A Diverse Workforce Is Essential to Quality of Care: Dr. Tina Loarte-Rodriguez, CEO of Latinas in Nursing

Lindsey Smith

Hi, I'm Lindsey Smith, welcoming you to Raise the Line from Elsevier, an ongoing exploration of how to improve health and healthcare.

People who identify as Hispanic or Latino make up nearly 20% of the U.S. population, but only eight percent of the nursing workforce — a gap that has important implications for access, trust, and culturally responsive healthcare. Today we're going to explore what it takes to strengthen and diversify the nursing workforce with someone working at the center of that effort, Dr. Tina Loarte-Rodriguez, Executive Director of the Connecticut Center for Nursing Workforce and Founder and CEO of Latinas in Nursing, a national organization dedicated to mentorship, leadership development, and expanding opportunity for Latina nurses.

She is also the driving force behind a series of books highlighting the stories and experiences of Latinas in nursing who have made a significant impact in education, healthcare, research, policy, business, and society.

I'm looking forward to discussing the pressures facing today's nursing workforce, the importance of cultural congruence in care, and how to build a stronger, more inclusive future for nursing.

Thank you so much for joining us today.

Tina Loarte-Rodriguez

Thanks for having me.

Lindsey Smith

So to start us off, I'd like to hear a little bit more about what first sparked your interest in becoming a nurse.

Tina Loarte-Rodriguez

Thank you for that question. Actually, my journey started with me actually being pre-med. I earned a C in chemistry as an undergrad, and that made me step away from that path. At the time, it was really less about capability, and it was really more about a lack of mentorship that I realize now. I didn't have anyone telling me that one grade wasn't going to define my trajectory. And so I pivoted into teaching, which gave me a really strong foundation in communication, learning, and really taught me how I learned best.

So I was able to incorporate that at a turning point when I was able to care for one of my loved ones who was hospitalized. That experience of seeing the direct impact of nurses -- not just as a profession, but as the advocate, the coordinator, the comforter, the nurturer of not only the patient but the family -- really made me realize that that was my calling and where I was supposed to be. So I've been able to really just understand the system better from this perspective and see now that nursing is at an intersection of care delivery, advocacy, and systems navigation.

Lindsey Smith

Absolutely. It's always so interesting, I think, to hear what kind of lights that spark for people and really kind of shapes everything that comes after that. So what has been the primary focus of your clinical experience over the years?

Tina Loarte-Rodriguez

So in twenty years of nursing, I still say I don't know what I want to be when I grow up...so there's still hope for you all out there who are still very much curious in finding your path. But my expertise spans a number of specialties, but they all center on patient safety, risk management, and kind of system level work.

I have really been able to use my lived experience and my training to not just see individual patient cases, but to really see patterns and how care is either given or sometimes where it breaks down. And so I've really been able to shift through my journey and through my professions and jobs, being able to use my perspectives to stop treating things as isolated issues and really understanding that these are results of systems that are producing these outcomes. And my clinical expertise and practice just gives me that credibility, right? It also helps me remember the bigger picture and focusing not only on the patient, but also kind of the workforce.

Lindsey Smith

That makes a lot of sense. We had another guest recently on the podcast who said nurses are at the heart of healthcare and so important in the role they play today. You've often talked about being the only one in the room as a Latina healthcare provider. Can you tell us what that's been like for you?

Tina Loarte-Rodriguez

Yeah, so it's something that I've navigated for much of my education and also professional life. And I often try to reframe it not as a personal experience, but actually a system signal. It's a reflection of who is being included in decision making and who is not.

It also has created added pressure, visibility, representation expectations, and isolation in decision-making spaces, particularly as I have advanced in leadership roles. For me, it's beyond the discomfort that I have felt at times. It's really about trying to address the root cause of why there's this imbalance between the populations we're serving and those who are serving them. And I really am grounded in knowing that it's a systems failure, right? Not that I'm an exception. Yes, I feel I am a unique and special person, but I'm not the only unique Latina nurse out there, right? There are many of us. And so I really am rooted in the fact that it's a systems issue that needs to be addressed.

