Latinas in the Pipeline to Baccalaureate -Prepared Nursing- Chall

University of Massachusetts Amherst ScholarWorks@UMass Amherst Open Access Dissertations 5-2010 Latinas in the Pipeline to Baccalaureate -Prepared Nursing: Challenges and Supports in Persistence to Degree and Professional Licensure Cheryl Ann Sheils University of Massachusetts Amherst Follow this and additional works at: https://scholarworks.umass.edu/open_access_dissertations Part of the Educational Administration and Supervision Commons, and the Educational Assessment, Evaluation, and Research Commons Recommended Citation Sheils, Cheryl Ann, "Latinas in the Pipeline to Baccalaureate -Prepared Nursing: Challenges and Supports in Persistence to Degree and Professional Licensure" (2010) Open Access Dissertations 209 https://scholarworks.umass.edu/open_access_dissertations/209 This Open Access Dissertation is brought to you for free and open access by ScholarWorks@UMass Amherst It has been accepted for inclusion in Open Access Dissertations by an authorized administrator of ScholarWorks@UMass Amherst For more information, please contact scholarworks@library.umass.edu LATINAS IN THE PIPELINE TO BACCALAUREATE-PREPARED NURSING: CHALLENGES AND SUPPORTS IN PERSISTENCE TO DEGREE AND PROFESSIONAL LICENSURE A Dissertation Presented by CHERYL A SHEILS Submitted to the Graduate School of the University of Massachusetts Amherst in partial fulfillment of the requirements for the degree of DOCTOR OF EDUCATION May 2010 School of Education Educational Policy, Research, and Administration ©Copyright by Cheryl A Sheils 2010 All Rights Reserved LATINAS IN THE PIPELINE TO BACCALAUREATE-PREPARED NURSING: CHALLENGES AND SUPPORTS IN PERSISTENCE TO DEGREE AND PROFESSIONAL LICENSURE A Dissertation Presented by CHERYL A SHEILS Approved as to style and content by: _ Joseph B Berger, Chairperson _ Elizabeth Williams, Member Jeungok Choi, Member Christine B McCormick, Dean School of Education DEDICATION This dissertation is dedicated to my mother, Essa, my husband, Jim, and my children, Siobhán, Caitrin, and Daniel Their love, support, and confidence in me helped me overcome even the most difficult times in completing my doctoral degree This work is also dedicated to present and future Latina nursing students My hope is that the findings from this study will assist them in their persistence to the baccalaureate degree and beyond To the Latina students who so graciously shared their time and stories with me, my sincere gratitude, and I include the following lines as they seem to capture their spirit of determination: “I have a dream, a song to sing, To help me through most anything, And my destination makes it worth the while, Pushing through the darkness, still another mile.” “I Have a Dream” ABBA, 1979 ACKNOWLEDGMENTS I would like to thank my Chair, Dr Joseph Berger, for his support and encouragement through the entire doctoral process His guidance has been invaluable and I will always be grateful to him for the time and effort he provided in shaping my dissertation Thanks are also due to Dr Elizabeth Williams and Dr Jeungok Choi, who served as members of my dissertation committee and provided advice and feedback during the many stages of this project Additional thanks go to my husband, Jim Sheils, for his expert and patient proofreading of the many iterations of this manuscript and to my friend and nurse colleague, Rosa Feldman, whose counsel has been of great help in carrying out my research I would also like to acknowledge the Beta Zeta at Large Chapter of Sigma Theta Tau, International, the Elms College, and the Elms College Alumni Association for providing funding this research project v ABSTRACT LATINAS IN THE PIPELINE TO BACCALAUREATE-PREPARED NURSING: CHALLENGES AND SUPPORTS IN PERSISTENCE TO DEGREE AND PROFESSIONAL LICENSURE MAY 2010 CHERYL A SHEILS, B.S.N., AMERICAN INTERNATIONAL COLLEGE M.S., UNIVERSITY OF CONNECTICUT Ed.D., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Professor Joseph B Berger The United States is rapidly becoming a more racially diverse nation Racial minority groups are projected to make up 47% of the total population in 2050 and if current population trends continue, they are projected to surpass the non-minority population by the end of the twenty-first century Furthermore, the Latino population, already the nation’s largest minority group, is expected to triple in size and is projected to account for 29% of the total U.S population by 2050 Unfortunately, the educational pipeline has created