A Tucson native who has spent her career working with Hispanic and Latino communities, Dr. Kiser is intimately acquainted with the need for culturally congruent health care that addresses the needs of native communities both in the U.S. and Mexico.

Rotary International District 5500 invited Dr. Kiser to Clinica Integral Almas in Alamos, Mexico, to help provide training and support for fourteen indigenous health promoters (or promatoras) from the Makurawe communities that surround Alamos, Mexico. Together with Southeast Arizona Area Health Education Center (SEAHEC) border binational coordinator Brenda Sanchez and Rotary Global Grants Coordinator Barbara Kiernan, Dr. Kiser travelled to Alamos on a trip that was part exploratory and part instructive. “We did a few trainings but we also wanted to learn about the community,” she says. “Before we brought students to their communities, we wanted to meet them and become introduced to their culture.”

"Clinica Integral Almas is a bridge between the traditional Mexican health care system and their traditional ways of healing and knowing, and we get to help connect both the clinic and the communities to our wonderful nursing community here at the College of Nursing.” ~ Lisa Kiser, DNP, CNM, WHNP, UArizona Nursing Clinical Assistant Professor

Dr. Kiser explains that, just as in the U.S., outlying rural communities like the Makurawe have access to fewer health services. The Mexican health care system attempts to connect with these populations but resources are scarce and travel times for patients to reach clinics are lengthy. “They encourage people to come in, but it’s a two to 7-hour drive on dirt roads, many of which are impassable in winter,” she says.

The goal of the Alamos binational effort is to provide Makurawe health promoters with training, supplies and technology such as solar-powered computer systems in order to increase their access to health care. Both Dr. Kiser and Brenda Sanchez emphasize, however, that the effort was anything but top-down. Cultural sensitivity and engagement were highest priorities for the team.

“I work with promatoras here in Arizona, so I was trying to find the similarities and the differences between the framework that we use here in the U.S. and the framework that is being used in Alamos,” says Sanchez. “They’re the bridge between the health care system and their community. At the end of the day, promatoras know their community best.”

“One of the things we learned is you’re coming into a system where there’s already traditional health care happening,” echoes Dr. Kiser. “With our current efforts around global health, we’re emphasizing to our students a model of global health where it’s not us coming to help. We’re partnering with these communities.”

During their four-day visit Dr. Kiser and Sanchez listened as much as they spoke. They worked with Clinica Integral Almas to determine next steps for needed trainings, community outreach, and potential community health fairs. They conducted direct engagement around reproductive health, basic anatomy, physical assessments, vital signs, and vector-borne diseases like malaria and dengue fever. They also learned about traditional Makurawe ways of healing. “We realized that they’re already doing health care, traditional health care, but still very important,” says Sanchez. “It’s just as valid as western medicine.”

Dr. Kiser wants to bring that realization to the training UArizona DNP students receive when the first immersion binational borderlands learning experience commences in March, 2020. Receiving a fully-funded student learning opportunity is rare, and we are grateful for our partnership with Rotary International District 5500.  This is an important opportunity to demonstrate the valuable contributions of UArizona Global Nursing to support the health of individuals and communities in Alamos, Mexico while focusing on the student educational experience.

Dr. Kiser envisions the seven-day trip as a chance for a fertile border binational exchange.  Two faculty—Dr. Kiser, and Martha Lizarraga de Garcia, MSN, RN, CFNP, will travel to Alamos with six DNP students.  DNP students will have the opportunity to learn from local health care workers about the needs and strengths of their community health knowledge, practices and infrastructure. They will also help develop community health fairs, observe healthcare provided by the Clinica Almas staff, and possibly source ideas for their required DNP projects.

In the end, the opportunity is a gift for both sides of the border. “We get to be bridges between the two cultures,” says Dr. Kiser. “Clinica Integral Almas is a bridge between the traditional Mexican health care system and their traditional ways of healing and knowing, and we get to help connect both the clinic and the communities to our wonderful nursing community here at the College of Nursing.”

Why did you choose to pursue nurse anesthesia in particular?

When I was researching the prerequisites for the nursing program and learning about best practices, I found out that nurse anesthetists can have much more independence to make decisions about what medicine they can give patients. They’re highly trained to deal with difficult situations like Code Blue. They have to manage everything, they’re very educated, very close to the work that anesthesiologists do. That really appealed to me.

