Joy Okumu is a pediatric nurse at Carle Health, board member with the Pediatric Nursing Certification Board, and an innovator of the hair care project at Carle, an initiative that is teaching healthcare providers about the importance of caring for 3C and 4C hair. Her goal? Bringing awareness about the myriad types and textures of curly and coily hair, teaching providers how to best care for those hair types, and providing curl-specific products for patients. During our interview, Okumu was accompanied by Brittany Simon, Carle Health PR Manager who provided valuable insight. Throughout our time together, I could sense Okumu’s passion and excitement not only for this project, but also for the potential it has to create a more inclusive and welcoming space for people at their most vulnerable.
Editor’s note: Louise is the daughter of Dr. Napoleon Knight, the current CMO of Carle Health. All questions and opinions are her own.
This interview has been edited for length and clarity.
Smile Politely: You started your nursing career in Kenya. Can you talk a little bit about your nursing journey?
Joy Okumu: I think I’ve always wanted to be a nurse. If I had to go back and choose a profession, I would still choose nursing. I started off back in Kenya with what you would call in the US an associates degree. I got my degree, then practiced for five years, then went back to school and got my bachelor’s degree or BSN, and I started working in pediatrics around that time. So half of my career was back in Kenya, and then half of it has been here.
SP: What has been the most rewarding part of your career to date?
Okumu: I have a doctorate in nursing in health systems, which I got when I came here. I think that’s been the most rewarding because I have enjoyed that journey. I didn’t ever think I would say that I enjoyed school. But the things that I learned during that time have been things I was really passionate about that I’ve been able to put into practice. I was really passionate about looking at ways to improve care, and things that I can do as a nurse. Sometimes you just tend to think of the bedside and can’t impact a lot of things. I think just being able to learn and being able to impact nursing events whilst working at the bedside, has been the most rewarding thing. Getting to that point where I have this knowledge and I have the platform to practice those things and bring about the change that I want to see.
SP: What’s been the most frustrating part of your nursing journey?
Okumu: I would say, the cost of health care across the board on both sides, interacting with the health system as a patient and also interacting with the health system as someone who provides care. I think healthcare is expensive, especially in the US. Yes, you want to offer this care, but then it can be so expensive, so that’s really frustrating.
SP: Can you both tell me about your role within Carle’s Diversity, Equity and Inclusion group and what they do, as it applies to you?
Brittany Simon: [Okumu] is one of our team members who has proactively taken on this project out of passion, understanding, and expertise. We do have a separate DEI team. She’s not on that team. But I think our approach to DEI is that it’s everyone’s job. So while we have some team members dedicated to doing that every day, we have a lot of project work that’s happening in the clinical space. We’ve got steering committees, we’ve got other clinical leadership doing different projects to change processes. And that’s where [Okumu’s] expertise is actually taking action. So while there’s not a DEI title, Okumu is definitely a leader in the space on the clinical level.
Okumu: That’s what I did. I sent an email to DEI and that’s how they connected me to the people that I would work with. I literally just found their email and sent the idea to them and they’ve supported me through the whole process.
SP: So you had this idea for the haircare project, and then you brought it to them? Can you tell me about it?
Okumu: The haircare project started when I was working on pediatrics. I was working nights and I had a patient who was six years old. And sometimes the parents of the patients that we take care of have to work or have other kids that they can’t find someone to take care of. We can take care of the kids in the hospital so they can go do other things at home. And so [the patient] asked me to help her get her hair done. I looked at her hair and she had 4C hair, the same hair that I have. And I’m like, “oh, shoot, we don’t have the right comb, we don’t have the right products, what we have is just not gonna work.” So I told her, “Let’s do it tomorrow. I’ll come back tomorrow and then we’ll get your hair done.” My plan was to go buy a comb and some products and then come back and do it when I had the right tools.
But that started the idea. That’s when I went to my leadership and I said, “you know, I think we should have something like this on our floor for kids. If someone needs haircare, then we can provide that for them. When it initially started it was at a unit level. Part of school was to do shadowing and observing a unit within the hospitals, and I picked rehab. When I went into rehab, I learned more about what they do and it’s a little bit different from inpatient nursing. This is where you teach patients how to take care of themselves after they’ve had an injury or stroke, and they are trying to learn how to do the basic care or activities of daily living. And one of the things was combing your hair.
