East Oakland’s Allen Temple Baptist Church is buzzing with chatter and upbeat music. On this warm Saturday morning, the church is hosting its annual holistic health fair. Students from Oakland’s Samuel Merritt University, clad in blue scrubs, hustle to give eye exams and check blood pressure.
A couple tables down, Samuel Merritt’s chief diversity officer, Shirley Strong, hopes to address prospective students. The Oakland-based university is one of the three biggest programs for registered nursing students in California and is committed to reducing health disparities by recruiting more students of color.
“The work of diversity at Samuel Merritt involves recruiting faculty, staff and students of color particularly,” Strong says, especially “African-American/black, Latino/Hispanic students because they’re the ones underrepresented in our community.”
Last May, Samuel Merritt University’s nursing program graduated its second-largest class of African-American and Latino students, including 10 African-Americans and 28 Latinos.
“What we’d like to do is train more (registered nurses) and more case managers and more nurse practitioners, people who are really in decision-making roles in hospitals,” says Strong.
The majority of the state’s registered nurses are white or Asian. While 39 percent of California’s population is Latino, just 8 percent of nurses are; 6 percent of the state’s population is black, but just 4 percent of nurses are.
David Hayes-Bautista is director of the Center for the Study of Latino Health and Culture at UCLA’s medical school.
“Clearly we are lacking African-American and Latina nurses,” he says, adding that the health of everyone suffers because of it. “Having them in the workforce will … make for better patient care [and] better language communication.”
But that can be hard when you have a population as diverse as California, where Latinos lack access to preventive care and African-Americans experience higher rates of heart disease and shorter life expectancy than whites. These disparities are what motivated Samuel Merritt grad Shanda Williams, who recently passed her registered nurses' licensing exam.
She grew up in Oakland, where there’s a great need for providers who understand the community. Williams says she’s experienced this firsthand.
“I would go to the doctor’s office with my grandmother,” Williams says, “and she would basically lie to all of her doctors about everything that she was doing.”Williams says her grandmother told her doctor she was eating her fruits and vegetables and cutting out fried foods. Williams knew this was not true.
“It sparked a conversation,” she says, but her grandmother “basically said, ‘They don’t understand the way we eat, this is part of my identity.’"
Williams says this moment stuck with her because the doctor never asked some key questions.
“There was never really a time when her doctor would ask her a question, ‘Well, why do you eat that way?’ or, ‘Can we find a compromise?’ or anything like that. Those questions never came up.”
Now Williams wants to extend what she’s learned to others. She tutors in Samuel Merritt’s academic success program, specifically geared toward Latino and African-American students. Today she’s working with junior Leslie Hernandez. The two are sitting in one of Samuel Merritt’s basement classrooms going over neuropharmacology.
Hernandez says she sees a lot of Latino students in nursing school with her, but it’s not the same when she accompanies family members to the hospital or when she’s at her clinical placements.
She remembers the moment when she realized the need for more Latinos — and Spanish-speaking — health care professionals. As one of her student placements, she was working in the psychiatric unit of a hospital. A patient had been deemed noncompliant by her doctors and nurses because she did not talk.
But Hernandez was able to communicate with the patient — in Spanish.
“She was speaking in Spanish and she felt like nobody could understand her,” Hernandez recounts. The patient told Hernandez that she had suicidal thoughts, and Hernandez could pass that on to the doctor.
Financial support is a major barrier for students of color. While lower-income students can take advantage of financial aid to help meet the steep $44,000 tuition at a school like Samuel Merritt, they can be derailed by smaller unexpected problems.
A sudden need for hundreds of dollars for a car repair or an emergency dental problem can force students to drop out, diversity officer Strong says, adding that these students come from families that often don’t have the resources to help in an emergency.
To help these students, Strong says Samuel Merritt is working to create a special fund, “so that when a student has a problem we just write the check from the emergency fund, [so students can] stay attentive and on course to graduate.”
But emergency finances and need for tutoring are the issues that black and Latino students face only after they get into nursing school. For so many others, nursing school isn’t even an option.
Strong says preparation for health care careers starts in high school — or sooner. “The key really is that they have to take science courses and the math courses early on, so when they get to college … they are prepared to step into these various programs.”
She says if students don’t have these courses, they spend a lot of time playing catch-up. Sometimes it’s just too overwhelming to tackle.
Samuel Merritt is partnering with pathway programs such as the Health Academy at Oakland Technical High School, and Berkeley High’s B-Tech Academy. The goal of these schools is to give students who are interested in the health care field specialized instruction.
The Board of Registered Nursing forecasts that Latino population growth will continue to outpace the number of registered nurses and doctors unless more efforts are implemented to encourage enrollment and graduation of Latinos from RN programs.
While African-Americans will be equally represented by 2030, they could be equally represented sooner if more African-American students are recruited to and graduate from RN programs.
As for Shanda Williams, she wants to open a clinic with some of her classmates.
“Working in my community is what also helped keep me motivated in school,” she says, adding that she thinks other students of color feel the same way. “We want to make changes in our communities that we have grown up (in) and that we have seen.”
She wants patients like her grandmother to seek care from people who they trust, people who can say, “I’m from the same neighborhood you come from.”