Spring is the season of new life, even rebirth. It’s a fitting time for graduation ceremonies to be held, as young professionals embark on new careers that had previously been half-lived in textbooks and lectures.
Soon, thousands of members of the Class of 2012 will be flooding into the “real world” to join the team on hospital floors, in emergency clinics, and at countless other nursing facilities. Here, you’ll meet four soon-to-be members of the nursing work force, as they share the experiences that led them to their field, their hard-won advice for future students, and what they believe will keep them in nursing for the long haul.
“People like you don’t go to schools like these.” That’s what Breanne Cisneros heard when she showed someone the list of colleges and universities to which she hoped to apply. “I was shocked,” Cisneros says. “Even though I was a low-income, Hispanic American female who had attended impacted public schools in the under-served city of Anaheim, California, I applied to top-tier institutions.” She eventually was offered admission and a full scholarship to Johns Hopkins University in Baltimore, Maryland.
Now, Cisneros is in the Master’s Entry Program in Nursing (MEPN) at the University of California, San Francisco (UCSF). She became an RN in 2010, and she is pursuing a master’s in critical care/trauma nursing. She hopes to become a critical care clinical nurse specialist. Cisneros says she “dreamed of working in health care” as a child, largely due to growing up with a disabled younger brother.
At Johns Hopkins, studying psychology, Cisneros says she “quickly learned [that person] was right—people like me don’t go to schools like that. Having come from a completely different socioeconomic background than my peers, and having very few shared experiences, I was isolated.” Not only that, she found her ambitions shaken during her academically challenging undergraduate years. “I lost faith in my abilities, and temporarily gave up on my dream,” she says. But her school and life focus shifted during her junior year at Hopkins, when her father sustained a traumatic brain injury (TBI) due to violent crime that left him permanently disabled. “This multifaceted tragedy changed my outlook and approach to life, resulting in a shift of priorities. It renewed my dedication to health care and motivated me to reach out to gain the academic skills I needed for success,” she says. “The RNs and Advanced Practiced Nurses provided warm, competent, patient-centered care that allowed my father and our family to heal. It opened my eyes to the world of nursing and changed my career and life trajectories.”
As a social work assistant in oncology at the Johns Hopkins Hospital and as an EMT-B in Baltimore, Cisneros “saw great socioeconomic disparities and their impact on health and access to care,” she says. “I recognized that my background was a unique tool that would allow me to help people who are scared, do not have adequate resources, feel isolated, and who do not understand the health care system or what is happening to their bodies. The Hispanic population is particularly vulnerable and subject to trauma, which I experienced firsthand.”
After graduating, Cisneros fulfilled her nursing prerequisites in a post-baccalaureate program at Tufts University in Medford, Massachusetts. “My educational journey has been just that: a journey,” she says. “I have struggled and faced many obstacles because of my background and socioeconomic status. However, support from the National Association of Hispanic Nurses, the Kaiser Permanente Latino Association, the Hispanic Association of Colleges and Universities, and the UCSF Nursing Alumni Association has helped me tremendously in achieving my goals and working towards my dreams.”
As an undergrad at the famously “physician-dominated” Johns Hopkins, Cisneros says she developed a “passion for interprofessional health care education.” She was the first nursing student to receive a fellowship to participate in the UCSF School of Medicine’s Curriculum Ambassador’s program, and she was the only nurse on the six-member team of interprofessional students. Together they developed and facilitated a nationally recognized, “revolutionary, school-wide, student-driven, student-centered interprofessional health care education curriculum for 500 students across the five health professions programs at UCSF,” she says. “Increased patient safety requires interprofessional collaboration, which is now critical given rising health care costs, an aging population, and physician shortages.” Cisneros and her team will continue to study the impact of interprofessional learning on collaboration, she says. She applies the skills developed in this program as a student representative on the Interprofessional Healthcare Education Task Force at UCSF as well, where she works with deans and other faculty members.
