When Lisa Marie Pacheco jingle-dances across the stage to become the first Native American to graduate from UNLV with a doctorate in public policy, she will wear Rebel-red Converse All Stars painted with “Dr. Pacheco” and a geometric pattern often found on her Laguna tribe’s pottery.
The shoes call back to “White Man’s Moccasins,” Lee Marmon’s iconic 1954 photo of an elder wearing a shirt, pants, headband, silver and stone jewelry, and Converse high-top basketball shoes. A member of the Laguna Pueblo in New Mexico, Pacheco says the photo “represents the journey we take and the reminder that we live in two worlds as Natives — representative of the assimilation of two cultures that often conflict. I will wear [my shoes] as a tip of my hat, or a point of my toe, to my people, our culture, and the resilience of our people.”
Resiliency has been a key trait throughout her life. She was a teenage mother and dropped out of high school. Pacheco knew she liked taking care of people when she began studying to be a nurse in New Mexico. It was initially just a job when she started in 1991, but it became a passion. When she moved to Las Vegas in 1996, a mentor at University Medical Center showed Pacheco how to influence health care beyond the bedside.
“I learned about community nursing, and I was just off and running because I found out that —through policy, through advocacy, through education — you can change health care for not just the person in the bed, but you can change health care for a whole community,” Pacheco says.
One early accomplishment was when she was on the March of Dimes Nevada board, successfully lobbying the 2003 Nevada Legislature to require bars and other establishments to post signs warning of the dangers of drinking during pregnancy.
Greater Influence Through a Ph.D.
Pacheco, 57, who recently left UMC after a 24-year career there, says she sought the doctorate because it was a “beacon” to learn how public policy is developed and gain even more credibility as an expert and influence as an advocate.
“When I speak as a nurse, [government and community leaders] trust what I say,” Pacheco says. “But now I have the knowledge to frame what I’m saying in a way that is easy for people to understand. … I understand how policy works now at a level that I never envisioned. … That is part of what can help propel policy forward.”
Topmost for her is addressing the region’s acute shortage of nurses through advocacy with the Nevada Nurse Workforce Center and other organizations. “We need to remind people what a noble profession it is. It’s not easy. …we [have to] start planting that seed in elementary schools, high school students, and then mentoring them when they get into college.”
She also plans to encourage Native American students to pursue nursing and other medical careers. Health care is historically inadequate on reservations, she says, and one disease can erase a small tribe. “We need to make sure that every available health policy covers and protects those nations that may be out in the middle of nowhere and they don’t even have clean running water or electricity.”
Moreover, it’s important for practitioners to understand Native American traditions, such as having a ceremony to stage a patient’s room and not making eye contact with a doctor as a sign of respect for their authority, she says. “Those cultural things are so important. If you don’t know about them, or you’re not from that culture, they’re shocking. And then they interfere with care.”