Name: Paula Cruz BSN, RN, CNOR
Nursing education: Undergraduate Nursing Degree, University of Massachusetts Dartmouth (2014) MSN Global Public Health Concentration, University of Massachusetts Dartmouth (Anticipated Graduation: May 2021)
Number of years in the nursing field: 6 years
Current title: Staff Nurse at the Colorectal and Pelvic Malformation Center and Operating Room Nurse at Boston Children’s Hospital.
Country of Origin: Philippines
1) Why did you decide to become a nurse? What has inspired you?
I was born in the Philippines and migrated to Saudi Arabia, where I lived for nine years before relocating to the United States in 2000 with my family. My parents immigrated to the United States to provide my siblings and I with a better opportunity. Growing up, my parents always told us that the best thing they could leave us with was education. I learned at a young age that access to healthcare is a privilege. When we had to bring my younger sister to the hospital in Saudi Arabia, I was so scared. When my dad was working, a family friend had to get my mom, sister, and I to the hospital. There were guardianship laws in Saudi Arabia that required all women to have a male guardian to access healthcare. At the time, we never really encountered doctors or nurses unless it was an emergency because w
e did not have annual check-ups like they do in the US. I do not remember much except for the nurses who took care of my sister and how they made me feel. They made me feel safe and let me know that they would take the best care of her. At that point, I knew that I wanted to do the same for other people and provide care to those who otherwise would not have access to it. I knew that going into nursing would be a challenge, but I was willing to take it on.
My parents have inspired me. It means a lot to me knowing how hard they work, what they have sacrificed to get us to where we are today, and how dedicated they are to their job and family.
2) What is your experience in global health?
In the last eight years, I have gone on one to two service trips each year. My global health experience started in 2013 when I went to Partners in Development (PID) in Port Au Prince, Haiti, as a nursing student at UMass Dartmouth. I traveled to Haiti again in 2014 as a senior nursing student and in 2016 as a nurse. With Partners in Development, I learned about health disparities and the needs of those who live in extreme poverty. It was an eye-opening experience that I knew would be a small step into the journey of global health. In 2017, I joined a team as an operating room nurse on an orthopedic surgical mission to Santiago, Dominican Republic. At this point, I started to realize the importance of sustainability and transferring healthcare education. I began to question the value of each trip. What happens after the mission trip? What does the team need to continue to provide optimal care and that patients have optimal outcomes? Before a mission trip, I started to ask myself – am I here to help get as many cases done as possible? OR am I going to share and exchange knowledge with the local team so that they would able to continue providing the best care even when we are not there? I chose to do the latter.
In 2018, I was able to join a surgical team going to the Partner’s in Health Hospital in Mirebalais, Haiti, as part of Mending Kids. This trip was led by Dr. Belinda Dickie whose vision aligned with what I believe service trips needed to be. We did a combination of simple and complex pediatric colorectal surgical cases. The cases were selected based on the needs of the local team. It was based on what they needed to increase their knowledge and gain exposure to complicated cases that would otherwise not be done. I was able to work alongside the local nursing team and in a hand-off approach allowing them to do as much as they can. Even with a language barrier, we could communicate effectively in providing patients the best care possible.
In 2019, I participated as an operating room nurse working alongside the local team in urological procedures at the Komfo Anokye Teaching Hospital in Kumasi, Ghana, as part of IVU Med. It was another experience where I witnessed the local team’s dedication to serving their community and learning/exchanging as much knowledge as possible. I saw their team come in hours before preparing the operating room and staying hours after leaving to work on sterilizing equipment and preparing for the following day. They showed the results of working collaboratively together to provide patient care effectively.
The following month, I functioned as an operating room nurse doing colorectal and urological procedures at the Guangzhou Women and Children’s Medical Center in Guangzhou, China. It was an eye-opening experience to see the contrast between Haiti and China. We were able to do similar procedures but with different resources. Like previous trips with Dr. Belinda Dickie, the focus was to exchange knowledge with the local health care team so that they would be able to do these complex cases independently. One of the most critical aspects of these missions is building long-term relationships with the local team. With the advent of technology, it is easier to discuss cases amongst providers and exchange knowledge as needed.
