “Your educational background is first and then your work experience,” says Bennett. But for new BSN nurses, flexibility with location or setting plays a big role in your job search.

Talk with recruiters in different areas of the country to find out about job prospects

and consider relocating, even if it’s only for a short while.

For instance, suburban and rural areas are traditionally less competitive job markets than the big cities like New York or San Francisco, says Mark, so you might land a position that matches your interests, even if it’s not your first location choice. “Once you come in with experience, it makes you a totally different candidate,” says Mark.

Be open to different options, but even if you consider a placement as a temporary stop on your way to something else, don’t treat the job as a place marker, advises Bennett.

Recruiters and employers want a candidate who is committed to the job, so give it your all to gain the experience you need.

If your field is especially competitive, consider all the places where you can gain skills first.

“As nurses, we have to be proactive and strategic,” says Fischer.

A long-term care facility, a school, or a substance abuse facility can offer enough experience to make you that much more marketable, says Bleakney. “This is not the time to be particular,” she says. “This is the time to get the experience on your resume. Nurses who get

How Do You Find a Recruiter?

Finding a recruiter is not hard. Ask around to find out who colleagues have worked with or who your school recommends. You can also call the human resources department of your dream organization and ask which recruiting firm they work with or even the contact information for the recruiter, says Bennett.

“If you really want to work somewhere, call that recruiter and ask what the process is,” she says. Do they have rolling starts or is it a month of interviews? Do they welcome calls after you have applied or are calls a no-no? Are new grads considered?

By asking relevant and specific questions, you can help shape your own process to maximize the recruiter’s time and resources as well as your own.

When you meet a recruiter, use the time wisely and be organized and open-minded.

Your different skills can help recruiters recognize other areas that would offer a good fit for your skills. Even roles you may not have ever entertained might turn out to be an excellent prospect, says Fischer.

Health coaches, care coordinators, and clinical documenta-

But for new BSN nurses, flexibility with location or setting plays a big role in your job search. the experience and then apply for their dream jobs are ahead of all the others who don’t have the experience.” Even working at a smaller community hospital might just give you enough knowledge of certain cultures or neighborhoods to make the difference in your next interview.

What Recruiters Expect from New Grads “We look for a new graduate that has a passion for pediatrics and family-centered care as well as proven leadership for the nursing profession. A critical thinker who will be in the forefront of delivering excellent nursing care while collaborating with the team to be a patient and family advocate.”

—Andree Mulia, RN, BSN, CHCR, Nurse Recruiter, Children’s Hospital Los Angeles “Florida Hospital looks for new grads who are passionate about the mission statement of the hospital, which is to ‘extend the healing ministry of Christ.’ We also look for new grads who are a model of excellence not only in their academics but also in their character.”

—Douglas Mvududu, HR Recruitment Team I, Florida Hospital “As a nurse recruiter with Sentara Healthcare, I seek registered nurses that will help us move forward with our vision to create an environment of health and healing for our patients. We emphasize Sentara’s culture of safety and accountability, creating a caring and compassionate environment, and collaborate with our health care team.”

—Erin Creath, PHR, Nurse Recruiter “We are looking for a nurse with a passion for pediatric nursing, excellent customer service and communication skills, and any experience working with children and their families. Nursing students should make sure that they include an excellent cover letter and resume with their applications. My best advice to students is to use the hospital website to research the organizations they are applying to in order to customize their cover letter and prepare for potential interviews. They have to be able to sell themselves. How will they help the organization they wish to join to meet the organization’s mission?”

—Jill Titone Board, MS, BSN, RN, NE-BC, Nurse Recruiter, Children’s National Health System, Washington, DC

tion specialists are just a few roles emerging for nurses, says Fischer.

“Flexibility is key in health care, especially as a new graduate,” says Bleakney.

“I like to know that the new graduate BSN is excited about becoming a nurse, is compassionate and sensitive to cultural differences, and believes in the hospital mission. I also want to know the new nurse is proud of their career choice and is professional in communication and appearance, dedicated to learning, and seeks opportunities to learn and grow.”

Julia Quinn-Szcesuil is a freelance

—Mary Blessing, University of New Mexico, Director of the Nurse Residency Program

writer based in Bolton, Massachusetts.

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Tackling Student Loan Debt 30

Minority Nurse | FALL 2014

BY DENENE BROX

Advancing your education isn’t a prescription for debt.

Here’s how to earn that degree without interest.

O

ne out of 10 Americans has student loan debt.

That debt is steadily on the rise, with projections putting the total at $1 trillion this year, according to numbers compiled by Consolidated Credit. That number may seem unfathomable to many, but how big is your slice of that debt pie? Do you view student loans as the only way to fund your nursing education?

If you answered yes, it’s understandable why you may feel that loans just come with

nurse and wish to earn an advanced degree (or two), know that you don’t have to contribute to those startling national student debt totals. Take the time to become financially savvy and seek out the right opportunities, and you could come out with substantially less student loan debt than your fellow classmates.

One of the first steps before making decisions about funding your education is to step back and thoroughly research your options. Look at the type of degree you are considering

Look at the type of degree you are considering and make sure there is a high enough demand in the job market and job growth projections for that specialty. the territory of higher education. After all, tuition is at an all-time high—with no signs of slowing down. According to The College Board’s Annual Survey of Colleges, average in-state tuition and fees are $8,893 for public four-year and $3,264 for public twoyear institutions. To put those numbers into perspective, the average yearly tuition at a four-year school in the 1980s was $3,449.

If you dream of becoming a nurse or if you are already a

and make sure there is a high enough demand in the job market and job growth projections for that specialty. Also, look at salary averages for your chosen degree/career plan.

“Very few people can afford to pay for college outof-pocket,” says Tiffany “The Budgetnista” Aliche, author of The One Week Budget: Learn to Create Your Money Management System in 7 Days or Less! “But student loans are avoidable if you plan carefully. Student loan debt in itself is not bad.

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The problem is that most people chose student loan debt as their first option and it really should be their last.”

Aliche stresses that getting an education is an investment.

“What you put in should give you more money back in return, and if it doesn’t then you have made a gross error,” she warns. “If you invest $150,000 and only make $40,000 coming out, that’s a mistake. It doesn’t make sense. For example, if a doctor invests $100,000— that’s OK because they’re probably going to make over $100,000.”

Shannon McNay, community outreach and customer support manager at ReadyForZero, an online debt elimination tool, agrees. “Crunching the numbers is the absolute best way a nurse can decide if he or she should pursue an advanced degree,” she says.

“What are the projected earnings for the position a higher degree will get you? Compare the price of the schools you’d go to and see which one you’d pick. If the tuition is equal to one year of the pay, it could be a worthwhile opportunity.”

The college or university you select can instantly drive up or reduce the cost of your education. “People will say ‘go to the best college you can.’ I

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disagree. I say go to the college that offers you the most money,” argues Aliche. “If you go to this amazing col-

nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives) are often primary care providers.

“People will say ‘go to the best college you can.’ I disagree. I say go to the college that offers you the most money,” argues Aliche. lege and they offer you no money [scholarships], and you come out owing hundreds of thousands of dollars, no one cares that you went to Princeton and you don’t have a job. If you work really hard and do internships, you can compensate for not going to a school with a big name.

But you can’t compensate for owing $100,000 in debt. And then you’re going to be stuck with a job that you hate because you have to pay off the student loan debt.”

The Importance of a Nursing Education The Institute of Medicine’s 2010 report The Future of Nursing reported that the Bachelor of Science in Nursing (BSN) degree is the new starting point to get hired as a registered nurse. In fact, according to the findings, nurses with a BSN will increase from 50% to 80% by 2020.

There’s no denying that the higher you go in your nursing education, the higher you can go in your nursing career and earning potential. With our ever-changing health care landscape that is a result of the Affordable Care Act, advanced practice nurses (e.g., nurse practitioners, clinical

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Those roles require a master’s or doctorate degree. They also require a large investment of time and money.

Paying for Your Education Before you sign on the dotted line for that student loan, it’s wise to explore other options for paying for your degree. For starters, look into scholarship opportunities—

you’re in school and pay as you go. Many students can’t go to college full-time and literally work their way through evening and weekend programs. Accelerated master’s programs can be good options for parents who need to maintain employment while working on their degree.

