Welcome to this episode of NLN podcast Nursing EDge Unscripted the Scholarship track. I'm your host Dr. Steven Palazzo, a member of the editorial board for the Nursing Education Perspectives. Nursing EDge Unscripted and our track entitled Scholarship celebrates the published work of selection educators from NLN's official journal Nursing Education Perspectives and the NLN
Nursing EDge blog. The conversation embraces the author's unique perspective on teaching, learning, innovation, and the implications for nursing program development and enhancement. This episode is on the collaboration between faculty members and nurses in all environments. We will discuss the author's article, The Lived Experience of DACA Recipients Who Are US Nursing Program Graduates and Their Pathways to Professional Licensure,
A Phenomenological Study. The discussion will focus on the unique findings of the author who published the manuscript and will be published in the manuscript November December this week, volume 43 number six of Nursing Education Perspectives. Our speaker today is Dr. Deborah Richardson who is an associate professor of nursing at Dalton State College in Georgia. Well, welcome Dr. Richardson. We're very happy to have you here today. Thank you. I'm honored to be here.
So let's start by beginning with the summarization of your study and the four themes that emerged. Yes. I studied the lived experience of deferred action for childhood arrivals who are US nursing program graduates and their paths to professional licensure. I don't know if it would be helpful to have a little more background for your readers. I think so. I think if you wanted to talk a little bit about the four themes that emerged in your work and maybe briefly what interested you in
this, what got you interested? Yeah. Well, a lot of nursing faculty who speak with me about this were completely unaware of deferred action for childhood arrivals or its impact on nursing, nursing education and the experience of the students and the nurses who are DACA recipients. It may be important to know that in 1982 the Supreme Court ruled that laws denying K12 education to undocumented children violated the equal access or equal protection clause
of the 14th amendment. 32 years after SCOTUS tasked Congress with creating a pathway for these children to receive some form of official presence, multiple drafts of the DREAM Act had failed in Congress and these students, many of them honor students, were graduating from high school with no documented status. Sort of they described themselves often as living in the shadows. They couldn't get employment. They weren't authorized to drive a car. They couldn't
get a driver's license. And so higher education was nearly impossible for many of them. Because Congress failed to pass multiple drafts of what came to become came to be known as the Dream Act. The Obama administration in 2012, 30 years after the SCOTUS ruling, created an executive action, Deferred Action for Childhood Arrivals, which essentially provides temporary relief from the threat of deportation, and it provides work authorization to certain undocumented young
people. They have to meet very specific criteria. As a result of DACA, many of these students were able to complete programs of nursing and become registered nurses. However, some states continued to withhold licensure for DACA recipients and some nursing programs refuse to admit DACA recipients to their programs. So increasingly random news articles, personal anecdotes were being published about this phenomenon, but I could find nothing about it in the nursing
literature. There was no research related to DACA recipients and their pathways to nursing licensure. So I got full board IRB approval for a descriptive phenomenological study. Hermeneutic phenomenology framed my study and the analysis followed Colaizzi’s process of qualitative analysis. My main question was what is the lived experience of DACA recipients who are US nursing program graduates
and have obtained professional licensure. So the inclusion criteria for my purpose of sample was they must be undocumented immigrants who had received deferred action for childhood arrivals. They had to be a graduate of a US nursing program and they had to be licensed as a professional registered nurse. And this yielded a sample size of 17 which of course was determined by data analysis additional interviews until the data were
saturated. The national sample of 17 participants resided in nine different states and represented each region of the United States. So tell me about the four themes that emerged. Sure. I had to really focus in on my research question and focus on their becoming registered nurses. And so, four overarching themes emerged that included pursuing the dream, finding support, figuring it out, and advocating for others. I found that pursuing the dream was
not limited to careers in nursing. Participants tended to describe a dream of being valued being respected as an individual. Imagine a lifetime of being called illegal. Just the term, right? The stigma associated with that. Yes. And so professional accomplishment was a means of achieving that value. I think one of the participants Maya explained it best. She said, "as a DACA recipient I felt like my humanity was always being questioned, but as a nurse..." Profound.
I never about that. Wow. Yes. And as a nurse, she felt that very fortunate that she could make therapeutic connections with patients and that they were both able to see humanity in that. That were that was her specific phraseology that we could see humanity in that. So pursuing the dream of course did involve nursing but for many of the participants nursing was not their first choice.
