Nurses for the World

By Jodi H. Beyeler

From the beginning, three main goals were at the heart of Goshen College’s nursing program: that students would graduate professionally competent, spiritually nurtured and prepared to nurse in overseas and in-country mission work.

Fifty years later, these goals for graduating nurses remain part of the program’s goals. Listed among Director of Nursing Vicky Kirkton’s expectations for graduates during the 2003 pinning ceremony were: demonstrating exemplary knowledge and skills, learning continually, living a Christ-centered life and providing culturally sensitive holistic care.

This country – more ethnically diverse than ever – is not only experiencing a shortage of nurses in general, but also a lack of nurses sensitive to cross-cultural needs. Founder of the Transcultural Nursing Society Madeleine Leininger said, “With the predicted great increase of immigrants, travelers and employees from every part of the world, nurses must know ways to care for or with the culturally different and go beyond treating only the emotional and physical symptoms or diseases of clients.”

Even before the nursing program offered a bachelor of science degree, a significant commitment to cross-cultural nursing characterized the program. In the first class of eight students, four spent significant time overseas after graduation. A survey in 2001 revealed that around 28 percent of nursing alumni served through Mennonite Central Committee (MCC), Mennonite Board of Missions (MBE) or Mennonite Voluntary Service (MVS).

Behind each is a story about traveling to a new place, tasting new foods, learning another language and giving care to the sick or providing preventative health information. But with experiences to different lands and cultures, come quite varied stories. Some people fall in love with the place and never want to leave; others learn and give what they can but are ready to return home; and yet others decide that what they learned must be told to others so they can have the knowledge as well. Here are stories of six alumni and former professors of nursing who have used the philosophy and skills they learned at GC – around the world and back home again.

From Korea to inner-city USA

When Arline Zimmerman ’54 was a seven year old, she remembers she “wanted to be a farmer’s wife and have lots of children when I grew up,” she said. When she turned eight, her ambitions turned to becoming a nurse and “helping a lot of children,” which is just what she did – from Korea to inner-city Philadelphia.

Before attending college, Zimmerman worked at the MCC headquarters in Akron, Pa., as a switchboard operator, receiving telegrams from all over the globe. She said that “the world shrunk.” She headed to Goshen College for training, where she received “a foundation good for work overseas.”

When MCC needed nurses in South Korea, Zimmerman responded to the call from 1957 to 1960, serving in a country still struck by a war that had ended only four years earlier. Zimmerman vividly remembers the challenges of a very poor economy, the frigid winters and the sight of starving babies. “I would come back from work and go into my room and cry,” Zimmerman said.

She found ways, however, to turn a desperate situation into one of hope. Zimmerman’s name was given by MCC to people in the United States as a contact for Korean adoptions and she made two plane trips back to the States, each time with five children to accompany them on the journey to meet adoptive families.

After spending time in India with the World Health Organization working with maternal and child health, Zimmerman moved to another cross-cultural setting much closer to her Lancaster County roots – south Philadelphia – and worked for 21 years as a school district health supervisor in charge of 50 schools and a staff of 33 to 40 nurses.

Retired since 1988, Zimmerman has been busy writing her memoirs in a series of books appropriately named after the nursing reform pioneer, The Nightingale Nursing Chronicles. In 2001, Korea Odyssey was published, in 2002 India Sojourn was released and late this year her recollections of working in Philadelphia will be available in School Daze.

Zimmerman gives thanks to God for presenting opportunities to her. “When I was young, I knew that I was interested in working with the poor, but didn’t necessarily want to go abroad,” she said. “But I went wherever the Lord led me.”

Not a job, but a life

Lois Shank Musselman ’53 decided as a child that she wanted to be a missionary, like her parents, and a nurse. Her mother died soon after she was born, and “I always felt I had to take my mother’s place,” she said. Having seen many photos of India and heard her father’s stories, Musselman dreamed of going to India someday, too.

To fulfill her dream, Musselman attended Goshen College and received a bachelor of arts degree in science in 1951, then continued to study and graduate with the first nursing class in 1953. She married Glenn Musselman, and the two went to Brazil through Mennonite Board of Missions. They stayed there for 37 years.

When Musselman left for her assignment, she had visions of doing full-time nursing in a Brazilian clinic or hospital setting, but that did not come to pass. Instead, she was doing nursing “when I was needed or a neighbor called with a sick child.” Neighbors would call for her help knowing her background. She often treated children who were malnourished or were infected with worms, and she was able to save the lives of two babies.

With five daughters, Musselman dedicated herself to her “family first, then my church and then did nursing in the community as needed,” she said.

She also contributed to the health of the community by teaching local women to add soybeans to their diets. She had noticed that soybeans were frequently grown in Brazil, but for export. Musselman said she recently received a letter from a Brazilian friend who remembered the lessons about soybeans with gratitude.

Teaching the gift of cultural openness

For Fran Wenger, GC professor of nursing from 1962 to 1990, “transcultural nursing” is not only her work, but also her approach to the world.

From the time she joined a Mennonite Board of Education three-month study-travel trip to Europe right after college to her appointment as president of the Transcultural Nursing Society later in life, Wenger has woven together nursing, cultures and faith.

