The plaques on Yu Xu's office wall bear two names, one Chinese and one American. Both suit the nursing professor -- known to friends as Philip. He was born in China but has seen more of America than have most Americans. He arrived at UNLV two years ago via Connecticut, Alabama, New York, and Henan Province. This journey is reflected in his research, which centers on the adaptation of Asian nurses to the American health-care system.
Yu Xu, nursing professor:
High Stakes: If (Asian-born) nurses are not successful, everybody loses. Asian nurses lose. The hospitals who invest at least $10,000 per nurse to recruit, bring, and train them here lose. Most importantly, the American public loses in quality of care and patient safety.
Nursing Shortage: I don't believe that bringing foreign nurses to this country will solve the long-term shortage of nurses because the gap is too big. On the other hand, I do think that bringing foreign nurses is a realistically quick way to boost the supply of nurses in this country.
Colorblindness: When I was a teenager I found out that I was colorblind. So, I couldn't study any health-related professions in China. There are dyes that you need to differentiate in chemistry. But, I believe, the test is a tool to screen applicants because there were not enough spots.
Career Path: My doctorate is in education. Once I came to this country, I realized there is no restriction to study any health-related field even if you have a genetic defect like colorblindness. So my dream to go into a health field was revived. Then I designed my career path very meticulously. It was a dramatic turn.
American Heroes: I particularly believe in the values of this country, of equal opportunities. You can start from scratch and become self-made if you push yourself. Benjamin Franklin and Thomas Jefferson, those are my American heroes.
Credentials: My wife is always making the joke that I have more degrees than a thermometer.
Voice of America: I listened to VOA every night for 12 years. On Mondays was science in the news -- I still remember. The more I learned about America the more it seemed to be that I fit better in American culture.
Male Nurses: There are virtually no male nurses in China. There are some ignorant people who think you don't need any preparation to become a nurse. And there is the cultural perception that the nurse's job is dirty because they come in contact with people who are ill, body fluids, waste. Anything associated with that from a Confucian perspective is not perceived as worthy study.
Adaptation: A lot of the Asian nurses may not be able to speak English fluently. They don't know the policies yet and, more important, they don't know the social and interpersonal dynamics involved. They have a soft voice, small stature, but a higher position and a much higher salary than subordinates who have worked for the hospital for five, 10, or even 20 years. That can create resentment. So the Asian nurses are put in a very awkward position because they need to lead as well as depend on their team.
Nurse Duties: In Asian countries nurses don't do baths, don't feed patients. That's taken care of by the family members who are staying at the bedside 24/7. But when you come here, you have to wash patients, give showers, turn patients -- all these are perceived low-level duties. It is physically exhausting to the nurses.
Personal Changes: Asian nurses basically have to change who they are in order to survive in the American health-care setting. Your biggest enemy is yourself a lot of times. The most difficult thing to change is yourself.
Nurse Migration: I believe that to immigrate is a fundamental human right. But then there's an ethical issue involved in recruiting nurses from other countries that need them to a greater extent than you do -- particularly for those sub-Saharan African countries, which are hit hard by HIV and AIDs.
Human Exports: If you are looking from the perspective of individual nurses, you will probably arrive at a very different conclusion than if you are looking from a facility's perspective or a national perspective. The Philippines has been exporting nurses for at least 40 years. In 2004, these nurses sent back $8 billion. So the Philippine government has intentionally adopted the policy of training nurses for export. It's their name brand product.
Move to Vegas: In Las Vegas there are a lot of foreign nurses and a large Asian community. That gave me a population to study. And, of course, there is the Chinese food. We didn't have much in rural Connecticut.
Missionaries: My father was saved by missionaries during the Japanese occupation of China. He had contracted tuberculosis -- at that time a deadly killer. These missionaries cooked him nine eggs each day. As a result of their tender loving care, he survived, miraculously, and was given the name Philip. When I came to this country I intentionally changed my name to Philip because I am really the son of Philip Hsu -- "Hsu" is an old spelling for "Xu."
Personal Mission: Before coming to study in the United States, I asked my father to tell me about the missionaries. I located the family of one in Alabama. We went to visit her church. I gave a speech for the congregation and visited her grave and thanked her family. I videotaped the entire trip. My father passed away two years after watching the tape. It gave my family a sense of closure, and that brings me solace and comfort.
