The Changing Face of Nursing

The Changing Face of Nursing
The accelerated class that began in June includes (l-r) Sean Braden, Elizabeth Billings, James Emerton, and Odunlade Adedeji. (photo by Will Kirk)

In 1990, the School of Nursing admitted its first group of students in a new accelerated class of baccalaureate students. The intense program, offered only to those students with strong academic records and a baccalaureate degree in another field, provides the same coursework and clinical hours as the traditional two-year program in just 131/2 months. The first class had just 15 students with one male and one ethnic minority student. This year’s June class has grown to 127 students—the largest class to date in the history of Hopkins Nursing—(the September ’04 class topped that at 140). This latest accelerated class represents the changing face of nursing today: more male students, more minority students, and more students experiencing other fields before choosing nursing as a career.

11% are men

As more men enter the nursing profession, this percentage reflects nearly twice as many men as in recent years.

This past summer, Justin Graves (left) spent three weeks at an extreme sports camp treating injuries sustained by children and teenagers from bicycles, skateboards, and gymnastics activities. Graves says the frequency and severity of injuries (wrist fractures were common) made for an intense learning experience. “With extreme sports, there is a phenomenal amount of injuries if the kids aren’t properly trained,” he explains. “We were there when the kids got hurt. You pick up the pieces and fix them.”

With a degree in athletic training, Graves was certainly well-equipped. But while pursuing that degree at Miami University, he realized being an athletic trainer was not what he wanted to do full-time.

Graves, one of 14 men in this year’s June accelerated class, decided in his junior year that he wanted to “go the nursing route.” After completing his degree at Miami, he immediately enrolled in the accelerated program at Johns Hopkins University School of Nursing. Graves’ knowledge of athletic training is enhanced by a variety of other experiences: assisting students with cerebral palsy at a residential college in England, volunteering as an EMT at fire departments, and even riding along on a 12-hour shift with a flight nurse. All combined, they’ve given Graves a good set of basic skills and a confidence in dealing with patients, particularly in emergency situations. “I’m not apprehensive in ER settings. I’m used to it now, and comfortable with it,” he says. Once he earns his nursing degree, Graves thinks he’d like to begin his nursing career in critical care or the ER. After gaining some experience, he may one day pursue flight nursing.

20% are ethnic minorities

Asian students are the most prevalent ethnic minority—16% of the entire June class. The class also numbers students who are African-American/Black, Hispanic, and American Indian/Native American.

From her earliest years, Grace Lin was raised to believe that caring for one’s family members, especially the elders, is an honor. She was 10 when her family, including her grandmother with whom she was very close, emigrated from Taiwan to New York in 1986.

In school, Lin gravitated toward mathematics, a subject at which she could excel despite the initial language barrier. While earning her first degree in math, she developed an interest in the medical and life sciences. She had decided to pursue a career merging medicine and mathematics and was working toward entering a PhD program in biomedical engineering when her grandmother suffered a massive stroke. As the only relative who could speak fluent English, Lin spent the next month in the hospital with her, facilitating communication between her family and the health care staff. She also shadowed the nurses and helped provide palliative care for her grandmother before she passed away.

“I came to realize that nurses play a very complex, challenging, and beneficial role for patients like my grandmother,” says Lin. “My mother is a nurse, and I have always had the greatest admiration for her compassion and dedication. But I had never thought of nursing as a career.” The experience made it clear to Lin that she wanted to work directly with patients as a nurse. “I realized I’m just not cut out to be an engineer,” she says. “I’m a people person.”
Lin looks forward to working with older populations. She’s found that geriatrics is not as popular as pediatrics among her fellow students “Everyone says they want to work with kids,” she says, “but someone has to care for the elderly. And we all get old.”

100% are seeking 2nd or 3rd baccalaureate degrees

The school’s accelerated programs require that students hold a baccalaureate degree before beginning the program. While not required in the traditional program, 80% of those students also hold previous degrees.

All students in the accelerated class hold a degree in another field, with biology and psychology being the two most popular fields. Tetyana Lepley is one of two students who first chose a career in music. She holds degrees from Glier State Musical College in Kiev, Ukraine, and the Ukrainian State Pedagogical University. She had a brief career as a music teacher and choir conductor at a secondary school in Kiev and had never once considered a nursing career.