“I think employment during your college/advanced degree experience is a good way to pay for—or at least offset—the cost of tuition, fees, books, and living expenses,” says John Heath, an attorney with Lexington Law, a credit repair firm. “Further, there are employers that will pay for college/advanced degree courses as long as the course fits their respective business model and

Before you sign on the dotted line for that student loan, it’s wise to explore other options for paying for your degree.

you may find easy money waiting for someone like you to claim it.

Aliche says that most students never apply for any scholarships. “It’s smart to explore scholarships as many programs offer them but have no applicants, making the competition low,” she explains. “There are a lot of people who say ‘I don’t want to apply’ or ‘I won’t get it.’ Apply, since you may be the only one. There may be three scholarships and three people applied; so by default, you win.”

Another alternative to student loans is to work while

you meet the criteria expected by the employer.”

If you have exhausted all other options for paying for your education, it’s time to look into student loans to help fill the gaps. But it’s vital that students fully understand the various types of loans and the terms and conditions.

As a general rule of thumb, Aliche advises students to steer clear of private loans because of interest fl uctuation. She says federal loans are the best choice because they offer a fixed interest rate and less risk overall.

“With private loans, if you

get sick or even if you pass away, you may still owe because, usually with a private loan, you have to get a cosigner—making that person equally responsible for the loan,” explains Aliche. “If you pass away, that person may still have to pay. But with a federal loan, if you pass away or become disabled, your student loan is forgiven. If you can no longer perform those tasks or face financial hardship, you can apply for forbearance, which means they allow you not to pay [on the loan] for six months to a year until you get back on your feet. Private loans do not offer that option. That’s why I tell people, if you’re going to get a loan, try not to get private loans because, when it comes to repaying it, there are very strict guidelines that are not there for federal loans.”

Loan Repayment Programs Because skilled nurses are in high demand, especially in urban and rural areas, there are programs through the government, nonprofits, and employers offering loan forgiveness to nurses who are willing to work in underserved areas for a specified amount of time.

The US Department of Health and Human Services Health Resources and Services Administration offers the NURSE Corps Loan Repayment Program (http://nhsc. hrsa.gov) for professional registered nurses working in a critical shortage facility.

Those accepted receive 60%

Corps alumna Tamara Bumpus, MSN, NP-C, a nurse based in Toledo, Ohio, took advantage of the loan repayment program and has already completed her twoyear commitment.

“I work for the Neighborhood Health Association, which serves the homeless,

that there’s money out there. I researched and found that the National Health Service Corps was available, and I applied for it. It seemed like a difficult process at first, but it was more of a waiting game—waiting to see if you were going to be approved or not for the loan reimbursement—and I

Because skilled nurses are in high demand, especially in urban and rural areas, there are programs through the government, nonprofits, and employers offering loan forgiveness to nurses who are willing to work in underserved areas for a specified amount of time. of their total qualifying nursing education loan balance for two years of service.

National Health Service

and the other office I work at serves the underserved— people with low-to-no insurance,” says Bumpus. “I always heard

was approved the first time I applied. There’s nothing better than getting money back after you’ve taken out student

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loans. I wanted to be a nurse practitioner, and it was so helpful to have that burden removed. If I had known about the scholarships, I would have done that also.”

Smart Budgeting for Repayment If you already have existing student loans or plan to get one in the future, it’s smart to plan early for how you will repay the debt. Aliche says an old-fashioned budget is the best place to start.

“Include everything from your rent to getting your hair done,” Aliche says. “Before you can pay a loan back, you need to know how much you can afford. So if you add up your money list and your life

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Student Loan Do’s and Don’ts There is so much information out there about student loans. Keep these expert tips in mind to keep your loans in check.

Do Face Your Debt “If you don’t already know who you owe or how much you owe, drop everything and find out right now. Ignoring the student loans will not make them go away. This website will help you figure it out: www.nslds.ed.gov.”

—Shannon McNay, community outreach and customer support manager, ReadyForZero

Do Be Careful When Consolidating “Do not refinance a federal loan to a private company.

All of the protection you get with a federal loan, you will not get it if you refinance with a private company. With a federal loan you can consolidate. So if you have 10 federal loans, they will take the average interest and give you one payment.”

—Tiffany “The Budgetnista” Aliche

Do Shop Around “Pick your top five schools and talk to each of them about the real cost of your degree. Financial aid packages vary greatly, so let the schools make you an offer.”

—Matt Kelly, founder, Momentum: Personal Finance Coaching

Don’t Waste Refund Checks “If you get back $2,000, some people think that’s free money. No, that’s money that you owe. If you don’t need that money, send it back. That will lower how much you owe when you get out of school.”

—Tiffany “The Budgetnista” Aliche

Don’t Overborrow “It’s a mistake to take a large amount (more than needed) of student loans to maintain the lifestyle you were accustomed to at your parents’ house. It is better to live like a student while you are a student than to live like a student after you have graduated because of your large student loan payment.”

—John Heath, attorney at Lexington Law

costs you $2,500 per month and you make $4,000, you will know how much you can afford to make in payments.”

Aliche says that only you can know how much you can truly afford to pay each

McNay says nursing students should stay mindful of what’s available to them after graduation.

month— not your lender.

“No one should tell you how much your payment should be, you should tell them,” she argues. “You can say, ‘Honestly, I did my budget and, with my bills, I don’t have $300 per month [for payments]. I have $150 that I can guarantee.’ It’s a different conversation when you say that. ‘I have a budget and you want me to promise you $300, but you’re not going to get that.’ That’s the kind of conversation that you want to have. You can definitely try to negotiate your monthly payment. It may take you talking to five people on the phone or a week of calling. I know someone whose monthly payment was $900 and she got it down to $400 per month.

You can e-mail them a copy of your budget so they can see that you don’t have things like cable. Most people are not having that conversation with their lender, so that’s why it’s easier for someone to say yes to you.”

Another good strategy for those still in school is to make payments now, not after graduation.

“Calculate a small amount of money to pay each month so you can get a head start,”

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McNay suggests. “You may also want to dedicate some monthly savings to building an emergency fund. If you end up finding a higher-paying job out of state, you’ll want some startup money to get

you there. Don’t lose out on opportunities just because you’re not financially ready for them. School is a great time to save.”

McNay says nursing students should stay mindful of what’s available to them after graduation. “If you’re really struggling, the [federal government’s] Income-Based Repayment Program [https:// studentaid.ed.gov] can be an absolute lifesaver— yet so few people know about it,” she says. “Stay up-to-date on changes in legislation that can benefit your finances— these changes aren’t just for current students.”

By educating yourself on the various options for funding your education, you can avoid the many pitfalls that land so many students in mountains of debt. Careful planning will allow you to begin to build the life you dream of after you graduate, whether that’s traveling the world or buying a home. The less student loan debt you have, the faster you can finance your other dreams.

Denene Brox is a freelance writer based in Kansas City, Kansas.

MINORITY NURSE SCHOLARSHIP PROGRAM Sponsored by the National Coalition of Ethnic Minority Nurse Associations (NCEMNA) and Minority Nurse Magazine Nurses will always be valuable members of any health care team, regardless of their educational backgrounds.

Yet, the baccalaureate and master’s degrees in nursing may offer the most professional opportunities.

That’s why Minority Nurse has teamed up with NCEMNA to co-sponsor an annual scholarship to help outstanding nurses from under-represented groups complete their studies toward a Bachelor or Master of Science in Nursing.

To date, we have awarded scholarships to more than 40 students, honoring their commitment to the profession, academic excellence, and community service.

We are currently accepting applications for our 16th annual scholarship competition, consisting of two $1,000 awards and one $3,000 award. Scholarships will be paid in summer 2015 for the fall 2015 academic term.

Questions? E-mail editor@minoritynurse.com or visit www.minoritynurse.com/scholarship/minority-nursemagazine-scholarship-program

MINORITY NURSE 16th Annual Scholarship Program

Application Form (Please print clearly) Name ______________________________________________________________________________________________ Address ____________________________________________________________________________________________ City/State/ZIP Code _________________________________________________________________________________ Phone _______________________________ E-mail________________________________________________________ Nursing school ______________________________________________________________________________________ Expected date of graduation _________________________________________________________________________ Gender: ❏ Male

❏ Female

Ethnic background: ❏ African American ❏ Hispanic/Latino ❏ Asian/Pacific Islander ❏ American Indian/Alaskan Native ❏ Filipino ❏ Other______________ Please list any nursing associations (student, minority, or otherwise) to which you belong: __________________________________________________________________________________________________________ __________________________________________________________________________________________________________

Who Is Eligible (Please read carefully. Applications that do not meet the eligibility criteria will be disqualified.)