"Nursing is a really worthy profession. Whenever you see your patients get better, you feel so awesome.” ~ Hyun Ju Oh, Senior Doctorate of Nursing Practice student with Nurse Anesthetist specialty

Why did you choose the UArizona Nurse Anesthesia program?

I was impressed by the online hype about the program. I found only a couple of programs that offered nurse anesthesia school and I found that the UA program provides a hybrid program that only requires me to travel to Tucson a couple of times per semester. That was a really big advantage for me since I’m based in Southern California. For the first half of the program, we focused on theory and then after that we started doing some clinical work. When we were winding up the first part of the program, I was actually able to work as a part-time nurse while I was taking some classes, so that was really nice for me. That flexibility is a big reason I chose UArizona to pursue nurse anesthesia.

What features of the UArizona program are you especially passionate about?

I actually love pharmacology. I love to learn about different drugs, so those are my favorite subjects in the anesthesia classes. I was already interested in pharmaceuticals while I was working as a nurse, because when you give patients medicine you see the results right away.

Share a favorite memory from your time at UArizona Nursing.

One of my favorite experiences in Arizona was during the Resident Intensive Summer Experience (RISE). As juniors, we took one day with the senior students in the Simulation Lab. Senior students came into our classroom and actually became our instructors for that day, so it was one-to-one instruction. Another favorite memory, now that I’m a senior, is when I did the same exercise with my junior students. I came down to the sim lab and taught them. It was a really interesting and rewarding experience for me to share my knowledge with up-and-comers.

During your final year, you’re immersed in your clinical rotations. Are you working as well?

Actually, no. Right now, I’m working four to five days, day and night, doing my clinical rotations at Arrowhead Regional Medical Center in San Bernardino County, so I’m pretty tied up with that. But I’m looking for some jobs already. Some of my classmates have already found jobs, so I’m going to start applying.

What are your plans and goals for the future?

Even though English is my second language, and I have some language barriers, I love teaching. I see myself teaching in the future. Even in my current clinical rotation, I have taken some medical students into my room and taught them, and I love it. Within five years, I would like to be a preceptor for newly hired CRNAs. Or maybe I’ll look for an opportunity as a clinical instructor for a nurse anesthesia program.

Do you hold any other degrees?

I studied nursing here in the United States, but back in the past in South Korea I was a kindergarten teacher and I had a degree in education.

"The college of nursing represents so many different aspects of nursing as a practice and so many different types of nursing, that after working as a nurse in various places around the city, it feels like I am finally coming home.” ~ De Anne Dwight, MSN, CRSS, Clinical Instructor, UArizona Nursing

What attracted you to the UArizona College of Nursing?

Living in Tucson, I appreciate the sense of community the university brings to the whole city.  It is an honor to be a part of that.  The college of nursing represents so many different aspects of nursing as a practice and so many different types of nursing, that after working as a nurse in various places around the city, it feels like I am finally coming home. If you are passionate about nursing, it just makes sense to share it with others who are also, and to be able to pass that on to the next generation of nurses.    

What is your field of research/specialty?

Working in the emergency room for many years, the behavioral health patients became my focus. Research shows adults living with mental illness die up to 32 years earlier than other adults in Arizona. That is basically and entire lifetime. When I heard that I wanted to do whatever I could to give someone or their loved one back their life. I am always interested in integrative care, peer support, and innovative ways to provide patient health education.     

Where are you from originally?

Baltimore, Maryland but then I moved to the Outer Banks of North Carolina in my senior year of high school.  Then on to Florida where I joined the military, Memphis, and then Yuma. 

What do you like to do in your free time?

I love being in the sun, period.  Either by a pool, hiking, or preferably by a beach. If I cannot be at the beach, then glamping and riding my four-wheeler in the desert full of saguaros with my husband, my dog and no cell phone service is a close second.

"It’s so much fun to see our Nursing students realize just how much they’ve learned in their program. As they’re teaching these kids, you just see them light up. For me that’s just great because they always say that this experience really brought home to them how much they’ve learned during their studies.” ~ Amy Boise, Assistant Site Coordinator, Phoenix Masters Entry, UArizona Nursing

“The Wildcat Hospital has interactive activities for pretty much all ages,” says Amy Boise, Assistant Site Coordinator, Phoenix Masters Entry, Nursing, who is one of the coordinators of the Hospital. “They learn everything from how to do eye charts, to hand cleaning with UV germ lights, to bandaging boo-boos on dolls and stuffed animals.”

