A Passion For People

By: Amanda Gibson

Dalton Fierst, the only male nurse who decided to study abroad, walked to row 27 of the airplane and took a seat as he waited for the plane headed to Managua, Nicaragua to take off on Jan. 4. He sat down quietly.

Upon first appearance, he is an athletically built guy with broad shoulders and a quiet demeanor. On this morning, he was casually dressed with a resemblance of the west coast he grew up on.

The St. David’s School of Nursing at Texas State University was heading to Nicaragua where they paired with International Service Learning to host free clinics in rural communities surrounding the city of Masaya.

Over the course of the next two weeks, the nursing students would split in two groups and provide healthcare to families in four communities who might not receive medical attention otherwise. This trip would serve as a class credit in community health for the 28 nursing students who were about to begin their last semester of nursing school.

The summer before he moved to Round Rock to begin nursing school, Fierst went on a solo adventure to the country of Uganda.

“I wanted to be spontaneous and go on an adventure,” Fierst said. “But I went there because I knew they were a poor country and I wanted to help the community.”

Fierst walks at the San Francisco community to gather a medical census of local residents. Photo by: Amanda Gibson

Fierst grew up in Malibu, California, before moving to Kerrville, Texas, at the age of 10. In Kerrville, Fierst found his niche in high school on the football and soccer field.

Upon graduation, Fierst and a group of his closest friends attended Blinn Community College in Bryan, Texas.

While at Blinn he obtained an associate degree in humanities and then decided to pursue his bachelor’s degree in nursing at Texas State University.

This same passion and heart to help the community and people around him is what has caused Fierst to find success in the nursing field, gain respect from his peers and experience the recent trip to Nicaragua.

“I chose nursing because I like to help people,” Fierst said. “I figured this was the best way to go about it.”

Fierst’s passion for the people around him caught the attention of his classmates.

“I think Dalton has one of the biggest hearts and he loves to make people feel good about themselves,” Fierst’s close friend and roommate, Caitlin Ortiz said. “Especially when they are feeling sad, he loves to make them feel better. I think as a nurse that will be good for him because nursing is all about caring.”

Ortiz said Fierst’s demeanor helps make patients immediately feel comfortable opening up to him.

Fierst gathers medical information for residents in the San Francisco community to better prepare for the free clinic that followed. Photo by: Amanda Gibson

“I think that’s a great strength for nursing because the patients have to trust you,” Ortiz said. “In awkward situations, like when you ask about their last bowel movement or what their pee smells like, if they are more comfortable with the nurse, patients are more likely to tell the truth and get the help that is needed.”

After the first few days in Nicaragua, Fierst knew this trip was where he was supposed to spend his winter break, despite being the only guy on a trip with nearly 40 girls.

“It takes a lot of courage to go against the grain,” Dr. Adriana Hernandez, a dentist and ISL team leader, said. “It’s hard to be different than what society expects.”

Many people may have let stereotypes of the industry and negative connotations toward male nurses slow them down, but Fierst has only allowed this to push him toward further success in the industry.

Community health was the course the nurses were enrolled in for the trip. It is a course that challenges them to go into an unknown community, evaluate the health conditions and then assess and diagnose patients who attended the weekly clinics.

The 28 nursing students split into two groups and each group went into designated communities. They visited families in their houses in order to gather a medical census of the surrounding area and invite them to the clinics.

Residents attended these clinics to acquire medicine for their different illnesses ranging from allergies all the way to a possible case of osteosarcoma-a type of cancer that starts in the bones.

Fierst was the nursing student who spotted this potential case.

He felt what he thought might be growths similar to osteosarcoma on the foot of a young girl. Fierst’s persistence to make sure the doctor made intentional notice of the growths he found led to a referral for the patient to see a specialist.

Regardless of the final diagnosis, Fierst remained humble and viewed this patient the same as all the others he had seen that day, but his care caught the attention of one of his peers.

