National Nurses United

Profile:FINAL 12/18/08 11:05 PM Page 12 In Their Shoes RN and board member mi rth ia kau fman educates and advocates for her Spanish-speaking patients as only a fellow immigrant can. by luc ia hwang F or many of Mirthia Kaufman's Spanishspeaking patients, medical appointments are a blur, a moment of involuntary amnesia. When doctors explain a diagnosis of diabetes, asthma, or high cholesterol, they can't keep up with the conversation and are too shy or intimidated to ask questions. "They just nod their heads, and go, 'Uh huh. Uh huh,'" said Kaufman, a registered nurse for Kaiser Permanente's Napa and Solano, Calif. clinics who specializes in health education and case management for Spanishspeaking patients. "Questioning authority is not something you do in [Latin] culture. They see the doctor, but come out and don't know what happened. They didn't really quite get it." Kaufman can sympathize with what it's like as an immigrant with limited language skills to navigate American society, much less the healthcare system. She herself is an immigrant, moving to the United States from Peru at age 17, not speaking a word of English. Since then, Kaufman has pursued a long career in registered nursing, parlaying her bilingual abilities and cultural sensitivities into medical and social advocacy for Latino workers employed in the agricultural fields, at wineries, at laundry service companies, at plant nurseries, and restaurants. In addition to serving as a nurse representative, on her professional practice committee, and on the Kaiser bargaining team, Kaufman joined the CNA/NNOC Board of Directors in 2006 and, as someone working with populations of immigrants often unable to access regular medical care, brings a critical perspective to the debate over universal healthcare. "My work is very rewarding," said Kaufman. "I have a great rapport with my patients and they are really thankful. My challenge with them is that it's hard for them to come see me, since most don't have sick leave. If they come to see me, they will lose money." Many of the women she sees do not drive, and depend on their husbands for rides. Patients may also be reluctant to miss work for fear of losing their jobs. As a result, Kaufman has struggled and fought at work to be able to spend one hour with each patient. Compared to the breakneck pace that managed care sets today, an hour might seem like a long time, but Kaufman said that appointments fly by with all the educating and troubleshooting of treatment plans that she must pack into each session. "I try to cover as much as I can in one visit when they come see me because I don't know when I'll see them again," said Kaufman, explaining that many of her patients only qualify for healthcare sporadically. Their benefits are often tied to seasonal employment or to how many hours they have worked that month. 12 REGISTERED NURSE W W W. C A L N U R S E S . O R G DECEMBER 2008

• Cover