The last trip that I went on before COVID-19 was to Komfo Anokye Teaching Hospital in Kumasi Ghana, in January 2020. Having already had a relationship with the team, we could continue building upon the knowledge that we provided from the year prior. Again, I was in awe to see how dedicated and hard the local team worked to care for their community. I was in awe of how they functioned as a team.
3) We don’t always have to leave our home country to be involved in global health. How does global health nursing come into play in your current job?
As a nurse at Boston Children’s Hospital, I have had the privilege of working with patients from all over the world. Some of our patients may be from the United Arab Emirates, Saudi Arabia, Haiti, and China. Acknowledging that we can provide patients with care regardless of where they are from is a privilege. Knowing that patients and families trust our team to provide this care should never be taken for granted. As a nurse, I believe in being a fierce advocate for my patients, whether in the operating room or the ambulatory setting. To do so, it is essential to listen and get to know your patients and families holistically, from their health care needs to their cultural backgrounds. Global health does address the needs of patients outside of the United States and the needs of those residing in the United States.
4) My Personal Statement of Professional Goals
My philosophy of nursing has evolved and continues to develop with every experience. My personal definition of nursing involves caring for patients as a whole with compassion, respect, and excellence. I value that the care I provide with a team by enhancing the quality of life from the patient’s perspective.
As a staff nurse in the Colorectal and Pelvic Malformation Center and an OR nurse in the main OR at Boston Children’s Hospital (BCH), I would best describe my career as a dynamic and fulfilling nurse. I am thankful for BCH’s opportunities as I have grown to love and enjoy what I do as I grow professionally as a nurse. Upon completing my MSN program with a concentration in global/public health, I plan to expand my knowledge and skills further to develop the Colorectal and Pelvic Malformation Center. Most importantly, my goal is to make an impact in the lives of the patients and families in this specific patient population locally and globally. I plan to look at the long-term health outcomes of patients with anorectal malformations and create educational materials to help patients and families have a greater understanding of their diagnosis and the care/management they need throughout their life. Overall, the goal would be to prevent any unnecessary ED visits or hospital admissions, as well as help patients transition from pediatric to adult care.
From a global health perspective, I would like to continue working with healthcare providers to create sustainable programs through knowledge transfer and collaborative partne
rships. From a surgical standpoint, I see the importance of providing educational support to health care providers and nursing teams to further their training and provide quality care to patients, even in low resource settings. Although surgical interventions are an essential part of the patient’s health, I believe their long-term care and management is just as important in achieving optimal health outcomes.
In my global health experience, I recognize that nurses strive for further education to provide their patients with the best care possible. I believe that access to healthcare knowledge for healthcare professionals is just as important as improving health access. My long-term goal would be to create access to healthcare knowledge for ALL nurses globally. While being at BCH, I realize that BCH nurses have an invaluable experience they can share with others. This project would become sustainable by encouraging BCH nurses to empower other nurses from other countries by sharing their knowledge. Even with language barriers and cultural differences, nurses have a common goal: to provide the best care to our patients every moment of every day. This can be achieved through collaboration and partnerships. Providing access to programs like OPENPediatrics to nurses globally would allow them to become better patient advocates and clinicians by gaining more knowledge in their specialty field.
My dream is to become a Global Health Nurse. I have found that I learn more about myself in the process of giving and serving others. Professionally, I have grown immensely in learning from other nurses’ practice, even in low resource settings. I have learned how to adapt to various situations and use my strengths to provide the best care I can to the community I am serving. I have never been the person to know what I wanted to do in 5 years, but I know that whatever it is that I will do in the future, I will do my best. I will make sure that I continue to educate, empower, and serve all the nurses and patients I encounter.