This month, Jose Pares-Avila, DNP, MA, RN, NP-C, AAHIVS, who recently joined the University of Arizona College of Nursing as a clinical assistant professor, is celebrating 10 years as a second-career nurse, and 30 years serving the lesbian, gay, bisexual and transgender (LGBT) community.
Prior to starting nursing school at age 40, for 20 years Dr. Pares-Avila worked in mental health and addictions treatment as a psychotherapist. His focus was on the LGBT community and communities of color. Both groups are affected disproportionately by HIV— particularly gay and bisexual men of color—and violence, with transgender women of color the most vulnerable.
“I see it as an ethical obligation to care for everybody with competence and compassion,” said Dr. Pares-Avila. “A patient should never feel ‘less than’ and should never have to educate his or her health provider.”
An adult nurse practitioner and certified HIV specialist through the American Academy of HIV Medicine, Dr. Pares-Avila’s area of scholarship is focused on understanding the most effective ways for health professions students to learn about re-shaping care in areas where stigma has existed.
“We tend to think of people in a binary way, as either male or female, instead of thinking about gender on a continuum,” said Dr. Pares-Avila, who teaches advanced health assessment in the online Doctor of Nursing Practice program. “People may have a body different from what you would expect, based on how they outwardly appear and present themselves. As educators, we need to give students room to stretch their thinking and master the language and skills of competent clinicians who don’t operate under narrow assumptions.”
Dr. Pares-Avila began working with the LGBT community in 1986, volunteering as a direct caregiver for those affected by the HIV epidemic.
“Those days were pretty tough,” said Dr. Pares-Avila. “There was no funding, and society at large was not yet invested in responding to the epidemic. I was in my early 20s, but I started seeing close friends and acquaintances get sick and die. I became very passionate about knowing more about the social determinants of health.”
Dr. Pares-Avila first considered nursing school in 1999, when he began working at a 24/7 psychiatric emergency service in Boston, where his supervisor was a psychiatric nurse. Over the course of his previous work, he had gained great respect for nurses and their holistic, relationship-centered approach to health and patient care.
“I met some amazing nurses in my HIV work,” said Dr. Pares-Avila. “I had patients dying alone, with only me and the visiting nurse at their side. Nurses did inspiring work in the early days of the epidemic.”
Dr. Pares-Avila initially was intimidated by the idea of returning to school and changing careers, but his supervisor kept reminding him it was never too late. After gradually accumulating the prerequisites for nursing school, Dr. Pares-Avila entered a master’s-entry-to-nursing program, similar to one offered at the University of Arizona. After completing that program, he immediately began studies to become a nurse practitioner and earned his Doctor of Nursing Practice degree.
“One question I get often is if I miss being a therapist,” said Dr. Pares-Avila. “And I answer, ‘I don’t think I’ve ever stopped being a therapist.’ My career as a nurse has been very much a continuation of my original career choice.”