Between 1990 and 2000, the Birmingham-Hoover Metropolitan Area experienced a Hispanic population increase of 348 percent. In 2004 the Hispanic population numbered 25,000 plus, an increase of more than 35 percent in just four years. At Cooper Green Hospital, at least 60 percent of the OB/GYN patients are Hispanic, according to Zaida Jones, director of the hospital's language department and the public health language coordinator for Jefferson County. "And of course, we see them in other areas, too," she says. "In the emergency room — a lot of them don't have medical insurance, so they wait until the last moment until they really, really have to come. And a lot of them have job-related injuries because they work in construction. There's a high incidence of diabetes — it's the number one killer in Mexico — so we're seeing those patients, too." Yet at this time, the hospital has no Hispanic or bilingual nurses, says Deborah Andrews, chief executive nurse. Right now, for those patients that are Spanish speakers, everything has to go through the language line or a limited number of trained interpreters. Bilingual nurses would mean less need for interpreters, which is especially a problem on nights and weekends. In addition, Andrews says, "It would be of a huge benefit to the patient to have the caregiver speaking directly to them instead of someone interpreting for them." The Jefferson County Personnel Board is advertising for Hispanic and bilingual nurses to fill the need. But that's not an easy task. Hispanic nurses make up only about 2 percent of the nation's RN workforce, despite being the largest minority group in the country (14 percent) according to a 2004 national sample survey conducted by the Department of Health and Human Services. "Hispanic or Latino RNs still remain the most underrepresented group of nurses when compared with the representation in the United States population," reports the study. Area nursing schools are working to find ways to get more Hispanics and bilingual nurses into the field, as well as reaching out into the area's Hispanic community to improve health. The UAB School of Nursing is looking at recruiting Hispanic students, says Dean Doreen C. Harper, PhD, RN, FAAN. "We are identifying some of the high schools and middle schools where our Hispanic populations are in greater proportion and will be targeting those schools. We have identified a strategy to do this and are working with particular funders about opportunities to develop that further." Other programs and opportunities help non-Hispanic nursing students learn more about the language and culture to help them in caring for this growing minority. For instance, Samford encourages its nursing students to have a minor, which Sanders says is unusual in the field. The most common minor is a foreign language, most frequently Spanish. "We are very committed to that population," says Nena Sanders, DSN, MSN, dean of Samford University's Ida V. Moffett School of Nursing. "For the last six years, we have had a summer program on Chandler Mountain where our faculty and students staffed the migrant healthcare clinic every summer, so we became very interested." The school does several mission projects a year, many related to the local Hispanic population or in Mexico or Latin America. Since the early '90s, the UAB School of Nursing is one of 11 designated World Health Organization collaborating centers for international nursing and midwifery. In the past, the school has done outreach work in countries such as Korea, Thailand and Japan, but is now in the process of developing its Latin America programs. "As part of that initiative we work with the Pan American Health Organization and have developed relationships with nurses in Chile, Argentina, Brazil, Honduras, Guatemala and other countries," Harper says. "We also have had the opportunity to have some of our students go to Guatemala for summer clinical experiences and study the healthcare system. We have a group scheduled to go to Honduras this summer. And we've had students to visit Chile." Such programs "help us and our students really learn what culturally competent, culturally sensitive care is all about," says UAB's Harper. The UAB School of Nursing has five bilingual faculty members. "Students are working with those faculty at sites in Shelby County and Albertville to run some of the clinical preventive clinics and help folks identify how to access health care, primary health care in particular," Harper says. "Nurses, and nurse practitioners particularly, really find the niches where patients don't have care and try to get them connected so they can identify where they can get care. It's one of the things we do." May 2007