Discover the Outstanding Contributions Made by AANP State Award Recipients
Hear from AANP State Award recipients Mya Yee Nandar of Illinois and Miki Miura of Hawaii as they share their personal histories and explain what the nurse practitioner role means to them.
At the 2024 AANP National Conference held this June in Nashville, Tennessee, the American Association of Nurse Practitioners® (AANP) honored the recipients of the 2024 AANP State Awards, which recognize one nurse practitioner (NP) from each state, district or territory. Since 1991, this award has been presented to NPs who embody clinical excellence and a dedication to providing lifesaving care to their patients. Two of this year’s recipients — Mya Yee Nandar, MSN, APRN, FNP-BC, PMHNP-BC and Miki Miura, DNP, APRN, FNP-C — spoke with AANP about moving to the U.S. from their home countries and the pivotal moments in their lives that led them on the road to delivering exceptional NP care. As the open call for nominations for the 2025 AANP State Awards approaches, learn what it takes to be an award recipient, or how to nominate a deserving NP you know.
Beyond “Kitsui, Kitanai, Kiken.”
Originally from Japan, Hawaii State Award recipient Miki Miura was inspired by her family — specifically her grandfather — to make health care her profession. “I decided that I wanted to go into the medical health care field after seeing my grandfather at work. He had a small clinic in the community, and he would always carry a huge, heavy bag wherever he went — even when we were on vacation. I remember asking, like, ‘What is that bag?’ And he said: ‘I want to be ready, whenever people need my help.’ That kind of inspired me, you know — I wanted to be like him.”
Miura began training as a nurse in Japan and explained that, in some ways, the nursing profession in Japan is more alike than different to America’s. After World War II, “the American government helped Japan to build a new system for nursing and nursing licensure. So, a lot of nursing in Japan is heavily influenced by American nursing,” she says. Of course, differences do abound. “The nurses in Japan don’t receive high regard for their specialist skills and knowledge. The nursing profession in Japan is known for three things: kitsui, kitanai, kiken. That means ‘hard, dirty and dangerous.’” Paired with this cultural perception is a lack of remuneration. “On the average, they make 4,920,000 yen, which is roughly 31,700 dollars per year,” Miura says. “And registered nurses often do everything.”
This imbalance in what nurses in Japan do with how they’re compensated and regarded is something Miura wants to change. “I was a registered nurse in Japan before, so I remember changing the bed linens, assessing patients, administering medications — they do everything. That’s something that I really want to help change. Registered nurses and NPs in Japan are very skillful, and they should be regarded highly like in America.”
Miura explained that while Japan has NP programs, NPs are not legally licensed. “They graduate from the program, but they’re not technically NPs,” she said. At her university in Japan, Miura attended a lecture by a health care provider who went to America and became an NP. The NP explained her role in the lecture, leaving Miura convinced that she wanted to follow that path. “It sounds like exactly what I want to do,” she remembers thinking. “This will be a perfect career option for me.”
Miura moved to the United States and labored to become fluent in English and to learn the often-complicated medical terminology required in her classes. “I remember my first nursing clinical — I had to bring a little small dictionary. I didn't have an iPhone — that wasn't a thing back then. I had to kind of look things up frantically, so that I don't make mistakes.” Miura credits her success in learning English to her classmates — “I didn’t have any other choice than just to catch up with the English so I can understand what they’re saying, [and] I don’t make a fool of myself” — and to her American teachers and American teaching culture. Unlike the perception of nurses in Japan, “teachers are highly regarded,” she says. “In Japan, students are not supposed to ask too many questions. Maybe one question is enough.” She found the contrast in America refreshing. “When I came to America, (asking questions) was what we were expected to do. I think that really helped me to improve not only my English but my knowledge and skills overall.”
“I Decided to Transform Myself”
Like Miura, Illinois State Award recipient Mya Yee Nandar was inspired to become a health care provider in her home country, and only later came to the United States to finish her studies. Nandar is from Myanmar, previously known as Burma, and was working “a cultural interpreter, a tourist guide,” when her life was interrupted by a tragedy.
