Crossing Borders
by Ashley Festa
The universe is expanding just a little bit more. January saw the beginning
of a new program in which 20 nurses from Monterrey, Mexico, began their
Master of Science in nursing (MSN) degrees from the University of the Incarnate
Word. 
The nurses work at CHRISTUS Muguerza Hospital in Monterrey, a division of the CHRISTUS healthcare system founded by the Sisters of Charity of the Incarnate Word. CHRISTUS Muguerza has been recognized as the first hospital in Mexico accredited by the Joint Commission International, which grants accreditation to healthcare systems worldwide.
Dr. Kathi Light,
the dean of the UIW School of Nursing and Health Professions, explained
that the accreditation is a big deal and attests to the excellence of care
at the hospital.
CHRISTUS Muguerza approached the university in late 2006 about a partnership to help several of its management level nurses earn master's degrees.
The nurses all have Bachelor of Science degrees from Mexico, but officials at CHRISTUS Muguerza, wanted to make sure the supervising nurses had advanced degrees, said Dr. Jim Sorensen, the UIW nursing professor teaching the nurses in Monterrey.
The master's degree is a way for the hospital to “ensure nursing staff is educated at the highest level,” Light said. “There's a strong relationship between education levels of nurses and patient outcomes,” she said.
A program with a purpose - Sorensen is helping prepare nurses for work in Mexico, not to recruit them for careers in the United States. In order to do that, the nurses have to learn about the Mexican healthcare culture, not the American culture.
“One of the goals of the MSN is that students recognize vulnerable
groups of patients,” Sorensen explained. “They must define
groups for Mexico.”
Because of the cultural differences between Mexico and the United States, he relies on the nurses to tell him if the models he is teaching don't fit the environment in Mexico.
One advantage of the BSN to MSN program is that it's possible some of nursing students would serve as adjunct faculty at the Universidad de Monterrey (UDEM), Light said.
“There's a significant nursing shortage. We are not taking our program to Mexico in order to export nurses from Mexico to the U.S. We are trying to help prepare nurses to work in Mexico,” she explained. “We can't have more nurses without more faculty to teach them.”
Classes commence - In January, Sorensen began flying to Mexico on Friday and teaching class on Saturday morning. He said the first class was a challenge because getting organized was difficult.
When Sorensen first met the class, he recognized “too many were looking at each other for understanding,” he said. Even though the students had taken English as a Second Language classes, they were still struggling with the language.
To address the issue, he suggested they meet Friday evenings before Saturday's class to discuss assignments and practice conversational English. However, Sorensen soon realized the nurses were too exhausted after working at the hospital all day, and changed the meetings to immediately after class on Saturdays.
In class, “everything takes twice as long” because of the language barrier, he said, so he allows the nurses to conduct group discussions in Spanish and then report back in English, which makes learning easier for them.
Sorensen intends to treat the class as a seminar. “They are responsible for their own learning,” he said. He encourages them to cultivate relationships in class through group work.
“I spent a lot of time to make sure they talked about themselves” during the first class, Sorensen said. “I want them to be a cohesive group.”
He emphasizes the importance of these bonds because “it is through relationships that we affect change” in nursing and healthcare.
“I believe very strongly that we have to have a
relationship with the clients,” he said.
Nursing Theory for Advanced Practice is the first class to be offered in the BSN to MSN program, and a research course will be offered in the fall.
“We are starting slow
because the students are
perfecting their English, and we want to give them all the support they
need to be successful,” Light said.
Despite the slow start, Sorensen said he's very strict in class and he doesn't just give the answers away.
“I like them to struggle with their own learning so that it becomes theirs, their own knowledge instead of something that they're repeating.”
Students' perspective - So far, Sorensen has had a good response from the nurses in his class. “They're very interested in learning,” he said.
Several of the students spoke about their experiences in the class via e-mail from Monterrey. (Because they are more comfortable speaking in Spanish, their responses have been translated.)
The nurses seem to agree that their hard work will be worth the effort. They have big plans for their MSN degrees.
“With the tools the master's degree will give us,” student Socorro Leal said, “I believe we will be able to begin programs that will be geared toward giving quality care to our patients, and we can also share our knowledge with our colleagues in order to form groups to work together and with more creativity.”
Not only do they plan to do big things at the hospital, but some would like to help other nurses advance their education as well.
“I would like to participate in a program that gathers new MSNs,” Maria Tiburcia Martinez Mata said. “Currently I am working at the Centro de Desarrollo Profesional para Enfermeras (Center for the Professional Development of Nurses) at the CHRISTUS Muguerza Hospital as a specialist of hospital development. Our goal is to incorporate incoming nurses to our team and continue their education with internal courses.”
Another student, Ana Delia Garza, said “This degree is, without a doubt, a step toward improving the professionalism of our group of nurses, and it will serve as an incentive to other nurses who want to continue learning.”
Before they can live these dreams, they must overcome the obstacles. The most difficult test ahead of her, Leal said, would be balancing her career and education.
“Working and studying at the same time is already a big challenge. As they say, you can't serve two masters,” she said. “Fortunately, we have the support of the organization where we work as well as our professors.”