I started thinking, what if this was me? I use an afro comb. My hair takes a lot of work. [A comb] is just not gonna glide through, it just needs a whole different mechanism. If a patient comes in, and they have, say 4C hair, how do you teach them? It’s not the same as someone with straight hair. I reached out to someone on that unit and asked her, do we have supplies here? If you have patients who have curly or coily hair, how would you teach them? And we started looking for resources. It was a need. But then I thought, “even if I get things for pediatrics, what about these other units?” That’s the point where I reached out to DEI and then they connected me to the multicultural group, which is one of their connection groups.
After a few months, we got lucky and someone from Strategic Sourcing reached out to me because they had these products. That was the other thing — to see what else is being done by other healthcare systems. This is a very niche thing. Other systems have started doing it within the last two or three years. There were literally no vendors, none.
SP: What kind of products?
Okumu: The products are specifically for curly and coily hair. It’s making sure that we have products that are appropriate for all hair types. What we currently had was okay for straight and wavy hair, but it was not appropriate for curly and coily hair. So just making sure that we provide equitable care. That’s another thing that I learned: with hair types, they just need different things, right? Curly hair tends to be dry, and needs more moisture, more oil, like heavier stuff, which would not be appropriate for someone who has straight hair. You don’t have a system that has just one type of product, we want to make sure that all hair types are cared for.
SP: How do you feel that this work is impacting patients and staff?
Okumu: Let me start with myself and the research. With hair, you have to make sure that it’s neat. But what is neat? If my hair is in its natural form, that’s the way it is, right? But there’s social stuff that’s there. There’s those pressures there. Hair is a representation of who you are, and in some spaces having dreadlocks, for example, or protective hairstyles or braids, were not considered very professional, but why is that? A protective style is something that I would need to keep my hair in a good state, right? It serves a purpose. Learning those biases that we might have, like, why do I think that this person does not look neat? Is it something that I’ve been taught? Being aware of them and, of course, interrupting those biases.
And there are things that happen out in the social world. For example, if i’m a trauma patient, and have a sew-in or a weave and then part of my hair is shaved off. I don’t want people seeing me like that. As a healthcare provider, that will not be something that worries me because I can still take care of you. But we can try to understand it from [the patient’s] point of view.
SP: Is there an education piece for healthcare providers?
Okumu: We did Health Grand Rounds, which was organized by DEI that touched on the social stuff. For example some people might say, “it’s just hair.” But for some, it’s not just hair. It can be a form of self expression. So for example, if you’re a person and you’ve been growing your locs for a super long time, then you wake up [in the hospital] and it’s all gone, that’s devastating. Imagine waking up, you’re in a very vulnerable position, and you’re injured or you’ve just come through something. Now, on top of that you have to deal with the loss of your hair. And everyone can’t understand why you’re so upset, because to some people it’s just hair, but this is a big deal for you. We’re trying to bridge that gap. And sometimes, it really is just a conversation. Even a question as small as, “can I save this for you?” That might not seem like it’s a lot, but for the patient or the individual it means a lot to them.
SP: Can you explain Grand Rounds?
Okumu: Grand Rounds is a system-wide education series, a way of getting information to staff members, and giving them tools or education on things that they can apply at bedside or with interactions with the patient, and even with our co-workers as well. especially
This one that’s called Health Equity is just learning about biases, the historical background of why we are where we are. Without understanding that part, it’s kind of hard to move forward or know where we want to be. So it’s learning about the historical injustices that have happened and why and how this affects the systems, getting us to a point where we are knowledgeable and able to disrupt those biases.
SP: Why do you think something like this is so important?
Okumu: Everyone’s different, and everyone wants to be understood. I want to help [the patient], I need to come to the point where I understand that this thing is important to them. This is what they need, I will try and provide it to them, that is going to be the most meaningful. As a nurse, we interact with so many different people, so many different walks of life, different experiences. Sometimes you have to unlearn some things. Being open minded, it’s important.
