Profile of Navajo nursing graduates: identification of factors affecting academic success

A descriptive study of graduates of Navajo Community College (NCC) was conducted to obtain a profile of Navajo nursing graduates and to explore factors that affected success in nursing. The great shortage of Navajo nurses available to care for the Navajo people was the problem which prompted this study. Interviews were conducted with 16 of the 22 Navajos who graduated from NCC's nursing program. A traditionality questionnaire was utilized to assess acculturation level of the graduates. Subjects were also asked to identify factors they perceived as affecting success or failure in completing the nursing program and passing state board examinations. Opinions as to why there are so few Navajo nurses were also elicited. Findings revealed that the majority of Navajo nurses in this study demonstrated adherence to many traditional beliefs and practices. Level of acculturation was not a definitive factor of success or failure. Family responsibilities and family support were major factors affecting graduates' abilities to pass state board examinations. Pregnancy during the nursing program and marital problems were more frequent among graduates who failed state boards. Poor English skills were noted as a problem. Psychiatric-mental health nursing was a difficult area for many graduates because of conflict with traditional beliefs. Factors related to the nursing program that were of concern to graduates were high faculty turnover, distances to clinical agencies and inadequate clinical experiences. Positive factors identified were small class size, individual attention and dedicated faculty. Reasons identified for lack of Navajo nurses included inadequate recruitment, expectations for Navajo women to marry early, financial difficulties, fear of violating traditional taboos, lack of family encouragement and fear of failure. Recommendations included provision of family support services such as family counseling and child day care for students, remedial classes to assure English language competency, teaching psychiatric-mental health nursing within the context of Navajo thought, and recruitment and retention of qualified faculty who are knowledgeable of Navajo culture. Major limitations of the study were the small number of subjects, possible response bias because of the investigator's prior contact with graduates and threats to privacy and confidentiality of study participants.