a shortage of Latinos in higher education At the same time, the United States is suffering from a national shortage of registered nurses It is, therefore, of great concern that the proportion of minority students in nursing education programs is also not keeping up with population trends Moreover, persistent inequalities in educational opportunities have led to persistent social inequalities between majority and minority groups, including inequalities in healthcare Increasing racial diversity among health professionals is essential, not only as a matter of educational equity, but also because evidence indicates that diversity among providers is associated with improved access to healthcare for racial vi minorities A main route to upward mobility and equality of opportunity for minorities in the healthcare industry is equity of access and success in achieving the baccalaureate nursing degree There is an increasing body of literature which addresses retention and persistence of minority nursing students; however, the greater majority has focused on Chicano Hispanics and Black students Further research is needed to identify factors associated with retention and persistence of other Latino groups This study uses a qualitative design with Spradley’s method of ethnographic interviewing to learn about the experiences of Puerto Rican nursing students attending college in the Northeast Obligations to family, financial constraints and academic under-preparedness are some of the key findings gleaned from analysis of the data vii TABLE OF CONTENTS Page ACKNOWLEDGMENTS v ABSTRACT vi CHAPTER PROBLEM STATEMENT Statement of the Problem Purpose of the Study .7 Research Questions Significance of the Study Assumptions 11 Definitions 12 Overview of the Paper 13 REVIEW OF THE LITERATURE .15 Introduction 15 Changes in the United States Population Demographics 15 Racial Diversity in Higher Education 17 Minority Access to Higher Education 21 A Racial Diversity in the Healthcare Workforce .57 Recruitment and Retention of Latino Nursing Students 59 Latino Nursing Students’ Persistence to Degree and Professional Licensure 64 Summary 66 Conclusion 67 RESEARCH DESIGN 68 Introduction 68 Conceptual Framework 69 Research Questions 74 Research Design 75 Participants and Data Sources 81 Data Collection and Analysis .84 Limitations of the Study .89 Conclusion 90 RESULTS 91 Introduction 91 Student Characteristics 91 Institutional Environment 110 Latinas and Professional Nursing 126 Conclusion 132 viii DISCUSSION AND RECOMMENDATIONS 133 Introduction 133 Overview of the Findings 133 Findings in Relation to the Research Questions 135 A Framework of Persistence 145 Contributions to the Knowledge of Latina Nursing Student Persistence 146 Recommendations for Practice, Policy, and Research .148 Concluding Message 154 APPENDICES A B C D E F CONCEPTUAL FRAMEWORK 157 CONSENT FORM 158 DEMOGRAPHIC DATA SURVEY 159 INTERVIEW SCHEDULE 161 PROFILE OF LATINA STUDENT NURSE PARTICIPANTS 163 FRAMEWORK OF PERSISTENCE .164 BIBLIOGRAPHY 165 ix APPENDIX C DEMOGRAPHIC DATA SURVEY Study of the University of Massachusetts Amherst Latinas in the Pipeline to Baccalaureate-Prepared Nursing: Challenges and Supports in Persistence to Degree and Professional Licensure DEMOGRAPHIC DATA SURVEY Dear Student: Please complete the following survey to the best of your ability so that I may have some background information about the participants in my study Your answers will be used only to describe the participant group as a whole, not to identify any one individual This survey is completely voluntary and you may choose not to answer any one or more of the survey items Thank you Please fill in or check as appropriate: Your year of birth: 19 Your gender:Male  Female  Please check the racial/ethnic group(s) that you most closely identify yourself with: Costa Rican  Honduran Cuban  Jamaican Dominican  Mexican Salvadorean  Nicaraguan Guatemalan  Panamanian Haitian  Puerto Rican Other(s) Do you refer to yourself as Latina/o  Hispanic  Other _?       Not Applicable  What is the name of the high school you attended? _ At what level are you in the nursing program? Sophomore  Junior  Senior  Did you transfer here from a community college? Yes  No  If you answered “Yes” to question # 7, what is the name of the community college you transferred from? _ 159 What is the total number of semesters you have spent so far in nursing education, including time spent in a community college?       What year you expect to graduate with your degree in nursing? 