To apply for this scholarship, students must meet all four of the following criteria: Be a minority in the nursing profession Be enrolled (as of September 2015) in either: • The third or fourth year of an accredited BSN program in the United States; or • An accelerated program leading to a BSN degree (such as RN-to-BSN or BA-to-BSN); or • An accelerated master’s entry program in nursing for students with bachelor’s degrees in fields other than nursing (such as BA-to-MSN).

Note: Graduate students who already have a bachelor’s degree in nursing are not eligible.

Have a 3.0 GPA or better (on a 4.0 scale) Be a U.S. citizen or permanent resident How to Apply (Please read carefully. Applications that do not include the required documentation will be disqualified.)

Complete and return this form along with all three of the following documents: Transcript or other proof of GPA Letter of recommendation from a faculty member outlining academic achievement A brief (250-word) written statement summarizing your academic and personal accomplishments, community service, and goals for your future nursing career Important: An English translation must be provided for any documentation that is not in English.

Minority Nurse will award one $3,000 scholarship and two $1,000 scholarships in 2015. Selections will be made by NCEMNA. Scholarships will be paid in summer 2015. Minority Nurse reserves the right to verify community service and financial need.

Deadline for application: February 1, 2015 Return application form and documentation to: Minority Nurse Magazine Scholarship, Springer Publishing Company, 11 W. 42nd Street, 15th Floor, New York, NY 10036

Academic Forum

The Life of a Humanitarian Relief Nurse

BY ARCHANA PYATI

Sharon Tissell, RN, dreamed of one day helping those around the world without the fortune of growing up in a loving, middle-class family like hers. Tim Harrison, RN, MPH, flew for 10 years with a medical helicopter service and knew he had the right skill set to make a difference. Martina Ford found that she thrived in multicultural settings.

Doctors Without Borders, who lives in Maine when he is not traveling for MSF. “It’s really about the direct connection between donors [of humanitarian aid] and beneficiaries.

You’re simply the conduit.”

ll three of these nurses have found their professional sweet spot, which, at most, pays them a modest stipend and requires them to endure Spartan—and often dangerous—living conditions for months at a time. They are humanitarian medical relief nurses who make multiple trips each year to the very places we see in the news that we are told to avoid.

Places like the Syrian-Lebanese border, which is experiencing the largest exodus of refugees in recent history as Syrians flee their country after a brutal government crackdown and civil war began in 2011. Or South Sudan, Africa’s newest nation where ethnic rivalries have destabilized a fragile government and led to violence, bloodshed, and the internal displacement of tens of thousands. Or the Philippines, where Typhoon Haiyan flattened towns and villages, crippling a country’s capacity to deliver basic services and medical care to its people.

What motivates Tissell, Harrison, and Ford to return to these situations time and again is the opportunity to offer unconditional care, comfort, and compassion to the world’s most vulnerable populations.

Across vast geographic, cultural, and ethnic boundaries,

While nursing can be a satisfying career, it also runs the risk of being repetitious; working internationally can be a “way to break out of the doldrums going into your shift every day,” says Sue Averill, RN, cofounder and president of One Nurse At a Time, an organization that provides information and scholarships to nurses who want to work in humanitarian relief. Averill herself has gone on eight missions with MSF and several others with Medical Teams International (MTI), based in Tigard, Oregon, and with Smile Train, based in New York City.

A

their work goes to the heart of what nursing is.

They don’t let politics and war keep them away, although these are often the factors fueling the crises at hand. While fearless, humanitarian relief nurses are hardly reckless, receiving intensive security training from their sponsoring organizations and working on highly coordinated teams where personal safety is valued above all else. Moreover, these nurses hardly see what they do as a personal sacrifice.

“It’s not about you,” says Harrison, a nurse with Médicins Sans Frontières (MSF), or

Wearing Multiple Hats

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Averill says experiences in the ER, ICU, surgical, and critical care floors are great preparation, as are courses in public health and tropical diseases such as Dengue fever, malaria, and others rarely seen in the West.

Also invaluable are critical thinking skills that empower you to be resourceful and in situations where supplies, medicines, and equipment are limited. Reorienting yourself to medicines that may be similar to those in American hospitals but with different branding, dosage levels, and packaging is also key.

Being able to communicate crossculturally and understanding cultural biases are as important as having strong medical training, Averill says.

For example, a small white pill may be perceived to be inferior to a large white pill or a colored capsule in certain cultures. Local people and medical staff

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Academic Forum may “imbue [Western nurses] with qualities [they] may or may not have,” she adds.

“People believe that simply because you came across the world to help them that you come with something better than they have,” even when that may not be the case.

That’s why it’s critical to have frequent conversations with patients to understand cultural biases and figure out how to work around them.

One major strategy is to make sure you and your translator are “on the same page,” suggests Averill.

Relief work also requires nurses to wear multiple hats, she adds: “You’re a human resources person. You’re diagnosing and treating. You’re hiring and firing.” But perhaps most importantly, you’re teaching local people to think critically.

Averill was once tasked with setting up a hospital for Darfurian refugees in an isolated village on the border between Western Sudan and Chad. The endeavor required training lo-

Sharon Tissell, RN, on a humanitarian mission with MTI in May 2013 to provide medical aid to Syrian refugees in Lebanon’s Bekaa Valley

but in fact didn’t understand how to do either. Another worker wore the same pair of gloves as she screened patients for malaria.

“They were doing these tasks rotely and not understanding what they mean,” Averill says.

While fearless, humanitarian relief nurses are hardly reckless, receiving intensive security training from their sponsoring organizations and working on highly coordinated teams where personal safety is valued above all else. cal workers, including a woman who said she was a traditional birth attendant. After asking the attendant how many weeks pregnant a local woman was, the attendant said “36,” when the woman was nowhere near full-term. It was then that Averill realized that the attendant was unable to count.

In a similar vein, other workers claimed to know how to take pulses and blood pressures,

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“That critical thinking piece wasn’t there.”

So, Averill went over the basics, teaching the staff how to take vital signs, the importance of glove disposal and frequent hand washing, and how to do A/B/O typing for blood transfusions. “It was really fun to see the light bulb go on,” Averill says, similar to the one going off in her own head as she stretched her own skill set.

Similarly, Ford had little experience in obstetrics before traveling with MTI to the Nakivale Refugee Settlement in Uganda last year. The local midwives were eager to see a “muzungu,” or white person, to deliver a refugee woman’s baby. So with “no IV, no monitors, no electricity,” Ford says she stepped up to the plate and did it. “It was mind-blowing.”

“When you’re talking to people about going on these trips, many people like the idea of it,” she adds. “But nothing is what you think it’s going to be.”

Street Smarts Having a successful experience as a humanitarian relief nurse also requires emotional fortitude, flexibility, and the ability to think on your feet, says Harrison. Being a medical transport nurse for Boston MedFlight not only gave him a broad skill set in obstetrics, pediatrics, and trauma care, but also taught him the importance

of teamwork and maintaining equilibrium in situations that are fluid and unpredictable.

Harrison first encountered MSF in 2004 working on a volunteer assignment in Chad with another medical assistance organization. What impressed him about MSF was its long-term investment in communities lacking the medical infrastructure to contend with disease outbreaks and public health emergencies.

He also observed that MSF didn’t do “drop-in medicine” like other relief organizations did, allowing it to have a larger impact; he also admired MSF’s independence from government funding and its neutral stance towards political debates and conflicts. With several international assistance trips under his belt, he decided to apply for a full-time nursing position with MSF. After a lengthy interview process with MSF, Harrison was accepted in 2008 and left Boston MedFlight with the blessings of his boss. That

Academic Forum year, Zimbabwe was being devastated by a cholera epidemic caused by the breakdown of water sanitation and sewage systems in urban areas; the disease spread quickly to the countryside after city-dwellers visited relatives in rural areas.

from Sudan in 2011 after a protracted civil war between rival ethnic groups. MSF has had a strong presence in the region since 1983, delivering primary and secondary health care in clinics and hospitals in several major cities including Juba, the

Also invaluable are critical thinking skills that empower you to be resourceful and in situations where supplies, medicines, and equipment are limited.

