On this episode of “Raise the Line” we welcome Dr. Sheldon Fields, a trailblazer in the nursing field and the president of the National Black Nurses Association. In this candid conversation with host Kelsey LaFayette, Dr. Fields shares his inspiring journey from the bedside to becoming a prominent figure in nursing, HIV/AIDS prevention and academia and also shares the challenges he faced as a Black man in a predominantly white and female field. It's a compelling listen for anyone interested in the intersection of health, policy, and social justice.
On this episode of “Raise the Line” we welcome Dr. Sheldon Fields, a trailblazer in the nursing field and the president of the National Black Nurses Association. In a candid conversation, Dr. Fields shares his inspiring journey from the bedside to becoming a prominent figure in nursing, HIV/AIDS prevention and academia and also shares the challenges he faced as a Black man in a predominantly white and female field. "I fell in love with a profession that has not always loved me back," he tells host Kelsey Lafayette. Dr. Fields brings over thirty years of experience as an educator, researcher, clinician, administrator, consultant, health policy specialist, and entrepreneur to his current role at NBNA, and as the inaugural associate dean for equity and inclusion at the College of Nursing at Penn State University, where he also serves as a research professor. Listeners will find Dr. Fields' insights on navigating a career in healthcare particularly valuable, as he stresses the importance of resilience, continuing education, and mentorship. It's a compelling listen for anyone interested in the intersection of health, policy, and social justice.
Mentioned in this episode:
National Black Nurses Association
Kelsey LaFayette
Hi, I'm Kelsey LaFayette, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare. Today, I'm happy to welcome a distinguished leader in nursing to the show, Dr. Sheldon Fields, who is president of the National Black Nurses Association and the inaugural Associate Dean for Equity and Inclusion at the College of Nursing at Penn State University, where he also serves as a research professor.
Dr. Fields brings over thirty years of experience as an educator, researcher, clinician, administrator, consultant, health policy specialist, and entrepreneur to his current roles. He is also a respected HIV/AIDS prevention research scientist with a focus on young men of color. Dr. Fields holds bachelor and master degrees in nursing and a PhD in nursing science and is an advanced AIDS certified registered nurse and family nurse practitioner.
He's the former Dean of the School of Nursing at Charles R. Drew University and the School of Health Professions at New York Institute of Technology, among many other academic leadership posts. He is also the founder and CEO of the SDF Group, which is a health innovation consulting company. Thank you very much for joining us today, Dr. Fields.
Dr. Sheldon Fields
Thank you for the invite, Kelsey, and the opportunity to come on your podcast. I'm excited to talk with you.
Kelsey
Yes, thank you so much. I'd like to start with learning more just about you and what first got you interested in medicine, specifically nursing?
Dr. Fields
Well, I’m originally from Brooklyn, New York, born and raised. And growing up, I was raised primarily by my grandmother and my aunt, my mother's oldest sister, who was a nurse. Because I was with my grandmother so much when my grandmother started to get ill -- she had really bad diabetes -- my aunt basically taught me at an early age how to help take care of my grandmother. My grandmother was my very first patient. I was ten and helping her with various things really got my helping juices flowing. My aunt really became my hero, my role model and I followed her footsteps into nursing.
Kelsey
That's awesome. And I think you've already kind of answered this next question, but nursing isn't really a typical career for black men. You see a lot of women, and usually the men that you do see are typically white. But as a black man who's obviously very successful, how have you navigated this successful career in this field?
Dr. Fields
Well, yeah, you know, the profession is majority women and majority still white. I'm often heard saying ‘I fell in love with a profession that has not always loved me back.’ It's not been a completely easy road, carving out the type of career that I've had in nursing. And I've been quite successful, you know, starting with first my education -- getting a bachelor's and then a master's as a family nurse practitioner, and then going on to be the first African-American male to ever get a PhD in nursing science from the University of Pennsylvania when I graduated in 2000. I carved my way into the academic space....research scientists, that tenure, you know, then eventually found my way into health policy and really into academic administration, which has led me to my roles as being the inaugural associate dean for equity and inclusion at Penn State.
But there were, there were quite a few obstacles, quite a few people who didn't see me and didn't understand why a black male with my background would even be in nursing.
