Our latest Nurse of the Week has a truly American story. A freshly graduated BSN from Herzing University-Madison, he began work in January as an ED nurse in Madison, Wisconsin. Richard Onyait was born in Uganda and worked there as an orthopedic clinician (roughly equivalent to a PA in the US). Six years ago, Richard came to be regarded as a dissident by authorities and was forced to flee the country for the safety of himself and his family. Upon his arrival in the US, he decided to become a nurse. DailyNurse spoke with Richard shortly after he took his NCLEX. To see the second part of this two-part interview, click here or use the link at the end of this post.
DailyNurse: So, how did the NCLEX go?
Richard: I was issued the license this morning.
DN: Congratulations! And you have a position already as an emergency department RN?
Richard: Yeah. They were basically waiting for my license. I will be starting on Monday.
DN: With your previous experience as an HCP, I guess you sort of knew you were going to pass the NCLEX.
Richard: Yes, I believed in myself.
DN: Do you still have family in Uganda?
Richard: Yes. I actually don’t have family in the US.
DN: Have you been going back to visit since you moved here?
Richard: I haven’t seen my family in seven years. [For a summary of conditions in Uganda, see this Human Rights Watch 2020 report.]
DN: Where were you born and raised?
Richard: I grew up in a city of about a million people. [Which we are concealing to protect his family in Uganda. -ed].
I was born an only child. And then somewhere along the way at 10 years old. I lost my dad. Which was part of the inspiration that drove me to study nursing and healthcare in general.
DN: What happened to your father?
Richard: Well, when I was 10 years old, my father was involved in a motor vehicle accident and sustained multiple injuries. He was treated at the local hospital. And it was during that time when the nurses took care of him that I was inspired by the compassion, the care, the love they showed in caring for him. Eventually, he succumbed to the injuries and passed on.
But that was where my inspiration came from to enter nursing school and study healthcare. So it was a painful moment for me to lose my dad, but it was also an inspirational moment that opened my eyes to serving humanity when they are broken down by illness, disease, accident, or old age. I like to call it the time that I received my calling into service.
“It was a painful moment for me to lose my dad, but it was also an inspirational moment that opened my eyes to serving humanity when they are broken down by illness, disease, accident, or old age. I like to call it the time that I received my calling into service.”
DN: You were only 10 years old?
Richard: Yeah. That was a hard time. Because my father was my everything. He was the breadwinner at home. My father provided for everything I needed. From clothing to eating to going to school, he was a friend of mine. So it was a hard thing for me.
DN: At that at that age, too. You lost the person who just seemed to make the world safer.
Richard: (With some emotion) Yeah, it still brings tears to me sometimes. It’s a loss.
DN: So, you experienced two major life events at the same time, and when you grew up, you worked as an orthopedic clinician in Uganda. Did you work in your hometown?
Richard: No, I ended up working in the capital city, Kampala, at the National Referral Hospital.
DN: When and why did you decide to leave and come to the US?
Richard: Well, my journey to the US wasn’t one of choice. It was one of escaping the claws of a dictatorship that is currently ravaging Uganda. I had to find another home, not by choice, but by necessity.
DN: It sounds almost inconceivable to someone who has never lived outside the US. We know that Uganda is a dangerous and repressive police state, but the reality is hard to fathom.
Richard: It’s a story that I have come to be able to verbalize, but I only share it with a few close friends I’ve made here. They’re the only ones who understand where exactly I came from and what happened to me.
But what is happening to many young men in Uganda is unthinkable, and some of them are not lucky like I was. It’s still happening. It’s not like it’s over. And, for the sake of the safety of my family, I prefer not to share too many details in public. Because my family still lives in Uganda and giving out a lot of those details would simply be too dangerous for them.
“What is happening to many young men in Uganda is unthinkable, and some of them are not lucky like I was. It’s still happening… And, for the sake of the safety of my family, I prefer not to share too many details in public.”
DN: Well, we won’t even mention the name of your hometown. But how did you end up in Wisconsin?
Richard: When I came to the US, I lived in Boston with the friend of an acquaintance who knew what had happened to me. It was the bitter cold winter of 2015. [Having come from Africa,] I remember feeling like my ears were dropping off, and the cold biting my fingers!
Then, I met a lawyer who suggested I go to the Boston Medical Center for refugee health and humanitarian rights. He recommended me and I set up an appointment. I went, and one young lady there, Jenna, even taught me how to dress for the cold. She was an amazing lady.
It took over a year and a half to get any work authorization. Oh, boy. I was craving to do something to contribute to the home that was hosting me, and I just didn’t have the means.
DN: So what was the very first job you got paid for here?
