Contributor – Patricia Isela Regalado, MSN, RN, CNE,
RCFE Administrator
They say nursing is a profession you can trust. Acts of caring, advocacy, and dignity have been woven into the fabric of nursing since the start of our profession. As nurses, we have prided ourselves on holding ourselves to high moral, ethical, and humanitarian standards. Peace and Power encourages us to remember that we cannot practice genuine caring and collaboration without respect, shared responsibility, and honoring dignity in every person, including those that policy and society push to the margins.
Clinics and hospitals have not always been safe spaces for immigrant families. More specifically, mixed-status families have been navigating hospitals and clinics with fear for years. I have quietly sat by over the years watching Immigration and Customs Enforcement (ICE) policies and procedures trickle into clinic spaces by way of increased surveillance, local law enforcement collaborations, and ICE raids interrupting our patient stories on local news stations (Hacker et al., 2011; Rhodes et al., 2015).
ICE may not be physically inside of clinics, but their presence is felt in the waiting rooms, exam rooms, and neighborhoods where nurses provide care. Immigration enforcement has created a sickening hush over nursing. There is something misaligned when what we write in our code of ethics is not what many of our patients and nurses are experiencing.
This is not immigration talking. This is nursing talking. We understand that immigrants receive delayed care, utilize less preventive care, and under-utilize health care when there is immigration enforcement or fear of ICE (Rhodes et al., 2015). What we don’t talk about as often is how detrimental this is to nurses. I worry about the undocumented nurses who have graduated from nursing school. I think of first-generation nurses and Mexican American nurses who look at their patients and see their families and neighbors. Going to work and providing health care for our families do not always fit into a 9-5 schedule for immigrant nurses and nurses who work with communities most impacted by ICE.
Peace and Power shows us that healing begins when we come together as a community. When we listen to each other with intention and engage in shared decision-making. How can we practice patient-centered care when the systems we work in were not designed with families like ours in mind? Moral distress, compassion fatigue, and powerlessness are emotions nurses experience when we have to provide nursing care that may harm our community to meet our employer’s expectations. Providing care already requires us to process a lot of emotions in our day-to-day work. This emotional labor follows us home after work and shapes how minoritized nurses perceive our profession and our ability to be scholars and leaders.
Immigration enforcement impacts more than our patients. Immigration policy and the separation of families impact who makes it through nursing school and who makes it into nursing academia. Latinx students, first-generation nursing students, and nurses of color were few when we decided to pursue master’s and doctoral level education have already overcome systemic challenges to academic persistence. Some of these challenges include financial burden, lack of faculty mentorship, and navigating institutions that were not designed with students of color in mind. Add on increased family stress, responsibilities, and fear caused by ICE and nursing school is no longer attainable.
I have spoken to several other first-generation nurse academics who all say the same thing: stress from immigration is what ultimately decides if they will finish school. There are very few people who have that kind of privilege who make it to promotion and tenure review as a first-gen nurse scholar. Research becomes very personal when the theories you read every day don’t look like you. Reading about Latinx student experiences in K-12 opened my eyes, but it wasn’t until I read Tara Yosso’s work on Community Cultural Wealth that I felt represented in academia. Yosso (2005) dismantles deficit perspectives of Communities of Color by articulating the various capitals these students already possess, such as aspirational, familial, social, linguistic, navigational, and resistant capital.
When nurses and students are pushed out of academia because they cannot financially afford it or do not see how earning a higher degree will benefit their communities (because they have already been excluded from them for so long), nursing loses. We lose community insight, we lose desperately needed research that will challenge how we teach and mentor future students, and we lose future leaders who understand health equity is more than just a noun we can insert into our research proposals.
Our national organizations love to speak about increasing diversity in nursing leadership and reducing health disparities. (National Academies of Sciences, Engineering, and Medicine, 2021) But if we do not address how ICE and trauma do not allow more room in nursing and academia for those who do not look like the nurses and students, we will continue to devalue our profession.
Creating trauma-informed pipelines for nurses and students from historically minoritized groups to succeed in academia is imperative. Peace and Power asks us to move into higher love by practicing love, justice, and empowering our communities as a necessary part of our nursing integrity. How we value and accept how knowledge is gained and displayed by nurses will and should dictate our peace and our power.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https: //www.nursingworld.org/coe-view-only
Hacker, K., Chu, J., Leung, C., Marra, R., Pirie, A., Brahimi, M., English, M., & Marlin, R. P. (2011). The impact of Immigration and Customs Enforcement on immigrant health. Social Science & Medicine , 73 (4), 586–594. https: //doi.org/10.1016/j.socscimed.2011.06.007
National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity . https: //doi.org/10.17226/25982
Rhodes, S. D., https://nursology.net/nurse-theorists-and-their-work/peace-power/Mann, L.,
Simán, F. M., Song, E., Alonzo, J., Downs, M., Lawlor, E., Martinez, O., Sun, C. J., & O’Brien, M. C. (2015). The impact of local immigration enforcement policies on the health of immigrant Hispanics/Latinos . American Journal of Public Health , 105 (2), 329–337. https://doi.org/10.2105/AJPH.2014.302218
Yosso, T. J. (2005). Whose culture has capital? A critical race theory discussion of community cultural wealth . Race Ethnicity and Education , 8 (1) 69–91. https://doi.org/10.1080/1361332052000341006
About Patricia Isela Regalado
Patricia Isela Regalado is a first-generation Mexican American nurse scholar with more than 28 years of experience in clinical practice, nursing leadership, and nursing education. She currently serves as Assistant Program Director for the Vocational Nursing Program at Stanbridge University, Riverside, California. Her professional background spans acute and long-term care, academic administration, and faculty roles in vocational and registered nursing programs. She is a United States Air Force veteran, having served as a Combat Medic and Non-Commissioned Officer in Charge. Instructor Regalado holds BSN and MSN degrees from the University of Texas at Arlington and is currently pursuing a PhD in Nursing at Texas Woman’s University. Her scholarly interests include health literacy, health equity, nursing education, and workforce diversity.