Fierst takes the vitals of a patient who attended the free clinic. Photo by: Amanda Gibson

“I don’t know what textbook he was reading but it definitely wasn’t the one I was,” Sydney Stilwell said. “I would say he got the diagnosis right 99 percent of the time.”

When talking with other nurses in the same clinics as Fierst, all of his peers had a similar review: he was an intelligent nurse too humble to see his own strengths.

“We need less sass and more of Dalton in nursing,” Stilwell said.


Helping to Bring Life

“In labor and deliver

By: Elisha Colip

A mom, wife, student, friend, painter, nurse, and chairman for Paws for a Cause are just a few of the hats that Sarah Lohmeyer, 35, wears on a daily basis. Lohmeyer isn’t your typical nursing student at St. David’s School of Nursing at Texas State University.

Lohmeyer didn’t always know what she wanted to do, but after years of trying different things, being a corrections officer and a personal trainer, she finally decided that she wanted to help people through nursing.

In January, she got the opportunity to go to Nicaragua in participate in clinics at local communities. Lohmeyer originally was interested in oncology nursing due to her grandmother’s death from cantaloupe-sized brain tumor when she was 15.

“That pretty much rocked my world because I saw her suffer for a year and a half,” Lohmeyer said. “I felt like there had to be something more that could have been done with her. She was misdiagnosed with an ear infection. She complained of earaches for months and they just kept prescribing ear drops and we just kept thinking there has to be something else.”

Her grandmother was finally convinced to go to another doctor after months of pain. They found the large tumor in her brain, they operated, but the tumor to grew back. Her grandmother’s story really inspired Lohmeyer to become the kind of nurse she is.

“We are all human and we all make mistakes,” Lohmeyer said. “There is more you can do to not just assume, but to ask more questions, get more evidence and try to find out what is really going on instead of just letting them be a number. Just to focus on the person not the symptoms.”

After her grandmother’s death, Lohmeyer said she quit going to church. In her mid-20s she started going to a non-denominational church. This church is where she met her future husband, Steve. When they met, they were dating others but a few months later they had their first date.

“We went to a Greek restaurant in South Austin for a casual dinner and then we went and bought two forties,” Lohmeyer said. “We went down to the lake and sat and talked for while.”

They got married in September of 2007. Only four weeks after getting married, Steve was deployed to Iraq for 10 months.

“It was hard for me because I always told myself I never wanted to be married to someone who has to leave and be gone so it was really difficult,” Lohmeyer said.“It helped me become my own person as a wife and just be able to take care of a household.”

Lohmeyer takes a census of the San Francisco de Nindiri in Managua Nicaragua. Photo By: Elisha Colip

Before her husband left for Iraq they decided that at the same time, from across the world, they would pray Psalm 91 together. While everyone interprets things a little differently, Lohmeyer interprets it, as no matter what falls around you, even if everything does, you will live.

While on her trip to Nicaragua she was drawn to a painting in someone’s homes.

“I didn’t know what it said because it was in Spanish and then at the bottom it said Psalm 91,” Lohmeyer said. “I literally had goose bumps all over because it reminded me of the time he left and I’m away from him again and it was just a little sign or something. It was really neat.”

After a couple years of marriage, Lohmeyer became a mother to her first-born Grace Lois Lohmeyer, who is now four and a half, and later Allison Naomi Lohmeyer, who is 18 months. Grace Lois was named after Sarah’s grandmother, Grace, who passed away from the brain tumor and Steve’s grandmother Lois.

Lohmeyer has become more interested in labor and delivery nursing because of her good experience when giving birth to her daughters.

“She came to nursing school with the idea to be a Labor and delivery nurse,” Elizabeth Biggan, assistant clinical professor at St. David’s School of Nursing, said about Lohmeyer. “This is her goal, her dream, her everything all the way through and you can see it in labor and delivery. She will skip lunch, she will do whatever she needs to do to be there with that mom and help her with delivery. So yeah I think she is really driven to be a labor and delivery nurse.”

