DiversityNursing Blog

By MICHELLE T. JOHNSON
http://michelletjohnson.com
Special writer to The Kansas City Star

September is Hispanic Heritage Month, which makes me realize how little reliable information — vs. stereotypes and inaccuracies — there is about Hispanics in the workplace.

Unfortunately, what pops into the minds of many when they think about Hispanics in the workplace is “illegal immigrants.” I’ve heard far too many people who should know better make that assumption.

This in part comes about because of what people see on television and the Internet, and because we tend to turn bits of anecdotal evidence into something we “know.”

In truth, Americans of Hispanic descent grapple with the same issues as any other group in the workforce — and like many groups battling stereotypes, their challenges are often greater than average.

For example, a recent study found that Hispanic workers were twice as likely to hold administrative or clerical entry-level jobs as “nondiverse workers,” which the study defined as white males who were not disabled, gay or transgender.

The study also found that 51 percent of the Hispanic workers surveyed were likely to be making less than $50,000 a year, compared with 31 percent for the non-diverse workers.

In terms of demographics, Hispanics have long since passed African-Americans as the largest U.S. ethnic minority, with 50 percent population growth in the last decade alone. And the most recent news is that Hispanics are the largest ethnic minority enrolled in college.

My longtime friend Mary D. Padilla says that one of the biggest misconceptions she thinks people have about Hispanics, especially in the workforce, is that they are all Mexican or of Mexican descent.

An estimated 63 percent of U.S. Hispanics are of Mexican descent, so that leaves more than a third who are not.

Diversity is about the distinctions and not just the differences. Details matter. Different groups have different cultural norms, different histories and different worldviews.

Hispanic Heritage Month is meant to remind us of that — it’s more than just having a fiesta with a feast in the lunchroom. We should recognize, celebrate and become educated about a big segment of our workforce.

Read more: http://www.kansascity.com/2011/09/05/3122994/assumptions-hurt-hispanic-workforce.html

Staff Assistant
Hausman Diversity Program at Mass General Hospital

The Hausman Student Nurse Fellowship was created when MGH patient Margaretta Hausman, a social worker and graduate of Brown University, recognized the need for diversity among the top-level nursing staff. The Hausman Student Nurse Fellowship provides an opportunity for minority nursing students enrolled in an undergraduate baccalaureate nursing program to gain experience in patient care across the continuum.

The fellowship allows student nurses between the summer of their junior and senior year in college to experience care at the bedside in both inpatient and outpatient settings.  Under the mentorship of Deborah Washington, R.N., Director of Diversity for Patient Care Services and Bernice McField-Avila MD, Co-Chair of the Fellowship, the recipients have an opportunity to further develop skills required to thrive in a workplace where unique challenge to the minority nurse must be managed.

The first fellowship was awarded to Stevenson Morency in 2007.  The program flourished significantly and in 2011, the fellowship was awarded to 8 minority student nurses, the largest group in the history of the program. The Student Nurses worked on various units such as Endoscopy, Orthopedics, General Medicine, Thoracic Surgery, Cardiac Unit, Neurosurgery Unit, Wang Wound Care, Cancer Center and the Grey IV department.

At the graduation ceremony on August 19, 2011, the Hausman Student Nurses provided feedback about their time in the program. Vicky Yu, a student of UMass and a 2011 recipient, felt honored to be part of the fellowship. She stated she saw many procedures she had only read about in her textbooks: colonoscopy, hip/knee replacements and urinary catheterization. “I got to work with a nurse 1-on-1. I don't get this attention on my school clinical and I loved it!” stated Vicky.   

Jennifer Etienne of Boston College stated: “As a minority nurse, it will be my mission to eliminate health care disparities and use my skills and knowledge to eliminate language barriers and become more culturally competent.”

Marthe Pierre shared: “The Hausman Fellowship is a ladder that provided a stepping-stone to my success. It allowed me to acquire skills, knowledge and confidence. It has also ignited my desire to one day become an extraordinary nurse who is culturally competent and compassionate.”

Jeffrey Jean of UMass Boston expressed that the program has reaffirmed his knowledge and his clinical experience. “Being able to walk in the shoes of a different RN has allowed me to re-invent myself. I have learned an abundance of new skills and techniques and have acquired a vast amount of knowledge. I believe that an important component of being an effective caregiver is to know what my strengths are.”

