HEALTH
CARE
HEROES

Texas A&M College of Nursing graduates are improving Texans’ welfare through their care, compassion and courage.
BY JEANNIE RALSTON

What do Aggie nurses have in common with the famous Captain Sully, the pilot who landed a plane in the Hudson River? They were both trained to be heroes.

Dr. Nancy Fahrenwald, dean of the Texas A&M University College of Nursing, believes the flight simulator that trained Sully to handle that emergency is the kind of system that will produce the very best nurses. Using standardized patients and high-fidelity manikins, the college has fast-tracked the incorporation of simulation exercises in its curriculum to ensure students experience a range of conditions they will encounter in exam and emergency rooms across the nation.

This nimble, innovative thinking is why the college, founded in 2008, has quickly moved up the rankings. Today, it ranks ninth in the nation for its online master’s in nursing degree program by U.S. News & World Report. It has also been redesignated a Center of Excellence in Nursing Education by the National League of Nursing, one of only 16 schools nationwide to receive the designation in 2020.

Enrollment is rising as well, and long-term plans include expanding nursing education to other parts of the state, especially as recent reports indicate that Texas will be short almost 60,000 nurses by 2032. “Texas’ population is growing; it’s getting older and more diverse,” Fahrenwald said, “and the pandemic has made us aware of how incredibly impactful nursing is to communities.”

Texas’ population is growing; it’s getting older and more diverse, and the pandemic has made us aware of how incredibly impactful nursing is to communities.

Three of the college’s strongest initiatives are directly related to answering the state’s needs. To support health care for rural and underserved populations, the college strategically recruits undergraduate and graduate students from these areas of the state. The college is also growing its family nurse practitioner program enrollment and launching a post-graduate Doctor of Nursing Practice degree program. Finally, the college is expanding its Center of Excellence in Forensic Nursing, the state’s leader in providing professional education and outreach in interpersonal violence prevention, investigation and post-trauma care.

Follow Aggie nurses Doris Poston ’16, Tuesday Sowers ’20 and Joanna Gutierrez Sangal ’07 ’18, who are using their unique backgrounds and passions to address these initiatives for a healthier Texas.

Doris Poston '16

For a
Father

Image of a smiling nurse, Doris Posten, with an eye chart behind her

He survived 20 years in the military, the Vietnam War and four teenagers, but he couldn’t survive his retirement in a rural area. He never complained about his health, but for him to have a massive heart attack at 53, I think something was going on, and he didn’t want to drive an hour to get the checkups he needed.

Doris Poston’s path to becoming a family nurse practitioner specializing in rural health care was set on April 5, 1997—the day her father died from a massive heart attack at age 53. But she knows he didn’t have to.

“He survived 20 years in the military, the Vietnam War and four teenagers, but he couldn’t survive his retirement in a rural area,” Poston said. “He never complained about his health, but for him to have a massive heart attack at 53, I think something was going on, and he didn’t want to drive an hour to get the checkups he needed.”

Today, Poston ’16 oversees the Bluebonnet Trails Community Services clinic in Giddings, Texas. Initially established to provide mental health care, the clinic’s services have expanded through a partnership with Texas A&M to include all primary care—an integrated, holistic approach to seeing patients in a three-county area of Central Texas with few doctors and no hospital. “If there had been a clinic like this, he would have come,” said Poston, age 56, her eyes filling with tears. “That’s why I went into nursing; that’s where my passion came from.”

Before the loss of her father, Poston worked in the state correctional system. In her mid-30s, with three young children, she earned her associate nursing degree from Blinn College and worked in various positions, including St. Joseph’s Hospital in Bryan. She later received her bachelor’s in nursing and earned a master’s degree from Texas A&M’s family nurse practitioner program in 2016. Now, she’s pursuing a Doctor of Nursing Practice from Baylor University.

Poston joined Bluebonnet Trails last summer, and the clinic saw its first patient in December 2020 during COVID's peak. “I feel like this position was meant for me,” she said, noting that providing services in underserved areas is an especially high priority in Texas.