Among her other extracurricular activities, Cisneros is one of five MEPN students serving a fellowship as a Clinical Scholar at the UCSF Medical Center, where she contributes to the Medication Administration Accuracy Project (MAAP) in Nursing Performance Improvement. “The goals of the MAAP project are to standardize the medication administration process and eliminate nursing medication errors,” Cisneros says. “The vision is to establish best practices so that every patient receives safe, excellent quality care.” This experience led Cisneros to becoming the first nurse to complete a School of Medicine Pathway to Discovery certificate in Health Systems and Leadership, a career development program with a leadership focus.
After committing herself to these organizations, it’s no surprise Cisneros is passionate about leadership. Her most recent leading role? Studying the 24-hour survival rates for VT/VF (Ventricular Tachycardia/Ventricular Fibrillation) arrest at the San Francisco Department of Veterans Affairs, working on a quality improvement project studying early chest compressions and defibrillation within two minutes of cardiac arrest. “The best strategies are unclear for hospital implementation of early defibrillation programs,” she says. “In-hospital cardiac arrest is a major public health issue, and both the American Heart Association and the American College of Cardiology recognize the importance of early resuscitative care.” Cisneros and her team explored the feasibility of a two-minute defibrillation standard for monitored units to identify best practices as well as barriers to successful early defibrillation in cardiac arrest, among other things. The American Heart Association published the abstract and accepted it for their 2011 national meeting; Cisneros went there to present those findings. “This was an incredible opportunity to conduct scholarly work and present it at a national level,” she says.
Cisneros shows no signs of slowing down. And after the challenges of her not-so-distant youth, she intends to give back to those facing similar difficulties. “I plan to be a role model and make changes to the system that will help recruit, retain, and to encourage further professional and academic development of underserved students like myself,” she says. “My contributions towards the well-being of individuals are limited unless I can pass my knowledge onto others.” To that end, she hopes to earn her Ph.D. in nursing, and she is already an early advocate for the degree. “A Ph.D. is invaluable for improving patient care, contributing to research, informing health policy, improving the nursing practice, and developing the profession,” Cisneros says. “As a Hispanic nurse, I would add to faculty diversity and help to create a healthy culture in the learning environment.” However, Cisneros says those days are still far away; she intends to develop her skills at the bedside first and let that knowledge inform her doctoral studies.
“Through advocacy, outreach, and strong professional organizational involvement, I plan to actively make changes and reach out to Hispanic nurses—to recruit them, to retain them, and to encourage further professional and academic development,” Cisneros says. “I feel a responsibility to communicate my future clinical, educational, and research findings to my colleagues. As a nurse, I not only plan to meet the needs of my patients, but also meet the needs of my colleagues, Hispanic nurses. I believe that we must be involved in nursing at the local, state, and national levels in order to impact health policy and improve health care for Hispanics, and gain visibility and recognition as professionals so that we can influence and facilitate such change.”
Even as a child in Nigeria, Musiliu Ogunbayo was acutely aware of the importance of health care and wellness. He applied that interest to the study of nursing, and he should graduate from the practical nursing program at The Salter School of Nursing and Allied Health in Manchester, New Hampshire, this spring. (He hopes to earn a bachelor’s degree in the future.) Ogunbayo’s career path was perhaps made more profound from early experiences with the tribal custom of tattooing.
“I am always proud of my cultural heritage,” Ogunbayo says. “We, the Yorubas, are known all over Nigeria and, indeed, the whole world for our tribal marks.” However, he did not receive the customary tattoos as an infant, due to his father’s absence at the time. After being ridiculed for his lack of tribal marks as a child, Ogunbayo finally, excitedly, went to have them done at the age of nine. This decision was also heavily influenced by his admiration of his school teacher and his tribal marks.
The tattoo incisions were made by a local baba, an elderly manwith experience administering the tattoos, using an old, rusty blade. Ogunbayo found himself in great pain following the procedure and for several days afterward, and he questioned his decision to have them done.
Upon returning to school, his teacher commented on the new tribal marks; Ogunbayo shared how the teacher himself had actually influenced his decision. The teacher’s surprising reply: he hated his own tribal marks. Having been done as an infant, he had no choice in the matter and now had to live with them. This led Ogunbayo to consider his own tattoos, and he pondered the health risk he had taken just in having them done. “Sometimes, I sit and think, ‘what if the baba had used that knife on someone with HIV before using it on me?’ I also imagine what if bacteria from the knife or from the [dye] had entered my bloodstream, causing an ailment that could not be cured?”
