When Matilde “Mattie” Upano left the Philippines at age 24 to practice nursing in the U.S., she never would have imagined that more than 45 years later she’d be leading advocacy efforts for others to do the same.
“Never in my life did I see myself doing something like this,” said Upano, who completed both a bachelor’s and master’s degree at IU School of Nursing. “I used to be really shy growing up; I wouldn’t talk unless someone talked to me first.”
Through her involvement in the Philippine Nurses Association of Indiana (PNA-IN), Upano has worked for more than 15 years to remove barriers for foreign-educated nurses to practice in Indiana. Prior to last year, qualified nurses educated in other countries had to pass a Commission on Graduates of Foreign Nursing Schools (CGFNS) exam before they could take the NCLEX exam for RN licensure. Arriving in the U.S. with very few resources, these nurses not only had to pay the costs associated with the CGNFS exam, they often had to wait months to take it because the exam is only administered a few times each year.
For a variety of reasons, the legislative efforts stalled several times, but Upano and PNA-IN persevered, with support from the Philippine Nurses Association of America, the Indiana State Nurses Association, the Indiana University Bowen Center for Healthcare Workforce Research & Policy, Indiana University Health, IU School of Nursing and other organizations. In March 2022, Indiana Governor Eric Holcomb signed into law House Bill 1003, which included the expansion of pathways for licensure of foreign-educated nurses.
“What really helped me during this most recent effort was that around the same time I met Dr. Crowder and learned more about the legislative process,” said Upano, who is serving her fourth term as president of PNA-IN. “She worked with me and held my hand, so to speak, when I testified at the Senate Committee and the House Committee for support of the bill.”
Upano became acquainted with Sharron Crowder, Ph.D., RN, ATSF, FAAN, special assistant to the dean, health policy initiatives, and clinical associate professor at IU School of Nursing, when she participated in Dr. Crowder’s program, Empowering Indiana’s Nurses of Color for Health Policy Leadership.
Upano’s commitment to helping nurses gain employment in the United States was driven by her own experience. After graduating from nursing school in the Philippines when she was 19 and obtaining her nursing license two years later, Upano worked for a medical center in Manila and then helped establish a hospital that was run by nuns. Three years later, she was recruited by a nursing administrator of a community hospital in Anniston, Alabama. She traveled to the U.S. with 17 other nurses.
“We helped each other and had each other, so we didn’t feel as homesick,” Upano said. “Homesickness is huge when you’re out of your own country.”
The group of nurses worked in Alabama for a year before disbanding to obtain employment in other states. Interested in working for a university-affiliated medical center, Upano found a job in Indianapolis in the renal unit at University Hospital. She was able to obtain her RN license in Indiana by endorsement because she had taken and passed the National Council of State Boards of Nursing exam in Alabama. While working at University Hospital, she enrolled in IU School of Nursing’s newly established RN to BSN program. She found her calling in anesthesia nursing and transferred from University to Riley Hospital for Children. When she completed her master’s degree at IU School of Nursing, she became the first nurse practitioner in pediatric anesthesia at Riley.
Upano retired from Riley Hospital in 2018 at the age of 72. In addition to her legislative and advocacy work in support of foreign-educated nurses, she helps nurses from the Philippines transition to life in Indiana. Upano organizes volunteers from PNA-IN to meet nurses at the airport, distribute welcome boxes and provide an orientation to the practice of nursing in the U.S.
“I’ve been really very fortunate and blessed that throughout my life and nursing career I’ve met a lot of people who have helped me and shaped me into who I am today,” Upano said. “I enjoy mentoring the nurses who come here and want to make sure they are assisted in the same way.”