Roughly two-thirds of the college’s family nurse practitioner graduates work in rural or underserved areas. “There are health care deserts around the state,” Fahrenwald said. “When a rural hospital closes, a lot goes with it. And these deserts also exist in urban areas—for example, if buses don’t run to clinics.” In particular, the dean has identified a tremendous need for nurses in the Rio Grande Valley. To this end, the College of Nursing’s strategic plan includes establishing a Bachelor of Science in Nursing program at the Texas A&M Higher Education Center in McAllen, Texas.

I look at the whole person—physical, spiritual and mental. It’s important we care for patients holistically.

On a Monday this summer, Poston’s questions to new patient Jabal Garcia, 39, ranged from family health history and bowel movements to whether he dips or smokes. “I look at the whole person—physical, spiritual and mental,” she said. “It’s important we care for patients holistically. When I see a patient, I want to lay my hands on them and listen to them—their lungs, heart and stomach, so I know what I’m starting from the next time I see them.”

The clinic also screens for mental and behavioral health concerns, as well as alcohol and substance abuse, Poston said, noting that her area has a critical issue with opioids. She believes preventive medicine is essential in a rural area like Giddings, where one EMS provider covers a wide area, from Brenham to Rockdale to Bastrop and LaGrange.

“In a rural county, it can take 10 to 30 minutes to get a 911 call answered," she said. "We want to prevent health crises from escalating, so people don’t have to use 911 or the ER.” Remembering her own experience when an ambulance was called for her father all those years ago, Poston concluded, “Basically, I don’t want somebody to experience what we went through.”

Expand
Care To
The Valley

The College of Nursing seeks startup funds to implement an undergraduate nursing program in the Rio Grande Valley and a Doctor of Nursing Practice program to prepare advanced practice nurses for expanded population health and leadership roles. Philanthropic support will enable students to enroll, contribute to transformational health care in rural South Texas and reinforce Texas A&M diversity efforts. Scholarships are also needed for students from rural areas who are pursuing entry level or advanced nursing careers outside of the Rio Grande Valley.

Tuesday Sowers '20

Being
The Voice

Image of a nurse, Tuesday Sowers, looking at her clipboard

There’s a reason Tuesday Sowers ’20 goes to Disney World three to four times per year: It’s truly the antithesis of the work she does. “Since I work in a high-stress profession where I see so much trauma and violence every day, it is nice to go to a happy place,” she said.

Sowers is a Sexual Assault Nurse Examiner (SANE) at Texas Children’s Hospital in Houston, which means it’s her job to treat children and teens who may have been sexually abused or trafficked. “It can be extremely hard and overwhelming hearing about nothing but trauma all the time,” Sowers said.

It can be extremely hard and overwhelming hearing about nothing but trauma all the time.

Image of gloved hand holding a form

Last December, Sowers earned a Master of Science in Forensic Nursing from Texas A&M, which houses the state’s first and only Center of Excellence in Forensic Nursing, recognized as the leading organization for this specialty in Texas. “Forensic nurses work in hospitals, clinics, psychiatric facilities, and medical examiner and coroner offices. They are part of a team of professionals who interact with survivors of trauma and violence,” said Dr. Stacey Mitchell, clinical associate professor and director of the center.

She gave an example of what sets a forensic nurse apart: If a crime victim comes into the emergency room, a nurse without experience or formal training in trauma-informed care might cut off their clothes and let them fall to the ground. A forensic nurse would put the clothes in an evidence bag, measure wounds and take pictures before the patient is taken to an operating room.

Sowers, 49, had always wanted to be an Aggie, but because the College of Nursing did not exist when she was younger, she went elsewhere for her associate and bachelor’s degrees. She was working as an emergency room nurse and was SANE certified by the Texas attorney general’s office when she learned that Texas A&M had started a forensic nursing program.