Sedina Giaff of Simmons College declared “It is with great pride that I introduce myself as a Hausman Fellow. This has been the best summer of my life. My experience as a Hausman Fellow has made me a better nursing student both clinically and intellectually. I have a better understanding and greater interest in the nursing profession. I am confidently looking forward to the coming school year and sharing my experiences with my classmates.”

Lauren Kang-Kim of Linfield College in Oregon had this to say: “Now I am reborn as a Hausman Fellow. For the last 5 weeks I found my own powerful voice and I am now proud of my minority identity. The Fellowship has opened the doors for me to become not just a better nurse, but a better person with a deeper understanding and respect for human beings.

Rosalee Tayag and Anna Diane of UMass Boston and Boston College respectively, stated that the Fellowship enhanced their leadership, critical thinking, assessment and communication skills; and  taught them to be more culturally sensitive. They also emphasized that they learned to work as members of a team more effectively.

Former 2010 Hausman awardees, Jason Villarreal and Penina Marengue, congratulated the Student Nurses on their graduation and cautioned them to use their new-found knowledge to provide competent care to their patients and uphold the good name of the Hausman Fellows.

Former Hausman Fellows include: Frew Fikru, Alexis Seggalye, and Christopher Uyiguosa Isibor 2008.  Chantel Watson and Stephanie Poon 2009.

The Hausman Fellowship is posted by Spring of each year at www.mghcareers.org. Qualified minority candidates should be in good academic standing (3.0 GPA or higher) and entering their senior year of a BSN program in the Fall.

The U.S. workforce is expected to become more diverse by 2018. Among racial groups, Whites are expected to make up a decreasing share of the labor force, while Blacks, Asians, and all other groups will increase their share (Chart 2). Among ethnic groups, persons of Hispanic origin are projected to increase their share of the labor force from 14.3 percent to 17.6 percent, reflecting 33.1 percent growth.

July - August 2011. Largest Listings Out of 5,400,000 American Jobs Listed Across the Internet

• Physical Therapists
• Occupational Therapists
• Assistant Managers
• Registered Nurses - Licensed RNs
• Crew Positions - Casual Dining and Fast Food
• Salespeople
• Shift Supervisors - Food and Other Industries
• Cashiers/Sales Clerks
• Customer Service Jobs
• Pharmacy Technicians
• Merchandisers
• Event Specialists
• General Managers
• Photo Lab Supervisors
• Project Managers - IT

Federal Projections for "Most Job Openings" Expected through 2016

• Registered Nurses (RNs)
• Retail Salespersons
• Customer Service Representatives
• All Food Preparation & Service
• Office Clerks
• Personal & Home Care Aides
• Home Health Aides (HHAs)
• Postsecondary Teachers
• Janitors and Cleaners, except Housekeepers
• Nursing Aides & Orderlies
• Bookkeeping, Accounting, And Auditing Clerks
• Waitstaff
• Child Care Workers
• Executive Secretaries & Administrative Assistants
• Computer Software Applications Engineers

In 2003, a small group of Chinese-American nurses, all working in the Kansas City area, came together to share experiences, learn from one another and encourage each other. Today, the CAN (Chinese American Nurses) Sisters meet twice a month as we continue to share our nursing and American life experiences. Our common denominator is that English is our second language. We feverishly try to improve our listening, writing, and speaking skills in English. We especially want to reduce our translation and response time during conversations. We also have in common that we all work extremely hard; we are reliable, friendly, caring, and happy at work.
  Recently, we met for one of our regular meetings. We sat in a circle in my living room and began with introductions. On that particular night we had three overseas visitors from China who were part of an exchange program at Children’s Mercy Hospitals and Clinics in Kansas City. The evening turned out to be an especially moving night for all of us. We each told the story of our life’s challenges and triumphs. We all talked of our struggles to memorize the names of cells, medications, and tiny germs in English! It was fun night.