Lindsey Smith

Absolutely, and thank you for being so open about sharing that with us. Can you help us understand the connection between a diverse clinical workforce and the quality of care patients receive?

Tina Loarte-Rodriguez

Absolutely, and this is something that gets misunderstood or diluted or kind of reframed from something that's really simple, and the data actually supports it as well. So having a culturally congruent workforce to the populations you are serving has a tremendous return on investment. There's going to be improved communication, improved trust, improved participation in clinical decision-making — which often gets termed "not compliant" or "adherence" — which ultimately will impact health outcomes. And so it really reduces these risks, particularly in high-stakes environments where misunderstanding does lead to harm.

And so when the workforce does not align with the population, your system is misaligned by design. So I really am a champion for health organizations and health institutions to really solve these quality problems by rooting some accountability and transparency and resources in addressing the workforce composition, because that's really how you're going to be able to affect positive change.

Lindsey Smith

Thank you for breaking it down for us. When you put it that way, it's really clear how much representation matters for patient trust, participation, and ultimately, and most importantly, overall health outcomes. Can you tell us a little bit about what inspired you to expand your work beyond clinical care into leadership and advocacy?

Tina Loarte-Rodriguez

Absolutely. I think it was a combination of my own living experience — being a young patient in healthcare, to helping family members and loved ones navigate through healthcare — but then also what I was seeing as a direct caregiver. So at the bedside, you are able to impact a patient and or their family, right? It's one patient at a time. At my level in systems work, I can impact thousands. And so I really realized that the core challenges were not clinical, but they were structural — educational pathways, workforce design, and policy. So moving beyond the clinical care has been about ensuring I am scaling and leveraging my expertise and my advocacy.

Lindsey Smith

I liked hearing how that shift happened for you and it seems like a kind of natural progression when someone sees a bigger need and really steps up to meet that. Can you give us an overview of the Connecticut Center for Nursing Workforce and what you're hoping to accomplish there and what you are accomplishing there?

Tina Loarte-Rodriguez

Thank you. Yes. It's been a great experience being in this historic organization. It's been around in one name or form for over forty-five years. So now being the executive director for the last almost two years has been just amazing. At the Connecticut Center for Nursing Workforce, we are aligning the supply, the demand, and the capabilities of the nursing workforce in the state of Connecticut. And so we're doing pathway development. We're partnering with both nursing programs and the healthcare institutions to strengthen retention strategies and rethinking our clinical education models. We're not just trying to produce more nurses, right? We're asking whether we are producing the right nurses for the future of healthcare for the residents in the state of Connecticut. What I have been really bringing into the spaces where I am now present is ensuring that we are realizing the fragmentation across the various institutions and really having alignment for impact and continued improvement.

Lindsey Smith

That's a really important mission in the best way. It sounds like you're trying to really kind of tackle the root cause of some of these challenges that we're seeing across every field in healthcare, I think, today. So let's go back to some of the challenges you kind of just touched on a little bit there. When it comes to burnout and retention among nurses, what are you seeing?

Tina Loarte-Rodriguez

Yeah, so I mean, it's interesting how post-COVID, right, we are finally having really transparent and open conversations related to burnout and resiliency. But I am seeing that sometimes burnout is used as the catchall. It's really a system strain and operational failure that it's the end product of. Nurses aren't leaving the profession because they lack resiliency, right? They're leaving because the environment is unsustainable.

There's been a shift in that perspective of we don't have to be martyrs — actually in our nursing code of ethics it says that we need to take care of ourselves first and foremost. And so there's this mismatch between the workload, the support, and in some cases the compensation, as we just saw was a big part of the New York City nurses strike. So what often gets framed as a wellness problem, right, retention is not that. It's truly a leadership and systems design problem.

Lindsey Smith

Those are all really great points and really tracks with what we've been hearing from other nurses in the field. How do we fix that?