Then in 1999 she came to the U.S. to join her American fiancé and took her first job as an office assistant at the JHPIEGO Corporation, a nonprofit health organization affiliated with Johns Hopkins University. JHPIEGO nurses, many of whom conducted training in gynecology and obstetrics, left quite an impression on Lepley. “I saw a lot of highly skilled nurses, and I thought, ‘Wow, this is neat,’ ”she remembers. “Nurses in the Ukraine would never do anything compared to what they do here.” Subsequent work at Hopkins’ School of Public Health showed Lepley that nurses also play an important role in research.

By then, nursing seemed the ideal career for her. “I wanted stability in my life, and the nursing profession can help me achieve that,” she says. “I knew about the nursing shortage, and I wanted to become something that is really needed.”

She was also inspired by her husband’s experience having an organ transplant 14 years ago. “He could have died,” she says, “but he and his family tell me it was the help of nurses who helped him get through.”

9% hold master’s degrees

Students hold master’s degrees in 11 different fields, from anthropology to biomedical engineering to history.

Grace Lin, Terrie Kolodziej, Bridget Basile, Tetyana Lepley (photo by Will Kirk)

As an anthropologist, Bridget Basile realized that health care professionals must be made aware of how different languages, cultures, religious practices, and beliefs about illness and medicine can affect medical treatment. While studying anthropology at Boston University, she looked at how immigrants and refugees adjust to life in the United States and learned of a Hmong family from Laos who lost their daughter from a misunderstanding about her health care. The family believed that their little girl’s illness made her spirit blessed and that medical treatments were taking away this gift, Basile explains. So the family avoided taking her to the doctor or administering her medications. “Her death could have been prevented if the doctors and nurses had been able to communicate with the family and if they had knowledge of the Hmong animistic belief system,” she says.

Basile, one of 11 students who possess a master’s degree, enjoyed working briefly as an anthropologist in international development but felt the work was too theoretical. She wanted to directly impact the lives of the local people with whom she was working, so she decided to pursue nursing.
Instead of seeing nursing as a completely different path, Basile intends for her anthropology skills to enhance her new career as a nurse. “Combining the two fields will enable me to care for individuals of varying backgrounds,” she says, “and give the best possible nursing care while ensuring that each individual’s cultural needs are met.”

While at the School of Nursing, Basile is looking forward to working with refugees through the school’s community outreach program. After receiving her degree in nursing, she plans to work with underserved communities, possibly abroad, targeting refugees and immigrants. “Wherever I am working,” she says, “I will contribute a cross-cultural understanding of health and apply it to patient care.”

6% are Returned Peace Corps Volunteers (RPCV)

An additional 22% have expressed an interest in the Peace Corps Prep Program, which allows students who have graduated to serve with the Peace Corps in a variety of national and international positions in nursing and health care.
With a background in social work, Elizabeth Billings knew she wanted to get a master’s degree, but she wasn’t sure which field to pursue. Traveling appealed to her, so she decided to serve in the Peace Corps. She was assigned to a remote village in Haiti—a mere two-hour flight from Miami, but “like stepping back in time,” she says. There was no running water, no electricity, and, as Billings would quickly learn, few health care resources. “I thought, ‘Why in the world are they putting me in health care?’” she says, of her initial reaction to her assignment as a rural health educator. “I didn’t know anything about it!” In the end, however, she let the village lead her to what they wanted—and needed.

Billings spent her first year in Haiti just getting accustomed to the village and earning the trust of its people. As she moved on to designing outreach health education programs and materials for HIV/AIDS, maternal care, and a variety of areas, her interest in nursing slowly grew. She realized she could not accomplish all that she hoped to because she lacked the practical nursing skills the villagers so badly needed. “The people in the village just expected me to know it [nursing],” she says, “and it was frustrating not to be able to help them.” One sad incident, when a child fell while playing and died three weeks later from swelling in her brain—something that would have been simple to diagnose and treat had the village had medical knowledge—strengthened her decision to return to school for nursing.

As a Returned Peace Corps Volunteer, Billings qualified for and was chosen to receive a full scholarship from the John R. and Ruth W. Gurtler Foundation. After completing Hopkins’ MSN/MPH program, she plans to continue working overseas, combining her knowledge of social work, practical nursing skills, and love for public health.

