A Nurse First

Fields of knowing

• Season 6 • Episode 5

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Roxana Chicas is turning personal history into powerful advocacy. As the first Latina on her research team, her journey weaves lived experience with scientific insight to uncover the human toll of heat on farmworkers and illuminate how listening can become a tool for change.

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I started off at a community college where I was obtaining my associate's degree in nursing. I never thought about being a nurse until someone told me I could be a nurse. And one day professors from every university school of nursing came to the school to talk about a program called Bridges to the Black Laureate. This program was looking for high-performing students that were underrepresented in science to teach them about research and immerse them into research. I did oftentimes notice that I was the only Latina in the room, so I applied into the program and I was in their first cohort of five students. That is where I learned about research that I learned that nurses could get a PhD because up until then I didn't know what a PhD was. My thought about nursing was that nurses only work at the bedside in a hospital. I didn't know that there was this huge breadth of opportunities for nurses. And from that research experience I realized that you can take an entire population and make them your patient. I became very fascinated with that. At that time I also had never thought that I could interact or potentially even go to Emory University, which seemed like so far fetched to me. But while I was in the program and I got to go on campus at Emory and meet more of the professors, everyone was very kind and warm and willing to share their knowledge with us. And I really liked that community feeling of scholarship there. I eventually applied to the PhD program at Emory and my advisor was already working with farm workers. So what we came up with is that we would look at the physiological response of chronic heat exposure among farm workers and also look at interventions that could protect them from heat stroke. Welcome to a nurse first. This is Roxana Chicas telling her own a nurse first story. Only our research team thought we're going to do work in Florida and it's going to be on pesticides because farm workers are exposed to pesticides so much. But we did a focus group with farm workers and what they told us was that what they were really concerned about was heat, how heat was affecting their health. They say we feel like it's getting hotter. What is it doing to us? This was mainly like the women talking. The women farm workers talking saying what is it doing to us? What is it doing to our husbands or other family members and friends? So from there we took that idea and decided that we were going to try to understand the physiological response of a chronic heat exposure among farm workers. I like to tell this story because I think it's very important for us to listen. As a nurse it's very important to listen to your patient, listen to your community as a researcher, listen to also to your patients, to your community, to the population that you are focused on because oftentimes they have the answer and if we listen it's something that will benefit the community. It's something that they want and you're honoring what they're telling you. So always, you know, my best advice is always just to listen. So in Florida we collaborate with the Farm Workers Association of Florida. They basically do all of the recruitment which is really hard work. They help us during field data collection to collect data. And by the time when I entered as a team member, as a PhD student to the program, I was the only Latina on the M-reside of the research team. I ended up taking over field data collection so I was the one in charge. Of course on the community side everyone that was working on the research team were Latinos. And I could tell that the community was really happy to have someone there that spoke Spanish that had a similar background as them. And that really changed things before the Farm Workers Association of Research team would have lunch over here and then the every research team would have lunch over here separately. We would do data collection separately, they would be in one room and then we would be in another room. When I took over I was like let's do this together and so we started doing all of our data collection in one room to be more efficient. While I'm taking blood from a participant from their finger, the Farm Workers Association asking them questions we have on our survey. I'm there also listening so I can understand everything that's happening so if there's questions you don't have to run across the rooms to get me. For us I can also talk to the participants in Spanish and they see me interacting with the Farm Workers Association. They see this really true kind of partnership. Eating together I think was very transformative to have a meal together. It's one way to make connections and solidify those relationships and continue them. I don't think that things had been merged like that before, no one really spoke Spanish. It just became easy right to just kind of stay separated. But me being bilingual was able to bridge that where it just became very natural that we would eat together, work together in the same room, do things together and I could understand what the Farm Workers were saying to the community health workers. Their stories hit home. Roxana came to the United States at just four years old, hand in hand with her mother. For 14 years she lived in the in between too, as an undocumented child. I was born in El Salvador. Before I was born my father had already immigrated to the United States. We come from very humble beginnings for poverty, stricken community. When I was six months old my mom made the difficult decision that she was going to immigrate to the United States because of poverty and also because there was a civil war going on in El Salvador. She was really afraid that she was going to get kidnapped because at that time a lot of young women were being kidnapped. So she came to the United States and she left me with my grandmother. When I was four years old my mom returned to El Salvador and I remember her when she arrived outside there's dirt and rocks everywhere, it's not like the rows are have pavement. My mom's in this truck and she's on the bed of the truck because there were several people on the bed of the truck and I could see her curly hair and blue eyeshadow and I just thought she was so pretty and so cool. While she was in El Salvador she kept asking me her reason for going back was that she wanted to bring me to the United States and she kept asking me do you do you want to come to the United States with me and I kept saying no because I was with my grandmother. She told me that the last time she asked me that was going to be her last time asking me because she was going to leave that day to come back to the United States and I was four years old and I said well if you put blue eyeshadow on me I'll go with you she immediately put eyeshadow on me blue eyeshadow and we came to the United States very much like you've seen on TV through the southern border my mom is really afraid because in that journey there's a lot of kidnappings that happen people would sometimes ask her can we help you with your child because my mom