That actualization many of them began pursuing medicine or law, MBAs, research degrees, scientists, and teachers, educators but once they experienced that value of humanity, that is evident in nursing their goals changed and they wanted to become professional nurses. Receiving DACA, of course, was pivotal to that, right? Because DACA made that possibility of becoming a nurse realizable. Mia described her life before DACA. She said, "I felt like I was stuck. It felt like my wings
were cut off. I wanted to do so much and I knew my potential but I was unable to do it because of a piece of paper." I am moved every time I read that quote. Because DACA provided for them a social security number, increased access to employment income, which of course they had to have to afford a higher education. And it just created a chance to fulfill their dream of becoming a nurse. What would you suggest or suggestions you have for those educators
wanting to support their DACA students? Many of the participants spoke of the need for support in addition to support that they found for overcoming fear, discouragement, defeat, uncertainty, the constant threat that if DACA went away, they could be deported. And then of course the threat that any member of their family could be deported. That separation, that
constant fear of separation. They had personal support systems and faith support systems, but many of them mentioned support that they received from faculty, particularly faculty who showed enough interest in them to encourage them to self-disclose their status and thereby reveal the need for those additional resources.
So, as an educator in my classroom and students that I recognize or will have reported to me, their status, it sounds like listening and support are the things that they need the most from me as an educator. What kind of resources would I would be helping me to offer those students? It's important to know that despite having a social security number and paying state, local, and federal taxes, DACA recipients are exempt from federal funded student aid.
So, private scholarships, any campus resources as far as funding that you are aware of. There are several organizations who provide scholarships that are not exclusive of DACA recipients. So if a nurse faculty member can just you know as you learn of things create a list of these resources. I get on mailing lists. So some of these organizations will just send me an alert.
Applications for this scholarship are now open or will be open in February and then I can forward that to students that I know could benefit from that additional funding. It's also important to know that in many states DACA recipients pay out-of-state tuition. They're often classified as non-resident aliens because of their lack of lawful presence, documented presence and therefore they pay nearly three times the tuition that other students pay. So nursing faculty are encouraged to
advocate for in-state tuition. these students pay the state tax that affords other residents in-state tuition. It's just a matter of justice to also allow them in-state tuition. You find this the biggest logistical challenge they face in nursing school is the financial piece and the access to the funding, scholarships, etc. or are there other logistical pieces that make it difficult for them to traverse the system? There are other things
that make it difficult. Some clinical sites misunderstand that DACA recipients have social security numbers and authorization for employment. There are programs of nursing who also misunderstand that DACA recipients can't attend clinical. So I found a few university websites that actually had a disclaimer for DACA recipients not to apply because they couldn't be licensed in that state. It's very important for nurse faculty to remember that the National Council of State Boards of
Nursing is a national organization. NCLEX is a nationally standardized exam and unless we exclude every student who may choose to become licensed in another state, it's unethical to exclude students from our programs who may be required to become licensed in another state. So, a lot of misinformation out there. Yes. How is a nurse educator, how would you suggesting educator impact at that policy level at the local, state,
federal level, if they were children? What could I do locally in my community to help impact policy or do I have to go more towards the federal level? First, at that local level, nurse faculty need to advocate against dehumanizing language. For example, we should eliminate the word illegal from our vocabulary in reference to human beings. Actions are unlawful. Never, never individuals. And you know that value of people and respect for individuals is what draws some DACA recipients to
nursing. So it's implicit for us to ensure that those values are manifested in our programs of nursing. We know that FERPA restricts how much we can ask. It prevents us from asking about status of any kind. But it also protects the students from us sharing that information with a third party such as clinical sites. So clinical sites could be made to understand that they contract with the school and students have a valid social security number. They have work authorization.
So the clinical institutions don't necessarily need to know the students documentation of immigration status or the lack thereof. So communicating with clinical sites is important. FERPA also doesn't minimize our obligation to know which students may need additional resources.
So, we need to create environments within our nursing programs that make DACA recipients and other students feel comfortable and safe so that they can share whatever barriers they may need help with and then allow us to help them find resources to overcome those barriers. for doing what we should be doing as educators and classroom environments and creating a warm, welcoming, non-judgmental environment where students feel safe for many variety of of issues and topics.