32% are from the West Coast

More students in this class come from California (31) than from Maryland (27). Overall, 31 states in the U.S. are represented.

Imagine traveling across the country and running into someone from your home state. That’s what happened to Sean Braden and James Emerton. The two Californians met at the school’s Accepted Students Day and are now roommates in Charles Village. They are among a sizable percentage of students who travel thousands of miles from their West Coast hometowns to become Hopkins nursing students.

An internship at a medical center and volunteering at a homeless shelter led to Braden’s interest in addressing the quality of life in the inner city population. When he decided on a career as a family nurse practitioner, there was no doubt in his mind that he would come to Johns Hopkins School of Nursing. “Hopkins is an excellent school,” he says, adding that Hopkins has an outstanding reputation among Californians.

Emerton was drawn to the School of Nursing RPCV program. He served for two years in Madagascar teaching English and working on HIV/AIDS awareness campaigns. He was also attracted to the school’s community outreach program and the accelerated option.

Both students agree that for them, despite Baltimore’s non-California climate, there’s nothing on the West Coast that compares to the Johns Hopkins School of Nursing.

After graduation, Braden plans to work as a nurse practitioner, providing health care to homeless and indigent individuals in his hometown of San Diego; Emerton looks forward to living overseas, working with patients with HIV/AIDS and doing HIV/AIDS awareness and education.

13% were born outside the United States

Students claim 17 different birth countries, including Nigeria, Vietnam, Ghana, Kuwait, Malaysia, and Armenia.

A native of Nigeria, Odunlade Adedeji first came to the United States to study biology at the University of North Carolina. With a father who is a doctor, a mother who is a nurse, and a sister in nursing school back home, she knew she wanted to go into the medical field. After working with a surgeon, however, she concluded that surgery was not for her. She preferred to spend more time caring for patients and getting involved in the holistic lives of patients and their families.

Adedeji faced some unique challenges coming to Hopkins to pursue nursing. Without U.S. residency, she couldn’t apply for a government loan, nor did she qualify for financial aid from the school. Just two days before orientation was set to begin, she finally got all the necessary documents needed for her continued stay in the United States. Throughout it all, she relied on the help of the School of Nursing’s admissions office and Hopkins’ international office for support.

“It’s so far away from home here,” she says, “but I’ve been made to feel wanted.” When she visited the school, Adedeji felt that those she met displayed an interest in her progress. “I love their optimism, spirit, and support for people. It’s something that I hope I pick up.

“I think it’s a great privilege to be here,” she adds. “It makes it all worth it, all the stress I went through getting things worked out beforehand.”
Adedeji’s interests lie in international health. She looks forward to returning to Africa to work. But first, she wants to learn as much as she can. “I don’t want to stop at a BS,” she says. “I want to earn a PhD. I want to go all the way.”

41% are age 30 or over.

Members of the class range in age from 19 to 49.

Terrie Kolodziej, 49, has been in the workforce longer than most students in this class, having earned a degree in sociology from Oregon State University in 1976. She first started thinking about nursing five years ago, when she was working for her alma mater in Sri Lanka as a project director in international research and development. When a staff member was in an accident and needed human albumin, Kolodziej was able to locate and have shipped the necessary amount from a U.S. source—an experience that provided tremendous personal satisfaction. But she was left wondering whether she could make even greater contributions. “There I was, pushing around millions of dollars in grants, but I couldn’t help rehydrate the children, I couldn’t be there for emergency care,” she says. “I wanted to do more.”

The following year, during which she spent nine months with a friend who was diagnosed with Stage IV cancer, was a turning point for her. She decided she wanted to provide care to others in need. It was her dream to study nursing at Hopkins. “I thought, ‘Let’s reach for the top,’” she says.

Kolodziej has found the accelerated program to be “all consuming.” As with other experiences in life, she has relied on something she first started practicing 20 years ago: yoga. “Yoga is so important when you are under stress,” she explains. “It increases circulation and respiration. It does wonderful things on the cellular level. I feel refreshed and can go on.” As a yoga instructor, she has enjoyed being able to impart to others the benefits of a personal commitment to health and fitness.

Although her current interests lie in oncology and end-of-life care, Kolodziej is keeping an open mind about where her career in nursing will take her. She knows one thing for sure: She is committed to spending the rest of her working life as a nurse.

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