When Stephen Perez, MS, RN, NP, took a part-time position as a case manager for patients with HIV in 2005, the disease was morphing from a death sentence into a chronic condition, thanks to revolutionary advances in antiretroviral therapies.
With the advances came new challenges and opportunities for health care providers who specialized in HIV/AIDS. Patients with HIV were living longer, but also developing other chronic conditions, such as heart disease and diabetes. Some were also coping with mental illness and substance abuse, all while facing the stresses of living with a socially stigmatizing disease.
“We really needed good, knowledgeable providers for these patients,” says Perez, who was earning his master’s degree in nursing at the University of California-San Francisco (UCSF) at the time.
Perez decided to help meet that need himself. Inspired by the successes he was seeing as a case manager, he focused his education on providing primary care for people living with HIV/AIDS and pursued a career in the field after graduation. “I saw that it was a great way to have an impact,” he says.
Working with People
Perez had gotten his start in health care as an undergraduate student at Saint Mary’s College of California, where he earned a bachelor’s degree in health science and worked as a physical therapy aide. After graduating, he found a job as a laboratory assistant, but soon came to realize that he wanted to care for people. Nursing, he realized, would allow him to do that.
So Perez earned a diploma in nursing at the University of San Diego and went on to earn his master’s degree at UCSF in 2008. After that, he was selected to serve as a Congressional Hispanic Caucus Institute Public Health Policy Fellow in Washington, D.C. While there, he worked at the Health Resources and Services Administration (HRSA) and at the Office of HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services.
The fellowship was “phenomenal,” he says. Working in the nation’s capital helped him see the “larger picture” of health care in the United States. He developed a better understanding of health policy and the stronger role nurses could play in shaping it.
“While I was there, I met a lot of really dedicated and motivated people in the policy arena,” he says. “But there weren’t a lot of nurses.” Nurses spend more time with patients than other providers, he says, and “have a really practical perspective on health care delivery.” Those attributes make nurses ideal leaders in health and health care, Perez said. “We need nurses to play a bigger role in health policy.”
Melding Research and Policy
Perez again decided to help meet that need. In 2014, after spending five years as a nurse practitioner in Virginia and an HIV clinical educator in Washington, D.C., he enrolled in the prestigious doctoral nursing program at the University of Pennsylvania and was named one of only 16 members of the inaugural cohort of Robert Wood Johnson Foundation Future of Nursing Scholars. The program—which aims to increase the number of PhD-prepared nurses to help meet the demand for a larger, more diverse cadre of nurse faculty, nurse scientists, and nurse leaders—is providing financial support, mentoring, and leadership development over the three years of his PhD program.
Perez continues to work on HIV/AIDS—as a researcher, policy analyst, and practitioner—but his research interests have broadened. He is now studying the effects of health-related laws on clinical outcomes. In particular, he is exploring whether laws requiring hospitals to report rates of hospital-acquired infections actually change provider behaviors and, if they do, whether those changes affect clinical outcomes. “Do these larger policy issues change how providers make decisions and how health systems make improvements?” he asks. “And if not, then why not?”
The research strategies could apply to any number of laws, such as those relating to needle exchange programs or patient-centered medical homes, he says. “We want to make sure we do good research to determine the effect of these laws.”
“I feel so privileged to be an RWJF Future of Nursing Scholar,” Perez says. “It’s geared toward developing the next group of nurse leaders who can have a significant impact, whether in policy, research, academia or government. It really trains nurses to make a difference.”