Two faculty members at the UW-Madison School of Nursing received a $1.3 million Health Resources and Services Administration (HRSA) grant to develop a comprehensive system of support services that will help to admit, retain and graduate 30 Native American nursing students over the next four years.
Dr. Audrey Tluczek and Dr. Mel Freitag will lead this project, called “Success Through Recruitment/Retention, Engagement, and Mentorship (STREAM) for American Indian Students Pursuing Nursing Careers,” which aligns with a Wisconsin Center for Nursing goal to expand the diversity of the nursing workforce to mirror the diversity of the population they serve.
This goal is based on evidence showing that increasing diversity in the nursing workforce improves access to health care and leads to better health outcomes for underrepresented groups, including Native Americans. Currently the Wisconsin nursing workforce is 94 percent white, while the Wisconsin population is only 79 percent white. Furthermore, about 90 percent of nurses who provide services in Wisconsin tribal health facilities are white while the vast majority of the patients are American Indian.
“This project is vital for the state, as we believe it can make a real difference in improving health outcomes within American Indian populations by increasing the number of Native nurses in these communities,” said School of Nursing Dean Linda D. Scott. “This grant validates the important relationships already forged by Dr. Tluczek and Dr. Freitag with Wisconsin American Indian communities and reflects the UW–Madison School of Nursing’s commitment to admitting, educating, and graduating students from diverse backgrounds in an effort to better serve all Wisconsin residents and eliminate the health disparities that many populations experience.”
All 12 Wisconsin tribes (11 federally recognized and one state recognized) are federally-designated Health Professional Shortage Areas.
This new grant builds on a previous community-academic partnership project among the Great Lakes Inter-Tribal Council (GLITC), the UW-Madison School of Nursing and UW Population Health Institute, which was funded by the Wisconsin Partnership Program. One of the objectives of that project, Increasing Cultural Congruence among Nurses in Wisconsin, was to increase the number of American Indian nurses in Wisconsin. “This new grant will help us do just that,” Tluczek said.
Additionally, this new project offers greater opportunities for us to collaborate with the Native American Center for Health Professional (NACHP) which is based in the UW-Madison School of Medicine and Public Health. NACHP has been instrumental in helping us promote nursing careers within American Indian communities by featuring 2 Native nurses on their website, We Are Healers (www.WeAreHealers.wisc.edu). Our NACHP partners will have a central role in STREAM to help us identify and address the unique needs of American Indian students pursuing nursing careers at UW-Madison.
“It’s been a privilege to be able to collaborate with and learn from tribal communities. Working closely with our American Indian partners provided us valuable insights about the need for more Native nurses who can help develop models of health care that combine traditional American Indian healing with western medicine. Doing so holds great potential for improving the health and wellbeing of tribal communities,” she said. “That experience also taught us much about the challenges that American Indian students and communities face and the role the University of Wisconsin–Madison can play in supporting these students interested in nursing careers.”
“In partnership with GLITC and NACHP, we have visited tribal communities throughout the state to develop relationships and identify ways the School of Nursing can help expand the Native nursing workforce and access to culturally congruent health care for Native populations,” Freitag said. “We designed this program with our Wisconsin tribal partners to educate Wisconsin students to serve Wisconsin populations. We’ve been saying all along that this is the Wisconsin Idea in action, and it is. It really is.”
The STREAM grant specifically calls for recruiting more students with the help of a nursing-specific online recruitment tool, and yet recruitment, Freitag says, is only part of the problem. While the school attracts a dozen or so Native pre-nursing students every year, only one or two of those end up successfully applying and gaining admission to the school.
“They are interested in nursing and they come to the school as pre-nursing students, but they don’t stay,” she said, noting that the challenging pre-requisites and competitive applicant pool can drive Native students to pursue other majors or leave campus altogether.
That is why the STREAM program will also focus on retention and graduation. This involves providing structured support designed to address the specific challenges and barriers Native students encounter when attending UW–Madison. Freitag says Native Americans, like many students from underrepresented populations, are more likely to face more barriers and challenges on a large, predominantly white campus. Geographic factors also come into play for Native students, as Madison can seem like a very isolating place to students.
“The desire for a sense of belonging, or the lack of a sense of belonging, comes up with our Native students as it does for other underrepresented groups,” Freitag said. “Underrepresented groups are small groups in Madison, and Native Americans are the smallest of the small. It can be difficult for them to find and forge peer groups on campus and certainly within the school.”
To foster community within the school and on campus, STREAM will use traditional American Indian talking circles to provide student peer support. The program will also work to foster confidence by connecting American Indian students with mentors who are Native nurses currently practicing in Wisconsin. Additionally, the grant proposal calls for continued efforts to strengthen relationships with tribal communities through yearly Native Nursing Nations Summits, which Tluczek and Freitag have organized since 2015.
The grant also provides financial support to American Indian students through monthly stipends.