During her first overseas experiences, Wenger began to question some of the nursing education she herself received. “I know that health is so intricately connected to culture, values and beliefs,” said Wenger, “so I was becoming increasingly dissatisfied with the U.S. healthcare system” – which is so often prone to healthcare expectations that don’t fit individual patients.

On returning to the States, she came across writings by Leininger, a pioneer in the field of transcultural nursing, and sought her out as a life-long mentor.

As director of GC’s nursing department in the 1980s, Wenger lifted up, from the nursing mission statement, “a broad vision of the importance of culture crossing as a part of the education of professional nurses.” This meant nursing students learned about people’s behaviors, values and beliefs as they relate to health, illness and caring. “I would always direct [students] to think about and learn that the time they spend with a patient is so very brief, but that the encounter is influenced by where the patient comes from,” said Wenger. “I don’t think you can do nursing well without being aware of this. We have a responsibility, I would teach, to learn about the major cultures in which we are working.”

She continues to renew her call – for herself and other health professionals – to cultural openness, which she defines as “a lifelong commitment to the quest of transcultural understanding, cultural self-awareness and continuing development of transcultural skills.”

Wenger has continued emphasizing transcultural nursing education at Emory University’s School of Public Health and the Carter Center in Atlanta, Ga., specifically building programs that study and make links between public health, medicine and theology.

“The focus of nursing is a science of caring,” said Wenger. “The more I learn about caring and the more I continue on my faith journey, the more I realize they are deeply connected.”

Nursing and SST

From the moment Jani VanPelt ’88 arrived at Goshen College as a nursing major, she knew Study-Service Term (SST) was going to be a highlight of the next four years. She had heard from friends back home in Oregon that it would change her life.

When VanPelt eventually headed to Costa Rica in the spring of 1987 on SST – her first trip overseas – she was very ready. For her service assignment, VanPelt worked in a hospital. She loved the job, the people she met and the culture, and promised her host family that she would be back. “They didn’t believe me,” she said.

VanPelt kept her promise, though, and returned for several short vacations after graduating and beginning a first job. But vacations weren’t enough; VanPelt soon realized that she wanted to stay longer in Costa Rica, so she worked to have her nursing license recognized in that country. “I remember the professors talking about being culturally sensitive to the population you were dealing with and taking a wholistic approach to nursing,” she said.

In 1996 she headed to the northern Costa Rica town of Guatuso to work as a supervisory nurse at a clinic, since the public health system in Costa Rica requires nurses to do a period of service right after graduating. But the experience was not what VanPelt had hoped for. She became frustrated when she felt she could not bring about change in a healthcare environment very different from what she was used to in the United States. In addition to running short on gloves and not being able to change bed sheets often enough, VanPelt said it was “discouraging to watch people stand in line all day waiting for care and many turned away because we could only see 40 people in a day,” she said.

She did find love in Guatuso, however, when she met Costa Rican Juan Jose Jenkins, who would become her husband. Now VanPelt and Jenkins run an adult foster home in their Oregon residence. She also works part-time in labor and delivery at Silverton (Ore.) Hospital.

VanPelt uses her second language, Spanish, often with her patients since there is a large Spanish-speaking population in the area. She gives extra doses of encouragement to her patients that make the effort to try and speak English, just like she used to receive on SST from her host family.

Like VanPelt, Jen Ryan ‘00 had never set foot outside of the United States when she headed to Costa Rica for SST as a Goshen College sophomore, and also found that it shaped her future goals in ways she hadn’t expected. After a very positive experience abroad, she has returned five times to the country and has plans to move back for at least a year to volunteer as a nurse.

Ryan works a clinical manager at a community health center in Elkhart, Ind., working primarily with minority and immigrant patients - many who have no insurance or are on Medicaid or Medicare. In this setting, she uses her Spanish - all the time.

After returning from SST, she continued to practice her language skills with others and on her own. But it was while she worked with a Cuban doctor for three years, speaking Spanish all the time, that she became fluent - not only with regular exchanges of information, but with medical terminology she now uses so often.

“My views have changed on the world and people in general, especially ways to relate with people from different economic classes,” Ryan said. Working with other nurses has made her aware that she “sees people differently,” she said. “I have more patience, more sensitivity and more awareness of spiritual needs,” which she feels is directly related to her cross-cultural learnings on SST and her education at Goshen College.

Books across borders

Katherine Yutzy, Goshen College associate professor of nursing from 1972 to 1993, has found ways to continue giving to a community in India long after she left her mission work at the Dhamtari College of Nursing.

Knowing that science and nursing textbooks quickly become dated at Goshen College, and that the nursing college she had served in India can’t afford many of its own, Yutzy has found a way to link the two in the broader goal of learning. Since 1973, Yutzy has been sending GC’s outdated – but still relatively new – science and nursing textbooks around the world through Books Abroad, a Mennonite Church USA ministry coordinated by Mennonite Mission Network. Because Yutzy has a personal connection with the Indian nursing college and knows their needs, she sends nursing journals there twice a year, which keeps their library up-to-date. Yutzy was instrumental in moving Dhamtari College of Nursing from a diploma school to a college and establishing its library when she was there from 1965 to 1972.

This summer, Yutzy “made a haul” because the GC nursing offices and classroom space were cleaned out before the second floor of Wyse Hall was renovated. She sent 78 books and 43 journals to India, and helped the GC nursing department “get rid of stuff and not feel guilty about it,” she said.