Nursing was definitely not the first career choice of Adriana Arcia, PhD, assistant professor. She holds a bachelor’s degree in theater, studied jewelry design, was an administrative assistant, and even worked in Major League Baseball in the office of the Commissioner doing public relations before she discovered nursing.
She says she remembers being interested in childbirth at an early age when, at 12 years old, her brother was born. In later years, this memory inspired her to train as a doula—a person who provides physical, emotional, and informational support to a woman during childbirth. She later attended nursing school with the sole intention of eventually becoming a midwife. She enjoyed nursing so much, however, she decided to embrace it as a career.
She now focuses more on academics and research in an attempt to find strategies to help patients—particularly childbearing women—get the information they need to support optimal decision making and self-management.
Explain your entry into nursing.
I trained as a doula, and then went to nursing school, with a plan to eventually become a midwife. I was really only interested in birth, and was expecting to just grit my teeth through the coursework that didn’t deal with maternity care.
In the process, two things happened. First, I fell in love with nursing and came to really value our unique body of knowledge. Second, I came to grips with the fact that I am not cut out to be a midwife—I’m too nervous! Hats off to those who can make the big life-and-death clinical calls required in midwifery. I instead went to work as a bedside nurse and got experience with antepartum, labor and delivery, postpartum, and nursery. During that time, I thought about my long term plans and decided to get a PhD.
What did you do instead of becoming a midwife?
I wanted to take a 10,000 foot view of maternity care because I see a lot of problems with how we manage childbirth in this country. There are better care models out there, and I wanted to have a larger impact than that which you can achieve by focusing on one patient at a time.
I became a researcher to investigate how best to convey what I know about birth to the public. Most women are not aware that where they choose to birth and the provider they choose to attend them can make a big difference in their outcomes. Out-of-hospital birth and midwifery care are excellent options for many women, but these options are not as well-known as they should be.
What about childbirth interests you so much?
Apart from the birth of my brother, the topic captured my interest because we already know that the midwifery model of care leads to better outcomes than we are presently getting—we just have to figure out how to get there from where we are now. I did a lot of reading and came to understand that how people are born can have lifelong effects.
How do you approach birth in your research?
Some researchers do policy work and clinical research. But the approach that I keep coming back to is looking at birth from the patient’s perspective, and making sure they have all the information they need to make informed decisions.
As a result, my work has actually branched out from childbirth to other areas of patient education. It’s really about helping people meet their needs in a way that is going to work for them. I’ve worked with people who have low-health literacy to make sure materials are culturally appropriate, specifically for Spanish speakers, and that is what led me into visualization work, which is a lot of what I do now.
You speak multiple languages. How has that helped your work?
I grew up speaking both English and Spanish in the home, and I often say that speaking Spanish is my most valuable nursing skill. Every time I end up in a clinical setting, for whatever reason, I am asked to translate something. That’s very valuable, especially because many of the clients we serve in Washington Heights are Spanish-speakers.
Hispanic nurses are underrepresented in the United States, when compared to the Hispanic population. Tell us about being a leader for other Hispanic nurses.
I spent some time in Latin America when I was a little girl, but for the most part, I grew up in North Carolina where there were almost no other Latino families at the time. I grew up in a very white context. I had great role models at home—both my parents have PhDs—so maybe because of that I didn’t feel a strong need to see people who looked like me in positions of influence.
Dean Berkowitz recently sponsored me to attend the inaugural Latino Leadership Institute organized by the National Association of Hispanic Nurses. Columbia Nursing was a sponsor. I heard so much there about the importance of representation. As a result, my main takeaway was the importance, as a Hispanic nurse scientist, of being more visible to young people, to our students and future Hispanic nurses.
In fact, through this experience, I realized that I have an obligation to my community to be more visible. Our ability to attract students depends on their ability to feel like they can connect, so I want to make sure that I’m available as a role model.
Is there anything else you would like to add?
My work explores innovative, informatics-based approaches to patient education and seeks to find ways to make information more accessible to patients. For example, I collaborated with my tech partner, Maternity Neighborhood, to do a study to see if their maternity education platform was adequately meeting the information needs of Medicaid-enrolled women. Our findings will help us make sure information is as accessible as possible to patients.
Outside of maternity, my colleagues and I have been at the forefront of developing tailored infographics to help patients with varying levels of health literacy better understand their health status. For example, I’m excited to be starting work on a new set of infographics designed to help Hispanic adults understand their level of asthma control.
One of the major takeaways of my research has been that you can’t make assumptions about what you think will work. You have to test ideas and see, because even though we have learned a lot, we continue to be surprised and learn new things.