Lohmeyer asses a young patient at a clinic during her trip to Nicaragua. Photo By: Elisha Colip

Lohmeyer was chosen for Labor and Delivery at St. David’s Hospital in Georgetown for her capstone clinical rotation and where she delivered both of her children, St. David’s Hospital in Austin.

She said that when she first started nursing school the hardest challenges for her were letting go of things she can’t control and finding balance between her school and family lives.

Only a couple months after applying, she found out she was pregnant with her second daughter Allison.

“It is ok if I make a B because the difference for me is time with my family. I chose to spend more time with my family,” Lohmeyer said.

A friend of Lohmeyer from the nursing school, Anastasia Houze reflects on a time they were orienting for a job. A questioner asked them what they would do if they had extra money from a bonus.

“She said she would give it to people in need and I think that really sums up what she is all about,” Houze said. “She truly wants to help people and really wants to make a difference in people’s lives. That shows in her work, in her friendships, and in her relationships… We all go through rough times and she is always working to be a better person to serve others.”

Her time in Nicaragua doing clinics a very humbling experience for Lohmeyer and she hopes to medically help and educate people in Uganda in the future.

“You have known them for three days and you can’t communicate but when you have to say goodbye it is the hardest thing to do,” Lohmeyer said. “They come up to you and remember you and give you hugs.”


Lohmeyer helped to pain an orphanage wall in Nicaragua. When the paintbrushes couldn’t get in the tight spots she resorted to fingerprinting the wave. Photo by: Elisha Colip


A Call To Action: Perseverance

For the past five years the St. David’s School of Nursing at Texas State University has sent a team of senior students to volunteer holding clinics in communities in Nicaragua. One of the students this year, Emily Asa, was heavily impacted by her time in Nicaragua.



Asa is 25 years old and from the city of Granbury, Texas, where she grew up with her parents and older brother.

It was as a young child that she first knew she would work in the medical field. Her dad was diagnosed 50 years ago with type-1 diabetes. One huge influence on her life and career has been her father.

“He’s really shown me the definition of perseverance,” Asa said.

He was told that he wouldn’t live to see his twenties, thirties, and every decade since. When she was younger, her dad would often go into diabetic shock and she would be the only one to get through to him.

“There were many nights I would wake up and check on him and he would be having an episode and I’d help him come to. It was like God was telling me he needed me.”

After a troubled past in her teenage years, Asa was court-ordered to spend time in a positive after-school program of her choice. Asa took the opportunity to join a church. It was then that she became the woman her colleagues know. She learned about forgiveness and she said she hopes to be the positive light in other’s lives that she has found through God.

Asa has a passion for working with children, specifically babies.

When she began studying medicine she found an interest in critical care and decided she would like to work in in the Neonatal Intensive Care Unit (NICU). Asa spent much of her free time in Nicaragua playing with the children in the communities.


Asa completed her nursing prerequisites at Austin Community College and then applied to the nursing program at Texas State. She was placed on a wait list and due to the course sequence of the program, had to wait a calendar year to re-apply.

The next year, she was not only accepted into the program, but also awarded Texas State’s Terry Scholarship- a prestigious award given to assist Texas high school students who have excelled in the areas of academics, service and leadership.

Asa is considered one of the top students in the program. She currently holds the office position of secretary of her class.

“She is supportive and helpful without being intrusive. If her peers need help, they know she is there,” said Beth Biggan, clinical assistant professor at St. David’s Nursing School. Biggan has worked with Asa on projects such as Faith In Action outside of school, where they donated several boxes of medical equipment.

Asa attributes her success in school to her devotion to mental health.

After her first semester, she found herself facing anxiety and set a strict schedule that keeps her balanced. She has set aside time for mental relaxation, personal time, and even a curfew to counteract late-night studying.

“She is super organized and stays after class to study right after (learning) the material, which is what we always strive to do. None of us do it, but she does,” said Marina Hendrix, colleague who will intern with Asa this spring at St. David’s Women Center of Texas in the NICU. “I think she is very strong-willed and puts in all the work that’s required to become a good nurse. When we graduate, she will have earned her degree.”

