For this issue of our new Changemakers in Washington Nursing series, WCN interviewed Butch de Castro, PhD, MSN/MPH, RN, FAAN. Dr. de Castro is the Dean of the Seattle University College of Nursing and holds the Robert J. and Mary H. Bertch Endowed Professorship in Nursing Leadership. He is also a Fellow of the American Academy of Nursing.

Dr. de Castro served on WCN’s Diversity Advisory Committee, where he led the development of the WCN So You Want to be a Professor workshop. In its sixth year, the workshop offers practicing nurses and nursing students the opportunity to learn more about starting a career in higher education.

WCN: Thank you for taking the time to talk to WCN today. Can you share a little about yourself and your nursing journey so far?

de Castro: I was born and raised in Los Angeles, CA, and received my BSN degree from UCLA. I started out in the acute care setting, having worked in a cardiac telemetry unit and the operating room, before transitioning into working in home health. While in nursing school, I knew early on that my goal would be to practice in community settings, and I eventually got a job as a public health nurse for the Los Angeles County health department. I loved being a nurse out and about in the community – doing everything from home visits and assisting families and households to managing infectious disease outbreaks to doing well-baby visits, among other things – so much more than being in a hospital.

I believe working in public health was a calling that was planted in my mind during my adolescence when I would spend after-school hours waiting for my mother to finish her workday as a nurse at a public health clinic in East Los Angeles. The clinic served almost entirely lower-income and immigrant families. The experience impressed upon me how societal-level factors – what we now know as social determinants of health – profoundly influence how and why people become ill, get injured, and have greater risk for disease and death.

Working in public health inspired me to want to do more than what my undergraduate nursing degree allowed me to, so I went to graduate school in Baltimore to get a joint Master of Public Health/Master of Science in Nursing degree from Johns Hopkins University. In graduate school, my faculty advisor happened to be an occupational health nurse. When asked what I was interested in, I responded about wanting to work in service to populations on the margins, notably garment workers and migrant farm workers. She asked me if I had heard of occupational health. I said “no,” but found out soon enough. I focused my entire graduate school education on learning about it.

After graduating, I did an internship with the Office of Occupational Health Nursing within the United States Department of Labor’s Occupational Safety & Health Administration, working on workplace regulations to protect workers across all kinds of industries from work-related injury, illness, disability, and death. During that time, I found this area of specialization fascinating and rewarding. I believe that people should have an opportunity to work in jobs that are safe and do not put them in dangerous working conditions. It is also critical to recognize how one’s work contributes to well-being through socioeconomic viability and upward mobility. While public health is my purpose, occupational health is my passion, and I returned to Johns Hopkins University to get a PhD in occupational and environmental health.
After that, I got a job at the American Nurses Association (ANA). The opportunity to work on federal and state policy advocacy and programming focused on protecting nurses was incredible. One of my roles was to be the science expert to help our government relations staff lobby for legislation, regulations, and funding to protect and promote the well-being of nurses.

After three years at the ANA, I made my way back to academia through a postdoctoral research fellowship at the University of Illinois at Chicago, where I spent two years developing my research, which centered on examining how job-related stressors contributed to poor health.

After that, I was recruited by the University of Washington to direct its Occupational Health Nursing training program, and I served in that post for 17 years (my entire time at UW). During the last 7 of those years, I also served as the Associate Dean for Diversity, Equity, and Inclusion.

After that stretch of time, I felt ready for the next career step and applied for the Deanship of the College of Nursing at Seattle University. During the interview, everything about this leadership position, given the reputation and prestige of the nursing programs and the university, especially as a Jesuit Catholic institution, felt so right.
And the future directions for the college and university that the President and Provost envision also posed an exciting opportunity to be a part of.

WCN: You mentioned your mom was a nurse. Did she inspire you to choose nursing as a career?

de Castro: You might think so, but it wasn’t that straightforward. In college, I didn’t know what I wanted to do. I changed majors several times. In my heart, I knew helping people was most meaningful to me and that I wanted to work in a helping profession. My mom asked me if I considered anything in the health professions, but she did not outright mention nursing. It wasn’t until a bit later that I approached her, asking what it was like for her to be a nurse. After she enlightened me on all that nursing as a career could offer, I was confident that it was the right path for me.

WCN: Through your leadership, how do you look to impact nursing and the advancement of health equity in Washington?

I want to help people understand that nursing can extend beyond hospital walls. There are other spaces where nurses work on promoting and protecting the health of individuals, families, neighborhoods, and communities. Nursing isn’t only hands-on patient care and doesn’t just happen in acute care settings. If I can offer anything, it is helping people understand that, as a nurse, there are many ways to make an impactful difference. Nurses can be involved in public policy, population health interventions, or work in non-healthcare organizations, as well as be educators and researchers.

My career has been oriented around understanding and acting on upstream factors that harm health – what we now know as social determinants of health. During my early career as a nurse in the early to mid-1990s, I recall that the concept or framework to think about health through a social determinants lens was not conventional in the same way it is now. It took a lot to convince healthcare clinicians to consider, no less understand, how societal-level phenomena – such as education level, employment opportunity, and residential zip code – powerfully influence health. I’m encouraged, though, by how much progress has been made and that more people appreciate this way of thinking.

WCN: What are some of the challenges you face in your work? And how do you work to overcome those challenges?
de Castro: Being in higher education, it is critical that we graduate students who are not just knowledge-ready but also practice-ready. They need to come out of nursing school competent in clinical skills and confident in decision-making to operate in the increasingly complex healthcare landscape. There is growing opportunity and reliance to utilize simulation training, which has become very sophisticated with regard to a variety of innovative technological and pedagogical approaches. Nursing students also need to be aware of the variety of roles, both within and outside of the healthcare industry, where they are needed and can make a real, positive difference.

WCN: What progress or trends do you find encouraging in Washington to support creating a diverse, supported, and highly skilled nursing workforce? And, where do you see we still have work to do?

de Castro: There has been a concerted effort in examining processes and practices to ensure equitable opportunity for access to nursing education and training. And we have seen commendable strides made. What we must continue to work on is finding pathways for nurses representing a diversity of identities and lived experiences to serve in nurse faculty roles. Additionally, faculty would benefit from professional development in building skills to effectively educate and interact with the current generation of students who have grown up in and see a very different world than faculty themselves have experienced.

WCN: What advice do you have for Washington’s future nurse leaders?

de Castro: My career has taken all kinds of turns that led me to a destination I would have never imagined for myself. My advice to others is to seize and leverage opportunities that come your way, as they will lead to yet other opportunities. In complement to that, if there is a destination in your career you want to get to, figure out and seek out experiences and endeavors that will give you the know-how and set you up for success when you get there. In your career, it’s key to be alert and ready when an opportunity presents itself and might help you out down the road.