From newcomer to community caregiver: One immigrant’s story

 

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Family primary care nurse practitioner and GSN alumna Ama Ahenkorah, MS, RN (right), and medical assistant Gena Sears, pause in front of the welcoming mural at the Edward M. Kennedy Community Health Center where they are colleagues.

 

Like many working women, Graduate School of Nursing alumna Ama Ahenkorah, MS, RN, has juggled childrearing, multiple jobs and going to school. But as a Ghana native, she also brings a unique perspective to her work as a family primary care nurse practitioner, shaped by her experiences as an immigrant encountering American health care for the first time. Beyond knowing the language and culture of Ghanaian-born patients, she brings a profound, personal understanding of the entire immigrant experience to her workplace and her community.

When Ahenkorah came to Worcester from Ghana in 2003, her first priority, as it is for most immigrants, was employment. Having worked in her native country as a middle school teacher and government policy analyst, she intended to eventually return to graduate school for a master’s in business administration—until her first job in Worcester as a home health aide piqued her interest in a health care career. Her own health care experience would intensify this interest.

In keeping with her culture’s norm to not publicly acknowledge pregnancy until the second trimester, Ahenkorah did not seek prenatal care immediately upon discovering she was pregnant with her first child. But when a scare sent her for urgent care at the Edward M. Kennedy Community Health Center, Ahenkorah was treated by a physician who would become her friend and professional mentor, as well as her family’s primary care provider. Heidi Shah, MD, assistant professor of family health & community medicine, first suggested that Ahenkorah look into medical school. “When I said that would take too long, she next encouraged me to consider becoming a nurse practitioner, a career I had never heard of,” said Ahenkorah. “I did my research, and by the time my daughter was six months old, I had made two decisions: to become a nurse practitioner, and to return to school.”

Seven arduous years and another child later, Ahenkorah became a family primary care nurse practitioner at the Kennedy CHC—the same place where she had her first encounter with the American health care system. It is also the place where she came full circle to work beside her mentor as a colleague. Ahenkorah’s personal journey reflects cooperation and connections not only among herself and others, but also among UMass Medical School, Worcester’s health care organizations and the communities they both serve.

“Faculty at the GSN also became my mentors,” said Ahenkorah. She is grateful for all the advice and support she received from them before, during and after graduate school—particularly Assistant Professor of Nursing Robin Klar, DNSc, RN, who sat down with Ahenkorah to discuss program requirements when she first visited the GSN to explore its Graduate Entry Program (GEP). The GEP helps individuals who have a bachelor’s degree in a field other than nursing to become nurse practitioners. In turn, Dr. Klar lauds Ahenkorah’s determination. “Ama demonstrated her passion and organizational abilities from the first time we interacted,” said Klar. “It is students like her that a faculty member wakes up for each morning.”

Once matriculated at the GSN, Ahenkorah worked the overnight shift at a nursing home as a certified aide in order to pay for her daughter’s day care while attending school full time. After completing the first leg of the GEP by becoming a registered nurse, Ahenkorah was hired by UMass Memorial Medical Center as a staff nurse in the orthopedics and trauma unit, where she had completed a preceptorship as part of her first-year GEP studies.

 

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The decision of GSN alumna Ama Aheknorah, MS, RN, to become a family primary care nurse practitioner stemmed from her participation in the community clerkship led by GSN Associate Professor of Nursing Rosemary Theroux, PhD. Here Ahenkorah (second from left) poses with Dr. Theroux(far left) and other GSN and School of Medicine students in the clerkship whose analysis concluded that cultural and language barriers were contributing to the high rate of infant mortality in Worcester’s Ghanaian immigrant population.

 

Then pregnant with her second child, Ahenkorah was enrolled in the acute/critical care track of the Master of Nursing program and planned to work in an inpatient intensive care or trauma unit. “I was really into working with very ill patients in the hospital setting,” she recalled. “I enjoyed the community clerkship the GSN placed me in, but it didn’t change my mind.” The turning point came when Ahenkorah participated in a community service learning project that addressed a problem identified by the clerkship: the highest rate of infant mortality in Worcester was within its Ghanaian immigrant population, Ahenkorah’s own community. (Related story)

“I was able to get pastors to allow us to bring messages about prenatal care to women in their churches, where I did all the Ghanaian interpretation,” she said. “The women welcomed us because I spoke their first language.” That’s when Klar and the project director, Rosemary Theroux, PhD, associate professor of nursing, began urging Ahenkorah to forego chest tubes and central lines for primary care. “Finally putting all the pieces together, I realized how disconnected from my community I would be in the ICU,” Ahenkorah said. “Within a week, I went to the dean and switched into the family primary care track.”

She also got a new job in outpatient pediatrics at UMass Memorial-University Campus as she completed her degree. Seeking permanent employment after graduating from the GSN in 2008, she interviewed at a number of sites including private practices and community health centers. Recalling how CHCs had helped her, “I decided to return and give back what I got so many years ago.”

Today, in addition to being a primary care provider at the bustling Kennedy CHC, Ahenkorah enjoys a dual role as nurse practitioner and educator in the clinic that the health center operates onsite at Worcester’s North High School. In addition to providing health services to students and staff, she occasionally teaches in the school’s Health Sciences Academy, where she also enjoys providing career mentoring to students, a role that benefits from her teaching and personal experiences.

Toni McGuire, RN, MPH, is president and CEO of the Kennedy CHC, where Ahenkorah is one of the more than 300 people on staff who speak 29 languages and come from 35 countries. She regards Ahenkorah’s story as a great example of the fruitful interplay within Worcester’s health care community, particularly the connections between UMass Medical School and Worcester’s community-based health care network. “What is interesting to me about Ama’s story is not only how we teach people to be healthy in this community, but how we teach people to be health providers in their cultures in this community,” said McGuire. “To me there is no greater joy than in watching our employment rolls grow with the people we are serving.”

As far as she has come, Ahenkorah’s sojourn as nurse practitioner is not the end of her professional journey. “I am looking at public health because one-on-one care only goes so far for prevention of common conditions like diabetes and hypertension,” she noted.

After gaining a few more years experience as a nurse practitioner, and when her children are older, Ahenkorah plans to enter a doctoral program.

Reflecting on her professional journey, which has been far more circuitous than her original trip from Ghana to Worcester, Ahenkorah credits much of her evolution from disoriented newcomer to engaged community caregiver to the mentoring, guidance and support she received along the way. “Most rewarding to me is providing care to patients like myself,” she said. “I’ve lived their lives before as an immigrant. Knowing that I was there for them at that critical moment is very satisfying.”