“I’ve wanted to work in this specialty since attaining my associate degree,” she said. Sowers earned her master’s in two years while continuing to work at Texas Children’s. The courses she took, mostly completed online, included training in pathophysiology and victimology, plus lessons in how to properly collect evidence, testify in court, and document injuries and wounds. For hands-on practice and testing in simulation courses, she traveled to College Station.

There’s a special way to talk to small children. You have to build a rapport and ask questions like, ‘How’s school?’ and ‘What do you want to be?’ before asking deeper questions like, ‘Do you know the difference between truth and lies?

At Texas Children’s, Sowers works the night shift, where she sees many adolescents but might also talk to children as young as five. “There’s a special way to talk to small children. You have to build a rapport and ask questions like, ‘How’s school?’ and ‘What do you want to be?’ before asking deeper questions like, ‘Do you know the difference between truth and lies?’” she said. “Then you ask whether they know different body parts and understand that some parts are private.” She pointed out that if a child doesn’t want to talk, she doesn’t push it. “We don’t want to retraumatize children.”

Sowers documents any tears, bruising, discharge, active bleeding or redness, but she often finds no evidence. “But just because you don’t see an injury doesn’t mean it didn’t happen,” she said. As crucial as gathering evidence is, she insisted that her main focus is making sure a child is healthy and safe. “Any medical needs come before evidence,” she added.

In areas of the state without SANE-certified professionals, Sowers also helps conduct forensic exams via telehealth platforms. “A nurse is physically there taking care of the patient,” she explained, “but a forensic nurse will monitor the entire exam, provide guidance and talk to the victim.”

Asked why she takes on such an emotionally heavy job, Sowers said, “I love caring for children and being a voice for them when they can’t have a voice. It makes me feel good as a human being.”

I love caring for children and being a voice for them when they can’t have a voice. It makes me feel good as a human being.

FUND Forensic Nursing Education

The College of Nursing seeks financial support to advance the goals of the Center of Excellence in Forensic Nursing. Needs include funding a chair for the center’s director, securing professorships for faculty and growing the number of available forensic nursing scholarships.

Joanna Gutierrez Sangal ’07 ’18

REACHING
THOSE MOST
IN NEED

Picture of Joanna Gutierrez Sangal wearing a mask

I love seeing the kids grow. That’s beautiful. And connecting with the parents and families, talking to them and seeing how they’re doing, especially after the year that we’ve all had, is rewarding.

“Es una luz. No duele,” Joanna Gutierrez Sangal, holding an otoscope, told a three-year-old girl with wary eyes and jiggling feet clad in pink Minnie Mouse shoes. It’s a light. It won’t hurt. Sangal ’07 ’18 moved the device to the girl’s ears to inspect them.

In Spanish, she asked the girl’s mother how long the child had symptoms and if anyone else in the house was sick. After feeling the child’s lymph nodes and taking other diagnostic measures, Sangal pronounced that it was nothing more serious than a cold and answered the mother’s questions about whether the girl needed a nebulizer.

Before leaving the pair in the exam room, she had one more piece of advice: The girl is old enough to be off diapers. “Pañales son muy caros,” she emphasized. Diapers are very expensive.

Encounters like these fill Sangal’s days as a family nurse practitioner at Houston’s Clinica La Salud, a primary care walk-in clinic that mostly serves children on Medicaid but also sees uninsured or underinsured adults. And they also fill her heart. “I love seeing the kids grow. That’s beautiful,” she said. “And connecting with the parents and families, talking to them and seeing how they’re doing, especially after the year that we’ve all had, is rewarding.”

Sangal grew up in Kingsville, Texas, in a home that prioritized making a difference. Both her parents were social workers with Child Protective Services. “As a teenager, I heard them talk about the abuse they encountered even in a small town,” she said. “I realized there are a lot of people who need help.”

In pursuit of entering the medical field, Sangal earned a biology degree from Texas A&M-Kingsville. In 2009, she received her bachelor’s degree in nursing from The University of Texas Health Science Center in Houston and began working at Lyndon B. Johnson Hospital in various areas, from postpartum care to the surgical floor.

