Wishing to Pursue Graduate Study Dr. Paul Essay

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Wishing to Pursue Graduate Study

Dr. Paul Farmer of Partners in Health was asked in an interview if he knew at a young age what he wanted to do or if it was an idea that evolved over time. He replied: "You can…grow into what you want to do…grow into your aspirations." I took that to mean that personal experiences can open our eyes to possibilities and that small successes can focus our attention on goals that once seemed too lofty. I have learned the importance of taking one step at a time and striving to excel in every stage before reaching for the next level. Like a rock climber, I have also learned to visualize my next handhold -- and picture myself achieving that goal even as I reach for it.

Despite some difficult life circumstances, I have been graced by my origins and my experiences as an immigrant. I learned the importance of cultural tolerance and the universality of meeting people's most basic needs for care, compassion, and respect. I have learned to practice the brand of patience that comes from not having the resources to make change happen immediately. I know the value of hard work first hand. I held full-time jobs during my BSN program; before that I worked two jobs to support my family members in two countries. And now, because of the earthquake, I understand what it means to start anew -- to pick up where you left off.

I think that I offer the best sort of investment a college can make: A student who has proven to be hardworking and goal-focused; and a professional who will make manifold community contributions. Caring for other people is my life's work and I wish to take it to a higher level by further developing my skills and increasing my knowledge.

Part 2: My interests, the kind of work I would like to do in my intended field

I love nursing and believe myself to be a good nurse. Because of my extended family and my own children, I have an interest in family nursing. My experiences in nursing extend across a wide range from Licensed Practical Nurse (LPN) to registered Nurse (RN). Learning to provide nursing services at different levels of responsibility coupled with my ongoing pursuit of more nursing training and education, has over the years, helped me develop strong interpersonal skills and management skills.

I used a quotation from Dr. Paul Farmer, the founder of Partners in Health, to introduce my essay because it exemplifies my interest in world health organizations. When I have a bit of leisure time -- which is a rare event in my busy life -- I go online and browse the Internet to see what is happening in various world health organizations across the globe. Happily, I am often surprised by the sophisticated approach that small non-governmental organization (NGOs) employ to provide health services to many of the globe's poorest people. These model programs actually use methods and strategies that work in more developed countries as well. For example, I read in The New York Times magazine that in the delta region of Mississippi, a program is being tested that uses community health workers to go door to door visiting people who need health care services in their homes. While this is not a novel idea, it is not a common practice -- at least not in the United States. Versions of community health workers have been active from Africa to China to Mexico. The groundbreaking work with community health care workers conducted by Partners in Health over the past two decades has informed the medical community about the barriers to accessing necessary health care. These barriers include discrimination, lack of information, social stigma, time constraints, and transportation costs.

An important learning that has come from the community health worker models, in the Mississippi delta and across the globe, is the importance of a personal connection between the community health workers and the patients who receive care. In the Mississippi delta, a common issue is the fundamental trust that takes its place when people are "of" the same place. The comment "You're not from around here, are you?" is posed as a question, but it is an unequivocal observation. Dr. Shirley recognized that hospitals and clinics need a person who is trained to figure out exactly what will help a patient get better, and that person must -- absolutely must -- come from that patient's world. The patient and the community health worker must talk the same language, recognize a similar history, share the same frustrations, and be haunted by the same fears.

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These are the connections that make the difference between being effective and being superfluous. Throughout the world, the importance of being from a place -- being familiar with the customs and fears and hopes of people -- can help medical personnel make a meaningful connection with the people who seek care. Doubtless, my interest in serving the people of Haiti stems from my deep awareness that my heritage is a strength that I can use to leverage trust and cooperation -- indeed, fidelity to treatment interventions and a willingness to consider scientific options -- from the Haitian people.

My brief detour into the community health model serves two purposes: to explain how it is that I have chosen a practice path, and to assert the importance of advancing my education to my goals -- and to those I hope to serve. As my exposure to models using community health worker has grown, so too has my understanding of the importance of knowledge that expands the boundaries of conventional medical and health care. Studying a problem, sharing insights, pushing ideas into action -- all of these are important aspects of a university education and the subsequent application of that learning to the demands of practice.

I know first hand the importance of personal connection in health care. My belief is that if personal connection is important in countries that have access to many resources and the best medical research available, how much more important must personal connection be for those who live in underdeveloped countries -- where medical care of any type is hard won. Healthcare is as much an art as it is a science. Medical research continually publishes information about the soft aspects of medical practice. We know, for instance, that having close social networks is associated with longevity and health. We know that laughter and joy change our blood pressure and reduce our pain. These elements of nursing fascinate me and cause me to identify with the type of nursing that embraces familiarity, empathy, and an engrossing commitment to care.

Jean Watson's theories of nursing hold that caring can only be practiced and effectively demonstrated on an interpersonal level. Watson argued that nursing is complementary to the science of curing and the human needs that are satisficed through caring as it is expressed through nursing, are separate from those human needs that are based in physiology. Yet, as we know from studies about the mind-body connection, these needs are not so very separate, nor are these needs addressed only in ways that are disparate. I have internalized the theories of Jean Watson, not because they are empirically sound and stem from seminal work in nursing, but because they resonate with my own nature -- as a person, and now as a nurse. My belief is strong that it is critical to accept a person when you are caring for them, as they will become, not as they are in their weakened or sickened condition. Also, Watson's theories center on a fundamental belief in the fight of a patient to choose what kind of care or type of action is right for them at any given time. Watson argues that it is up to nurses to create the sort of caring environment that fosters dignity and independence in managing one's own health care needs. Jean Watson's theories are fundamental to my practice of nursing, and her framework fits well with the care configurations and cultural concerns in the locations where I hope to provide nursing care.

After the earthquake I went back to Haiti and saw people dying because of the lack of care, compassion, and resources. The shortage of medical doctors and nurse practitioners reached extraordinarily high rates after the earthquake. No fundamental health care system was in place and health insurance was non-existent. The Haitian people had to pay out of pocket for any care they needed -- they had to buy your own supplies and no one seemed to care. That observation was the most difficult for me, and it completely catapulted me back to college -- I decided to go back to school get my BSN. Still, a BSN degree is insufficient to support my objective of serving the people of Haiti. To provide that service, I need to earn a FNP degree, so that I will be….....

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