June 3, 2017

The story Anthony and Rita Adeniran shared is filled with laughter, respect, love, hard work and compassion and one that, while not yet finished being written, gives testament to what people can accomplish when they have vision. Alumna and part time faculty Rita K. Adeniran, DrNP, MSN, RN, NEA_BC,  FAAN  and her alumnus husband, Anthony A. Adeniran, DNP, MSN, RN, PCA came to the United States from Nigeria a long time ago as an engaged couple with dreams of continued education; he to study aeronautical engineering and she to study medicine. Where their passions have led has brought them both much success as nurses, entrepreneurs, parents and role models.

When Rita was a little girl in a remote African village, she marveled at the nurses walking to and from work. She thought they were brilliant and beautiful and loved the hats the women wore. She wanted to be just like them and declared nursing as her path of education even though she didn’t know what nurses really did.  After starting nursing school program in Nigeria, she quickly realized that nursing is grossly undervalued, viewed as an appendage to physician's work; and reserved mainly for women or less intelligent men. Adeniran wanted to be respected and wasn’t about to kowtow to medical students whom she knew were not as smart as she. “I didn’t like being a nurse if my contributions will not count or be valued,” she recalled. “When doctors walk in the wards, nurses have to stand up, hand them their stethoscopes and gloves.” Adeniran could not comprehend the rationale for nurses to serve doctors. because she was always at the top of her classes prior to nursing school which got her nickname “Ever First” and knew there were plenty of medical students with much lower rankings in her class before medical school. So when the nurse matron wanted me to get up when the doctor walked in, I said, ‘No, I’m not getting up. I’m smarter than he is. I’m giving him no glove.’” She was a rebel in African context.

It is unfortunate, perhaps, fortunate that she could not change her nursing major, in their culture, once you’ve declared a major, you cannot change it, almost impossible due to the financial implications. She liked what she was doing, but didn’t want to be undervalued or  be a doctor’s handmaiden.  Already in love with Anthony, who wanted to go to the United States to continue his education in engineering, shecouldn’t wait to go so she could go to medical school. However, she was delighted to find out that here, nursing is a much respected calling and wouldn’t have to study to be a medical doctor. “As a nurse, I’m allowed to think. I am not subservient to physicians but rather collaborate with them.” Rita proclaimed that she would rather be a nurse and is quite proud of that fact. So much so, she convinced Anthony to change his career path to nursing as well.

If it hadn’t been for engineering though, Anthony would have never met Rita. He received his higher education degree and had only to finish his practicum which involved a two-day sail from the city of Lagos in West Africa to Rita’s village, Burutu. Their courtship lasted a while and included Anthony writing her letters using a female name as Rita’s father wouldn’t allow her to receive letters from a boy. Her father and their polygamist, patriarchal culture were very strict. “In the sender area, I used a female name, Kemi” Anthony recounted. “It was like Kathy in Africa, when I got a letter, my father would read it before giving it to me,” explained Rita. But it didn’t stop them from finally getting married. They had a traditional engagement in Africa and a white wedding here in the United States. They embraced their life in America which proved to be counter to what it would have been like had they stayed in Lagos. Anthony was labeled a “woman wrapper” by relatives and friends. They thought Rita did some sort of “voodoo” to get him to braid their kids’ hair, dress them, feed them and do many other things that were considered woman’s work. In a speech he gave on Rita’s 41st birthday where many of their relatives  and friends attended — the same people who saw him as worshipping his wife — he said, “Some of you here called me a woman wrapper. I will tell you that any smart man would be proud to be Rita’s wrapper.” They share very deep and mutual respect for each other and trust in the other’s opinion and advice.

When Anthony decided to pursue a master’s degree in nursing at Drexel Online and Rita questioned the quality of the education he would get not being in a classroom, they trusted each other in that decision and became very active members of the Drexel family. Anthony, who later received a DNP degree from Drexel, has proven to be an incredibly compassionate and well-liked nurse. “What got me in to nursing was when my second daughter was born prematurely,” he shared. “The kind of care they gave her gave me the impression that I wanted to do that too.” He has never regretted their decision or introducing his wife to Drexel. Anthony was cross-trained to care for pediatric and geriatric patients and claims to love both. Rita conveyed that he has patients who won’t follow their doctors’ instructions unless Nurse Anthony is on board. “His patients love him because he is very, very caring,” Rita gushes. “He used to have a 107 year old patient who would go to the hospital and get advice about her treatment. She would tell the doctor to call Nurse Anthony and if he said yes, then she would do it,” she added. He’s very attentive and respectful of the elderly, something that is ingrained from their African culture and tradition. He has infused that commitment to the aging and to diversity in his company, Health1st Home Health Services. Caring for, and honoring the elderly is something that they would like to see done more in the U.S. They offer their skilled nursing, medical social services and physical and occupational therapies in Philadelphia, Delaware, Montgomery and part of Chester counties and are considering adding non-skilled services. “We are strategically looking at all the changes going on with healthcare and are suited to do it though we have chosen in the past not to,” Anthony acknowledged. “The reimbursement is not great and we don’t like to give sub-standard care. Our therapists are doctoral prepared and most of our nurses have masters’ degrees. We’re not that big, but it’s quality care, CMS rates Health1st as a Five-Stars Agency, the highest standard in the industry,” Rita commented. They cited that most of their referrals come from their patients’ families because they see that they go above and beyond which isn’t surprising when you hear what they think makes a good nurse. The willingness to suffer for another person is how Rita defines compassion. And that, in her opinion, is the main element of what makes a good nurse. “When I teach, I say that nursing is the only educated professionals that comes that close to poop, so if you aren’t willing to go that low  and dignify another human being, don’t be a nurse,” she stated. “They are heroes in how they interact with patients and how they carry their patients’ burdens with them,” Rita continued. “They are the voice of the voiceless.”