As a young mother, she took a job as a school nurse because the hours were better for her family. “That’s where I fell in love with the kids,” she said. But as a school nurse, even if she saw the signs of infection, she couldn’t diagnose or treat. “I couldn’t tell the mom, ‘She has an ear infection, and she needs this medication.’ I could only say, ‘You need to be seen by a health care provider.’ That was hard because I worked in a low-income school, and I was always trying to solve where to send these families to get treated. That’s when I decided I needed to be the person who treats people.”

I couldn’t tell the mom, ‘She has an ear infection, and she needs this medication.’ I could only say, ‘You need to be seen by a health care provider.’ That was hard because I worked in a low-income school, and I was always trying to solve where to send these families to get treated. That’s when I decided I needed to be the person who treats people.

From the start of her career, Sangal had wanted to earn her master’s degree. After her time as a school nurse, she knew she wanted to be a family nurse practitioner. Sangal took her Texas A&M classes mostly online but traveled to College Station several times per semester for practical labs, where students diagnosed “problems” from actors who played patients.

“Teachers observed us in an exam room through a camera as we tried to determine the patient’s issue,” Sangal recalled. If the “patient” was there with abdominal pain but the student didn’t ask the right questions to discover that, they would not pass the lab.

“As a student, I hated it,” she laughed. “Being watched made me so nervous, but once I was out, I thought, ‘Now I know why they had me do that. As hard as it was, it was helpful.’”

At Clinica La Salud, Sangal can assess, evaluate and treat patients from infants to the elderly and refer those who need further care to a specialist. Though the clinic was initially established for pediatric care, Sangal’s credentials, plus another family nurse practitioner on staff, allow it to serve more adults. That part of the clientele is growing mainly by word of mouth, she reported.

Helping adults who are uninsured or underinsured is especially gratifying for Sangal. “In my experience, my adult patients neglect seeking consistent medical care or preventive services such as blood pressure and cervical cancer screenings because of the costs,” she said. “It isn’t that people don’t care about their health; they just simply lack the availability of affordable health care.”

In my experience, my adult patients neglect seeking consistent medical care or preventive services such as blood pressure and cervical cancer screenings because of the costs, It isn’t that people don’t care about their health; they just simply lack the availability of affordable health care.

Create an
aggie nurse
pipeline

The College of Nursing seeks funds to cover travel costs for students like Sangal who commute to College Station several times per year for in-person labs and simulation training. Additionally, the college is initiating a Doctor of Nursing Practice degree, a practice-focused program that will prepare graduates for the highest level of clinical nursing practice. A critical component to stay competitive as a college, the doctoral-level degree will focus on the science, business and management side of nursing and will allow graduates to use their clinical knowledge to conduct research projects that can immediately inform health care delivery. Funding opportunities include a program chair, professorship and comprehensive financial assistance packages to recruit and retain high-quality doctoral students.

Aggies in the College of Nursing are addressing some of the most pressing health issues facing underserved Texas communities. To learn how you can strengthen the college and partner with its health care heroes, contact Patty Rabel ’80, senior director of development, below.

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Contact

Patty Rabel '80
Senior Director of Development & Foundation Relations
Texas A&M Health
Call: 979.436.0175

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HEALTHCAREHEROES

Texas A&M College of Nursing graduates are improving Texans’ welfare through their care, compassion and courage.BY JEANNIE RALSTON

Texas’ population is growing; it’s getting older and more diverse, and the pandemic has made us aware of how incredibly impactful nursing is to communities.

Doris Poston '16

For aFather

ExpandCare ToThe Valley

Tuesday Sowers '20

BeingThe Voice

It can be extremely hard and overwhelming hearing about nothing but trauma all the time.

FUND Forensic Nursing Education

Joanna Gutierrez Sangal ’07 ’18

REACHINGTHOSE MOST IN NEED

Create anaggie nursepipeline