Tending to More Than a Physical Illness

By Alicia Vazquez

Michelle Juarez arrived at Hogar San Antonio – a nursing home in Nicaragua – with her fellow classmates of the St. David’s School of Nursing at Texas State University on Jan. 16.

Like the rest, she walked into the infirmary and soon noticed the single patient who lay in a bed. Her name was Petrona and she had been at the nursing home since 2007.

In the two weeks prior to the team’s visit, Petrona’s kidneys had started to fail her. Juarez had been taught that once the kidneys go, everything goes.

Petrona was now in sepsis and had anasarca all over her body. She was in hospice care, but her family didn’t want her to receive any other type of care. The only thing she was getting was normal saline to keep her hydrated. She couldn’t drink anything because of the risk of aspiration pneumonia.

Knowing that Petrona’s mouth was probably dry, Juarez went for a gauze, moistened it with water and swabbed Petrona’s mouth. Another student gave Petrona drops of water.

Petrona’s sounds from her struggle to breathe filled the room. Petrona needed oxygen. She didn’t have it. She needed pain relief. She didn’t have it. She needed someone to hold her hand and comfort her. Petrona would probably pass away in her sleep, so Juarez prayed for her and loved her in every way that she could.

As a senior in her last semester of nursing school, Juarez will soon be in many more situations similar to Petrona’s because she wants to be a critical care nurse. She said that being Petrona’s nurse that morning helped confirm her decision.

“When you’re a student you have no clue as to how you’re going to be as a nurse, you need that confidence, so caring for her honestly made me feel great that I know what I’m doing and that I can handle this,” Juarez said. “My desire to help critical patients is stronger than my desire to go cry in a corner. I don’t do that until later.”

The fast pace of the emergency room and intensive care units give Juarez an adrenaline rush.

“It’s just something about having to learn every day,” Juarez said. “You don’t know what’s going to happen but you’re ready to be there.”

One of Juarez’s reasons for pursuing a nursing career is because her little brother has Down syndrome so she was exposed to the medical environment at a young age.

Juarez will be the first person in her family with a four-year degree and now that she’s about to graduate, her parents, little brother and patients give her the drive she needs to continue.

“Every single patient that I have encountered, I remember their stories. I remember their family. I remember their faces,” Juarez said. “And it’s not easy. It is the hardest thing I have done in my entire life, but it’s definitely worth it. If you ask any of us, we all have patients that have stuck with us already and we’re not even nurses yet.”

At 21 years of age, Juarez is one of the youngest in her nursing class, but that doesn’t stop her from being a leader.

Shawn Boyd, clinical associate professor at Texas State University, said that Juarez has the three skills that professors look for in nursing students: critical reasoning, dexterity and caring. Although the third skill, being caring, can be tough to teach, Boyd said that’s what makes Juarez stand out.

“She looks patients in the eye. She uses touch. She does all those things that might be somewhat uncomfortable for some people. She is an exemplary student,” Boyd said.

Juarez often chooses the most difficult cases to challenge herself. She takes the sickest patients. She takes initiative. She is confident. She doesn’t doubt her nursing abilities. Yet, Juarez is humble and loving toward everyone.

FullSizeRender (5)
Juarez walks a woman who turned 110 years old the previous day.

While in Nicaragua, Juarez helped her peers improve their Spanish and even cooked dinner for more than 30 people. She bought snow cones for kids at the San Joaquin community and gave her backpack to an elder at the nursing home after he asked if she could bring him one the next time she visited.

“I don’t have anything to lose by giving someone something that I don’t need,” Juarez said. “The man then said ‘Que Dios te bendiga’ (God bless you). The happiness that I gave him is unmeasurable.”

For Juarez, the best part of her day is talking to her patients.