After graduating, Ogunbayo intends to work in America to gain more experience, which he will then take back to Nigeria. “I feel like a lot has been given to me, so I chose nursing as a career because I want to be able to give back to my community someday,” Ogunbayo says, and he hopes to apply his nursing knowledge and create more awareness upon returning home. “I want to be able to contribute to a healthier environment where people are more cognitively aware of their health needs. I want to see a society where people would not have to wait till they get very sick before they go to see the doctor. I want to help build a society where people with medical needs are treated with fairness and respect.” He intends to open a clinic in his home country to provide high-quality, affordable health care.
To would-be nursing students, Ogunbayo does not shy away from the difficulties of the program: Cutting down on his work hours to make time to study has also cut into his income, causing a strain in finances. Socially, he has little time for friends or family. “The biggest of all is a cultural conflict,” Ogunbayo says. “I always find myself having to do something different from the way I was raised. But I finally understand that meeting my patients’ cultural and health needs is more important.”
And Ogunbayo sometimes finds being the only male in his class to be a challenge, but he credits his instructors and classmates for giving him a positive learning experience. “Make sure you choose a good school that meets your career goals, financial status, and lifestyle,” Ogunbayo says. And don’t forget: “Your instructors are your best resources; use them and see them as your mentor and not your judge.”
Despite its challenges, Ogunbayo maintains his passion for the field. “Nursing is a very rewarding profession,” Ogunbayo says. Even if the particular field or specialty a nurse pursues isn’t the most lucrative, such as treating impoverished peoples, “you will be happy for the differences you are making in people’s lives.”
Kelsey Sonnabend finds strength and meaning all in one quote: “To the world you may be one person, but to one person you may be the world.” She adopted this saying from her friend Kate, and she relies on it when her work and studies in Arizona State University’s (ASU) B.S.N. program become challenging. “This quote is what makes it all worth while in the end,” she says. “That one patient that you help that looks you in the eye and tells you how thankful they are that you are there helping them when they can not help themselves.”
A native of Gilbert, Arizona, Sonnabend’s family is from Rapid City, South Dakota. They are members of the Oglala Sioux tribe situated on the Pine Ridge Reservation, roughly 120 miles away. “I was raised so far from my reservation because my dad is a part of the commissioned corps and was placed in Phoenix, Arizona, to work,” Sonnabend says. “However, I remember spending my summers in South Dakota visiting my family and grandpa, Pahaska who, if you have ever been to Keystone, South Dakota, is the amazing Native American painter who many tourists took pictures with.”
Sonnabend is currently in her final semester at ASU, scheduled to graduate in May of this year. As a high school student, she says she couldn’t decide what to study in college—but she did know she wanted to impact others in her work. “I knew there was many different ways I could do this, either through politics or business,” she says. “Then I remembered my mom.” Also a nurse, her mother would share work stories with Sonnabend and her brother. “I remember listening to her stories and how much people appreciated what she would do for them.”
But as the years went by, different factors colored Sonnabend’s desire to become a nurse. The first was her determination to prove naysayers wrong. Second in time, but perhaps more importantly, Sonnabend became friends with a fellow nursing student, the aforementioned Kate. “We took many classes together and went through many grueling nights of studying, editing each other’s papers, and the stress of applying for the program together,” she says. In the spring of 2009, Kate grew ill, her health declining quickly and impacting her school work.
“Kate had many strange symptoms of many things and saw many doctors,” Sonnabend says. “When the semester ended I remember eating a grilled cheese sandwich with her and her telling me a doctor told her it was a severe sinus infection and she was headed home to Washington to get it all fixed up and she would see me in the fall for our first semester of nursing school. Two days later I got a call that she had passed away. That completely changed my world. Everything was different; to truly see how fragile life is was so shocking for me. I then at that point made the decision that no one should have to go from doctor to doctor in pain and fear. I wanted to be that nurse who would be more caring, loving, and support my patients.” Talking with Katie’s parents after her passing only solidified Sonnabend’s resolve. “What initially inspired me to be a nurse was the amazing, caring, and courageous stories of my mom,” she says. “What changed the kind of nurse I would be and re-kindled the want to be a nurse was the death and life of my friend Kate.”