The Hospital also featured two pediatric simulation mannequins that kids will had an opportunity to examine using stethoscopes and reflex hammers. “We even have teaching stethoscopes,” says Boise. “Our nursing students have a set in their ears and the kids have one in their ears, and then we listen to their heart and lungs and tell them what the sounds are they’re hearing.”

Another popular feature of the attraction is the Wildcat photo booth, where kids donned a miniature white coat and stethoscope and posed for photos with their parents.

The event was rewarding for both the kids and the UArizona Nursing students who take part. “It gives children a real opportunity to see that there’s something for everyone in STEM,” says Boise. “But it’s also so much fun to see our Nursing students realize just how much they’ve learned in their program. As they’re teaching these kids, you just see them light up. For me that’s just great because they always say that this experience really brought home to them how much they’ve learned during their studies.”

Connect2STEM 2020 occurred Saturday, January 25 at the UArizona College of Medicine - Phoenix on the Phoenix Biomedical Campus, located at 475 N. 5^th St. in downtown Phoenix. For more information visit the official Connect2Stem site.

Current Beta Mu President, Clinical Assistant Professor Carolina Baldwin, DNP, RN, CCRN, accepted the Chapter Key Award at Sigma’s Chapter Awards Recognition Event. “It was a real honor,” says Dr. Baldwin, who credits the win to the strong engagement of Beta Mu’s more than 400 members and the dedication of its leadership. “We have a bunch of great people working on the board,” she says. “They love nursing, they love patients, they love nurses, they love students, and they’re just trying to do their best.”

"We have a bunch of great people working on the board. They love nursing, they love patients, they love nurses, they love students, and they’re just trying to do their best.” ~ Carolina Baldwin, DNP, RN, CCRN

Beta Mu’s path to success within Sigma Theta Tau has been paved with many accomplishments. In addition to developing and presenting educational health programs for the Tucson community and forging bonds with international allies, the chapter keeps its roster strong with an annual induction ceremony for qualifying candidates.

Dr. Baldwin explains that there are two ways to become a Beta Mu member: being a high-performing student or demonstrating excellence as a nurse leader. “We send invitations to all our students,” she says, “and the ones that qualify are inducted in the April ceremony.” New members receive purple and white graduation cords that signify their Beta Mu membership, which is a lifetime honor and can be transferred to other Sigma Theta Tau chapters if members relocate to different states.

Last month, Beta Mu formed an educational program that will enable the chapter to expand its good works to an international stage. The move comes at an opportune time, considering UArizona Nursing’s growing focus on global education. Beta Mu is in the opening stages of a venture that will ultimately see its members embarking on medical trips to Africa. “Every year we fundraise to benefit a deserving group,” says Dr. Baldwin. “Usually, we choose a local organization, but this year the board voted that any funds we collect are going toward a program aimed at helping the people of Kenya.” Past Beta Mu President and UArizona Nursing Clinical Instructor Stephanie Ann Donovan, BSN, MSNEd, CCRN, is spearheading the effort, which the chapter hopes to launch this year.

Dr. Baldwin is in the second and final year of her term as president, but she couldn’t be more proud of the part she has played in the chapter’s most recent success. When she filled out the application for the chapter key award, one requirement was an accounting of Beta Mu’s local, national and international activity. The response she received was inspiring.

“I put out a call to our faculty members to please send me what they had done over these last two years and the response was overwhelming,” she says. “Within 10 minutes I thought my email was going to crash from the amount of material I received from the members from the college. The response from our student members was equally unbelievable. The chapter key award speaks to all of that. That’s really what you’re showing when you fill out that application -- that the members are publishing, that they’re presenting, that they’re involved in educational programs and that they’re sharing their knowledge with the rest of Sigma Theta Tau.”

