Health care’s challenges strengthen resolve of new Dell Children’s nurse

Jose Francesco ‘Frank’ Escobar began working as a registered nurse last month amid a staffing crisis throughout the industry. He expects it to be hard — but he says he’s ready.

By Olivia Aldridge, KUTOctober 19, 2023 10:11 am, ,

From KUT:

On a mild day in early May, Jose Francesco “Frank” Escobar sat in the courtyard at the center of the UT School of Nursing building, taking a break from a marathon study session.

He was at the end of his final year of a bachelor’s degree program. Graduation was imminent and so was his date with the National Council Licensure Examination, the test standing between him and his license to practice as a registered nurse. Once that hurdle was cleared, his next step would be starting a job in the mental health unit at Dell Children’s Medical Center.

“What I’m really excited about is doing the specialty that I want to do every single day,” Escobar said.

He felt ready to move forward. But also, he said, he wasn’t naive about the challenges of the career field he and his classmates were entering.

Even before 2020, hospitals across Texas and the United States were struggling to find enough qualified nurses. Then, COVID-19 filled hospital ICUs in 2020 and 2021, throwing health care workers into daily crisis conditions and pushing them to burn out. Many experienced nurses left the workforce. Often, nurses with only a couple of years’ experience were given more management and training responsibilities, even as staffing levels lagged. And nurses fresh out of school found it difficult to find experienced mentors.

Locally, hundreds of nurses at Ascension Seton Medical Center formed a union last fall, citing many of these issues. They continue to negotiate with hospital management to secure an initial contract that ensures lower nurse-to-patient staffing ratios, among other provisions.

This climate hung over Escobar as he navigated through coursework and field clinicals. While he felt hopeful watching nurses fight for better conditions, he also saw a lot of young nurses and students turn to different careers.

“It is quite discouraging to see so many people flock away from the profession,” he said. “But in another way, it just increases my resolve to be like, ‘OK, I really need to stick to it.’ Because my future unit, my future hospitals and my future patients are going to need me.”

‘Actually helping people’

Heading into this challenging environment, Escobar felt like he was in good hands with UT Austin Nursing. His professors showed compassion during stressful moments — one even brought homemade biscuits made with eggs from her backyard chickens to a study session for the license exam. They worked hard to find the students clinical placements in hospital units that could provide strong nurse preceptors — experienced staff who work alongside nurses-in-training.

UT’s top-ranked Texas nursing program is what attracted Escobar to the university. He decided he wanted to work in either health care or social work while attending high school in his hometown, Eagle Pass.

“I didn’t want to slave away 9-to-5 … at that cubicle desk job where you’re not interacting with people and you’re not actually helping people out,” he said.

But during college, his motivations for becoming a nurse became more personal when a person he was close to was diagnosed with schizophrenia and he saw the importance of mental health care up close.

“I was the first person that they saw when they had their first psychotic break,” he said. “And ever since then, I’ve always been thinking about what could have been if someone helped them earlier.”

During his senior year, Escobar pursued an internship in Dell Children’s mental health unit, working with kids who had major depression, bipolar disorder, suicidal ideation and other conditions. He said he liked working with kids because they are capable of immense growth despite their challenges. The work also helped him make sense of what his friend went through and felt like a way to take action after a situation that left him feeling out of control.

Escobar also liked the culture of the unit, which seemed to have good retention of nurses and fostered a strong sense of rapport among the staff. So after his internship ended, he applied to work there full time — and got the job.

One last summer

Escobar’s first day of work was set for September, so he had a few months of breathing room after graduating. Friends and mentors in the industry told him this was a good thing, that it was a valuable chance to relax and regroup before beginning an emotionally and physically demanding job.

So he spent the summer at the movies — or, more accurately, working at Alamo Drafthouse. But despite working through the infamous “Barbenheimer” phenomenon that crowded theaters this summer, any stress he experienced while serving fried pickle spears and margaritas to pink-clad throngs of moviegoers was easy to keep in perspective.

“I feel like when I’m in Alamo, it’s like a fun little side quest thing that I do,” he said. “It doesn’t have the consequences of working in health care and putting on those blue scrubs.”

Escobar says boxing helps him manage his fear.
Michael Minasi / KUT

When he wasn’t working at the theater, he spent hours each day on his passion outside of nursing: boxing. Escobar competes in the amateur boxing leagues and trains at Easley Boxing Gym in South Austin. It’s a pastime that garners a lot of surprised reactions — his friends at the gym are surprised to learn he’s a nurse, and nurses are often surprised to learn he’s a boxer.

But to Escobar, they’re connected: The fear he felt when his friend was experiencing a mental crisis led him to boxing as an outlet. He said learning to take punches and fight against opponents that seemed on paper like they should outmatch him taught him to manage his fear.

“The thing that drives me is that I just never wanted to be as scared as I was in that moment ever again,” he said. “That just really pushes me to keep going on.”

Reaffirmation

Escobar ended up needing that outlet this summer more than he ever could have expected. What was supposed to be a relaxing few months turned pretty stressful when his father suffered a heart attack. The experience taught Escobar to view health care workers with renewed appreciation and reaffirmed his decision to become a nurse.

“It was like an extra nail of like, ‘OK, OK, I like doing this. I want to continue doing this. And I want to be like those good nurses that took care of my dad,’” he said.

Escobar began work at Dell Children’s last month. Over the coming months, he will receive training and treat patients alongside a preceptor, sometimes working days and sometimes nights.

So far, he’s enjoying learning the ropes and feels optimistic that his passion for the practice of nursing will carry him through any challenges.

“I’d say [it’s] a very cautious optimism. We love nursing with all our heart — especially those that have made it this far,” he said. “But we really believe in the future of this profession, that things can get a lot better for us and our patients.”

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