Sonnabend hopes to use her nursing degree wherever she is needed, she says, whether that’s a well-known hospital in Phoenix, a third-world country, or another underserved area. She also wants to earn her master’s and doctoral degrees to further her abilities to help those in need.
“Walking into this program, there are a lot of stresses, such as the need to have a high GPA, competing against many other highly qualified students, and spending four years of your life strictly focused on studying and school,” Sonnabend says. She remembers being warned during the first week of school: even if you get into the “impossible” nursing program, you probably won’t graduate on time. Right on schedule, four years later, Sonnabend is ready to enter the nursing workforce.
Though she admits she found her studies challenging—“it does take a lot of self-discipline and sacrifice,” she says—in Sonnabend’s young life, she has found this much to be true: when you’re passionate and committed to becoming a nurse, nothing can stop you. Even those that might falter along the way can push themselves to achieve their goals. To the generations of nurses to come after her, she has this to say: “You have the ability to do anything another human has done.” Even if you sometimes struggle academically, “this simply means you just have to put a little more time in figuring out the way you learn best,” she continues. “Do not listen to everyone around telling you that you aren’t smart enough or that nursing is not a good field, because if this is what you want you shouldn’t let those things get to you. If you work hard and you keep in contact with your school advisors and professors, you will get far. It is a difficult program but it really will be worth it when you finally get to walk across that stage and call yourself an RN.”
David Allen didn’t always want to be a nurse. He did know, however, that he had a passion for medicine in a broad sort of way. Growing up in the Boston suburb of Natick, Allen was a “pretty big athlete,” and he developed an interest in muscles, body movement, and his own physical therapy and sports-related injuries. Allen says he spent a good deal of time in the ER and even negotiated with his orthopedic doctors. He’ll be graduating in May of this year with a B.S.N. from the University of Pennsylvania School of Nursing.
“I’ve always been really interested in emergency medicine,” Allen says. At 16 years old, he wanted to be an EMT. He took a wilderness first responder exam to get involved in outdoor recreation, and his adventurous spirit endures. “My dream job would be a flight nurse, which I know isn’t that original for a guy!” he says with a laugh.
The decision to study nursing came after the decision to attend UPenn, as the school simply “grabbed” Allen and met his overarching undergrad goals. A brief informational meeting with UPenn’s admission office introduced him to nursing, particularly the role of nurse practitioner, which he says he had never really heard of. It too clicked with him, as he realized it would allow him to do all the things that interested him.
Allen says it took a few years for him to really appreciate nursing and the ability to work one-on-one with patients. Now, he says he can fully articulate why he is happy with his choice to become a nurse.
Allen says his classmates are brilliant and highly motivated. “Everyone’s working to be the top in what they’re doing.” Yet, though his nursing class only started with about 10 males, several have dropped out, as did a number of nursing students in general. Given the trying nature of the first years of the nursing program, this didn’t surprise him. “It can feel subservient, especially in some of the basic classes,” he says. “You grow to appreciate the role nurses play in patient care—which is why we’re all here.” Allen says he believes the work will become more fluid, second nature, and perhaps easier as years go on and he gains more experience. “I think I’ve been really lucky,” Allen says. “UPenn does a really great job in supporting students.”
True to his past and his flight nurse dreams of the future, Allen says he enjoys the fast-paced nature of the emergency department, and he hopes to work in a similar trauma-based environment.
The challenges may scare would-be nurses, particularly those graduating from high school in this economically uncertain time, a world where nurses are desperately needed to fill current and projected future vacancies. But Allen offers some sage advice: “Really think about what you value and what you want to do, and then talk to people in other fields” to see if your vision of the future and the reality align, he says.
After enrolling in the program, know that it will be difficult. If you find you don’t love nursing, Allen says, give it a chance, talk to more people, and try to determine if what you don’t like is really indicative of nursing or if it might change as time goes by. Perhaps then you, like Allen, will find the rewards far outweigh the challenges.