Flashback Friday - The Singular Voice of Ildaura Murillo-Rohde
The controversy was buried in the back pages of the American Journal of Nursing, the official publication of the American Nurses Association (ANA). After several years of fighting in vain for formal recognition within the ANA, about 15 Hispanic nurses, led by Ildaura Murillo-Rohde, broke ranks at its 1976 annual convention.
“Spanish-Speaking Nurses Form New Organization,” the brief announcement read, “to answer the needs of Spanish-speaking nurses and recipients of nursing care”—leaving unanswered the reason why this goal necessitated a wholly different organization.
Murillo-Rohde may have lost her battle within the ANA, but she launched something bigger: a movement of self-advocacy for Hispanic nurses and the communities they served. The National Association of Hispanic Nurses (NAHN) that she founded nearly 50 years ago now has more than 40 chapters across the U.S. and is the collective voice of 300,000 Hispanic nurses.
“There were so few Hispanic nurses in the country—and, especially, very, very, few in academia... Back then, it was a time when ‘minority’ wasn’t a buzzword and the isolation was very acute.”
Mary Lou de Leon Siantz, a founding member of NAHN
They were not the first minoritized group to find representation lacking in the majority-white ANA. Black and Native American nurses also left to establish their own groups, stating that the ANA was not responsive to their needs and was failing to address the needs of people of color. The National Black Nurses Association formed in 1971, followed a year later by the American Indian Nurses Association.
“There was no money to do anything,” Murillo-Rohde said about the NAHN’s early years. As its first president, she funded its growth from her own pocketbook. “For the first four years, I was the chief cook and bottle washer for the NAHN. I promoted the association, I put out the newsletter, I did everything.”
That bracing activism was a pattern throughout Murillo-Rohde’s long and varied career as a psychiatric nurse, family therapist, educator, researcher, author, dean of nursing, and permanent representative to UNICEF.
Born in Garachine, Panama, Murillo-Rohde came to the U.S. in 1945 to help the war effort, viewing nursing as the quickest route. She trained at the Medical and Surgical Hospital School of Nursing in San Antonio, Texas. At that time, San Antonio was 47 percent Hispanic, but there were no Hispanic nurses, she recalled. The cultural disconnect was profound: American nurses could not communicate with their Spanish-speaking patients or understand their customs and beliefs.
Murillo-Rohde left Texas for Columbia University in New York, where she earned a bachelor’s degree in psychiatric nursing—the only Hispanic student in her class. In 1971, she became the first Hispanic student to earn a PhD from New York University. Later, when she became a professor, Murillo-Rohde was still an army of one; there were almost no Hispanic individuals working in academia, conducting research, or advising policymakers about the healthcare needs of Hispanic people.
The “culture within a culture”
In the 1960s, working as a therapist with Puerto Rican families in Harlem, Murillo-Rohde witnessed an immigrant community in crisis, trying to assimilate and often hindered or ignored by the agencies and government programs meant to support them. To assist them, “the helping professionals need to know a good deal more than they do about the ‘culture within a culture’ that is concentrated in an inner city such as New York City,” she wrote in a 1976 article in Perspectives in Psychiatric Care.
Spanish-speaking people were receiving less mental health care than the rest of the population, when, in reality, they needed more, she claimed, enumerating the social, economic, and educational discrimination they endured. Murillo-Rohde called on psychiatric nurses, in particular, to commit to equitable healthcare for all ethnically minoritized families.
“To do otherwise is unconscionable, unethical, morally reprehensible, and un-American,” she wrote. “As health professionals, we have an obligation to use our expertise to devise appropriate and effective treatment modalities to meet the needs of the Puerto Rican family specifically, and the Spanish-speaking population in general, since the various models used with [the] white Anglo-Saxon middle class are not effective.”
A strong message, but it didn’t seem to carry with her colleagues in the ANA. The national nursing organization’s priorities in the mid-1970s were clearly stated in the American Journal of Nursing: the “implementation of standards of practice enunciated by the ANA” and “establishing the mechanism for the profession to monitor its own practitioners and to hold them accountable for that practice.” Historian Catherine C. Choy has argued that these steps were part of a controversial effort to limit the influx of foreign-trained nurses from the Philippines and elsewhere, even as these nurses were recruited to the U.S. to address the nursing shortage. These nurses could practice in the U.S. as long as they were endorsed or licensed in their own country—exempt from the licensing exams required of American nurses.
“There were so few Hispanic nurses in the country—and, especially, very, very, few in academia," Mary Lou de Leon Siantz, a founding member of NAHN, told an interviewer in 2013. “There was little available in terms of mentorship and networking with other Hispanic nurses. Back then, it was a time when ‘minority’ wasn’t a buzzword and the isolation was very acute.”
Today, the shortage of Hispanic nurses is less acute, but clearly persists. Their ranks have not grown proportionately to meet the health needs of the Hispanic community, who make up 19 percent of the nation’s population. Just 9 percent of registered nurses in the U.S. identified as Hispanic, Latino, or Spanish, according to the 2022 National Sample Survey of RNs.
Still, the NAHN has made plenty of inroads. Murillo-Rohde said she was particularly proud of its success in encouraging members to pursue advanced education—a ticket to the echelons of leadership in healthcare and policy-making circles, where so often she was the lone Hispanic voice.
A nurse to the end, in retirement, Murillo-Rohde manned an emergency help hotline, reaching out with comforting words to callers in the middle of the night. She died in 2010 in her native Panama, one day shy of her 90th birthday.
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Today’s #FlashbackFriday is brought to you by the Bjoring Center for Nursing Historical Inquiry at UVA, which is dedicated to the preservation and study of nursing history.