Tina Loarte-Rodriguez

Yeah, this is the magic wand moment. Well, I mean, first and foremost, we could just start putting nurses everywhere decisions are made, right? That would be one step in the right direction. But in honesty, right, we need to stop treating the symptoms and really start redesigning the systems and having them be human centered as well as innovative, but also including the key stakeholders, right — like the front line has to be part of this problem solving and many times they're left out of the rooms where these decisions are being made. Staffing models need to be restructured so that they can accurately account for patient acuity but also staff's workload and skill. There are discrepancies also related to kind of scope of practice among some of the professions, not only in nursing across states but also many of our other allied health professionals. Incentives is a huge component of it, but they should be aligned with long-term workforce stability and not used as short-term fixes. When you have that imbalance, it just continues to perpetuate the broken system.

Then lastly, I am a huge supporter and advocate for having clear and meaningful career pathways so that anyone who has a calling or an affinity interest in not only nursing but any health profession can actually continue on that journey and can see their growth and not be stagnant, because unfortunately due to some of the barriers and burdens in navigating training, many are either turned away or are not able to advance to their fullest potential.

Lindsey Smith

Thank you for outlining those so clearly. It's encouraging to hear solutions — or magic wand solutions — that feel doable and not just kind of theoretical. So in the beginning of this interview, you talked about mentorship. I know this is a passion of yours. Can you talk about the role mentorship plays in nursing?

Tina Loarte-Rodriguez

Absolutely. How I'm working to reframe it is that mentorship isn't optional, right? It has to be part of core infrastructure to ensure a healthy, engaged, and satisfied workforce. This goes across any industry, any allied health profession. Particularly for those of us who are minoritized or underrepresented in certain spaces, mentorship directly impacts our access to opportunity, but also to advancement. So it accelerates our social capital, which unfortunately many don't have. I really look to reframe the issue of mentorship again as not being informal or inconsistent, right? It has to be structured, intentional, and measured.

Lindsey Smith

I love what you said there about mentorship not being optional and I think it shows how mentorship can be grounding and empowering especially for people who might not see themselves represented, which I think is really important there. Let's talk about your book series. You created a book series, Latinas in Nursing. Tell us more about that project and the impact it's having.

Tina Loarte-Rodriguez

So what started as my need to heal during COVID has really transformed into a narrative infrastructure. I had been looking for a book about me for me back in 2020. I'm a nerd and I love to read. I couldn't find one and I was disappointed, and you know we talked about earlier how Latinos are 20% of the population but make up only eight percent of the registered nursing workforce. There's so much power, right, in this group, and so I went on a search for other Latina nurses so that our stories could be told and it's just been a remarkable movement. Each contributing author gets to share their story in their own words, and so that was really important to me because I didn't want to mask anybody else's lived experience. I wanted to give them a platform to share it.

What's happened through that is we've been able to document our leadership, our influence, and the pathways that we have been kind of compelled to take in our journeys, in our professional development and in our lives. What was an act of claiming visibility in a system that often doesn't acknowledge us, doesn't celebrate us, doesn't support us and develop us — we are now using these books. Now there are three: there's Latinas in Nursing, Volume One and Two, and then there's the Latinos volume for the male nurses. We're also working on another book, LGBTQIA in Nursing, because again there are so many powerful stories that need to be shared. So we're using these stories, these narratives in education and leadership development and in workforce conversations. So long term, what has been a dream, a tool to help heal, is really influencing pathways, identity, and ambition.

Lindsey Smith

Incredible, and stories like these that you're sharing can be so validating and so inspiring and they're so important. Where can our listeners go to find these books?

Tina Loarte-Rodriguez

You can go to latinasinnursing.org and we are actually featuring another national book club in the month of May to celebrate Nurses Month. So there'll be more information related to how to sign up to join those conversations that are happening Wednesdays, five to six thirty p.m. Eastern Standard Time, free for everybody to participate in and all are welcome.