Kelsey)
Yeah, and you said something really profound that you fell in love with a profession that hasn't always loved you. Bouncing off of that, what advice would you give to young men of color that do fall in love with this profession but haven't maybe had the best experiences with it, if they wanted to pursue a career in nursing?
Dr. Fields
You know, the best advice I can give them is to persevere. Choose your path. Stay true to yourself. Stay true to your nursing code of ethics. Be the best nurse that you can be. You need to show people because people won't always give you the benefit of the doubt. And ultimately, this is your decision, your choice. Find good mentors.
I try to do that. I mentor quite a few men of color at various levels because they don't have role models. I didn't have a single one until I found my role model, Dr. Randolph Rash, who was the first black man to ever get a PhD in nursing in the whole country. It took me a while to find him, but when I did I got that sort of affirmation of ‘you can do it.’ You really must maintain a high level of integrity and accountability because at the end of the day you really have to look yourself in the mirror and be satisfied with the things that you have done, have been called to do, and you'll realize that your life has touched many others and it has been successful and you’ve got to take those wins.
I don't know, Kelsey... the haters are always going to hate. I don't know another way to put that.
Kelsey
That is probably the simplest and most down-to-earth way to put it. But that's right, the haters are always going to hate. No, that's really great advice. You've touched on a lot of things throughout your career. You've said you've done policy and bedside care and all these other things, and you've had a really big impact in HIV and AIDS. So I'm just wondering if you can tell us what led to your interest in HIV/AIDS and why specifically the focus on young men of color?
Dr. Fields
So interestingly enough, I started my career out of undergrad working in oncology. My very first job was at Sloan Kettering Cancer Center in New York City. And in that role, I actually encountered working with patients who were dealing with HIV because of the cancer-related sequelae related to HIV. Subsequently, at the same time, I had a really good friend contract HIV and subsequently died of AIDS.
I looked around at the communities in which I was living, interacting with, and a lot of people were getting sick. The epidemic was disproportionately affecting brown and black communities. Then we looked at the demographic statistics coming out of the CDC at the time. One of the fastest growing rates was young men of color whose particular risk factor for acquiring HIV was having sex with other men and nobody was really honing in and finding solutions and preventative measures.
It's why I went to the University of Pennsylvania to study with Dr. Loretta Sweet Jemmott who is my mentor. She is an absolute legend in HIV prevention research science -- a black woman who was really doing innovative work at the time -- and I was meeting a mentor. And I needed to learn and I needed to learn from her. She is still my mentor to this day. I love her with all my heart. She is a phenomenal research scientist. She currently just took a new role at Villanova.
With research, you gotta ask probing innovative questions and you gotta be solving a need. There was a huge need for prevention, research, methods to help these young men avoid becoming HIV positive, and then if they did become HIV positive, how did you live with and still move forward with your life? And it became my passion.
Kelsey
That's wonderful and really great that you were able to find a mentor specific to that research area. But once you got into it, what other barriers did you face doing this work? Obviously, nobody was paying attention to this population, but what other barriers once you were in there did you find?
Dr. Fields
Well, importantly enough, I found the postdoc program. The Center for AIDS Prevention Studies at UCSF had a visiting nurse scientist program that I did my postdoc work at. And there -- because you know, even though I had got a PhD, Kelsey, they didn't teach me everything at the University of Pennsylvania, ironically enough...
Kelsey LaFayette (10:02.523)
No (laughs)
Dr. Fields
I know, I know...and I realized like, what do you mean there's something else after this PhD? But it was a great program. It's still a great program. But I needed to be in fellowship in learning with other people who were doing HIV research, so it gave me a great learning community. But the crux of all of this and trying to do high-level research is always funding And nobody was really looking to try to fund this type of research. It has a lot of stigma attached to it, which is unfortunate. But I winded up getting some funding through HRSA,
which is a division of Health and Human Services.
They put out a special SPINS project -- Special Projects of National Significance -- and they were following the demographic data. So they were setting up programs specifically around HIV prevention for minoritized communities, particularly young men, because again, the numbers were rising so badly. And that was my first big research grant. We did a project called Brock Healthy Youth Project, which was youth empowerment around HIV. We have several publications out there, so people can go back and take a look and find them. But that was one of the main obstacles.
