Contributor – Rachel Krogstie, MSN, RN
Nurse Educator | Ph.D. Student in Nursing Science

According to the International Diabetes Federation, the United States has the third-highest number of adults with diabetes (International Diabetes Federation, 2025). Of these adults, an overwhelming majority are in a minority ethnic group. Mexican and Mexican American people with diabetes make up approximately 12.3 percent of the population (National Center for Health Statistics, 2024). So, when I was considering  a population to study for my dissertation on diabetes, this population seemed like the one that would yield the most promising results. I live in a very populous part of Texas with many places to reach Mexican American people living with diabetes. I wanted to engage them in interviews about their experience of living with diabetes –  not anything invasive. Unfortunately, when I started looking to engage  participants for the study, this was far from the truth. 

I have always had a passion for alternative and complementary medicine. Therefore, I thought it was a natural step to incorporate this passion into my research for my dissertation. I explored multiple approaches to this topic; however, I ultimately settled on plant-based supplements for diabetes management in Mexican women. I began searching for participants to interview at the start of 2025, coinciding with the country’s shifting political environment. I started noticing that no matter how many people or clinics I contacted, I either received no answer or a solid refusal. No one wanted to speak to me about healthcare or even about medications. I only interviewed one person for my feasibility study. So, my study was a tremendous failure. 

I had to re-evaluate how this study could move forward. To assist in this, I am returning to where my passions lie, in transcultural nursing. Transcultural Nursing  was introduced in 1991 by Dr. Madeleine Leininger, and some of the significant concepts include the client’s culture, worldview, and holistic health and well-being (Fawcett, 2018). One of the primary goals is to provide culturally competent and congruent care to people that is beneficial and aligns with their worldview. Returning to this framework raises the question: Is now the right time to target this particular marginalized population for research? Being the type of person I am, I did not want to give up this fight this quickly. I wanted the voices of these women to be heard and for the value of the alternative treatments to be seen.

However, in my pursuit to make my decision the correct one, I came across Dr. Marilyn Ray’s Transcultural Caring Dynamics in Nursing and Health Care Theory (Ray, 2018). In this theory, the central tenet speaks to Transcultural Caring Awareness, Understanding, and Choice. It was the choice part that showed me my path forward. This tenet pertains to the process of transcultural inquiry, encompassing transcultural ethics and context. These are mutual decisions that create environments of ethical caring and health. Although my research may have the best intentions and is definitely needed, it is not timely or beneficial for this particular population, given the current political culture and environment. So, I have to move on and find a new study or a new population. 

Through this journey, I have learned many lessons. I, like many others, was taught in nursing school that we leave our politics and opinions at the door; it has no business in our practice. However, through this feasibility process and the coursework that has led to it, I have found that this is not true. Politics and nursing are linked. What our representatives vote into law or sign into being affects the way we care for our patients and how those patients perceive healthcare. Second, research is messy, and you have to get your hands dirty to accomplish anything. Starting over is hard, but maintaining the standards of ethical and culturally sensitive research is more important than pushing through just for the sake of research. Lastly, failure in research is not the end of the road. It is a point to reflect and regroup. Thomas Edison famously said, “Many of life’s failures are people who did not realize how close they were to success when they gave up.” He created over a thousand versions of the light bulb before succeeding. When asked about his failures, he said, “I have not failed. I’ve just found 1,000 ways that won’t work. When I have eliminated the ways that will not work, I will find the way that will work.” So, off I go to find another way to make this study work! 

References

Fawcett, J. (2018, September 3). Leininger’s theory of culture care diversity and universality. Nursology. Retrieved Feb 18, 2024, from https://nursology.net/nurse-theories/leiningers-theory-of-culture-care-diversity-and-universality/

International Diabetes Federation. (2025). Diabetes Atlas: United States of America. International Diabetes Federation Diabetes Atlas. Retrieved Oct 12, 2025, from https://diabetesatlas.org/data-by-location/country/united-states-of-america/

National Center for Health Statistics. (2024). Percentage of diagnosed diabetes for adults aged 18 and over, United States, 2024. Centers for Disease Control and Prevention: National Center for Health Statistics. Retrieved Oct 12, 2025, from https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html

Ray, M. (2018, September 20). Transcultural caring dynamics in nursing and health care. Nursology. Retrieved Feb 18, 2024, from https://nursology.net/nurse-theories/transcultural-caring-dynamics-in-nursing-and-health-care/

About Rachel Krogstie

Rachel Krogstie is a dedicated nurse educator and Ph.D. student in Nursing Science at Texas Woman’s University, where her research focuses on alternative and complementary therapies for chronic diseases, particularly diabetes. Rachel’s healthcare journey began in the U.S. Navy, where she served nearly a decade as a Hospital Corpsman. Her time in service provided diverse clinical experiences that deepened her commitment to patient care and laid the foundation for her future in nursing. Following her military service, Rachel earned her Bachelor of Science in Nursing (BSN) and then began pursuing her first nursing passion, nursing education, by completing her Master of Science in Nursing Education.

Rachel returned to Texas in June 2020, during the height of the COVID-19 pandemic, where she has continued to advance both her clinical expertise and her impact on the next generation of nurses. When she’s not teaching or researching, Rachel enjoys spending time with her beloved cats and proudly embraces her role as a devoted fur-mom.