Being an advocate for patients, giving them voice, entails possessing humility and understanding and embracing cultural, educational, ethnic, gender and socioeconomic differences, indeed, diversity in its broadest sense. According to both Anthony and Rita, two people who profoundly champion diversity, in “nowhere else is it as important as healthcare because where you have two people, diversity exists.” Nurses cannot show up at the hospital for their shift and choose which patients they want to treat, so, in order to perform at an optimal level, they have to be able to manage all variables. Even nurses with the best intentions may inadvertently foil optimal outcomes by dismissing unfamiliar thought processes, cultural values and belief systems and treatment concepts. “Your expertise  for  a cure, may not worth or be as important as the patients’ culture. When you understand that, you are in a place of humility,” described Rita. “When you’re in a place of humility, you allow your patient to be the teacher of his or her culture.” They offered a perfect example of this from their own lives.

In Africa, “real women” go through labor without medication, pain or otherwise. Imagine the reactions when Rita and Anthony arrive at the hospital, here in Darby, Pennsylvania, for the birth of their first child and Anthony strongly declined any pain medication for his wife. “Once she was in labor, the nurses were trying to convince her to take it to relieve the labor process,” Anthony disclosed. “I didn’t want her to take it. They were thinking I was an abuser,” he added. “When I was close to my due date he asked me if I was going to be a real woman and not take the pain medicine. I said yes, I want to be a real woman,” Rita remembered. But this was her first baby therefore had no idea what labor pain was. “I was pregnant and carried this baby and I’m still not a real woman?” she asked. “As the labor progressed, they gave me oxytocin and I saw Jesus and Allah and forgot all about being a real woman.” She ended up asking for something for the pain which Anthony pleaded for her not to take it. “The nurse was ready to throw him out of the window. They thought he was abusing me and had planned on sending a social worker to our home when we were discharged.” The nurse, no doubt, was caring for her patient, but there was an obvious disconnect between a cultural tradition and belief held by the Adenirans and what was the norm in American labor and delivery practices. Anthony explained that he should have been asked why he was adamant about pain medication. Rita points out that nurses are not to blame, but she also stresses that there is a great need for cultural competency and flexible thinking. “Part of your skill is to get to the bottom of the rationale for my husband’s actions,” Rita remarked. It should be part of a proactive assessment and she says there is a very specific way to ask about these delicate items: “We would like to honor everything about you and your culture and to give you the best delivery and support. Is there anything we should know during your labor process to honor you?” “You’re going to honor me? When you put it that way, I’m more likely to give you more information than if you just asked me “Do you have any cultural concerns?”” she said. This then let’s the patient know that the nurse is truly interested in learning and being attentive to their unique needs.

Rita’s work in diversity has garnered her much acclaim. She is a fellow of the American Academy of Nursing and completed a three-year fellowship through the Robert Wood Johnson Executive Nurse Fellows’ Program where she and six other nurse leaders from across the country designed a “Civility Tool Kit” to help identify, intervene and prevent workplace bullying. She’s been invited to speak in more than 18 countries delivering commencement and keynote addresses on adversity and diversity, she served as  the director of Diversity and Inclusion at The University of Pennsylvania Health System and co-chairs the Nursing Diversity Council of the State of Pennsylvania Action Coalition. In May, she was inducted into the Drexel 100 and received the 2017 Healthcare Advocate Award from the Pennsylvania Diversity Council and in June she will receive the “Every Day Nursing Hero Award” from the Pittsburgh Black Nurses in Action.

Their business is growing, their five children are getting more settled in their education and careers (three of them are pursuing a career in healthcare) and there are still plenty of things they want to do. It doesn’t look like Rita and Anthony will be slowing down anytime soon to do the traveling they hope to do in retirement. As Rita put it, “In the race for excellence, there is no finish line.”

By Roberta S. Perry