160 APPENDIX D INTERVIEW SCHEDULE First, I’m going to ask you a few general, basic questions about why you decided on a nursing career: Can you describe for me how you got interested in becoming a nurse? Tell me what brought you to this particular nursing program Explain for me why it is important for you to get your BSN What you hope to accomplish by getting your BSN? What you think your life will be like as an RN? Describe for me how you expect your life will be different when you are an RN Next, I’m going to ask you some questions about your experiences as a student nurse: If you were speaking with a younger (e.g freshman or sophomore) nursing student, what would you say about the nursing major? How would you describe it? What you spend most of your time on when you’re not in class or in clinical? Can you tell me all the things that happen when you are preparing for class? For clinical For an exam? Since starting college, tell me about the courses that were or are the hardest for you? Could you describe for me what typically challenges you the most as a student nurse – in class/ in clinical? Could you give me an example of what gives you a hard time as a student nurse – in class/ in clinical? Can you give me an example of an experience you found especially challenging in class or clinical? Can you give me an example of an experience you found especially helpful or supportive in class or clinical? If you were having difficulty with your schoolwork, where would you go or who would you go to for support or help? Make a list of all the different kinds of things that could stop you from staying in school and finishing your degree – having to with school or outside of school 161 Make a list of all the different kinds of resources that can help you stay in school and finish your degree – again, both at school or outside of school Look at the list of what can stop your success Which one is the most important? Explain Look at the list of what can help you be successful Which one is the most important? Explain Now I’m going to ask you a few questions about being a Latina/Hispanic student nurse: Can you talk about what your experience has been like so far as a Hispanic woman in a bachelor’s degree nursing program? What has it been like for you bringing your Spanish culture into the culture of nursing? When you are with other Spanish-speakers, you usually speak Spanish or English? If you were talking with another Spanish-speaking classmate about what makes it hard for you to be successful in the nursing program, how would you say it in Spanish? What words would you use? If you were talking with another Spanish-speaking classmate about what helps you to be successful in the nursing program, how would you say it in Spanish? What words would you use? If you were speaking with a younger (e.g freshman or sophomore) nursing student, what would you say about the nursing major? What words would you use? How does your life experience as a Latina/Hispanic help or get in the way of your success as a nursing student – any impact of birth order or gender? And a few final questions for today: Will you be the same kind of nurse as a non-Latina/Hispanic nurse? Does membership in the Latino/Hispanic culture make a difference as to the kind of nurse you’ll be? How? Is there a question that you thought I would ask but didn’t or a question that you feel I should be asking about Hispanics in nursing education? 162 APPENDIX E PROFILE OF LATINA STUDENT NURSE PARTICIPANTS (n= 10) Pseudonym Age Racial/Ethnic Background Ilysa Amanda Olivia Dania Nina Lola Jamie Eva Victoria Joslyn T NT NT NT T NT T T NT NT PR PR PR/D PR PR PR/D PR PR PR PR ESL Transfer Student Level in Nursing Program # of Children Yes Yes Yes Yes Yes No No No Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Junior Junior Senior Senior Sophomore Senior Sophomore Junior Sophomore Senior None One or more One or more One or more One or more One or more One or more None One or more One or more Note PR = Puerto Rican; D = Dominican; ESL = English as a Second Language; T = Traditional Age; NT = Non-Traditional Age 163 APPENDIX F FRAMEWORK OF PERSISTENCE 164 BIBLIOGRAPHY Allen, W R., Bonous-Hammarth, M., & Teranishi, R T (2006) Obstacles to diversity: Examining the educational pipeline In W Allen, 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Alumni Association for providing funding this research project v ABSTRACT LATINAS IN THE PIPELINE TO BACCALAUREATE- PREPARED NURSING: CHALLENGES AND SUPPORTS IN PERSISTENCE TO DEGREE AND PROFESSIONAL