After my guests left, I started cleaning the dishes. As I did, I suddenly was struck with the thought: How could I ever take these amazing, beautiful nurses for granted? I am so lucky to know them! At the end of every meeting, we feel charged and ready to face the world together. CAN nurses only need opportunities to prove themselves as great nurses. Here are a few of their stories:

SS – She was a nurse in China. After arriving in the United States, she started studying for the nursing board while also raising a child and working at local restaurants to help support her family. She studied hard and passed the nursing board. She then enrolled at Johnson County Community College for an RN refresher course. She completed her clinical RN training at a local specialty hospital. Her clinical instructor noticed how hard she worked and her solid knowledge of nursing. The instructor’s immediate supervisor then hired her as soon as she completed her clinical training practice. SS has being doing very well at that local specialty hospital for more than five years. Doctors trust her and her nursing judgment. She consistently receives praise from the doctors and other staff members.

FF – She also was a nurse in China. She studied and passed the nursing board soon after SS passed the board. FF went on and studied many more nursing specialties, and earned herself national certification in infusion nursing and wound care. She was a supervisor at a local nursing home with multiple certified nursing skills. She was doing an outstanding job in nursing.

GG – She practiced medicine in China. As soon as she arrived in the United States, she went to nursing school, studied extremely hard, and she passed the nursing board. She does not practice nursing yet; she is still waiting for her green card and permission to work. She is ready to serve.

HH – She was a nursing instructor in China. Right after arriving in the United States, HH started studying for the nursing board, even while she was caring for her premature baby. She passed the nursing board exam, and then went to work at a hospital. For many years, she has been a well liked and well respected weekend night nurse. She turned down a promotion opportunity, as her nurse manager suggested, to become a night charge nurse.

MM – When she arrived in Kansas City, MM was hired as a nurse technician even though she was a RN in China. She was living in an empty apartment so learning English was difficult. A phone book became her best tool to learn conversational English. For eight to 10 hours a day, she would turn the pages and randomly pick a person or a store from the phone book, call them and ask questions;  when she flapped on “W” section and saw a water bed shop, she would ask  “what is water bed? How much cost for a water bed” --- etc. She listened attentively and tried to learn as much as possible. Alone in her apartment, the phone book connected her to her new world; this is how she learned and improved. She wanted to work as a nurse as soon as possible. Eventually, she passed her nursing board, and earned two master degrees and four national nursing and nurse management certifications. She is working at a hospital today as a Hospital Shift Supervisor.

ZZ – She was a nurse in China. Months of hard studies for boards, she passed her nursing board a few months ago. She sent out many applications to many hospitals. She received only one reply, requesting a phone interview. After the phone interview, she never heard from the hospital again. Personally, I believe a telephone interview can be a form of discrimination, especially for a nurse for whom English is her second language. We loss over 50% of effective communication tools in a telephone interviewing. Phone interviews don’t always allow us the opportunity to show how much we can do and how well we can be as a great nurse.

KK – She was an experienced nurse in China. She is now taking care of a child with multiple allergies. She would like to work as a nurse in United States.

DD – In China, DD majored in English. She worked in a non-nursing field in the United States for a while and then decided she wanted to be a nurse. She went to LPN school, and then to an RN bridge program. Soon she became a RN. In her nursing student training, she worked at a telemetry unit. She was well-liked in her nursing practice and she was hired by that unit as soon as she completed her clinical training. The staff in that unit love her, and she loves nursing.

WW – She came to the United States with her husband. At that time, her husband was an owner of a local restaurant. WW did not want to work in the restaurant, she went on to study nursing as a new fresh beginning foreign student, and passed the nursing board. She worked as a nurse at a large local hospital for a few years, and then she earned her advanced nursing degree to become a nurse practitioner. She works as a nurse practitioner as soon as she completed school. She was alone and struggled for a long time in learning what was the nursing about, but she made it.

One of our visitors, Janice, asked, “Was there anyone who did not make it? Did anyone go back China?” Without pause and without knowing who else was going to respond, the CAN sisters answered in one voice in the spirit of our sisterhood:

“No, that  was not an option for us.”

They continued:

“Nobody said it was not hard.”

“We were determined to make it in this world together.”

“We were not going to quit.”

“We appreciate each other.”

“We learn from each other.”

“We are going to be strong, stand up straight, and shine.”

Our visitors were very impressed and encouraged. They also said they were very proud of their countrymen who are “making a difference in their new world.”

CAN, yes we can. CAN, yes we can.

This article was written for DiversityNursing.com by:

Mai Tseng RN, BSN, MPA, EMBA, NE-BC, LNC, CRNI.
Hospital Shift Supervisor
Children's Mercy Hospitals & Clinics
2401 Gillham Road
Kansas City, MO 64108

Thank you to Pilar De La Cruz-Reyes, MSN, RN from the California Institute for Nursing and Healthcare for the content of this video.

