Transcultural Nursing: Interview with Catherine Heinlein

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Transcultural Nursing: Interview with Catherine Heinlein

A second-career nurse finds her passion in India

By Keith Carlson, RN, BSN, CPC, NC-BC
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Tell us what brought you to India and how that has shaped your nursing journey.   

I’m a second-career nurse. My first undergraduate degree was in nutrition. I also have a master’s degree in nutrition science and an Ed.D. in education and organizational leadership.  In 2008, I was asked to accompany another Azusa Pacific University faculty member and a group of nursing students on a mission trip to Kolkata (Calcutta), India.

That trip opened my eyes to many things, including the painful realization that there had been an exponential increase in the incidence of diabetes in a country where I had thought malnutrition would be a bigger issue.  I returned with another group of nursing and applied science students in 2009, and the increased incidence of diabetes continued to weigh on my heart and mind. 

During that second mission trip, the dean of our School of Nursing asked if I would be interested in becoming a nurse. I said, “You know what? I could do that,” and enrolled in an accelerated early-level master of nursing program.  I focused my early nursing career on ambulatory care and educating patients as an RN certified diabetes educator [CDE].

I currently work as a clinical supervisor at our Neighborhood Wellness Center and I’m also an associate professor of nursing.  I have to give a lot of credit to my dean and the chair of the School of Nursing. They had the vision that I could have even more impact on students if I had a background in nursing culture and practice — and they were right.

What has becoming a nurse brought to your work?

In hindsight, I’m now a better clinician because I’m a nurse. Essentially, I needed to be exposed to the collaborative nature of nursing to have the best of both worlds.  Some of our nursing students minor in nutrition and some choose international health nursing, both of which offer opportunities to learn and apply holistic healthcare to populations in need. Being in nursing school prevented me from returning to India in 2010 or 2011, but I’ve managed to return annually since 2012, including giving presentations at conferences there.

In August, I’m going to Kolkata for a month with a nursing student group on one of my regular visits. Since Azusa students consistently choose to go to India for their transcultural healthcare experience, I continue to connect with Indian individuals and organizations who want to collaborate and improve the diabetes situation in their country. 

You were recently awarded a Fulbright Scholarship. Tell us what that will entail. 

In January 2018, I will return to India to embark on my six-month Fulbright collaborative project. I’ll be oriented at the Fulbright office in Kolkata. Once we’re underway, I’ll be mentoring Indian nursing students in their community health nursing course, helping them to create a sustainable diabetes prevention program.  The use of validated instruments — a diabetes knowledge pre- and post-test and a diabetes self-efficacy pre- and post-test — will assist us in assessing students prior to their interactions with the community.

Students will then be empowered to use this project as a service learning component of their community health nursing course.  I want to guide these nursing students to be difference-makers. This is a “train the trainer” model, so they must become competent enough to eventually create and administer their own programs. 

Another goal is for students to learn the processes of research, participant recruitment and obtaining informed consent in the interests of game-changing community outreach and education.  The Fulbright award is a blessing because it will allow me to do the heart-and-soul work that I feel drawn to do in my life. I’ll now be able to work alongside Indian nursing students and collaborate more robustly with hospitals and ministries willing to partner with me. 

What else can you tell us about your upcoming work in India? 

In addition to my collaborative project, I will also serve as an educator, mentor and guide to the students in Calcutta Mercy Hospital’s nursing program.  I’m very excited about the possibilities. I hope to generate conversation about how other disciplines — including physical therapy, mental health and pharmacy — might contribute to this effort in a supportive, collaborative team approach. 

While engaging in this project, I’ll have the great privilege of learning from my nursing students in an effort to make cultural adjustments to the AADE7 Self-Care Behaviors established by the American Association of Diabetes Educators (AADE).  These seven behaviors include healthy eating, being physically active, monitoring blood glucose, taking medications for diabetes, developing problem-solving skills, reducing complications and practicing healthy coping. 

What are the major impetuses to this work? 

While I have a professional occupation as a nurse and a dietitian, it’s really a calling. It’s my mission and testimony to do what God has called me to do, which is promoting wellness and facilitating patients’ desire and competence to care for their own wellness. It’s a calling of the heart.  Working in another culture, I must maintain a high level of cultural awareness and sensitivity.

This is very important to me. It’s the human condition: You must know your patients, and the only way to do that is by learning from and listening to them. My students and I are going to be making an investment in the people of Kolkata.

What was it like to apply for a Fulbright scholarship? 

I’m so grateful to my dean — she brought up the Fulbright in a meeting and I decided to go for it.  There’s an individual in our provost’s office who announces upcoming Fulbright opportunities, including application deadlines, workshops on how to apply and webinars. I spent a week at a summer writing retreat and poured myself into the Fulbright application process. 

A Fulbright project must focus entirely on education, research or a combination of the two. I chose 80 percent education and 20 percent research. On the application, you have only five pages to address a whole series of questions about what you plan to do and how. [See the sidebar.]

If other nurses feel this type of calling and passion, how can they take action? 

You have to truly stand behind your passion. I am lucky to have had the full support of my colleagues and the university as well as a professional background that has prepared me for this experience. You have to be open to being uncomfortable.

This type of work requires authentic curiosity and a true desire to know another culture. Your goal for embarking on such a project can’t just be adding a feather to your cap. This isn’t just a resume add-on; it’s a personal and professional ministry.  If you feel that you must do something because you just can’t walk by people who need your help, this may be the moment of your calling. 

What are your future goals?

I would really love to work and live in India. I don't exactly know how that will happen, but I’d love to serve as a liaison and preceptor for students going to India in a service capacity. I want to understand that culture so deeply that I can help acclimate students and assist them in being as effective and culturally sensitive as possible.


Fulbright Scholarship Application Questions

• What do you propose to do? 
• How will you carry out the project?
• Why is your project important? 
• What are the benefits? 
• What experience prepares you for this project? 
• How will you teach your project’s participants? 
• How will you adapt to another culture and language? 
• What validated tools will you be using? 
• What research methodology will be used and how will the research be disseminated?

Keith Carlson, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at


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