Boyd saw that eagerness in Juarez and describes her as a patient advocate. Boyd sees Juarez as continuing to do work with people who do not speak English either in Latin America or on the Texas border, contributing for those who are underserved.

Alexandra Orzech, nursing student and fellow classmate, said it’s important to Juarez to protect a patient’s dignity. Juarez is respectful: she explains what she’s going to do before starting. And she is a good listener to her patients.

“I think she’s going to be an awesome nurse. She’s book smart but she’s also personable. When she’s with patients you can tell there’s more than a textbook behind her knowledge,” Orzech said. “She’s very at home at the hospital. You can tell that’s where she’s supposed to be.”

Juarez plays with a child in a crib during the home visits at the Campuzano community.

The muse.

Sydney Stilwell examining, Matias, a young boy from the San Francisco de Nindirí community in Nicaragua.

It was Sadie—an 8 year-old girl in pink cowboy boots—who inspired Texas State University nursing student Sydney Stilwell to pursue a nursing career.

Stilwell volunteered as a camp counselor at Camp Discovery a Kerrville, Texas based summer camp for children battling cancer and for children who were survivors. That’s where she met Sadie.

As a former camper for eight years, Stilwell was diagnosed with acute lymphoblastic leukemia at the age of six. After two long years, her cancer was in remission.

She made many friends there which convinced her to return as a camp counselor upon graduating Camp Discovery.

“I was like ‘I’m not going to be a counselor, I don’t even like kids,’” Stilwell said. “I never really knew that I liked kids until I did this.”

Little did she know that Sadie would be her muse to pursue a nursing career.

Stilwell remembers Sadie picking the top bunk right next to hers that summer. Sadie was battling stage four rhabdomyolysis and was a bit weaker than some of the other campers that year. Stilwell on occasion would give Sadie piggy back rides from activity to activity.

“She just has such a beautiful soul despite the fact that she was quiet casually kicking cancer’s ass,” Stilwell said.

Executive Director of non-profit advising and co-director of Camp Discovery, Joey Cavazos, has known Stilwell since she first started camp.

“Sydney has always been a really fun, loving, not very serious girl and I never thought that she would want to be a nurse,” Cavazos said.

The connection between Sadie and Stilwell was evident from the beginning. Cavazos said that they quickly latched on to each other. In Cavazos’ eyes the fight that Sadie was putting up was a large part of where the inspiration came from for Stilwell to become a nurse. The fight was all too familiar to her and she knew exactly what it was like to be in Sadie’s shoes.

“When I heard she wanted to do this because of Sadie that made me even more proud of her,” Cavazos said.

Stilwell still remembers which nurse made her feel at ease and the one who would make her cry while she was receiving her chemo treatments. She said she wants her patients to remember her as the nurse who understood what they were going through and allowed them to be a kid despite being sick.

“I want to make sure that the kids have such a good experience,” Stilwell said. “I know that because I’ve been through it.”

Stilwell spent two weeks in Nicaragua giving free healthcare to people of all ages in rural communities, but her love for children was visible in the way her face lit up as she ran after the children and the laughter she shared with the kids in just that short period of time spent there.

“Sydney is a big kid herself so it’s no surprise she loves working with kids,” said Sarah Lohmeyer, fellow classmate and Texas State University nursing student. “It was cool to see her bring so many smiles to the kids’ faces even though there was a language barrier.”

Stilwell will graduate in May and receive her Bachelor of Science in nursing from the St. David’s School of Nursing, Texas State University at Round Rock. After graduation her goal is to work in pediatric oncology at Dell Children’s Hospital in Austin, Texas which is where she received half of her treatment as a child.

“That would just be an amazing story to be able to tell the parents,” Stilwell said. “I can at least say ‘Things get better. You go through the ups, you go through the downs and I’ve been through it.’”

What Michelle Wali Found In Nicaragua

Wali takes the vitals of a young boy in Nicaragua at a clinic in San Joaquin.

For the past five years a group of seniors from St. David’s School of Nursing at Texas State University has traveled to Nicaragua every winter break to set up free clinics and treat people in rural communities outside of Managua.