And then of course, getting a Black community, with a history of medical mistrust, to actually participate in your research...well, you know, one of the things that helped that was the fact that I myself am a Black man and I was able to leverage that into a community that trusted me and was able to get over that hurdle of being able to even recruit participants into a research study.
But funding continues to be that linchpin and unfortunately funding has now gotten harder with the current administration in the dismantling of NIH, the National Institute for Nursing Research, the National Institute for Minority Health and Health Disparities, and the National Institute for Allergies and Infectious Diseases, which is where a lot of HIV funding for research comes through.
Kelsey
Yeah, on a good day, funding is the crux of every research scientist's life, but now more than ever.
Dr. Fields
Yes. Yes. You eat what you kill in research high level science, Kelsey. Especially in academia.
Kelsey
Absolutely. Focusing still on your HIV and AIDS work, I've always been fascinated by how far we've come in the research since the 1980s now that we're able to prevent transmission and manage it as a chronic condition. It's not a death sentence anymore. Do you see us building on this progress or what else do you see down the road for HIV?
Dr. Fields
So, it’s ironic you should ask that because we do now have the tools to end this epidemic. You know, we're forty-plus years into this epidemic and we have everything we need to end it except we do not have the collective will and we do not have the support. And, again, what the current administration has just done with ending funding to the CDC; ending funding to USAID and the PEPFAR program that provided HIV medications around the world; ending people's research grants because they're studying things or populations the administration doesn't believe in -- people who have sex with men, transgender individuals, anything that they don't like -- they're putting people's lives at risk.
They've stopped studies midway. We were working on a study called HPTN 096, which was a multi-level, multi-intervention type study specifically focused on HIV interventions for black men -- whose, again, primary risk factor was sex with other men -- in the southern United States because that's where the epidemic is still growing. And that study, led by my colleague and one of my former students, Dr. LaRon Nelson, who's a professor at Yale, has been stopped. Just cold stopped, endangering the progress we've made, endangering the trust that we've built in the communities that have come to the table because they trusted us. It's not a good way to do real science and it puts in doubt the whole research enterprise and it will have unintended consequences because they don't even know, and we don't even know, the extreme damage this will have to the End the AIDS campaign.
As you pointed out, this is no longer a death sentence. People who become HIV positive can live a complete and full life with the medications that we have. But more importantly, Kelsey, pre-exposure prophylaxis, or PrEP medications, are available. And if these medications are given to individuals and they take them, we can absolutely prevent HIV acquisition. We know how to do this and we have the science to do it. We have an administration who is undermining us at the moment.
Kelsey
Absolutely. This is a perfect segue, actually. You're also the president of the National Black Nurses Association and so I'm just kind of wondering if you could first maybe describe its mission and vision a little bit, but then more importantly, what is this association doing to support its mission and its membership during a time when there is all this open hostility to DEI efforts coming from DC and everywhere else?
Dr. Fields
Yes. Well, thank you for that. And you're absolutely correct. I have the honor and the pleasure of being the 14th president of the National Black Nurses Association. I am its servant leader at the moment. NBNA, as we affectionately call it, formed in 1971 and we formed because of the long history of nurses of color in this country being disenfranchised.
within the nursing community. Mainly the historic mistreatment from the American Nursing Association, who for many years in its formation wouldn't even allow nurses of color to be members. That didn't come about until the 1950s with an agreement to sundown the National Association of Color Graduate Nurses as a condition of becoming members of ANA.
And once that happened, nurses of color were still not given full access to ANA membership. Like, they couldn't run for office. They couldn't do those types of leadership things. It wasn't until many years later when Barbara Nichols became the first black president of ANA did some things really begin to change. But ANA went on and ANA has been trying to do that with us. We still have some work to do.
Currently, NBNA has 113 chapters in 34 states and the District of Columbia. We're headquartered in Silver Spring, Maryland, with access, of course, to the District of Columbia. We do our advocacy work, and we focus on supporting communities of color, and we are the voice of the Black nurse -- almost 400,000 Black nurses -- we are that voice. Our mission is very clear: we are focusing on improving the conditions of health for people that live in those communities and supporting the professional Black nurse.