"The recent U.S. News and World Report ranking is further evidence of our commitment to excellence and innovation in nursing education and to meeting the educational aspirations of veterans.” ~ Ki Moore, Dean, UArizona Nursing

“I am so proud of our Online Masters of Science in Nursing Clinical Systems Leadership program and the outstanding faculty who are dedicated to preparing the next generation of nursing leaders,” said UArizona Nursing Dean Ki Moore, PhD, RN, FAAN. “The recent U.S. News and World Report ranking is further evidence of our commitment to excellence and innovation in nursing education and to meeting the educational aspirations of veterans.”

A master's degree in nursing can pave the way for more advanced roles in administration and leadership. UArizona Nursing’s Online Master of Science in Nursing Clinical Systems Leadership program is designed to strengthen students’ patient care and leadership abilities as well as expanding their expertise and understanding of emerging interventions and technologies. The program also teaches students about the inner workings of care systems across a spectrum of health environments.

The Clinical Systems Leadership program offers two tracks: One for students who hold an associate degree in nursing (ADN) and one for students holding a bachelor of science in nursing degree (BSN). The RN-MSN program is paced for employed RNs (ADN or BSN), with three annual starts, and continuous 7.5 week-long course access. The program can completed in 15-24 months with majority emphasis on systems leadership. Learn more about the program here.

"After speaking with students from several other schools, I realized how blessed I was to be able to apply the skills I was acquiring into bedside nursing. Many other programs weren’t offering nearly as many hours in clinical settings which made it more difficult for those students to integrate into nursing positions after graduation.” ~ Gillian Fernandez, Graduating BSN Student, Class of 2019

What features of your program are you especially passionate about?

I am passionate about the amount of time that students have access to in clinical settings. After speaking with students from several other schools, I realized how blessed I was to be able to apply the skills I was acquiring into bedside nursing. Many other programs weren’t offering nearly as many hours in clinical settings which made it more difficult for those students to integrate into nursing positions after graduation. The College of Nursing does a great job providing students time to implement their knowledge in a safe and practical manner. 

What faculty particularly made the biggest impressions on you?

While there was a faculty member each semester that left me with a lasting impression, Dr. Sharon Hom left the biggest impression on my developing career. Dr. Hom teaches pathophysiology in the first semester of the four-semester program. She applies herself to her work and offers students as much knowledge and support as possible. The biggest impression she made for me was her kindness. Dr. Hom was consistently compassionate each day and offered students words of encouragement during difficult weeks.

Can you share a favorite memory from your time at the College of Nursing?

One of my favorite memories at the College of Nursing was learning how to insert peripheral IVs into the simulation arms of the SILC lab. I fondly remember spending a lot of time in the lab practicing the skill with friends and offering each other support. For me, it was one of the first skills that I learned where I truly felt like I was becoming a nurse.

What are your hopes for the future?

After graduation, I will be staying in Tucson, Arizona and will take a new graduate RN position on Banner University Medical Center’s trauma ICU. I hope to continue improving the nursing care behind trauma and burns at the bedside and policy level. I am also extremely passionate about the prevention of central line infections. In the distant future, I plan to continue my education for a Master’s of Science in Nursing (MSN).

What are your extracurricular activities?

Throughout nursing school, I mentored and tutored pre-nursing and nursing students in subjects that I had already completed. I also spent time shadowing nurses in several fields to better understand the environment I was hoping to work in post-graduation. During my time in nursing school, I also began networking with the board members of the American Organization of Nurse Leaders (AONL) to better comprehend legislative matters that influence nursing practice. I have completed several certifications including Advanced Cardiovascular Life Support and the NIH Stroke Scale. Throughout my four semesters with the College of Nursing, I was an active member within the Student Nurses at the University of Arizona (SNUA) and participated in as many social and volunteer opportunities as possible. One of my favorite volunteer opportunities was answering questions for pre-nursing students after their interviews each semester. I have also volunteered for several events around Tucson such as the annual Tucson Nurses’ Week Foundation Conference and Gala. In the future, I hope to do more fundraising for cancer research through the American Cancer Society.

Students were able to compare and contrast the health care systems – both acute and public health - of each country. “We brought a border binational focus to the curriculum,” Dr. Larson said. “Students were able to identify binational strengths, differences and similarities and, develop hopefully lifelong relationships with UNISON nursing students in just a few short days.”