SP: I can imagine as a patient or a family member, that this project is helping them to worry about one less thing. What has the response been to this project?
Okumu: I have been pleasantly surprised. I’m doing it because I’m passionate about it. When we did the Grand Rounds, I got some feedback from some of our providers that was really impactful. People have said, “I did not know that [about hair],” about the implications, social, and economic and all that stuff. Or “wow, that was really great, this should even be part of the nursing curriculum,” because you don’t learn that in nursing school.
SP: Really?
Okumu: Oh, yeah. It’s not in the curriculum. You do learn about hygiene. There isn’t someone to tell you, “there are four types of hair.” When I was doing the research about the structure of the hair, I learned that type three and type four, when they form a knot, it’s more like two knots. So the more you try and comb it, the worse it gets. You have to use products and something to detangle it. It’s the most fragile, so say you are in bed, say in hospital for two or three days and your hair is not in a braid or a protective style, it’s gonna be so bad. This should be part of the nursing curriculum. You know, just the basic research.
For this to be successful, you need the education, you need the product. And then of course, people who are willing to learn, and that’s the good thing that I’ve seen. Overall, it’s a system people are willing to learn. And we’re giving them the language to understand and communicate with their patients. If you told a patient, “Oh, I see you have type 4C hair, can I offer you this product,” that in itself makes a huge difference.
SP: When I think of the Black community, there’s a lot of distrust with the healthcare system, but I feel like having education and products can go a long way with creating trust between the patient and their provider.
Okumu: What is trust? It’s me knowing that you know what I need, right? You’re gonna take care of me wholeheartedly. Offering something like a hair bonnet means something to me. And we want to make sure that we have these things and are having these conversations. Figuring out how we can provide care that also supports all patients.
SP: Do you see opportunities like this for Carle to create a more comfortable experience for patients of color and historically marginalized people who may be receiving care from people who don’t look like them or share the same backgrounds?
Okumu: I think Carle is definitely doing things to help bridge that gap. We want to also make sure we get to a point where we reflect the patients that we’re taking care of.
Simon: Education is the approach we’ve taken so far. We understand that there’s a systemic history and our role is acknowledging that. And [Okumu] has really helped us do that, in this area, apply tools and resources to make change with individuals. We do have a very robust education program that reaches different team members to address the pieces and parts that might impact providing more equitable care for our patients and members. [Then it’s about] creating spaces in the environment to empower team members to do more to speak up and to feel like they can talk about their different areas. That might not be mainstream, like Joy mentioned, [but] our Carle Inclusion Connection groups, which are employee groups that are minority affiliations help create these conversations so we can identify opportunities to bring forward process, change, and inclusion.
Okumu: I like that it’s creating an environment where if you have an idea you can just send an email. I was just someone working on night shift. I literally just sent an email, and they wrote me back and connected me to the right places. With the multicultural group, the support has been amazing, just being able to front those ideas and have the conversations. It can be hard to have a conversation if you feel like no one’s listening, but the environment that we have here, I feel like they are listening to these ideas, and we can brainstorm and chart the way forward.
SP: So if say, a nurse who has never seen 3C or 4C hair is taking care of a patient that has it and has questions about it, what resources do they have access to?
Okumu: So right now, there is an LMS and all of the knowledge that our staff has.
Simon: I do want to clarify, LMS is our Learning Module System. Every clinical team member will go through this training. It’s a virtual training that will be a resource. And then of course, people can ladder up questions to their leader.
Okumu: And just piggybacking on that, there were two parts of it. The first one, which is the Grand Round, was touching more on the social aspects to understand why I care so much about my hair, why it’s a big deal. And then there is the hands on/bedside piece: “Here’s my patient, what hair type do they have? Once I figure that out, what do I need to do? What products do I need for my patient? What can I offer?”
SP: So there’s an awareness and an application?
Okumu: Yeah.
SP: Switching gears: What do you like most about living in Champaign-Urbana?
Okumu: The diversity. There’s people from everywhere. I like that. It makes it easier to fit in. Then you don’t feel like you’re the outsider.
SP: And where do you find joy and relaxation outside of work?
Okumu: I like to travel any chance I get. I also like trying new types of food. I will try any cuisine once.