Harrison’s first assignment was to manage a database that tracked the epidemic as it moved from cities to towns and villages. Later on, he joined a team responding to malnutrition and cholera in prisons around Harare, the country’s capital. Rather than focusing on the prison’s water delivery system, the MSF team focused on chlorinating the water supply, boosting the immune systems of prisoners through antibiotics and nutritional therapy, and getting infected prisoners into treatment.

After six years with MSF and multiple trips to conflict zones throughout Africa, Harrison says the work brings out his street smarts. “I seem to have the mentality that [MSF] can put me some place in the world and I can work out what’s going on,” he says.

At no other time was Harrison’s even-keeled temperament tested more than a harrowing trip to South Sudan late last year. His experience also underscores how rapidly the situation on the ground can change and the importance of staying alert and in contact with team members.

Since 2009, Harrison has made trips to South Sudan, which achieved independence

capital, as well as Lankien, Bor, Bentiu, and Malakal.

On his first trip in 2009, Harrison went to Lankien to oversee a feeding center for malnourished residents. He spent time training local hospital staff who had little or no medical training. After a brief trip to the region in 2010, he returned to Malakal in October 2013 to see the fruits of MSF’s investment in the local workforce. “You could really see the change,” he remembers. “I had skilled people working for me.”

As with his previous trips, Harrison was assigned to one of MSF’s kala azar treatment centers within the Malakal Teaching Hospital. Kala azar, a tropical disease that attacks the immune system and is fatal if untreated, is transmitted to humans through sand flies, carriers of the leishmania parasite.

The disease persists in Sudan despite MSF’s long-established kala azar clinics.

On December 15, 2013, a coup was attempted on President Salva Kiir’s postindependence administration after long-simmering tensions between rival ethnic groups, the Dinka and Nuer, exploded. A Dinka, President Kirr accused Vice President and Nuer politician Riek Machar of insti-

gating the coup. The military began splintering along ethnic lines, and armed conflict began spreading from Juba to other regions.

By the week of Christmas, the fighting had reached Malakal. Harrison and an Amsterdam-based MSF team were hunkered down in their rented house in the middle of Malakal’s downtown marketplace, gunfire and mortars exploding around them. Harrison and others had been staying in touch with MSF outposts in Juba and other cities to get the latest news. “By the time it became obvious something was going to happen, we couldn’t get out,” he recalls.

The group managed to move down the street to a house rented by an MSF team from Spain.

Altogether, there were nine MSF team members who had remained in Malakal, holed up in a 12 x 12 room for 36 hours until Christmas Day, when the shooting began to dissipate. By Thursday, the day after Christmas, the teams decided to make their way back to the Malakal Teaching Hospital to assist an International Committee of the Red Cross (ICRC) surgical team with a brand new set of patients: soldiers and civilians wounded in the crossfire.

When he returned to the hospital, Harrison noticed that many of the healthier

numbers of wounded streaming into the hospital. With his experience as a trauma nurse, Harrison jumped in to assist the ICRC surgeons with anesthesia, wound debridement, IVs, and “whatever was needed.”

Harrison’s work continued on like this until mid-January, but what was becoming painfully obvious was the deterioration of the security situation inside the hospital. Initially, the soldiers agreed not to bring their guns inside, but soon, guns and “cases of whisky” could be found on the hospital grounds. Family members of the wounded and refugees from Malakal soon began overrunning the hospital to escape the violence.

“At one point, there were 1,000 people in the hospital,” Harrison says. “It had become an IDP [Internally Displaced Persons] camp.”

What finally convinced Harrison and his fellow MSF team members who had remained in Malakal that staying was no longer an option was when teams in both MSF residences took a hit. The Spanish team was robbed of their mobile phones and laptops at gunpoint by an armed group; a drunken soldier burst into the compound where Harrison and the rest of the Amsterdam team were staying and started shooting in the air. The house’s se-

Having a successful experience as a humanitarian relief nurse also requires emotional fortitude, flexibility, and the ability to think on your feet, says Harrison. kala azar patients had simply fled. He quickly switched gears and helped set up a 60-bed triage unit to deal with the sheer

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curity staff talked the soldier down and got him to leave.

The next day, Harrison and the entire MSF team headed

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Academic Forum to a United Nations compound outside of Malakal and were on a flight out of the county soon after.

Harrison says the decision to leave was wrenching, but one that ultimately made sense given the escalating conflict.

The hardest part was wondering whether the work could be continued by the hospital’s local staff, many of whom said that it probably wouldn’t. (By February, MSF had to suspend its activities at Malakal Teaching Hospital, according to a recent MSF report.) Still, the team’s departure weighs on his mind: “How does this look that you’re having to flee? You can always leave. You can always go home. What about the people left behind?”

A Higher Purpose Tissell remembers clearly what inspired her to work internationally: the National Geographic magazines her parents subscribed to at the family’s home in Kerkhoven, Minnesota. As she perused stories about hardship and traditional cultures from all over the world, she began to realize that “not everyone had the same upbringing as me.”

Her parents, now in their 80s and extremely supportive of her work with MTI, gave Tissell both a great childhood and self-awareness. “I had a strong sense as a young person that I had a whole lot and [some] people had nothing,” she says.

Ford, too, was deeply affected by the unequal distribution of medical care throughout the world. As a childhood survivor of uterine cancer, Ford pursued nursing because of wonderful care she received at a children’s hospital in Portland. “I have a lot of guilt related to inequali-

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ties in medicine and education,” she says. She channels her guilt into providing medical assistance and communicating across cultures through trips with MTI. With her propensity to help those in need, nursing was a natural fit for Tissell. When her eldest of four children turned 17 in 1999, she decided to join an MTI month-long trip to Honduras to set up mobile medical clinics in remote villages destroyed by Hurricane Mitch. The last two weeks, Tissell’s team packed their medicine and supplies and rode mules into the dense jungles of the Mosquito Coast. “We saw a lot of Dengue fever, malaria, a lot of infections from injuries, upper respiratory infections…and childhood disease that hadn’t be treated with vaccines,” she recalls.

Over the next 15 years, Tissell went on more than a dozen medical trips with MTI. She now works shifts at two different hospitals to accommodate and subsidize her travel.

Through her work, Tissell has provided medical care to refugee communities around the world uprooted by high-

Tim Harrison, RN, MPH, on one of his many trips to South Sudan to work on an MSF project treating kala azar

Los Angeles-based International Medical Corps, she was treating civilians at hospitals in Libya just days before Colonel Quaddafi was captured and killed. And she was in a tented settlement in Lebanon’s Bekaa Valley in May 2013 providing medical care to the thousands of middle-class families from Damascus and other Syrian cities streaming across the border after President Bashar al-Assad began shelling his own people.

When she asked the woman if she thought God had abandoned her, the woman turned to her and said, “Of course He hasn’t. Otherwise you wouldn’t have made it here.” profile natural disasters and wars. She has treated famine-stricken Somali families seeking refuge in Ethiopia.

She served in an IDP camp in northern Uganda to receive malnourished women and children who had fled the terror of Joseph Kony and his Lord’s Resistance Army. On a trip with

The families, who had left homes and careers behind, weren’t suffering from exotic diseases, but rather chronic illnesses such as lymphoma, diabetes, and heart disease that they were unable to treat without access to medicines and regular medical care. “One woman said, ‘We lived in a

nice house, we had three bedrooms,’” Tissell says. “This was a total disruption of what their life had been like.”

Each time she returns to her home in Happy Valley, Oregon, Tissell arrives with photos and memories of the families she has helped. Motivated by a strong sense of divine purpose, Tissell says she is perennially awe-struck by the gratitude expressed by people who have just lost everything—and in many cases, everyone. She says she’ll never forget a Congolese woman she met in Uganda whose husband had just been shot during an outbreak of violence in their native country. When she asked the woman if she thought God had abandoned her, the woman turned to her and said, “Of course He hasn’t.

Otherwise you wouldn’t have made it here.”