Lindsey Smith

Amazing. We'll be sure to include all of those details in the show notes for our listeners. So since we're a teaching company and we always love to fill knowledge gaps, is there a topic you think Osmosis should make a video about, something that you feel is underserved or urgently needed?

Tina Loarte-Rodriguez

Let's do a couple, Osmosis — we have at least four I can give you off the top of my head. Definitely workforce design in healthcare. What's really interesting is that unfortunately many of our specialties and disciplines are trained in isolation and siloed, yet the minute we go out into clinical, we're put together with all these other specialties that we didn't learn side by side with, right? So that I think is a space. Cultural congruence in care, beyond language, right? Because language is important, but it's about trust, shared decision making, and patient engagement. One area that we are working on actively in Connecticut is that transition from education to practice, which is still a huge opportunity in the system — and again, I would say for probably many of the allied health professions, not just nursing. Then the last that I will kind of recommend is really understanding the role of nurse leaders as a system level lever, and not just the management function. You know, I did say that nurses belong everywhere decisions are made. Nursing really has many skills and expertise that would serve in many leadership capacities. So just ensuring that there is that awareness of the skill set and expertise of nurses, I think would be helpful as well.

Lindsey Smith

Those are all great ideas. I always love hearing these suggestions because they help us create content that actually meets real needs for students. So we will pass those along to our content team. In our audience, we have many students and early career health professionals. What's your advice to them about meeting the challenges of this moment and building a career in medicine?

Tina Loarte-Rodriguez

Yeah, so as a student myself again now — I'm currently pursuing my executive MBA at Yale because everything is a business, right? Unfortunately, that's one of the areas that I did not learn in my nursing training — I am very much aware of the demands of being a student now. These are things that I try to remind myself of daily as well, so I will share them with you. Really be intentional about the environments that you're engaging in, particularly if you're early in your career. Some of your first roles will definitely shape your trajectory, so just be mindful of that. It's okay to ensure that you are aligned with the environments that you're going to be practicing in. Definitely build skills beyond your clinical care. Really challenge yourself to understand systems thinking. Communication is always an area of opportunity for any professional or any human being, I think. Really understanding that leadership is a possibility in all settings and you don't have to have a title in order to be a leader within your settings. Don't be afraid to get close to those making decisions early on, right? Regardless of your expertise or years of experience, even compared to C level, you have something to contribute to the teams and the systems and the environments that you are part of. Don't wait to participate and don't wait to be called on, right? Definitely get involved so that you have a say in the environment you're working in.

As I shared, healthcare is a business, so really understanding that is crucial so that we are able to influence and not react. Then lastly, and this one is a two-parter, right? Don't confuse being busy with being effective. No is a complete sentence. You can say no.

Lindsey Smith

Okay, so much thoughtful advice there. I'm going to try my best to play that back for the group here. So be intentional, be aligned where you're practicing, build skills beyond clinical. Communication is so important in any field that you're getting involved in. Leadership is a possibility and it's okay to get close to those making decisions because you can contribute to that. Understand the business aspect. Don't confuse being busy with being effective and you can say no. How did I do?

Tina Loarte-Rodriguez

Perfect.

Lindsey Smith

Very good. Before we wrap up today's episode, is there anything that we didn't cover that we should have?

Tina Loarte-Rodriguez

Just that I'm really excited for the opportunity. Know for all of you listening that I'm proud of you. I know that you will continue to do great things and will have such positive impact on those that you care for.

Lindsey Smith

That is such a great way to wrap up today's episode. Thank you so much for being with us.

Tina Loarte-Rodriguez

My pleasure, thanks for having me again.

Lindsey Smith

That's all for this episode of Raise the Line. A huge thank you to Dr. Tina Loarte-Rodriguez for sharing her insights, her passion, and her commitment to building a nursing workforce that truly reflects the communities it serves. Conversations like this remind us that representation isn't just a goal, it's a catalyst for better care, stronger trust, and healthier outcomes. I'm Lindsey Smith. 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.