Now, all of that being said, we are a Black focused organization, and in this anti-DEI, anti-Black environment, we are encountering some folks who don't think our organization has a right to exist. So I'll give you an example. For thirty-seven years, NBNA holds a Black Nurses Day on Capitol Hill event. It is the first Thursday in February to coincide with Black History Month. That is our advocacy day. And right before that day, this last February, I got a call from someone in the press and they were like, “Dr. Fields, is MBNA still coming to DC? In this anti-DEI, anti-black environment, are you all afraid of coming?” And I said to that reporter, “Absolutely not. We are coming to DC as we do every year because this day has been congressionally given to NBNA and we are coming with our annual research agenda. We are 600 plus strong and we will be there.”
We did show up and we had a successful day, but he also asked me, “Is NBNA considering changing its name to not be so Black-identified?” I'll tell you exactly what I said to him. “We have always been and we will continue to be unapologetically Black. So no, we will not change our name. We will not bow down to fear mongering and we will continue to push forward our mission.”
We are not directly federally funded so, you know, you can't threaten me by pulling my funding because that's not a lever that you have. We are a member-driven association and we do have several donors and supporters and people who continue to support us and the important work that we do.
Kelsey
That's wonderful. I'm glad that your association has such a strong leader at the forefront of it that won't back down. We need more people like you in lots of different associations across the US right now. So we're just going to wrap it up with this last question to kind of get some advice. We have lots of students and early career health professionals in our audience. What's your advice to them about meeting all the challenges that come with just being a student and early health care professional in this moment, and approaching their career in health care?
Dr. Fields
So particularly, if you're looking at a career in healthcare at this time, stay the course is one piece of advice. I tell all students all the time, particularly those who are looking at nursing, if you don't have an acumen for science, you're going to have a harder road. All of these pathways to careers in healthcare require a science background. There's an entire list of science courses in a nursing program that we're going to make you take before we let you take a nursing class. So that's one.
Two, nursing in particular is a calling. Find your calling, find your niche, find a mentor. You know, students can become members of NBNA at the student level and that's a great way to meet a mentor because we will assign you a mentor if you need one. We'll provide scholarships because the other thing too is about how do you finance your education and we have some scholarships available through our organization. I really would encourage folks to go to www.nbna.org and take a look at what we have to offer including our upcoming conference which is August the 5th through the 10th in Dallas, Texas.
Everyone's always welcome at our conferences. Even though we focus on minoritized and brown and black communities, I want to make it very clear to everyone listening that NBNA is open to everyone irrespective of how you identify in terms of your race or ethnicity. We absolutely welcome everybody as long as you understand our mission and can support our mission you are most welcome.
I know students out here nowadays really have to make some early choices and we need more people in nursing. We are the largest segment of the health care workforce and there's a lot of turnover because people realize maybe it's not for me or they will leave for lots of other reasons. But nursing offers so many opportunities, as do a lot of areas in healthcare. So, do some exploration if you have not yet focused on what role and understand that no matter what role you ultimately wind up in, most of healthcare operates as a team. so you're have to sort of figure out what part of this team are you gonna be on and where are you most effective and how can you do that to the best of your ability with the training that you would have required as a healthcare professional.
But know that it comes with a great deal of responsibility as well because people are then gonna start to look to you -- whether it be people in your immediate family, your church community, your any other community that you identify with -- people are gonna see you as a leader. It happened during COVID. I don't know of a nurse in this country that wasn't playing double duty -- answering questions, consoling people, teaching -- that is part of what we do and you can't turn it off, especially when somebody finds out you're a nurse, because they're gonna ask you anyway.
I hope in that statement, Kelsey, somebody out there heard something that is of value, is helpful to them. I do hide in public. I tell people that all the time. I'm willing to have follow-up conversations, and people can find my LinkedIn. If you go to www.nbna.org, you can find my email address. So I'm quite accessible and willing to have follow-up conversations as well.
Kelsey
Well, that's wonderful. Thank you very much, Dr. Fields for being with us today and giving us all your answers and wisdom and advice.
Dr. Fields
Thank you for having me.
Kelsey LaFayette
I'm Kelsey Lafayette. Thanks for checking out today's show. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.