Archana Pyati lives in Silver Spring, Maryland, and writes frequently on health and science topics.

Second Opinion

Keeping an Open Mind: My Brief Career as a Certified Home Health Agency Registered Nurse

BY BRANDON ARCHER, RN, BSN

“Keeping an open mind” is probably one of the most clichéd expressions within the English lexicon. Yet, when I placed that phrase into action, it sparked my nursing career. I hope that my message will allow others, especially new graduate, millennial registered nurses like myself, to consider a growing yet still relatively small aspect of nursing: home care/visiting nursing.

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ike countless other children and teenagers, I had many different career aspirations.

However, in retrospect, my becoming a RN is not an extreme surprise. Being the son of Afro-Trinidadian immigrants and growing up in the predominately African American/Caribbean neighborhoods of Central Brooklyn in New York City, I had decent exposure to the health care industry. While it is a generalization, it is common to see many Afro-Caribbeans (e.g., Haitians, Jamaicans, and Trinidadians) in New York City working within health care, ranging from nursing assistants to LPNs, RNs, and so forth. With that assertion, I indeed have famwww.minoritynurse.com

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Second Opinion ily members and friends of my parents who are active in these occupations.

After I finished high school, I did more research on health

my associate’s degree in nursing in January 2011 and passed the NCLEX later that year. I returned to New York City College of Technology

It took me time to adjust from a standard memorization model of learning to the analytical and criticalthinking process that is the essence of nursing school. careers, specifically nursing.

Of course, I was not ignorant of the fact that nursing is a profession dominated by women and that, unfortunately, there are myths and stereotypes about men who enter into the profession. Being a man, especially a young African American man, I knew that I was not the image that most people would think of in regards to being a nurse. Nevertheless, I kept an open mind. I enrolled at New York City College of Technology in Brooklyn, and I was eventually accepted into the nursing program.

Without a doubt, nursing school was the hardest academic endeavor that I have experienced thus far in my life. It took me time to adjust from a standard memorization model of learning to the analytical and critical-thinking process that is the essence of nursing school. There were times when I wondered if I could ever get that cognitive skill. Of course, despite the fact that I was in school, the process of life still went on.

From my anxieties about my future to dealing with illness and death in my family (two of my relatives passed away in roughly a three-month span), nursing school was not easy for me. However, with perseverance, I graduated with

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to complete the RN-to-BSN program and received my BSN in 2013.

Despite holding my BSN degree, I still found it challenging to find employment with the hospitals in New York City. While I obviously had the degree requirement, I lacked the RN experience that was specified for a majority of the jobs. Also, by speaking with some of my colleagues who were also having issues with nursing employment, I knew that I was not suffering from random bad luck.

There were indeed structural issues—things beyond my control—that were affecting the nursing job market.

While I was never depressed during this time, it did hurt

While it is true that some home health organizations want an experienced nurse (hospital or otherwise), I heard that some organizations were willing to take new graduates and train them as needed for their nursing duties. Even though the thought of going into clients’ homes did not seem overly appealing, given my limited employment options, I once again kept an open mind and did my research. I found organizations within my district of New York City that were willing to take recent graduates.

Currently, I work with three different CHHAs (ValuCare, PellaCare, and The Royal Care) that are based in Brooklyn. The crux of my duties as a CHHA RN includes making a full physical assessment of the client, inspecting their home environment, and viewing their active medications for compliance and side effects. In addition to those tasks, I contact their respective physicians to get pertinent data and give current information. Then, I craft a care plan for the home health aide to follow to assist cli-

As minority nurses, being in this role allows us to give back to our respective communities by being agents of preventive care and health advocacy that will hopefully alleviate some of the ailments that afflict minority populations. to some extent to have a viable degree yet no tangible evidence (e.g., a nursing job) to show for it.

To quote the late R&B singer Marvin Gaye, I “heard it through the grapevine” from some of my colleagues about visiting nursing with a certified home health agency (CHHA).

ents with their needs, from helping them with activities of daily living to calling the EMT/paramedics for emergencies.

Like any subdivision of nursing, there are pros and cons with being a CHHA RN. For cons, you never know what you might encounter

in a client’s home, and being a New Yorker, I do go to some districts that suffer from urban decay. However, the benefits definitely outweigh the negatives. I am able to create my own schedule. If you live in a city with a decent mass transit system like my hometown, you can use the bus, subway, or tram instead of a car. And due to New York’s diversity, I get to see clients of all backgrounds. As minority nurses, being in this role allows us to give back to our respective communities by being agents of preventive care and health

Being a man, especially a young African American man, I knew that I was not the image that most people would think of in regards to being a nurse. advocacy that will hopefully alleviate some of the ailments that afflict minority populations. Finally, with national health care reform, this area of nursing is growing.

Obviously, being a CHHA RN is not for everybody. If you love the hospital, nursing home, or another clinical setting, then do what is right for you. Nevertheless, given the somewhat tough job market for new nurses, let life be a lesson as it unfolds and keep an open mind.

Brandon Archer, RN, BSN, graduated from New York City College of Technology in 2013 and currently works as a CHHA RN. He lives in the New York City borough of Brooklyn.

Second Opinion

Nursing and the Table of Brotherhood and Sisterhood

BY LATOYA LEWIS, RN, MSN

“I have a dream that one day on the red hills of Georgia, the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.” These were the astounding words of Dr. Martin Luther King, Jr., during his famous “I Have a Dream” speech. Unfortunately, this is, in part, still a dream. Sons of former slaves and sons of former slave owners are not sitting together at the table of brotherhood. Rather, sons and daughters of former slaves and former slave owners are hiding underneath a table of institutional inequities, especially in nursing. A great deal of work must be done in order for this dream to come true. However, some of this work must be put into the hands of successful African American nurses, who ought to feel a sense of obligation to motivate and empower other African American nurses and nursing students. There are, indeed, accomplished African American nurses out there, but not enough. Nonetheless, are we holding our younger brothers’ and sisters’ hands as we should be? This can be put into practice with enlightening and enriching high school and college mentorship programs.

A

The author (right) and her mentee, NiaMarie Jackson

ccording to a 2013 survey conducted by the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers, the RN population is 6% African American. Additionally, data from the American Association of Colleges of Nursing’s (AACN) annual survey revealed that 9.6% of students enrolled in baccalaureate nursing programs in 2013 were African American.

At the master’s level, 14.4% were African American; only 14.2% were African American at the doctoral level.

These statistics reveal that not only is there a tremendous shortage of African American nurses in the workforce, but there are not many African Americans being enrolled into nursing programs, despite recruitment efforts that have been put forth. This is problematic when considering the www.minoritynurse.com

population of patients; the nursing workforce is not reflective of the changing and diverse demographics of the United States population.

Mentorship programs can help to increase enrollment rates, help the African American nursing shortage, and help with the deliverance of culturally competent nursing care.

There are several recruitment programs for potential African American nurses, but is this enough? For example, the Robert Wood Johnson Foundation (RWJF) joined with the AACN in 2008 to launch the RWJF New Careers in Nursing scholarship program. The program is designed to alleviate the nation’s nursing shortage by

Mentorship programs can help to increase enrollment rates, help the African American nursing shortage, and help with the deliverance of culturally competent nursing care. dramatically expanding the pipeline of students from minority backgrounds in accelerated nursing programs. In January 2010, the AACN published a set of expectations for nurses completing graduate programs and created faculty resources needed to develop nursing expertise in cultural competency. Several scholar-

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Second Opinion ships for African American nurses are also available. Additionally, the RWJF initiated the Doctoral Advancement in Nursing project in 2013 to enhance the number of

and frustration.

It has also been noted that the smaller the number of minority students on campus, the greater the problems because of limited social con-

Though feeling extremely proud and esteemed for becoming a graduate of the UConn School of Nursing, I would have been even more grateful to have a successful African American mentor who consistently told me, “You got this!” minority nurses completing PhD and DNP degrees.

During my years at the University of Connecticut (UConn), I was awarded multiple scholarships, including the Yale Minority Nursing Scholarship, the Husky Nurse Scholarship, and the Chi Eta Phi Scholarship. All of these scholarships in my recollection were awarded to me because of merit and because I was from a minority background. What about mentorship programs? Why weren’t these offered to me?

