Mayra Dawkins found her calling as a teenage intern at Children’s Hospital of Colorado, struck by the bonds between doctors and nurses and their young patients.
Now as a urology nurse on the Children’s Hospital staff, she seeks to provide the same sense of connection — with a soft spot for children like her, from Spanish-speaking families, for whom hospitals and doctor’s offices can seem overwhelming and confusing.
“I see these families, and I feel like they’re like my family,” said Dawkins, who participated in the hospital system’s Medical Career Collaborative program in 2010 and 2011 while a student at Overland High School in Aurora.
The program — now in its 22nd year — has helped hundreds of young people like Dawkins explore careers in health care, many of them students of color who grew up speaking Spanish at home and who may have never thought a job in health care was a realistic option.
Bringing more Spanish speakers into Colorado hospital rooms has only become more critical in the past 19 months as the pandemic has disproportionately affected the state’s population of more than 1.25 million Latino residents and highlighted the “stark inequities faced by the Latino, Spanish-speaking community,” said Dr. Lilia Cervantes, associate professor in the Department of Medicine at the University of Colorado Anschutz Medical Campus. During the first seven months of the pandemic in Denver, Hispanic residents experienced the most cases, hospitalizations and deaths of any adults, according to the Centers for Disease Control and Prevention.
But Colorado hospitals don’t need to look very far to find more people of color to draw into the health care pipeline, she said. With many Latino kids more likely to stay long term in the state their family calls home, Cervantes emphasizes the need to build up the state’s future health care workforce with its own students. That’s the central goal of the Medical Career Collaborative program, which each year accepts about 40 Denver-area students and sets them on a path to learn more about jobs in health care and ultimately connects them with a paid hospital internship.
The program, launched in 1999, primarily focuses on drawing students of color and students from low-income homes and helping them get a start on promising careers in health care. Since the program started, more than 90 participants have obtained health care jobs across Children’s Hospital Colorado — as physicians, physician’s assistants, nurse practitioners, nurses, clinical assistants, radiology technologists, laboratory scientists, social workers, respiratory therapists, medical interpreters and in other positions, said Stacey Whiteside, director of experience and engagement at Children’s Hospital Colorado.
“We believe that a workforce that represents the communities we serve is going to be an even more effective team,” Whiteside said, as diversity helps create better outcomes for patients. Families living in poverty or facing housing insecurity, for instance, face significant challenges with obtaining consistent health care and medications.
A health care employee who grew up with the same kinds of struggles better understands the scope of help they need, Whiteside said.
“That gives you an awareness of what the family in front of you might be going through, and you might be able to adapt your care plan to respond to the unique needs of that family,” she said.
Language factors into meeting patients’ needs and also putting them at ease, Cervantes said. Spanish-speaking families in need of health care will often light up when greeted by a doctor or nurse who shares their language. It’s something she has seen when tending to her own patients as they relax, relieved to be able to ask questions and understand what comes next.
“It just provides a sense of comfort and ease…to be able to connect with one’s clinician in the language one feels most comfortable,” Cervantes said, especially as patients find themselves in a vulnerable state while hospitalized.
About 17% of Coloradans speak a language other than English at home, and 11.4% of Coloradans speak Spanish at home, according to estimates from the 2019 American Community Survey by the U.S. Census. And about a third of those Spanish speakers report they speak English less than “very well.”
The struggles to access quality care that Dawkins encountered as a child in a family whose first language was Spanish have stayed with her and motivated her to give her patients a better experience.
Dawkins, 28, didn’t originally see herself working in a hospital, in part because no one in her family had had a career in health care and so she grew up without much exposure to the job possibilities. Her parents immigrated to the U.S. from Mexico, and while her mother earned her GED diploma, her father did not complete high school. After Dawkins’ sophomore year science teacher encouraged her to consider the program and apply, the course of her life completely shifted, she said. She turned her attention from wanting to help people as an immigration lawyer to wanting to help patients recover.
As a program intern, Dawkins worked on an inpatient unit, shadowing nurses, certified nursing assistants, physicians and other providers. She was blown away by how staff developed close relationships with their young patients as they cared for them.
“What can be such a scary time for families, you get to be part of that in such a positive way,” Dawkins said.
One experience during her internship has stuck with her for the last 10 years. She remembers tending to a redheaded, blue-eyed boy — only 2 or 3 at the time — alongside a CNA while his parents stepped out. Comforting him during “a really stressful time and a really scary time” impacted Dawkins and helped her see the meaningful way she could uplift patients.
She’s now worked full time at Children’s Hospital Colorado for eight years, the past four and a half in the urology clinic with her sights set on becoming a nurse practitioner. She also has served as board vice president of the Medical Career Collaborative program — which she credits for not only directing her toward health care but continuing to support her as she navigated college and applied for new positions throughout her career. The program is a joint venture of Children’s Hospital and Denver Health.
“I don’t know what I would have done without it, really,” Dawkins said.
Preparing students for college and other post-secondary programs is a key part of the internship, Whiteside said. The Medical Career Collaborative application mimics a college application so that students can practice submitting a transcript, letter of recommendation and essays all within a deadline. Students who enter into the second year of the program during their senior year receive more intensive support with college and career coaching and help with writing and filling out college and scholarship applications.
The first year of the program centers more on educating students about the many fields they can explore. Students embark on field trips, workshops and training, Whiteside said, with tours of the hospital system’s pathology lab, a course in first aid and a day spent with emergency medical professionals. A paid internship rounds out their learning experience, with students placed in departments across the hospital to observe clinical staff, stock supplies, prepare rooms for patients, work on data entry and handle other entry-level tasks.
As juniors and seniors identify interests to pursue beyond high school, “we want to influence that,” Whiteside said.
She added that the need for a local program focused on developing the next generation of health care workers has become more important as many current employees have suffered burnout during the pandemic.
Ashley Esparza is among the students enrolled in the program this year, interning in the hospital system’s pharmacy department, where she helps get rid of expired medicines and stock medicine trays for the emergency department. Esparza, a junior at York International School in Thornton, interns four hours a day on Saturdays and Sundays and attends weekly seminars in which she learns medical terminology, different types of health care jobs and how to interact with patients.
The program has sharpened the 16-year-old’s interest in becoming a pediatrician or a pharmacist and shown her how much bilingual students like herself are needed in Colorado’s health care systems.
“With the language barrier, it just makes it more difficult,” Esparza said, particularly when trying to explain medical terminology to a family.
She’s already stepped in to help translate. Along with helping translate words or mail for family members, Esparza took time while getting her second COVID-19 shot at a Walgreens store to help a woman struggling to pick up the right medication. Esparza left smiling “just happy knowing that I helped someone because I knew two languages.”
Introducing more students like Esparza to health care should be a state priority, Cervantes, of the University of Colorado Anschutz Medical Campus, said. Cervantes is frustrated that Colorado’s Latino residents continue to struggle with quality health care at a time so many have risked their lives on the front lines working essential jobs.
“I think as a country we need to do better to reduce health inequities, and one way to address disparities is to work towards making sure that our physician workforce mirrors the demographics of the patients that we serve,” Cervantes said. “And in Colorado, one particularly vulnerable patient population are the Latino community and especially those who have limited English proficiency. We can provide better care for them if we reduce language barriers.”