The fast-paced program, which often immersed faculty and students in 16-hour days, allowed MEPN students to conduct a comprehensive community assessment. The assessment considered factors such as history, epidemiological and population data, and how the health of the community is influenced by local health care systems, politics, government, education, transportation, safety and communication. Students from UNISON’s baccalaureate program paired with UArizona Nursing students, embarking on an academic journey to understand population-level health and health care systems in Sonora, Mexico.

“Our UNISON nursing faculty partners carefully selected the student ambassadors who worked one-on-one with our MEPN students,” said Dr. Larson. “UNISON students were fluent in English and Spanish, decreasing language barriers contributed to an effective the partnership because content and concepts could be delivered in both languages. Our students crossed the border with a smattering of Spanish, but returned five days later with a greater understanding of binational health issues due to the rich immersion experience. They learned to tune in empathetically to all the nonverbals of what was going on with the people they were interacting with.”

Claire Bethel, a UArizona Nursing PhD student who was part of the group, added, “Our students were hungry to have discussions with our health care colleagues in Sonora regarding public health issues facing immigrant communities. This is especially important considering our geographic location as the largest city in Southern Arizona closest to the US-Mexico border. As future nurses, the students were eager to learn about how they could take what they learned from this experience to provide better care to immigrant communities at home in Tucson.”

The Hermosillo experience culminated with an interdisciplinary community health fair delivered at a colonia, an acutely disadvantaged community on the outskirts of the city. The pop-up fair featured health promotion and risk reduction health education about public health issues such as healthy diet, vaccination, pap smears, breast exams, diabetes, dental health and accessing public health services.

This experience proved pivotal once the UArizona nursing students returned north of the border. “Much of the colonia is composed of migrant communities and there’s a lot of abject poverty,” said Dr. Larson. “Our students were able to compare and contrast binational migrant health issues after conducting a focused community assessment of Tucson South side neighborhoods.” 

Bolstered by their new insights, students divided into two groups to develop interventions based on analysis of the binational community assessment data. The next step was to identify a population-level nursing diagnoses to focus risk reducing and health promoting interventions for a similar population in the U.S.  Students chose migrant families in the Catholic Community Services of Southern Arizona’s Casa Alitas program as the recipient of their interventions. Casa Alitas provides care and short-term shelter to migrant families who have left their home countries to escape violence and poverty.

“The students were able to contextualize their experience because of the knowledge they gained in Sonora about the migrant population,” said Dr. McEwen. “Students were concerned about being responsive to the health care needs of migrants seeking asylum in the U.S. from Mexico as well as Central America.  Students were committed to providing culturally tailored interventions for this vulnerable population.”

One intervention focused on ways for people to stay hydrated using inexpensive rehydration fluids with the correct balance of sugars and salts. The second intervention zeroed in on ways to manage stress. Stress is a major factor for migrants who are briefly with Casa Alitas and are coping with the major upheaval of adjusting to a new country and language, often before journeying across the country to connect with family members or other services.

“Casa Alitas staff were so impressed with the intervention,” said Dr. McEwen. “And the migrants were grateful for the information and strategies they received, real things in terms of breathing, in terms of soothing teas, strategies that are portable because they’re on the move.” The educational intervention was conducted in a hotbed of stress, the room in which continually operating monitors inform migrants when the next phase of their journey will begin, whether it is by train, bus or plane. “There are layers and layers of stress, because these are families have been broken apart, waiting to move to the next step,” said Dr. Larson.  “It was amazing what these students did, their interventions were on target and well received by the migrants.”

Drs. McEwen and Larson were pleased with the binational component of the clinical experience and with students who exceeded learner outcomes for the course. They plan to offer the binational experience as an option within the MEPN Population and Community Health Nursing course next year. With positive results for both our partners at UNISON and our UArizona Nursing students, the cultural and health systems immersion was a vibrant success. “I think it is safe to assume that these students have been changed as nurses,” said Dr. McEwen. “They will see their patients in the future very differently than students who have not had this kind of global opportunity. In their role as nurses, when their patient is not from our country or speak the English language, they’re going to ask ‘How do I best communicate with this individual? How can I best advocate on their behalf? What might their cultural beliefs and values be about the health care they are expecting to receive? And how can we help them understand how health care delivered in the U.S. might differ from health care in their country of origin?” The Hermosillo clinical rotation is aligned with the College of Nursing Global Strategic Plan for providing binational student experiences in partnership with our nursing colleagues in Mexico.