As I reflect on my own undergraduate experience, I remember being very grateful for the scholarship funds. But I also remember being unprepared for the culture shock that I was about to face at the UConn campus in Storrs, Connecticut. Current literature highlights the fact that African American students in predominantly white institutions find it difficult to reach a level of comfort and acceptance within the new cultural environments. Students have reported feeling underrepresented, which results in feelings of loneliness, isolation,

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tacts. Out of my class of over 100 students, approximately 10 of these students were from minority backgrounds.

Though feeling extremely proud and esteemed for becoming a graduate of the UConn School of Nursing, I would have been even more grateful to have a successful African American mentor who consistently told me, “You got this!” Self-empowerment and motivation can only go so far.

What about those students and new nurses who require a pat on the back from the hand of a “brotha or sista” who truly understands and has “been there and done that”?

A few months ago, I was asked to become a mentor for an African American high school student, NiaMarie Jackson, who was inspired to become a nurse while dealing with her mother’s lifelong diagnosis of HIV. Our mentorship experience has been focused on effective nurse-patient relationships. She revealed to me that she had been included in a trial to test the efficacy of drugs that would decrease the likelihood of vertical transmission. Her childhood consisted

of multiple visits to doctors and nurses who all deeply impacted her life and led her in the direction of becoming an aspiring nurse.

We developed a wonderful rapport. The very first meeting consisted of an emotional, heartfelt sharing of experiences. It felt as though I had known this ambitious young lady for more than an hour.

She reminded me of myself when I was younger. Just as I had done, she participated in many programs and was doing very well academically. I found myself becoming frequently concerned as her mentor. I often questioned her about her college application process. If I had not heard from her in a few days, I became worried.

She is currently doing exceptionally well and has been accepted to Winston-Salem State University in WinstonSalem, North Carolina. Here,

ber from an underrepresented group become successful while contributing to the diversity of today’s workforce. My mentee knows that I am only a phone call, e-mail, or text away as a source of support.

Mentorship should be considered as the main vehicle for African American nursing success. It allows African American nurses to connect on a level of cultural familiarity. It is easier for the student to say, “If he or she can do it, then I can do it too.” I can happily say that I am a witness to this. Dr. Martin Luther King’s wishes may still be a dream; however, it is not an impossible dream. His efforts need to continue with the African American nurses who are successful. We need to feel a sense of obligation to help others from minority backgrounds with their accomplishments.

When this happens, there may be a possibility of sons and

There is nothing more gratifying than knowing you have helped a member from an underrepresented group become successful while contributing to the diversity of today’s workforce.

she will pursue a bachelor’s degree in nursing. According to NiaMarie, the mentorship experience not only “reassured me that I wanted to become a nurse, but I gained a new outlook on life and how to deal with different people in different situations.”

Every nurse from a minority background should be able to experience this. There is nothing more gratifying than knowing you have helped a mem-

daughters of former slaves and former slave owners sitting together at a table of brotherhood and sisterhood.

Latoya Lewis, RN, MSN, is employed at the University of Connecticut Health Center in Farmington, CT as a medical surgical nurse. While obtaining her master’s degree in nursing education, she has developed a passion in reaching out educationally to underrepresented populations.

Degrees of Success

An Effective Teaching Method: Double Testing

BY ANNIE M. CLAVON, ARNP, PhD, MS, CCRC

Current literature reminds us that active learning helps promote critical thinking and problem-solving abilities. Active learning requires that students be engaged through more than listening, reading, writing, and discussion.

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esearch has significantly proven the opposition amid adult and child learning styles.

Established on the research that adults do not learn in the same style as children, it is practical to accept that one

cannot teach adults employing methods developed and planned to facilitate the learning experience of children.

Malcolm Knowles, a pioneer in the field of adult learning, hypothesized some assumptions to assist teachers with

teaching children and adults.

These assumptions include: The Need to Know. Adult learners need to know why they need to learn something before undertaking to learn it.

Learner Self-Concept.

Adults need to be responsible for their own decisions and to be treated as capable of selfdirection.

The Role of Learners’ Experience. Adult learners have a variety of life experiences that represent the richest resource for learning. These experiences

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are, however, imbued with bias and presupposition.

Readiness to Learn. Adults are ready to learn those things they need to know in order to cope effectively with life situations.

Orientation to Learning.

Adults are motivated to learn to the extent that they perceive that it will help them perform tasks they confront in their life situations.

The reason most adults enter any learning experience is to create change. This could

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Degrees of Success encompass a change in their skills, behavior, knowledge level, or even their attitudes about things. In a 2006 article published in the journal Urologic Nursing, Sally Russell suggested that, compared to school-age children, the major variances in adult learners are in the degree of enthusiasm, the extent of earlier experience, the level of engagement, and how the learning is applied. Double testing allows the adult student to be engaged in the learning process.

Students need support and validation from their peers. In any classroom, evaluation is necessary. In 2012, the National League for Nursing suggested in its fair testing guidelines that tests and other evaluative measures should be used “not only to evaluate students’ achievements, but, as importantly, to support student learning, improve teaching, and guide program improvements.” Double testing is one such teaching method in which evaluation, peer support, and validation can be instituted to support student learning.

Instructors who teach in higher education can no longer rely on lecturing as their

the use of technology so that students will be more actively involved and engaged in the learning process. Also, faculty must focus more on teaching in a learner-centered fashion, as opposed to the teacher-center approach.

Double testing has been proven to be an effective teaching method. A 2013 study published in Nursing Education Perspectives found that learning, communication, and collaboration were prevalent themes in students’ perceptions and opinions of double testing. According to the researchers, the study found that “a majority of students preferred double testing and indicated that this testing method had more advantages than disadvantages.”

Throughout nursing programs, instructors are responsible for assessing students’ abilities and assuring they are competent to practice nursing. Since one of the nursing instructor’s goals is to prepare students to be safe and competent nurses, I believe that collaborative learning, such as double testing, is an excellent strategy to assist students in being able to successfully

The reason most adults enter any learning experience is to create change. This could encompass a change in their skills, behavior, knowledge level, or even their attitudes about things.

main teaching method. In Teaching in Nursing: A Guide for Faculty, scholars Diane Billings and Judith Halstead emphasize that dependence on the use of the lecture is no longer an accepted teaching technique.

Instead, faculty must integrate

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care for patients. I have used this teaching method for more than two years with senior two-year nursing students and have found that double testing promotes group interaction, interpersonal skills, and interdependence among the

nursing students—qualities needed to work with members of any health care team.

nant in higher education. In a traditional classroom, students become passive learners or just

In a traditional classroom, students become passive learners or just receivers of teachers’ information; whereas, with double testing, the students make the decision whether or not to participate.

In using the double-testing method, I have also found that students are more engaged and more cooperative; they also exhibit improved critical thinking skills. For example, when double-testing scores were compared over a six-month period, students’ overall grades increased from 69% to 82%. Indeed, a systematic review conducted by The Campbell Collaboration confirms that the benefits of collaborative testing “include— but are not limited to—better critical thinking skills, better collaboration and team work among peers, reduced test anxiety, and improved test taking performance.”

In a 2011 study published in Science, Deslauriers, Schelew, and Wieman compared the amount of learning students experienced when taught—in three hours over one week—by traditional lecture and by using interactive activities based on research in cognitive psychology and physics education. The researchers found that students in the interactive class were more involved and absorbed more than twice the learning than their colleagues in the traditional class.

Twenty-first century students should be allowed some control over their learning. For many years, teacher-centered instruction has been domi-

receivers of teachers’ information; whereas, with double testing, the students make the decision whether or not to participate. This way, students take charge of their own learning and are openly involved in the learning process.

In “Helping Students Get to Where Ideas Can Find Them,” an article published in 2009 in The New Educator, Eleanor Duckworth asserts that teacher-centered learning actually hinders students’ learning.

In contrast, double testing is a learner-centered teaching method, which focuses on how students learn instead of how teachers teach.

I believe that double testing is a worthy teaching method that instructors can use in the classroom to enhance student-student and studentteacher interactions. Most educators understand that learners have different preferences and styles of learning and believe that it is essential to use teaching methods and approaches that will satisfy the variety of learning styles in the learning event.

