Throughout their long and accomplished careers as nursing practitioners and educators, Maria D. Krol and Jéssica Alicea-Planas have recognized a need to diversify the demographics of health care personnel, a concern now amplified by the coronavirus crisis.
“As our communities become more diverse ensuring that our healthcare professionals are just as diverse is paramount,” said Dr. Planas, a member of Fairfield University’s nursing faculty. “A diverse health workforce has been linked to increased patient satisfaction, improved patient-clinician communication, and greater access to care for patients belonging to racial/ethnic populations,” said Dr. Planas, whose roots are Puerto Rican.
Then devastating COVID-19 pandemic arrived unleashing a wave of societal-altering illness that has been particularly devastating for lower-income people of color, including the nation’s burgeoning Hispanic population who are experiencing a disproportionate share of the suffering and death.
Almost overnight, hospital practitioners such as Dr. Krol, along with thousands of her “heroic” colleagues, were thrust into an environment that the Peruvian born nurse characterized as “crazy, unstable” and nerve-wracking.
“This pandemic puts additional pressure on our healthcare system in terms of language needs, said Dr. Planas. “We have needed Spanish-speaking nurses to talk with patients and families to ensure that they understand what guidelines to follow if they have tested positive and or had an exposure and need to self-quarantine.”
In Connecticut, Hispanics, who comprise about 16.5 percent of state’s population, have accounted for at 25 percent of the COVID-19 cases. This percentage could be higher but is uncertain since state officials have not identified the racial identity of more than one-third of those stricken by this face-moving epidemic.
This disparity was underscored at a recent National Association of Hispanic Nurses (NAHN) meeting, Dr. Planas said, where a member mentioned that she worked in acute care on a COVID-19 floor, and out of her five patients, four were Spanish speaking.
Both Drs. Krol and Planas possess ample credentials to support their mission to bring greater diversity to the health care system. They have doctorates in nursing and get to influence the next generation of nurses as associate professors, Dr. Planas at Fairfield University, and Dr. Krol, as a teacher and director of the bachelor of science (BSN) program at Southern Connecticut University.
In addition, the two Latinas are active in professional organizations such as the Connecticut chapter of NAHN, where Dr. Krol is the current president, and Dr. Planas is her predecessor.
A public health specialist, Dr. Planas has worked with low-resourced communities for more than 20 years.
Dr. Krol has been a maternal care specialist for 30 years, and for much of this period a neonatal intensive care unit at Stamford Hospital.
Stamford Hospital, being close to New York City, the “hot spot” for the COVID-19 outbreak, had the state’s highest number of coronavirus patients, including many Latinos, Dr. Krol said.
Included in the hospital’s expanded caseload were expectant mothers from the city where overwhelmed hospitals advised them to go elsewhere to deliver their babies.
In addition to working with new mothers who had been tested positive for the highly infectious disease and caring for their babies, Dr. Krol contributed her Spanish language skills and affinity with Hispanic culture to help providers communicate with patients and their families as well to enhance the comfort level.
At the outbreak’s peak, Stamford Hospital had as many as 160-170 coronavirus patients, Dr. Krol said, with some nurses assigned one protective mask per week, but not the preferred N95 type, which was reserved for clinicians working in the busy acute care sections.
But by early May, the situation was getting better, and the caseload was down to about 70 patients, but anxiety about personal contamination remains high.
Dr. Krol said Stamford Hospital has a “good amount” of Hispanic nurses, but this representation tends to lag statewide. According to the Connecticut League for Nursing, Hispanics only account for 3 percent of the state’s registered nurses, even though their ethnic community has grown to more than 16.5 percent of the population.
Historically, there has always been a need for more Spanish-speaking nurses in the U.S., Dr. Planas noted, with about 18 percent of the population is Hispanic and 6 percent of RNs self-identify as Hispanic.
Dr. Krol said that working in the COVID-19 environment had raised her anxiety level, especially when she experienced flu-like symptoms and a slight temperature in mid-March. This concern was abated when she was tested for COVID-19 and the result came back negative.
In addition, Dr. Krol has been extra cautious about avoiding the spread of the insidious virus to her family. She has three grown children who are out of her home. This was not the case with her husband Bill, and her 90-year-old mother.
Each time she arrives for work Dr. Krol is interviewed regarding her health and undergoes a temperature check.
Like many frontline health care practitioners around the nation, Krol has had to endure shortages of personal protective equipment (PPE). Dr. Krol recalls being allocated one safety mask per week, which was not of the preferred N95 type needed by acute care staff.
Dr. Planas said that “the lack of PPE has put many in the frontlines in precarious situations, which then has the potential to also impact their families.”
“We (NAHN) have always been committed to supporting the health of Hispanic communities, Dr. Planas said, “and during this pandemic, our mission has not changed. We want to ensure that accurate information is being given to people in English and Spanish, so bilingual nurses are even more essential in terms flattening the curve and slowing the spread of the coronavirus.”
Moreover, Dr. Krol has found that her understanding of how many Hispanics families live – often a half dozen people including a grandparent in a small apartment – has been valuable
For example, she recalled that she was called upon to communicate with a new mother and her father, who did not speak English well. In another case, she established a rapport with a new mother who spoke English well like herself but appreciated having someone present who shared her Peruvian background.
Dr. Planas said that family is often such a foundation and integral part of the Hispanic community’s culture. “Patients who are hospitalized and have to be without families are really suffering, making that connection with a bilingual/bicultural nurse even more significant. Families can’t be with their sick family members. That is added trauma that may not be recognized,” she said.
The NAHN is attempting to reduce this stress and anxiety that nurses face in the new health care environment, Dr. Planas said. The national association, the veteran nurse, said: “has a COVID-19 resource center on its website that lists various resources for members such as what other chapters are doing throughout the U.S., mental health resources, call to action for nurses and PPE (to name a few items).”
Dr. Planas added that during the Connecticut NAHN chapter’s most recent meeting, there were discussions about what kinds of work members were performing as well as suggesting access to a webinar titled “caring for yourself and others during the pandemic: Managing healthcare worker stress.”
Dr. Krol sees excellent career opportunities for Hispanics in health care. “We need more Hispanic nurses, and we need them now.”