“One day I was way up on the edge of the Himalayan mountains with a tour group. Before we got to the summit, we had to take a break because a snowstorm was coming.” At a small village with just a few homes, the tour group was invited to stay the night with one of the local families. “We were received warmly at their little hut [...] and before I fell asleep, someone woke me up.” Calling Nandar “teacher,” a “form of endearment and respect,” a young girl who lived in the home asked her: “Could you please help me? I don’t know what happened to my mom, and she can no longer breathe.” The woman had been snakebit in the night, and she died. “That first incident, it was striking to me. It ripped my heart [...] It shook me greatly, and I decided to transform myself to do something meaningful. That’s the beginning of my nursing journey,” remembers Nandar.
Challenges arose immediately, as Nandar was essentially excluded by her country’s rules to become a nurse. “There was no other nursing school than a school run by the Burmese government at that time,” she said. Restrictions for entry into that school included that students must be younger than 18, “and we have to be a certain height, weight and you’re not wearing reading glasses...all sorts of restrictions.” Already in her late 20s, Nandar could not see a path toward becoming a nurse in her home country. She would instead study at Assumption University in Bangkok, where she met a visiting professor from America. The professor told her that she “might want to consider applying somewhere where the east and west meet” — the University of Hawaiʻi at Hilo (coincidently, where Miura is also an alumnus).
“I am not from a wealthy family, but I was a little entrepreneur back in Burma when I was working as a tourist guide. So lucky, lucky me, I was able to sell this tiny little piece of land that I purchased.” The sale allowed her to pay for not just the flight to Hawaii but for school as well. Her education continued at Indiana University South Bend, where she became an FNP. But the longer she worked as an FNP, the more curious she became about the connection between the body and the mind — and she decided to pursue additional education related to mental health.
She went back to school for her PMHNP at Northern Kentucky University and began administering to patients — many of whom are refugees from Myanmar — in Fort Wayne, Indiana. On a journey that took her from her from Myanmar to Thailand and then to various cities in the United States, Nandar finally accomplished what she could not in her home country — and is now a NP leader able to care for those who need her help.
“Soul Care” and Shared Humanity
Both Miura and Nandar made it clear that one of their primary goals as health care providers is to make their patients feel able to confide in them — and to break down the barriers that prevent honest and open-ended conversations. “I want to make [patients] feel comfortable, and that they can ask any questions without feeling embarrassed,” said Miura. “One of the best compliments I ever got was a patient who told me that she doesn’t like to go to health care or medical offices, but I’m the only one who she looks forward to seeing.” Says Nandar about her practice: “It’s soul care. To get more in depth of what’s going on and to try and understand a client on a personal level, and then to know myself — I am also only human.”
Asked about how she felt to be the recipient of the 2024 AANP State Award, Miura said that “this award means so much to me, and also to my international nursing colleagues who dream of advancing their nursing careers [...] this award made me really realize the generosity and open-mindedness of this amazing country that gives opportunity to whoever wants to do more.” She also wanted to give a special recognition to the people of Hawaii, where she is an AANP state liaison: “Hawaii has a special place in my heart because the community opened its arms and welcomed me with warm ‘aloha.’”
When asked about being honored with the 2024 AANP State Award, Nandar said “I'm receiving this award, [but] it is not my award — it's an award of the 12,000 - 15,000-strong refugee community who taught me the ins and outs about their lives, their journeys, the difficulty that they've gone through. I cannot thank AANP enough — for your support, love, kindness and empowerment.”
Learn More About the State Awards Ahead of the Call for Nominations
The AANP State Award for Excellence — which going forward will be known as the State Award for Outstanding Contribution — is presented annually to one deserving individual per state, honoring those individuals for their efforts to advance the NP role. Current AANP members are encouraged to nominate — or self-nominate — deserving candidates before the Sept. 11 deadline.