Annie M. Clavon, ARNP, PhD, MS, CCRC, is an associate nursing professor at Keiser University in Ft. Lauderdale, Florida.

The Take Pride Campaign The country is changing, with one-third of the population representing a historical “minority.” In this increasingly diverse world, you can confidently say your workplace actively fosters diversity, inclusiveness, and cooperation. For these reasons and others, you’re proud to be a part of it—and we want to hear from you.

Minority Nurse is looking for nominations for health care’s diversity MVPs, from the magnet hospitals to nursing schools to local hospice care centers. Nurses can nominate their workplaces based on the facility’s efforts to improve and maintain inclusiveness and diversity.

Think about what makes for a diverse institution. What does a “commitment to diversity” mean? And what does it mean to you? At Minority Nurse, it’s not just about a visible variety of skin tones seen in the halls. It’s . . .

• Faculty and staff recruitment and retention efforts aimed at underrepresented populations • Collaborative hiring practices • Diversity initiatives and accessible organizations on site • Cultural competency training and resources, such as diverse foods, translators, etc.

• Partnerships with other diversity organizations • And so much more When hiring groups devoted to minority recruitment and retention not only exist, but are consistently used, it shows a commitment to diversity. When hospital administrators take the time to include their nursing staff in development, they exhibit a commitment to diversity.

And you, in taking the time to recognize your workplace for its commendable practices and diverse work environment, are showing a commitment to diversity as well.

It’s not necessarily a numbers game—we don’t require applicants to produce statistics or quotas, though you are welcome to do so if you wish. We’re simply looking for readers who take pride in their workplaces’ commitment to diversity.

A PDF of the Take Pride Campaign application is also available on our website, www.minoritynurse.com. Applications must be received before July 1, 2015. We will then reach out to our nominees to deter determine our winners!

Questions? Let us know by e-mailing editor@minoritynurse.com.

MINORITY NURSE

2015 Take Pride Campaign Application Application Form (Please print clearly. All fields required. The 250–500-word nomination can be attached separately.)

Your name__________________________________________________________________________________________ Your place of employment (must be a health care facility or institution employing nurses*) _______________________ ____________________________________________________________________________________________________ Location of facility___________________________________________________________________________________ How long have you worked at/for this facility? _________________________________________________________ Preferred e-mail_____________________________________________________________________________________ Preferred phone number _____________________________________________________________________________ In 250–500 words describe why you are nominating this facility—what makes it a model of diversity and inclusivity? __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ * All nominees must be health care–related workplaces that employ nurses, such as hospitals, nursing schools, nursing homes, hospice facilities, etc. Those work environments falling into nontraditional territories will be considered according to the discretion of the editors, staff members, and advisors of Minority Nurse.

MINORITYNURSE.COM In the Spotlight

Newsletter

SPECIAL EDITION:

Meet Our Scholarship Winners First-Prize Winner, Christal Leitch

Christal Leitch found out firsthand that the biggest surprises often come when your mind is focused elsewhere. “I was so surprised,” she says, laughing, noting that she almost didn’t open the e-mail notifying her of her win right away.

Leitch, who begins her nursing school studies at the Georgia Baptist College of Nursing at Mercer University this fall, came to nursing in a roundabout way. “My mom is a nurse,” she says, “but that was never one of my things.

I wanted to work in an office 9 to 5.”

In 2006, Leitch realized she wanted to change careers.

Her ill mother-in-law came to stay, and Leitch nursed her

and cared for her. “It was so rewarding,” says Leitch. “I thought, ‘This is what I want to do.’”

Leitch immigrated to the United States from Trinidad and Tobago Islands in the 1980s and says her primary goal was to earn a college degree and return back home.

But being unfamiliar with the accreditation process in the United States led her to get a degree in office technology in 1996 from a school that had state, but not national, accreditation.

By the time nursing came on her radar, Leitch had already started a family and worked for a variety of Fortune 500 companies. But, she says, something was missing

from her career, and she now realizes it was a mismatch between her interests and her job. “I am naturally a very caring person, and I didn’t realize that that’s where I’m most comfortable.”

In 2009, when she decided to return to school for a nursing degree, she had to begin taking her prerequisite classes all over again. But on the same day she started classes, she also started a job as a medical assistant for a group of vascular surgeons, and she knew she was on the right path.

In earning her prerequisite classes for nursing, Leitch qualified for a bachelor’s in psychology, which she earned last May. Nursing school will be challenging, but Leitch is excited. She’s confident that her journey will be smoothed by her strong support system of family and friends.

“My focus will be on trying to keep patients comfortable and giving patients someone to lean on and to hold their hands,” says Leitch. “I want them to know ‘I’m here and you don’t have to be alone.’”

Leitch says in those particularly stressful times, a nurse is essential. “In times of distress, I want them to know

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someone is there to comfort them,” she says.

Leitch envisions a career as a certified nurse-midwife or a certified registered nurse anesthetist, although she realizes that could change. Noting that each stage of nursing school could reveal something that is a calling, she is especially looking forward to the labor and delivery training.

Eventually, she would like to work for an organization like Doctors Without Borders. “It’s one of the first things I’ll do when I get my degree,” she says.

“I am so ready to sign up.”

Despite coming to nursing a little later than most, Leitch is comfortable knowing she is finally where she belongs.

“When my aunt heard I was going to nursing school, she said, ‘It’s about time,’” Leitch says laughing. “I just never thought about it, and then it just dawned on me.”

Although her journey to nursing is long, Leitch says she lives and models what she tells her sons—failure is not an option. “Your hard work will pay off in the end,” she says. “Nothing comes easy, but at the end of the day, no one can take your education away from you.”

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MINORITYNURSE.COM In the Spotlight

Newsletter Runner-up, Karachi Egbuta

From a young age, Karachi Egbuta knew she wanted to be involved in health care. A bachelor’s degree in biology led her to different health care jobs after graduation, but it was seeing the interactions between nurses and patients at various jobs and volunteer positions that convinced her nursing was the career choice for her.

“Nurses interacted with patients from start to end,” says Egbuta, a student at Roberts Wesleyan College in Rochester, New York. “I saw how caring nurses are, how they comforted patients, and how they would advocate for their patients.”

And seeing patients put so much faith and trust in the nurses—confiding in them in ways they might not with their physicians—impressed Egbuta.

“I just watched that, and I knew I wanted to do nursing,” she says. Her husband, an OB/ GYN resident, opened her eyes to actually making a career out of nursing and encouraged her to follow that path.

Egbuta’s varied health care experience, through work, vol-

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unteerism, or her own travels, have all given her a global understanding of health care’s pressing and vast issues. She spent two years as a public health advocate with the Jacobi Medical Center researching and testing patients for HIV, and she continues to volunteer in an ER department where she sees all kinds of health care needs and situations. Her work impressed upon her the importance of patients’ health care education and information. Her own travels to visit family in Nigeria gave her insight into the discrepancies of global health care and fueled her passion to help others. “They talked about the

hunger and the struggles, and it makes you realize everything you have here,” she says. “It’s all those little things they need that we have access to here.”

Egbuta, who expects to earn her nursing degree in May 2015, knew going back to school wasn’t going to be easy for her. She says she struggled getting her first degree, so she knew another degree would require all her focus, but she was pulled by nursing’s appeal.

“The beauty of nursing is that you can do anything,” says Egbuta. “I love that because I like a little bit of everything.” And with an infant daughter, she says nursing’s

flexibility will help her manage work and family.

Egbuta already knows the challenges of trying to manage family and work. Her daughter was born during the toughest semester of nursing school yet.

With the help of family, support from faculty, and a razorsharp focus to finish nursing school, Egbuta had her baby on a Thursday and was back in class on Monday.

As a student, Egbuta sees that nursing is a challenging profession despite its rewards.

“There’s lots that will test you in nursing,” she says. “The hardest is dealing with different patients’ moods. You want

MINORITYNURSE.COM In the Spotlight

Newsletter to do everything you can to make them happy.”

Egbuta finds compassion for their situation helps: “You have to put yourself in their shoes. No one wants to be in the hospital. They are just uncomfortable. So you have to be comforting to them even when

they are in a bad mood.”

Egbuta plans to start in a medical-surgical unit upon graduation so she can get broad experience. “You learn about everything that has to do with medical conditions,” she says.

