By: Catherine Lee
Through a unique certificate program, School of Nursing students are learning to provide optimal health care to Hispanic patients by connecting with them in their native language.
Inside the Roberto Clemente–Santa Ana Health Clinic in Limon, Nicaragua, junior nursing major Meghan Twomey prepared an injection for a 6-year-old girl who had an infected cut on her foot. Admittedly a bit nervous, Twomey knew that the child was probably even more anxious. Speaking to the girl in Spanish, Twomey assured her that the shot would be over quickly.
Later Twomey spotted the girl in the waiting room of the clinic, where she was sitting while her mother was seen by a doctor. Twomey approached her and the two started talking. The girl listened to her heartbeat using Twomey’s stethoscope. In that moment, Twomey said she experienced “what nursing truly means. It is not just about giving an injection. It’s about breaking through barriers to get to know the patient as a person.”
The moment is captured in a photo of Twomey wearing dark blue scrubs and the girl a pink and white dress. More than three years later it is still Twomey’s Gmail profile picture. “It makes me happy,” noted Twomey, and serves as a reminder that she plans one day to go on an overseas medical mission trip.
Twomey’s experience was part of a 2013 trip sponsored annually by Catholic University’s Spanish for Health Care Certificate program, which is unique among colleges and universities nationwide. Enrollment in the program has increased significantly since 2011 when six students earned the certificate. By 2015 that number was up to 36.
Through the program’s courses, internships, and required community service, students receive medical Spanish training and an understanding of the cultural and linguistic factors that play a critical role in health care. They learn to discuss symptoms, illnesses, and diagnoses in Spanish — conversations that they’ll have as professional nurses working with Hispanic patients.
About 40% of nursing majors graduate with the certificate. They tend to land jobs at higher salaries than their co-workers who don’t have the certificate, said Patricia McMullen, dean of nursing.
In a year when the nursing school is celebrating its 80th anniversary, McMullen noted that the program “aligns perfectly with the nursing school’s mission, which stresses ethics, values, and spirituality in health care. Teaching our students to better communicate with Latino patients reflects the nursing school’s commitment to providing the best possible care for all patients.”
Twomey, B.S.N. 2014, said she first learned about the program as a high school senior during Odyssey Day when admitted students spend the day at Catholic University. During a presentation about the nursing school at Gowan Hall, a couple of students showed pictures of
a trip to the Dominican Republic and talked about their experience working there. Hearing that, Twomey, who had participated in an exchange program to Costa Rica while in high school, said she “was sold on Catholic University.”
The Boston native embraced life at the University. She was a member of the crew team, spent a semester studying in Australia, served as an Orientation advisor, and went on a summer mission trip to Jamaica. Still, she maintained that the most memorable part of her time at Catholic University was the certificate program. After she graduated, she worked at the Washington Hospital Center, where one day, Twomey talked to a Hispanic patient who was complaining of chest pain.
As Twomey listened, she realized that the woman wasn’t suffering from chest pain. “I figured out that the woman was saying her heart hurt because of sorrow.” Using her Spanish to help the woman “was kind of a proud moment,” noted Twomey.
“The Spanish for Health Care program and my experience in Nicaragua have helped shape my nursing career,” she said. “They’ve helped me to be open minded, non-judgmental, and most importantly, accepting of every patient I have the pleasure of taking care of. They’ve helped me to incorporate the ideals of social justice and compassion into my work.”
Sophomore Pierina Jijon stood at the front of a McMahon Hall classroom in late April holding a raw egg. Facing her was classmate Kyrstyn Aberin, her arms outstretched. Jijon passed the egg along Aberin’s arm, occasionally making the sign of the cross. Other students nodded as they recognized the ritual, which many Latin Americans believe cures a malady called mal de ojo or evil eye. Believers maintain that someone with mal de ojo can put a curse on others, making them sick.
For her presentation on alternative medicine and cultural beliefs — part of the certificate program’s Cultural Competence in Health Care course — Jijon was playing the role of the curandera, a folk healer who believes that passing a raw egg over the afflicted person absorbs the negative power cast by the one with the evil eye.
Other students gave presentations on Latin American herbal remedies, passing around bits of dried plants and salves in small containers that cure common ailments. Program director Jennifer Maxwell, who is a competitive cyclist, told her students that she uses arnica salve, which hails from the sunflower family, to soothe muscle aches and reduce inflammation.
The course helps students to better understand their beliefs about health care as well as those of their patients “to provide the best health care outcomes in a culturally sensitive manner,” Maxwell noted.
Maxwell started teaching at Catholic University in 2008 in the Department of Modern Languages and Literatures. At that time the department offered only two courses in medical Spanish. Meanwhile the Hispanic population in D.C. and nationwide was growing rapidly.