For two weeks in January, the most recent group of 28 set up clinics from the ground up in schools and churches for people in the surrounding community to come for free.

One nursing student, Michelle Wali, brought back more than just nursing experience.


Nursing a Person, Not a Disease

“I want to be a nurse because it is the most social science,” Michelle Wali said. “You can look at a patient from a medical perspective, and then you can look at them as who they are as a person and assess them that way.”

Because of Wali’s Nigerian roots, academics were pushed since day one. Wali said her family’s expectations for her were to either become a doctor, nurse or engineer. In a different world, maybe she would have gotten a degree in sociology and minored in history, but that didn’t fit with her cultural expectations.

Her degree in nursing will allow her to work with patients through an entire illness from diagnosis to recovery.

“As a nurse you see social issues, nursing was the perfect medium and I love it,” she said.

Full Immersion in Community Health

When she went to Nicaragua, she wanted to connect with patients and work on her health assessment skills. The students saw patients in rural community health clinics from 9 a.m. until 3 p.m.

“I felt like she really connected to everybody she met. She is a very caring and empathetic person,” said fellow classmate, Stephanie Tollette. “I feel like because she is fluent in Spanish, she was able to connect with people on a deeper level. In the hospital, it can be really isolating for patients that only speak Spanish, and Michelle is the kind of person who will cheer them up and let them know that they aren’t alone.”

Wali discusses potential diagnosis with patient at a clinic in San Joaquin.

Full Immersion in a Language

Besides working in Nicaragua on patients, Wali also traveled to Spain, Chile and the Dominican Republic to perfect her Spanish and make sure she didn’t just graduate with a Spanish minor, but was actually fluent in the language.

“I basically learned Spanish in four months,” Wali said. “It really helped me taking Spanish one, two, three and four while I was there, going home and not being able to speak English ever.”

Working in those countries didn’t just help Wali learn another language, she also learned about people and why people are the way they are as a culture. It helped her realize the kind of person she is growing into, is exactly who she wants to be.

“I may feel that in my Texas bubble one type of way, but actually there is a clear trend.” Wali said. “When people come in the hospital with diabetes or kidney problems, I don’t automatically just think, ‘Oh you’re a lazy person’ I can connect the pieces of the puzzle and get more of a macro point of view and not a micro point of view.”

The Hands-On Learning Experience

Throughout the rest of the trip, Wali worked on several things to improve her nursing, but stood out to her was the hands-on experience she saw with the Nicaraguan doctors.

“Her assessment skills really developed,” classmate, Caitlin Ortiz, said. “Even though she was already really confident, her confidence with collaborating with physicians built more.”

The extra confidence that she gained because of how hands on the doctors are caused her to realize a possible career path to set up clinics similar to the ones she worked in Nicaragua in the United States.

“Having similar types of groups from anywhere in the world and going to similar pockets in the states would be really beneficial,” Wali said. “I grew up without healthcare and not being seen and I was in the states.”

Patients Worth Remembering

While in Nicaragua, Michelle saw several patients. On the last day of clinics she had what most would take as a really hard case.

A 21-year-old girl came to the clinic to talk to the students and doctors about a genital breakout. After her examination, it was clear to Wali, and the doctors that the patient had a rare strand of HPV.

When they told her that her breakout was from HPV, the girl was overcome by emotion and shared that she had only been with one person when she was raped at 16.

“It was interesting to see that strand of the virus that I had never seen before, but I didn’t connect with her as much as I just comforted her as much as I could,” said Wali.

Wali was most taken by an extremely thin mother and her two daughters that looked like they hadn’t eaten in days.

“The mother and daughter that came in that were super malnourished that came in were more special for me because the next day I was able to give them rice and beans and actually provide help to them,” she said.

Wali asking a patient about her symptoms in a clinic in San Jaoquin.


An immersive study abroad program in the School of Journalism & Mass Communication