Mata agreed. “It is hard to combine work and school because both are very important to me and to all my classmates, but it is less difficult to work as a team, and that is what we are currently doing. The challenge is for all of us.”
Plans for the future
In the beginning, the collaboration between the Universidad de Monterrey (UDEM) and UIW started as a very different plan.
Whereas the collaboration between UIW and CHRISTUS Muguerza Hospital offers current nursing staff an American master's degree, the partnership between UIW and UDEM centered around a dual degree program.
What's going on right now at UDEM is “an entirely UIW master's degree,” said Dr. Pat Watkins, UIW vice president for international programs. CHRISTUS Muguerza is trying to upgrade its nursing staff, so the hospital approached UIW for help. The advantage of the UIW program, compared with similar programs in Mexico, is the point of view the students receive on healthcare.
“New ideas always generate growth,” she said.
While the universities' leaders discussed the collaborative undergraduate degree program, CHRISTUS Muguerza pointed out their immediate need for a master's program. The BSN to MSN program was created in response to their request. Meanwhile, the two universities are still finalizing plans for the undergraduate dual degree program.
Watkins said the hope is that four degrees will be avail-able in the beginning and a minimum of eight when the program is more developed.
“We're looking at everything,” she said.
Likely programs being considered are political science, economics and bilingual communication arts.
“We're trying to find common ground” between UIW and UDEM to find out what's best to offer in a dual degree, she said.
Because students will have both Mexican and American degrees, the internship opportunities and practical opportunities are doubled. But before offering a UIW degree at another location, it's necessary for UIW to receive approval from the Southern Association of Colleges and Schools (SACS), the agency that grants accreditation to schools in the southern United States. The approval process takes a minimum of six months after which the program will launch. The goal is to begin the program by the Fall 2008 semester, or soon thereafter, Watkins said.
Ministerio de Salud
The Ministerio de Salud, or Health Ministry, began
as a partnership between the UIW School of Nursing and Health Professions
and the St. Philip of Jesus Parish to help improve the health of the community
surrounding the parish as well as provide outreach opportunities for students
and faculty. 
“We were looking for a place or a way that nursing faculty and students could provide a service to the community,” said Dr. Sara Kolb, a UIW nursing professor who helped establish the health ministry in the fall of 1999 with a grant from the Pierre Fund of the Sisters of Charity.
Focusing primarily on Hispanic elderly, the ministry offers health screenings, education about disease management and health promotion. There are also cancer support groups, a bereavement group and an exercise group.
Home healthcare visits are a particular favorite among the ministry's patients. “By having these experiences, the students will be better nurses,” Kolb said.
The newest service the ministry offers is foot care by nurses who provide foot assessments, care and education. For slightly more than a year, foot nurses have been working with patients, especially those struggling with diabetes.
“It's the most popular thing,” Kolb said.
At first there was the question of “how are we going to convince people they need to get their feet checked?” she explained. “But now, they're just lined up. They have to make appointments.”
In addition
to nursing students, students from other UIW programs are offering their
services as well. For example, nutrition students have demonstrated low-fat
cooking
techniques. Business students have helped with record keeping for both
the ministry and the church. Communica-tion arts students videotaped a
yoga demonstration and documented the parish's 90-year history.
There are also opportunities available for alumni who would like to volunteer at the ministry, which is supported entirely by grants. Kolb said they can adopt a person for home visits, help with screenings, or attend community classes about healthcare.
Kolb said the Health Ministry would appreciate any help they receive, “even if we get just one person.”
The ministry has received grants from the Kenedy Charitable Foundation, the Archbishop's Appeal Fund, the Pierre Fund, the Kronsky Foundation and HRSA.
Improving the classroom experience
From the beginning, the university has been committed to providing a quality educational experience to nursing students dedicated to serving San Antonio and South Texas. Now with the help of a five-year $2-million capital campaign, which began in 2005, UIW has plans to remodel and install state-of-the-art technology in the building housing the university's School of Nursing and Health Professions.
There has been no major work since the building's opening in the 1970s, said Dr. Kathi Light, dean of the School of Nursing and Health Professions.
Currently, the university must send students to local hospitals or clinics to gain practical experience, but no two hospitals are identical, and so every student receives a different experience. The proposed renovations to the nursing building include a fully equipped hospital setting, which will serve as a model for nursing students. Other equipment upgrades also are planned to improve the classroom experience.
“We're continuing the tradition of upgrading our program, so it will be as up-to-date as when the alumni went to school,” said Sr. Kathleen Coughlin, CCVI, UIW vice president for institutional advancement. “We're moving forward. We're not stagnant.”
To move the nursing program forward, the university is trying to raise $2 million for the improvements. In 2006, the School of Nursing and Health Professions celebrated the 75th anniversary of the founding of the program by launching the 75 Club for nursing alumni. To be a member, alumni may give $75, $750 or $7,500 toward the capital campaign.
The renovated facility is expected to attract more highly qualified students to the school's nursing program, which likely will lead to more graduates and relief for the nationwide nursing shortage.
For more information on the 75 Club, call Diane M. Echavarria, the director of major gifts and planned giving, at (210) 829-6071.