As an interpreter in North Carolina and later in D.C., Maxwell has seen firsthand how the language barrier can affect health care for Hispanics. Unable to communicate with health care providers, they aren’t able to get the care that they need. [The Centers for Disease Control and Prevention (CDC) have cited heart disease, cancer, stroke, and diabetes as some of the leading causes of illness and death among Hispanics.] Maxwell started meeting with McMullen and
others at the nursing school to establish a program that would address the language barrier. The program aims “to help achieve health access and justice by addressing the specific needs of the traditionally underserved Hispanic community,” noted Maxwell.
Students can choose from more than eight courses to complete the five-course, 15-credit certificate. Students enrolled in these courses are required to volunteer a minimum of four hours per course at organizations such as the American Kidney Fund, Bread for the City, Miriam’s Kitchen, and Children’s National Medical Center.
Students participate in semester-long internships at D.C.-area institutions that include the Latin American Montessori Bilingual Public Charter School (LAMB), the Spanish Catholic Center, and the Hospital for Sick Children Pediatric Center, contributing a minimum of 100 community service hours.
Kelly Dossena, who graduated in May with a B.S.N. and a Spanish for Health Care certificate, had an internship last spring at LAMB, where almost 58 % of the students are Latino. The school doesn’t have a nurse so Dossena stepped into the role, checking students’ vaccination records with the D.C. Department of Health and giving lessons on the best ways to maintain good eye health.
She said that her certificate courses and internship proved helpful during her nursing clinicals at Inova Alexandria Hospital in Virginia, where many of her patients spoke only Spanish. Because of her experience at LAMB, Dossena said she’s considering the possibility of one day working as a nurse in Latin America.
Last spring Jijon interned at the Spanish Catholic Center in D.C.’s Columbia Heights neighborhood. Run by Catholic Charities of the Archdiocese of Washington, the center provides more than 22,000 clients with medical and dental care, employment, food, and immigration legal help annually. On an April day at the center, Jijon talked to a woman in Spanish who complained of a stomach ache —un dolor de estómago. The woman was shy and soft spoken.
“I know how hard it can be when you’re visiting the doctor and you can’t express yourself,” said Jijon. “I want them to feel comfortable.” Born in the small town of Portoviejo, Ecuador, she grew up speaking Spanish, but she didn’t study it. The program has helped her to learn the medical vocabulary she’ll need as a nurse.
As part of her internship, she helped to recruit patients for a Saturday program on diabetes. “When I called them, I learned how difficult it can be for some people to take advantage of health care opportunities,” she says. “A lot of people don’t drive. Men who are in construction have to take jobs that are on a Saturday.”
Jijon noted that she’s interested in the CDC initiative called Healthy People 2020, which started in 2010 and is aimed at improving the health of all Americans. Through her internship and the Spanish for Health Care courses that she’s taken, Jijon said she’s realized the value of connecting with a patient on a cultural level.
“If you can connect with someone culturally and speak their language, you can establish a relationship. If you can talk about favorite foods that you have in common, it’s easier to help them make healthier food choices. I think all of that is critical to becoming a more compassionate nurse.”
A 2012 video of then Catholic University senior Erin Bridget Vick shows a young woman on the beach in Nicaragua. She’s beaming as a strong wind blows her pink dress and long brown hair. Erin talks about some of the Spanish words she’s learned that describe her facial features: camanances for dimples and pecas for freckles. A photo shows a more serious Erin as she focuses on giving a man a vaccination.
The photo and video show a young woman who was transformed by her trip to Nicaragua with Catholic University’s Spanish for Health Certificate program. “She couldn’t stop talking about it,” said Erin’s mother Colleen. “I think that at the time we didn’t realize what an important role the trip played in her life.”
Erin left for Nicaragua with a pink suitcase and backpack. Her mother said Erin returned with “so much love and compassion for the people of Nicaragua. I think she would have gone back if she had the chance.” But early the morning of Dec. 7, 2012, Erin was killed in a car accident while driving to her home in Ridgefield, Conn.
The young woman’s death prompted her family to create the Erin B. Vick Memorial Nursing Scholarship, which helps to defray some of the costs for students who participate in the trip. In 2013, the Vick family sponsored the planting of 22 fruit trees — one for each year of Erin’s life — around the Roberto Clemente–Santa Ana Health Clinic, where she had served in Nicaragua.
Colleen acknowledged that when Erin first told her she wanted to go on the trip, she was nervous. “But I did some research and realized that she was going to be fine.” In hindsight, she said she’s glad that she let her daughter go. “After losing Erin, I realized that if I had said no, my heart would be broken, knowing that she had missed this experience. She had the opportunity to learn about divine mercy. This is what God is asking us to do, not to be focused on ourselves but to think of others and to give of ourselves. That was the blessing of the trip for Her.”
To contribute to the Erin B. Vick Memorial Nursing Scholarship, you can make a gift online at cuatoday.com/VickMemorial. You may also mail contributions to the Division of University Advancement, Father O’Connell Hall, 620 Michigan Ave., N.E., Washington, DC 20064 or call 202-319-6910.