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Many entered nursing specifically to work in their communities, but Wilson lets them know they can always further their education and return at a new level. She tells them, "I want to see you back for your master's."

Equal opportunities

Hospitals and clinics that want to attract and especially retain minority nurses must look at their environments to see how welcoming and supportive they are, including how many minorities they have already hired and what positions they hold.

"It's not just about money, it's about how they treat their employees," said Benavente, noting that Magnet hospitals have been praised for how they recruit and retain minority nurses. "We want to be made to feel important and that we matter to the institution."

If she were looking for a job in a hospital, Doswell said, "I would like to see how many African Americans are on staff and what positions they hold. If they are all nurses aides, that's not a place I want to work."

Despite the difficulty in recruiting bilingual nurses, Rosario said her clinic has no problems retaining them partly because they are comfortable working among people who speak the same language and come from similar backgrounds.

"Because they are serving their community, they feel the loyalty and dedication to stay here," she said.

The hospital where Benavente worked for many years has Hispanic physicians, nurses and support staff, as well as patients, and she always felt comfortable there. But when she went to a predominantly Caucasian hospital across town, no one talked to her while she was wearing her nursing scrubs, she said. People there became friendlier only when she wore her lab coat and university identification.

Such attitudes, whether conscious or not, have a huge effect on minority nurses. "Why would I stay in a place where I know that I'm just being tolerated and I'm not wanted?" Porter asked.

Rather than look for a simple solution, nursing needs to examine its history and ask difficult questions, Doswell said. Until the 1950s, many hospitals were segregated and the American Nurses Association did not accept African-American nurses as members.

Rhonda Flenoy Younger, a recruiter for the school of nursing at UCLA, said she has heard stories from African-American nurses about patients who said they did not want an African-American nurse caring for them.

"I was shocked," she said. "But things like that happen in 2002. Some people are still like that."

Hospitals must find ways to show appreciation for the contribution minority nurses make, Louie said. Bilingual nurses often are asked to translate and interpret in addition to their regular nursing duties. "Many of these nurses feel they are taking on a double load," she said. "They feel used."

Some nurses from Asian or Hispanic backgrounds who speak only English may feel pressured or inadequate because they aren't bilingual, even though their non-Asian or non-Hispanic counterparts don't speak another language either.

Navarrette, who is more worried about passing his Spanish test than his board exams, said part of that pressure comes from his own expectations. Many-although by no means all-minority students go into nursing because they want to help their communities, which are often in desperate need of health care professionals.

Navarrette said his father told him he finally understood the importance of his chosen career after his experience with the nurses who cared for Navarrette's grandmother in a small hospital in Kansas.

He told Navarrette, "I know that you're going to be a nurse, but until I saw what they did, I didn't really know how important your job is-not just to the patient, but to the family."

Contact Cathryn Domrose at kaguilar@well.com