Breaking the Barriers is a great compilation of nursing stories put together by the California Institute for Nursing & Health Care that show how everyday people can overcome adversity to follow the career of their dreams. The nurses in this video will inspire you and show to our young people how you really can achieve if you have the desire and passion for a career in nursing.

Once you watch this video, we would love to hear your feedback. Please comment here on our blog when you have a minute.

Four Innovative Initiatives to Attract and Retain Diverse Women

By Tina Vasquez for Evolved Employer

Recently, Working Mother Magazine released its 2011 list of the best places to work for multicultural women – essentially, a survey of the availability and usage of diversity programs, as well as the accountability of the managers who oversee them at top corporations. For the fifth year in a row, Pepsico has been named number one, along with with 23 other companies, all of which are committed to supporting women of color with strong diversity, leadership, and education programs. Here are four of the most innovative initiatives included on 2011 list, that help advance and retain diverse women.

IBM
IBM’s cutting edge Reverse Mentoring pilot program turned mentoring on its head. Ten senior executives were given the opportunity to choose a culture they wanted to learn more about and for 10 months, and multicultural women (who were primarily non-executives) from these cultures acted as their mentors, helping them better understand cultural differences. The need for the program was identified as a key initiative of the Multicultural Women’s Group at the company, whose mission it is to attract, retain, and develop women through mentoring, networking, fostering a sense of community, and exchanging information.

According to Angela Archon, IBM’s VP of systems and technology, the program promoted cultural sensitivity and adaptability and demonstrated the impact of globalization and why culture matters.

“The hallmark of the program was to increase knowledge and sensitivity around cultural differences and continuously improve global collaboration. It helped dispel myths; it provided clarity to issues related to stereotyping; and it increased cultural awareness,” Archon said. “Executive mentees gained knowledge about their mentor’s culture and how business is done in that culture and the multicultural women who served as mentors had the opportunity to build a relationship with an IBM executive and enhance their leadership capabilities.”

Deloitte
It should come as no surprise that the ever impressive Deloitte was featured on Mother’s list for the sixth year in a row.

This year, two of Deloitte’s programs were spotlighted on the list: Navigation to Excellence and the Leadership Acceleration Program. After an internal survey of almost 4,000 multicultural employees, the firm found that multicultural women desired more formal sponsorship, so Deloitte launched its Navigation to Excellence pilot program, a one-year program that matches female managers and senior managers of color with leaders who help them orchestrate a career plan, gain access to key assignments, and enhance their knowledge of what it takes to advance. The 18-month Leadership Acceleration Program even allows female partners and principals to shadow their sponsors on the job, receiving intensive mentoring and coaching.

To continue moving these types of initiatives forward, the firm has quietly invested $300 million towards the creation of a state-of-the-art learning and leadership development center that will open its doors this fall after two years of construction.

According to Barbara Adachi, the National Managing Principal for Deloitte’s award-winning Women’s Initiative, it was never the firm’s intention to be a leader, but awards and recognition such as those given by Working Mother, inspires them to keep moving forward.

“We’re our biggest critics and we’re our biggest motivators. We don’t do this for the publicity. Diversity is a business imperative here. I recently read that half the population will be comprised of minorities in 2050 and I strongly believe that by being diverse, we attract the top talent in the market and we better serve our clients,” Adachi said. “We’re not doing this because it’s the right thing to do, but because this is the way business should be done.”

Chubb Group of Insurance Companies
This is the third time Chubb has been featured on Working Mother’s list, but the company has a long-standing commitment to promoting diversity with decades old programs and initiatives in place. According to Trevor Gandy, Chubb’s chief diversity officer, in order to form lasting business relationships with customers and become a true global leader in the industry, the company must understand its customer’s “diverse cultures and decisional processes- and not merely their languages.” To do so, the company strives to create a diverse workplace through programs such as their Count Me In: A Culture of Inclusion micro inequities program. The program began over 10 years ago and aims to help the company educate their workforce on the often small details and behaviors that help build an atmosphere in which all employees feel they have a voice.