would carry me and it was tiring she said she would always decline because she was so afraid that someone would just take me we got to Texas and from there we were there just a few months and then we came to Georgia because there's lots of jobs in Georgia because they were preparing for the Olympics. I was undocumented until I was 18 then I got temporary protected status which was it's a program where every 18 months you have to pay a fee to immigration services and they'd run a background check on you to make sure you're not a criminal you know have a criminal history and they give you a work authorization a social security card so that you can work legally and get a driver's license and so that was very transformative to have those documents 18 because you know I had seen all my other peers going to applying to college or getting a driver's license and I couldn't so I have this understanding of what it is to live with a precarious immigration status I've just had other opportunities that many farm workers haven't had or about three million farm workers in the United States it was estimated that 50 to 70 percent of them are undocumented workers I grew up in an immigrant community where everyone around me many of them worked outdoors whether it's construction landscaping and I would hear them talk about how hot it was that day and what they had felt and there were several laws that were passed into place to protect workers unfortunately many of these laws exclude farm workers because of agricultural exceptionalism for me it's an honor to be able to combine my lived experience with my training to hopefully one day improve the working living conditions of farm workers heat really affects the health of farm workers growers will push back and say we don't need heat protection standards we don't need research we don't need these interventions because farm workers they're all ready being protected they push back on this and so my question then is if that is the case why is it that farm workers have the highest heat related mortality 35 times more likely to have a heat related death than any other occupation it doesn't make sense there are no heat protection standards at the federal level not only about five or seven states have state heat protection standards none of those states are in the southeast in Florida after the death of one farm worker who the media really talked about if Ryan Lopez Garcia who died on the hottest sale record in 2023 there was a big push by local organizations to get heat protection standards at the local level at the county level after years and years of trying to get heat protection standards at the state level everything indicated that Miami-Dade County was going to pass heat protection standards and the industry went and lobbied to legislators state legislators and said you know if you allow counties to have heat protection standards we're going to have a patchwork of heat protection standards it is going to be too difficult for us to keep up with each county it's going to be too costly and so what the legislators in Florida and the governor decided was that no one could have heat protection standards and that was a huge huge setback for all of the advocacy organization who had worked really hard on that they should not be treated as less than human which many of them are my hope is that you know if we say that they're essential to the country and they're critical for the national security then we should be protecting them we should be protecting them when they're working to pick the food that we eat every day the improvements I would like to see for farm workers is that they have some basic protections such as water rest shade at the workplace where breaks are they have regular cycle breaks scheduled breaks where they are provided clean and cool water where they are provided personal protective equipment clothing that is for working outdoors in the heat they should be able to have sick days access to healthcare good housing I just think some basic basic things so that farm workers aren't dying in the field from heat stroke are necessary when heat stroke and heat related illnesses are preventable we have to come up with interventions that farm workers can use themselves independently from like growers and their employers we have to be more creative and we have to think about what are some other opportunities out there that we can make effective change farm workers keep me motivated they still have to wake up every morning three four five in the morning to go to work even when they're tired they still have to go during COVID they still had to show up to work there's wildfires they're still showing up to work in Florida hurricanes are about to land and they are there to the last minute and so we as researchers that's what inspires me that they they haven't stopped and if they haven't stopped then why should I your groundbreaking research with farm workers and the health impacts of warming planet conditions didn't just shed light on an urgent public health issue it also earns you a nomination as a fellow of the American Academy of Nursing one of the highest honors in the nursing profession why do you think it's so important that we have more nurses pursuing PhDs and contributing to research and leadership at this level many PhD prepared nurses are going into retirement so we have even more spots to fill out we also need more diverse people in academia from all kinds of background not just racial and minoritized communities but from all backgrounds to be in academia because that really helps the science but it also helps students to be exposed to such diverse people the more diverse we are the stronger we are and the more that we can impart different types of knowledge that we all come with I mean if you think about science we talk about interdisciplinary science right here diverse scientists from different disciplines coming together to make amazing science and to generate knowledge I know it sounds sometimes intimidating all this research that we do all this writing and reading coming up with ideas generating knowledge but in research you have a team and you are guided throughout this whole process I recently became the director of the BSN Honors Program because I think it's really really important to create programs for nursing students to learn about a PhD like what is the difference between a PhD and a DMP and what are the career paths that you have with a PhD what all is it that you can do the primary goal should be to try to develop these students to think about a PhD to give them the skills to be competitive applicants into a PhD program to make research fun and engaging and safe accessible that we use language that students can understand and slowly we build on that language so I think that it's really important for us who are a faculty to really make the space for students to be interested into explore research I would also say to undergraduate students to explore research email faculty and say hey I'm interested in your research I like to know more so that way kind of get a glimpse of what research is we need more PhD-prepared nurses in academia in science and to move the profession forward thank you for listening to a nurse first from sigma if you loved this episode do us a favor and subscribe rate and leave us a review it is very much appreciated for more information about a nurse first and sigma visit sigma nursing dot org until next time