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During a brief window of opportunity occurring at labor and delivery, nurses can improve or change a woman and her family’s life. One nursing alumna, who is now working on her Doctor of Philosophy in Nursing at the School of Nursing, found that is especially true for women in the lower economic strata.
Marisol Breton-Leija, B.S.N., RN, who is an immigrant from Mexico, is concentrating her doctoral research on Bexar County’s community of immigrant and refugee mothers.
She said some of those mothers may have limited resources for themselves and their babies. She is on a mission to increase nurses’ awareness about how to assist them through cultural differences with maternity care services in the United States, and to identify and refer them to needed resources.
“When patients come to us, it gives us nurses a small window when we can impact not only their health status but also the well-being of their babies,” Breton-Leija said.
The 1991 Southside High School graduate is a nurse educator at University Hospital in the University Health System, where she has worked since 2000 after receiving her Bachelor of Science in Nursing from the School of Nursing in 1999. She earned a Bachelor of Science in Biology from St. Mary’s University. Since 2003, her role also includes teaching childbirth classes.
She’s been drawn to childbirth as her focus because “it’s such an amazing experience in a woman’s life.” Pregnant women aren’t ill. “Pregnancy is a different phenomenon. For most women, it’s a positive experience,” Breton-Leija said, who is married, the mother of a teenage daughter and has lived in the United States since middle school.
The nurse must be able to help someone from another culture who “does not know the language, the culture and how things are done in the United States.” All these factors affect a foreign-born woman’s maternity care experience. Some women are confused because they fear the unknown, don’t know how they will be treated, and don’t know what is or is not appropriate to do in this country, she shared.
As part of the literature review for her B.S.N. to Ph.D. track and eventual dissertation, Breton-Leija, noted that many foreign-born women in the U.S. face a variety of challenges—poverty, citizenship status, insufficient English language proficiency, lack of education attainment, no access to affordable health insurance, and marginalization.
Any patient entering a health care system completes a profile related to social, economic and physical history. During that needs assessment, a nurse could learn that her patient does not have specific safety items for her baby.
For example, when a nurse asks her pregnant patient where the new baby will sleep, the patient might answer that the baby will sleep with her in the bed or on the couch. “It’s a red flag, and we get the social worker involved to assist with any public assistance, because we know that we can prevent something that could harm that baby, such as an accidental suffocation,” she said. “In addition to referring, we have a duty to provide our patients with education in a culturally sensitive manner.”
The culturally competent nurse can spot issues by asking questions designed to promote the well-being of mothers and babies and by engaging in conversations that allow the nurse to see the bigger picture, she said.
A key tool is transitioning them into clinics that provide obstetrical/gynecological and pediatric services. “They can get services so they already have some type of continued care with a provider to help them be healthy for the next baby,” Breton-Leija said.
As a nurse educator, “we provide staff education so we’re always teaching our nurses to recognize the risk factors for any woman who has a baby and for them to respond by getting them appropriate care with a provider.”
When Breton-Leija graduates in 2019, she plans to continue being a nurse educator.
“The doctoral program has been an eye opener because it has helped me think differently about my purpose in my professional career and what I do for the population I’m interested in,” she said. “I reflect on my own humble trajectory as an immigrant in the U.S., the experiences on my path to achieve my dreams, and how that connects me with many patients and their families in my profession as a nurse.”
She looks forward to continuing her work and blending research into it. “That’s the beauty of the program. It allows you to be flexible and provide clinical care and perform research.”
By Ginger Hall Carnes