Chubb also has a 29-year-old Minority Development Council whose mission is to advance the company’s business objectives by fostering the career development of people of color into leadership roles. Even more impressive, the company’s Women of Color strategy strengthens the bonds between women of color and their managers by providing them with meaningful feedback and structured development plans. The overriding goal, according to Gandy, is to prepare the company’s female multicultural employees to compete for leadership positions.

CA Technologies
Like Chubb, CA Technologies firmly believes that their business relationships in more than 140 countries drives their commitment to workplace diversity and it enables them to create, support, and sell the best IT management software.

The company’s Women in Technology Mentoring program is geared towards female employees that are in technical and quasi-technical roles within the company’s technology and development organization. The program was established to ensure that female employees are provided with the appropriate environment, knowledge, and sponsorship to achieve their full potential within the company. The company also supports the pursuit of higher education and provides up to $5,250 a year in financial assistance to eligible employees completing undergraduate and graduate level courses. CA Technologies also offers 15,000 online courses that employees can access. An adoption assistance program includes reimbursement of adoption-related expenses up to a maximum of $5,000 per child and $10,000 per family within a two-year period.

CA Technologies also aims to help working parents, so nearly 30 percent of the company’s North American employees participate in a full-time telecommuting or work from home program. The company also has Global Marketing and Finance associate rotation programs that were developed as a way to attract and develop entry level candidates and enable them to jump start their professional career with structured training programs, job shadowing, and access to mentors.

According to CA Technology’s VP of human resources, Beth Conway, the company is focused on fostering diversity both inside and outside the company.

“In addition to our efforts within the company, we’re also an active partner of the Anita Borg Institute for Women and Technology, a nonprofit organization dedicated to increasing the impact of women on all aspects of technology,” Conway said. “We also sponsor ABI’s annual Grace Hopper Celebration of Women in Computing conference in the U.S. and India. We’re dedicated to helping the leaders of tomorrow develop their talents and career paths by providing and encouraging a collaborative working environment.”

from Jacob Braude is vice president for strategic planning and director of the Saatchi & Saatchi Wellness Lab at the advertising agency Saatchi & Saatchi Wellness for Forbes.com

Health and wellness are becoming big all across marketing. Even carmakers are getting into the act. Ford, for instance, just announced plans to partner with WellDoc to build mobile health sensors into its cars. In the future your Focus won’t just get you from here to there; it will also monitor your glucose levels, adapt to a high pollen count, and even remind you to take your medicine.

But in the rush to make the most of health and wellness, there is a danger that companies will miss one of the most important aspects of wellness. It’s not technology, or supplemental ingredients, or even medicine. It’s friends.

In a talk he gave at the TED conference in 2006, Dr. Dean Ornish, who first became well known for talking up the benefits of diet and exercise in fighting heart disease, told a story about a year he spent studying under a well-known swami. As Dr. Ornish recalled it, the two of them were speaking to a room full of medical students when someone asked the swami to talk about the difference between illness and wellness. The swami went to the board at the front of the room and wrote “Illness” and “Wellness.” Then he circled the I in “Illness” and the We in “Wellness.”

It was a simple and profound way to make a point, and a recent series of studies have proven him right. Researchers have shown that what I call “we-ness” affects all aspects of our health and wellness, from how likely we are to survive killer diseases to how likely we are to carry some extra weight and how generally satisfied we are with our lives.

In one survey of almost 3,000 nurses diagnosed with breast cancer, researchers discovered that women who had fewer than 10 close friends were four times more likely to die of the disease than women with 10 or more close friends. That’s an increase in survival rate that any pharmaceutical company would be thrilled with. In another study, of men in Sweden, researchers discovered that the leading risk factor for heart attack after smoking was having only a few friends. More recent research has demonstrated that people living with a lifelong condition like heart disease do better if they share their experiences with others going through the same thing—even if those people aren’t their friends.

Having friends isn’t just about long life. It’s also about quality of life. Highly publicized work by James Fowler and Dr. Nicholas Christakis found that having a friend who became obese made you 57% more likely to become obese as well. Researchers are discovering that both good and bad habits spread socially—not just weight issues but all aspects of health and wellness, including dietary and exercise habits and stress levels. The importance of friends to a person’s health and wellness has become so accepted that in a March 2011 interview with the Los Angeles Times, the U.S. surgeon general said, “We can’t look at health in isolation. It’s not just in the doctor’s office. If you have a healthy community, you have a healthy individual.”