And with dermatology and skin conditions being one of Egbu-

ta’s top interests, she is likely to see patients with a range of skin issues. “Skin is the first barrier,” Egbuta explains.

Eventually, Egbuta can see furthering her education to become a family nurse practitioner, but until then she wants to just be the best nurse she can be.

“A lot of people know nursing is the hardest undergrad and a lot of people don’t make it,” Egbuta says. “I always say, ‘If I can do it, anyone can do it.’ You have to put in the time.

It’s very intense, but they are trying to prepare you to be the best nurse you can be.”

Shih, who expects to graduate in May 2015. But, she says, her own personality traits of enjoying taking care of people and making others comfortable might have tipped her off.

“I definitely like the idea of being able to help people for the rest of my life,” Shih says.

Making patients feel comfortable in an unfamiliar setting or situation that isn’t always easy appeals to her. And the variability of a nursing career, one where you can care for patients at their bedside in a hospital setting or out in the community, is something that she finds compelling. Events like school shootings or the Boston Marathon bombings, which happened so close to BC, have helped shape Shih’s future course. She is interested especially in psychiatric nursing. “With the school shootings, you can see how important being a psych nurse is and how it can benefit the community,” she says.

Despite the enormous time challenges of any nursing student, Shih fits in even more nursing-related activities outside the classroom. She is the

president of the Massachusetts Student Nurses Association; she is a group leader at the Cornerstone Church of Boston; and she represents BC in several networking and leadership events. Of everything, Shih finds her own internal expectations to be the most daunting: “It’s just tough being hard on yourself, and making sure you are on top of everything and presenting yourself well. It’s hard to maintain a balance of everything.”

Shih finds incredible support in her family, friends, school, and her faith. And, she says, even pressure beyond just the typical school worries show her just a taste of what life after college might hold. But she has had incredible mentoring experiences working with BC faculty on an advanced study grant for her research on nurse staffing ratios in California and Massachusetts and a fellowship for an NIH-funded study on sleep apnea.

Although she says people might fi rst notice her skin color or her features, being a minority isn’t a disadvantage as a nurse, even if some people

might still believe that, she says. She would like to empower other minority nursing students to see their strengths.

At BC, she has even led a faculty and student discussion on racism at the BC Connell School of Nursing Diversity Advisory Board Stand Against Racism event.

Shih believes in meeting others and being brave or bold enough to just ask people for help. When she first arrived at BC and wanted to find out how to combine studying nursing with the economics and business of health care, she simply asked a dean about it.

The dean, in turn, put her in touch with several faculty who had the expertise she needed.

With one more year to go, Shih is thankful to her family and her school for the support they have given her. She follows the advice she would give to any nursing student who is trying to make a mark and to find others to guide them along their journey.

“You might not instantly click with everyone,” she says.

“But don’t feel discouraged.

And don’t ever give up.”

Runner-up, Yvonne Shih

Yvonne Shih took a huge leap of faith when she moved from California to Boston to attend the Boston College (BC) William F. Connell School of Nursing. Tough as it was to leave family and friends behind in the area where she spent her whole life, Shih knew the move was going to bring her closer to her goal of becoming a nurse. “It’s not about seeing problems or obstacles but to just look ahead,” she explains.

Pursing a nursing career wasn’t something Shih even considered until her freshman year of high school. When a family member had health issues, a visiting nurse made a lasting impression when she simply said to Shih, “Maybe you should think about nursing.”

“I didn’t know it was even an option until she said it,” says

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51

MINORITYNURSE.COM Highlights from the Blog

Newsletter 4 Reasons Why You Have to Make Time to Network Lots of professionals say they just don’t have time to network. With busy schedules, having a membership in a couple of professional organizations is about as far as they get.

Managing Job-Related Stress Your job-related stress can affect your patients, colleagues, and loved ones, so getting it under control should be a high priority. The first step is to admit to being stressed.

If you find yourself dreading going to work, ask yourself: How well am I managing my stress?

How to Land an Internal Job Opening Have you been working for a company awhile but would like to move up the ladder or on to another unit? Career changers can often find opportunities within their current company instead of having to start afresh.

Don’t Risk Becoming a Casualty of the Keyboard Repetitive stress injuries (RSIs), such as carpal tunnel syndrome and tendonitis, are common in the health care workplace. Though not life-threatening, RSIs are a painful and potentially disabling health hazard.

To read more, visit www.minoritynurse.com/blog.

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Minority Nurse | FALL 2014

Academic Opportunities

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he world needs more nurses. With that comes the need for experienced, dedicated nursing faculty to train them.

There is a true shortage of nursing educators—particularly minority nursing professors, who comprise a small percentage of nursing faculty overall. The American Association of Colleges of Nursing says the scarcity of professors may actually be stunting the growth of nursing programs. To counter this, nursing schools are improving the pay for nursing school faculty to increase their numbers, especially those who hold a doctorate.

This section of Minority Nurse is dedicated to open faculty positions from nursing schools all over the country. Requirements vary, but all are sure to lead to exciting, rewarding careers in nursing education and research.

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53

Academic Opportunities

Tenure-track positions are available at all ranks. Excellent opportunities exist for leadership, clinical and professional development, and student-faculty collaborative research. Priority areas of expertise sought: Nurse Practitioner (NP): Gerontology, Adult-Gerontology, Adult, or Family Primary Care with certification and prescriptive authority; Clinical Nurse Specialist (CNS): Gerontology or Adult/Gerontology with certification; NP or CNS: Psychiatric/Mental Health with certification. Applicants with other clinical practice and or scholarship expertise may be considered depending on departmental need. For a complete list of qualifications and to apply, please visit our website at http://www.uwec.edu/Employment/ NursingFacultyF-648.htm.

The University of Wisconsin-Eau Claire is an EEO/AA institution.

Nurses today.

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Minority Nurse | FALL 2014

Passion. Intellect. Honesty. Drive.

Academic Opportunities

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The Doctor of Nursing Practice (DNP) degree represents an important advancement in the evolution of the nursing profession. It is a practice-focused doctoral degree that prepares nurses to create, administer and evaluate practice interventions to reduce health care disparities.

The DNP curriculum is offered in a hybrid format that blends online components and one long weekend of face-toface class interaction twice a semester.

The BSN-DNP Nurse Anesthesia degree program targets bachelor’s-level prepared nurses with or without a master’s degree. Program highlights include small class sizes, low instructor to student ratios, challenging academics, world class campus facilities, and superior simulation and clinical experiences. Over 250 community partners provide excellent opportunities for clinical exposure to diverse patient populations across a range of practice settings.

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s you are probably aware, the demand for nurses continues to skyrocket. What you may not know is that there’s also a critical need for nurses with advanced degrees, as hospitals turn to nurses to fill more administrative and leadership roles.

Nursing schools around the country are jumping at the chance to fill this void by offering flexible Master of Science in Nursing and Doctor of Nursing Practice programs, and you’ll find many great examples in the following pages.

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Online starts: October, March & April.

www.roberts.edu/nursing-degrees

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55

Faculty Opportunities

TENURED/TENURE- TRACK FACULTY POSITIONS Washington State University College of Nursing, Spokane, Washington, is seeking exceptional faculty applicants to contribute to our established research strengths in community engaged approaches; rural health; American Indian and Hispanic community partnerships; care transitions; injury prevention in children; drug and alcohol abuse; suicidology; and multiple methods research.

Tenure-track/tenured positions are located in Spokane, Washington at the rank of Assistant Professor, Associate Professor or Full Professor. The College provides high quality and accessible education to Baccalaureate, Master’s, and Doctoral students.

Salary, rank, and tenure status are dependent upon experience and qualifications.

To apply visit www.wsujobs.com.

The online application requires: 1) a cover letter discussing education and experience as related to the required and desired qualifications 2) curriculum vitae 3) names and contact information for four professional references.

Positions will remain open until suitable candidates are identified. Review of applications will begin September 4, 2014 and continue until suitable candidates are identified or until March 15, 2015. Position start dates are January 1, 2015 or August 16, 2015. This posting may be used to fill multiple positions.

WASHINGTON STATE UNIVERSITY IS AN EEO/AA/ADA EDUCATOR AND EMPLOYER.

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Index of Advertisers ADVERTISER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PAGE #

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