This being one of them. Exactly. Treat them like individuals, the wonderful mind, body, and spirit that they are. Get to know them, make them feel comfortable so that they can share with us their needs. Where are we at at the latest policy level at the federal level with that student and is there any movement in that area? Currently, DACA authorization is being renewed for those who already have deferred action for childhood
arrivals. But because of a Texas appeal of the program, they are not currently taking new applications. And I don't know about other states, but in Georgia, statewide there is a reduction in students applying to college, students returning to college. And so we need to advocate so that these students who are now graduating from high school and they're in the same situation that many of these nurses found themselves in in 2012 and before Deferred Action for
Childhood Arrivals. You know, when I read Mia's quote, I think of all the students who are graduating now, who feel like their wings are clipped, who feel stuck, who know their potential. Many of them are offered scholarships, both academics and sports related, and then those offers are withdrawn when their status is revealed. That has to be heartbreaking. So at the federal level we can advocate not only for DACA because DACA remains a temporary solution.
Applicants have to reapply every two years. In fact, they're encouraged to apply 6 months before their DACA certification expires, which you know, when you think of it like our nursing license, it's like, oh well, they just have to apply early. But unlike our nursing licenses, if they apply six months early and for some reason their paperwork goes through without a hitch, their next two-year cycle begins the day they
receive their authorization. So they may become authorized every 18 to 20 months rather than every two years. One of the nurses I interviewed was an experienced obstetrics nurse in the midst of a pandemic. She was a frontline worker and she was motivated to respond to my invitation because she had received notice that she had two more weeks of employment if her DACA her DACA authorization which she had applied for over six months earlier
did not come through. This was an experienced nurse in a nursing shortage in the midst of a pandemic and she was going to be unemployed because of this paperwork. DACA...yes, it's just inconceivable to me. DACA also doesn't provide any path to citizenship, any path to permanent residency. It doesn't provide any documentation
of lawful presence. So with the tenuous situation with DACA right now, I'm reading and receiving calls from nurses who are considering applying for license in other countries like Canada for example. And we really just can't afford to lose these experienced nurses simply because Congress has failed to pass permanent legislation, a clean DREAM Act that will provide these students who came to our country under no volition of their own. They don't remember
living anywhere else. Right. And they're being penalized for it. Yes. Right. Most of the participants in my study arrived before age four. So for senators to tell them go back to your home country and follow the current rules. It's impractical for them and it's devastating to us because they are nurses. We don't want them somewhere else. They carry this terrible stigma with them throughout. It's a stigma because that's how people have defined it.
Carry that with them throughout their life and their career and these are basically kids who don't know any different. They've been here their whole life, you know. Yeah. What's your main takeaway for us? What would you like us to take away from the work reading this podcast today? I think two main takeaways. We all know that research informs advocacy. And to my knowledge, my study is the first nursing research done
among this population. We also know that evidence motivates change and as nurse educators, we are obligated to be leaders and change agents. So I would like to see more research particularly disaggregation of DACA recipients data from other health care professions as well as from other
minority nursing populations. For example, I think a great study would be how DACA recipients data differs from other English as second or other language candidates performance on standardized tests because these students have attended the same K12 education that citizen nursing students have attended. They don't have the same barriers. So differentiating and disaggregating their data I think would help us evidence the impact that these
nurses have on our profession. As far as diversity age, the median age of the population in my sample was 26. We need a younger nursing workforce. Yeah. I had four nations of origin. Mexico, Uruguay, the Philippines, and Korea were represented in my small sample. So I can only imagine the diversity among thousands of DACA recipients who have become nurses.
So I tell you it was so interesting is when I saw your article and because I haven't seen anything about this topic discussed before in the literature and so I appreciate you so much doing this work and bringing to our attention and I think it's a great read for those who are joining the podcast who haven't read it yet and it's a great reminder on how we always remember to humanize those students and really understand their lived experiences and what is our role in helping them
that journey through nursing school is go sometimes beyond the nursing concept itself right and actually being a more active role myself included in better understanding some of these experiences of the student and how we best can
assist them. Yes. And again for our listeners, if you have not had the opportunity to read about this work, you will find the manuscript published in Nursing Education Perspectives, The Lived Experience of DACA Recipients Who are US Nursing Program Graduates and Their Pathways to Professional Licensure, A Phenomenological Study. And it will be published in hard copy in the November December issue volume 43, issue 6. And I want to thank all of you for joining us for
this podcast. Have a wonderful rest of your day.