Given all that, it’s not surprising that a study by the RAND Center for the Study of Aging identified “social contacts and family” as the No. 1 factor affecting life satisfaction. This was a robust study, conducted in both the U.S. and the Netherlands. There were differences between the two countries in other life satisfaction elements, such as job, income, and daily activities, but the people of both countries agreed that social contacts and family had the greatest effect on how satisfied they felt.

Fiat’s new eco:Drive system makes the most of the feel-good aspect of we-ness. It began with a wellness product that lets you in put your driving habits to a program that will teach you to blow less carbon into the environment by changing the way you drive. It became a we-ness product when Fiat created Eco:Ville, a virtual town modeled on the company’s hometown of Turin. Software permits you to join Eco:Ville, but only if you’ve changed the way you drive and improved your carbon footprint.

Another marketing-related innovation that builds on the connection between we-ness and everyday health and wellness is the Nike+ system. Nike took a health product—smart running shoes that can record your distance and pace and sync the data to your iPod—and made it a we-ness product by incorporating massive social integration in the form of running teams, geographic challenges and automatic posting of runs to social networks like Twitter and Facebook.

Asthmapolis, an organization that is just getting off the ground, connects we-ness to improving health for chronically ill patients by attaching a small GPS-enabled device to rescue inhalers. With today’s medications, asthma can often be well controlled but isn’t, because people rely too much on their rescue inhalers. Using Asthmapolis technology, whenever someone uses their inhaler, the time and location of use are recorded, creating a searchable map and timeline of their treatment habits that can be shared with friends, family, and physicians.

All these innovations make use of social technologies to weave we-ness into products that have a flavor of health or wellness. But we-ness doesn’t mean just plugging social media into whatever you’re selling. Coke recently rolled out special vending machines in Argentina to promote International Friendship Day. Most of us don’t associate Coke with health and wellness (sorry, Coke), but the company’s smart use of we-ness deserves to be recognized. The vending machines in Argentina were so tall that only by getting a boost from a friend could you put money in. When you did, you were rewarded with two Cokes—one for you and one for your partner.

We-ness is a part of all of our lives, so much a part that we sometimes take for granted just how good connecting with other people feels. Research proves that it doesn’t just feel good; it’s good for us. If you’re in the health and wellness market, or you’re ready to take the plunge, you will do well to include some aspect of it into what you’re selling.

Margaret Stineman spent many of her formative years in the slow classes that were then the domain of children who were, as she delicately puts it, "not achieving."

Born with a severely deformed spine and shoulders, she endured 15 operations as a child on her eyes, internal organs, and misshapen bones. She spent much of her adolescence in a body cast, making her the object of ridicule. Problems with the muscles that control her eyes severely limited her vision. People around her did not think she was capable of much, and she agreed.

How that child - functionally illiterate when she left high school - became an artist and then a doctor and then a respected researcher and then a member of the prestigious Institute of Medicine is a remarkable story of serendipity, determination, motherly devotion, and well-timed mentoring.

Then there's the emotional alchemy. A set of circumstances that would have made many people angry, bitter, or at least deeply insecure seems instead to have forged a woman who is, at 58, confident, profoundly thoughtful, joyful, and serene.

Joel Streim, a longtime friend and research collaborator at the University of Pennsylvania, called her "one of the special people of the world." Just as Stineman focuses on her own strengths rather than weaknesses, he said, she sees other people's abilities and "has a real talent . . . to make them more creative and innovative."

Now a professor of both physical medicine and rehabilitation and epidemiology whose work has focused on measuring and compensating for disability, Stineman does not like talking about her physical problems. But she recently gave a rare speech to colleagues at Penn about how she had made it in academia, and now hopes her story will help fellow health workers see the potential in their patients.

Stineman's journey to the upper levels of medical research began with art. Bored in school, unable to see well, and plagued by medical problems, she turned inward and expressed her private world by painting and sculpting. In early adaptations for her handicaps, she used templates and mirrors to compensate for a lack of depth perception. Some of her teachers noticed her talent, and it got her into Temple University's Tyler School of Art.

Soon after art school, Stineman won a prestigious scholarship that would have sent her to Rome to paint for two years. She said members of the selection committee rejected her after she had a physical. "They didn't want to send a crippled person to represent the United States," she said.