Richard: I was hired to take care of a gentleman who had MS. I got the job through a friend who was caring for that man but had to take some time off. Because he knew about my orthopedic degree, he asked if I could take over for him after I got work authorization.
Once I saved enough money, I enrolled at a small school in Framingham to get a CNA certificate. I was just trying to start. And this way I could work in an assisted living facility, which was more stable employment. So, I took the very first money I earned and paid it to the CNA school.
DN: Did you find a nursing home position?
Richard: Yes, in Framingham, a place called Valley Farm. I worked there for some time. This was also when I met the gentleman who ended up bringing me to Wisconsin.
DN: Nursing in assisted living is hard, hard work for not very much pay.
Richard: Yeah. It is hard work. I was trying to make ends meet, get a second job, so I applied to multiple agencies. One of them recommended me to this gentleman, who, unfortunately, had gotten shot in Wisconsin. He likes to say he was in the wrong place at the wrong time, but he was shot in his face and got paralyzed from the neck down.
DN: How old was he at the time?
Richard: I think he was 50 years old. And he was doing rehabilitation at Spalding. So the agency referred me to his family in Boston, and I met with them and met him as well. He needed care during the day, about 8.00 am to 4.00 pm, while his family was at work. I took care of him during those hours, drove him to his rehabilitation appointments and other appointments that he had during the day. And during that time, of course, we interacted, built a relationship, and became friends. For a few months down the road, after finishing with him at 4.00 pm, I then went to the nursing home and worked from 7.00 pm to 7.00 am.
DN: (Sigh) Nurses seem tireless!
Richard: Well, I basically was not sleeping. I left his place at four. I went home, took a shower. You know, if I took a nap for an hour, and then got ready to go to the nursing facility and work.
DN: So, why did the gentleman end up going to Wisconsin—with you in tow?
Richard: That’s where he originally lived, and he wanted to go back to be closer to his daughter. He asked if I could go with him for two months, allow him to settle in and get a new caregiver, then train the new person, come back to Boston, and move on.
I hadn’t been anywhere [in the US] except Boston, so I told myself, give it a try. You never know what you find there. But after I came to Wisconsin on my two-month contract, he wasn’t able to find another caregiver. There was no one else to care for him and he was living alone.
DN: At that point, did you decide to settle down in Wisconsin and study for your BSN?
Richard: After two months, he said, ‘Hey, I still haven’t found somebody. Can we extend this agreement for another month or so, until I can find somebody? Or would you be willing to move to Wisconsin and live here for whatever time that you can be here with me?’ I thought about it, asked a few friends, and it felt like a move that would help me gain some independence… and get some sleep!
When the man asked me to stay, I told him that I have ambitions, so I don’t think I can [be his live-in caregiver] for the entirety of my life. I have a profession I’ve always loved. And by that time, I had told him what had happened to me in Uganda, and the situation that led me to the US. So he knew I would try and push myself and start going to school so I could do more.
So, I went back to Boston, to pick up the few things I had there, and came back to Wisconsin to live with him as a home caregiver. And that’s what I’ve been doing all through nursing school, until about two weeks ago, when I moved out.
DN: Did your home-care patient finally find someone who could maybe not replace you, but take care of him?
Richard: Yes; he found a person about a month ago. Since then, we’ve been training and going over the routines with the new caregiver – you know, everything that needs to be done until they get comfortable together.
DN: When you have a talent or affinity for something like nursing, you feel the need to exercise it.
Richard: Yes. I felt like there was a lot I could offer, but I didn’t have the credentials. Even when we went to appointments—for instance, one Sunday at a hospital appointment, his suprapubic catheter got blocked. The hospital was trying to find a urologist to come and change it, scan it, and so on.
As it was a Sunday, though, we waited a long time, and they kept going around. I was there looking at him, like, ‘this is something I can basically do in less than five minutes.’ But they are trying to find somebody and it’s taking hours. And I know that he’s in distress from the retention, is feeling uncomfortable, and I can see he’s a little sweaty. So I asked them, ‘hey, do you have any catheters around?’ They said, ‘we do have cutters, but the urologist has to do it.’ I told them, “Well, this is between me and my patient. He knows I can do it, and he trusts me. Can you just get me the catheter, and everything that I need? And we’ll do it on our own in our room.’
DN: What did they say?
Richard: They refused to do it, at first, but then [my patient] demanded it. Mm-hmm. Eventually, they succumbed. And they gave me a catheter, sterile gloves. I did it, and he was good. The next day, they went in and redid everything! But at least it was okay for the day.
DN: I thought they would have screamed about insurance and things like that.
Richard: Oh, there was a lot [of screaming]. I think my patient had to sign off on some documentation.
Click here to read Part Two of Richard’s story.
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