She was crushed at first, but then looked at the problem from another angle - a defining quality of both her life and art.

"I was hurt. I was upset. I was angry," Stineman said. "This transformed into something that was so beautiful: a recognition that I must be smart or I wouldn't have won this thing. I must be smart. Something must have been missed. That's when I had the wake-up of my life."

For a while, she rejected art - she saw it as too emotional - and threw herself into the discipline and rules of science. Stineman's dream, and she knew it was probably an impossible one, was to become a doctor. Engineering was her fallback.

Her inventor father worked as a machinist at Drexel University. She enrolled as a special student there, taking one class at a time. "I decided that I would do absolutely anything to learn," Stineman said. "I was so infatuated with the fact that I could go from barely knowing arithmetic to getting an A in calculus just because I had applied myself."

She met what might have been her Waterloo in biology. She did well on the fill-in-the-blanks part of a test but flunked the essay.

"You can't spell," the professor told her. "You have no sense of sentence structure, and you can't formulate your ideas. Are you from a foreign country?"

Instead of taking offense, Stineman took an English-as-a-second-language class.

"This professor really saved my career," she said.

After using her art portfolio to talk about visual perception, she got into Hahnemann Medical College. It was a lot harder to keep up there. She almost quit, but some key professors helped her at crucial moments. Because Stineman learns better through hearing information - and can process it quickly - than by reading it, her mother read her textbooks into a special tape recorder that Stineman then played back at high speed.

She brought a different perspective to the care of people with disabilities. "I felt as a child they kept trying to fix me," she said, "but nobody was helping me to learn how to live with the way I was."

Stineman can walk short distances, but usually uses a motorized wheelchair or cart. Patient reaction, she said, ranges from dismay - "Now even my doctor's disabled" - to "Oh, my God, if she can do it, I can do it."

She reconciled with art after she recognized the creativity in science.

One day, she was fascinated by how a spherical bottle stopper inverted the landscape outside her window. She decided to write a mathematical formula explaining why that would happen. Yes, that's her idea of fun.

"I painted the image, and then I used mathematics to solve the image. This has been what has driven my whole life," Stineman said. "If you want to understand something, whether it is human nature, whether it is a scientific problem, use many different ways of looking at it."

Her facility with math and computers led to her biggest claim to fame: She helped design the system Medicare began using in 2002 to decide how much to pay for rehabilitation care for individual patients.

She remembers the responsibility she felt going to work the day the hospital began using the new system. "I was practicing medicine under rules that had come out of my head," she marveled.

As Stineman waited for the elevator, she said the prayer she says each day about her patients. "May I have the strength to see what I need to see, to know what I need to know, so that I can care for you in the best possible way."

Stineman, whose long brown hair is streaked with gray, focuses on research now. She is in charge of three large National Institutes of Health grants aimed at identifying the most helpful rehabilitation services after stroke and leg amputations and at helping older people stay in their homes. Although lung problems reduce her stamina, she is known as a tireless worker. A computer that speed-reads documents out loud makes it possible for her to handle the work.

She stands only 4-foot-9, barely tall enough to see over a lectern. She estimates she'd be 9 inches taller if she had a normal spine. She often props herself up with her knees and elbows to sit upright.

She does special exercises and eats an organic vegetarian diet. Although she has had suitors, Stineman said she had never loved anyone enough to curtail her work. She relaxes in a Zen garden her mother created at the house where she lives near the university. She said she had dealt with the pain in her life by creating art, writing music, and keeping journals.

During her recent speech to coworkers, Stineman used self-portraits to explain the evolution of her art and her psyche. A high school effort shows a pretty, intense-eyed girl's face framed by dark, ill-defined hair. There's no body, and the work lacks perspective. Another early, harsher piece shows her twisted body lying on a table in a bare room with a pit.

In 2004, she did a painting of her face and body as an adult with an X-ray-like rendering of her curving spine highlighted.

Two years later, she added her white lab coat, stethoscope, and gold caduceus with the word courage carved in it. Finally, Stineman had put it all together, proudly.

"My body is a vehicle for my mind, and I can wear this coat and I can take care of others," she said, displaying the painting on a screen.

"Was I disabled or was I gifted or am I both?" she asked. "Are we all both? I believe we are."

We want to hear from you. What do you think about Dr. Stineman and her ability to overcome all the obstacles in her life?