There is much discussion about the need for diversity in nursing and the importance of educating a health care workforce that mirrors the population. Recently, Dr. Ernest Grant, president of the American Nurses Association wrote, “A diverse workforce allows us to use our varying cultural perspectives to ensure all patients and populations receive optimal and empathic care, which also may speed up their recovery and reduce the risk of preventable chronic conditions.”
Powerful words – “speed up their recovery and reduce the
risk of preventable chronic conditions” – which are exactly the actions and
goals we should be striving to achieve in an effort to increase the health of
the population and eliminate health disparities.
While contemplating diversity in nursing, a few key population statistics are worth considering. According to the U.S. Census Bureau, 49.2% of the American population are men, 41.5% of the American population are of a race other than Caucasian, and 21.3% of the American population speaks a language other than English at home.
However, according to the 2017 National Nursing Workforce Survey, just over 9% of working RNs are men, and only 19.2% are minorities. While reliable data about the number of nurses who speak a language other than English is scarce, based on the statistics demonstrated above, it’s unlikely this number mirrors the population.
In order to reduce health disparities by addressing inequalities and eliminating care gaps, it is critical to educate a vast and diverse health care workforce. The systems that educate and train nurses should place a focus on increasing the diversity of their nursing student population. Another key step is to make programs increasingly accessible through holistic admissions processes to admit a larger number of qualified nursing students.
Additionally, providing students with exposure to patients of all types of backgrounds and demographics during education and training, will help them achieve a better understanding of patient needs and how they can connect with them to provide quality care and improved experiences. Diversity in all its forms, from innate characteristics including age, race, and mental health to acquired characteristics like religion, education, and language skills, requires an awareness and respect for every person. This helps transition students from viewing their work through a cultural competence to a more inclusive lens of cultural humility.
Building cultural humility begins with a better understanding of the unique challenges every student faces and putting in steps and processes for helping them succeed while in their program. By teaching students that they are cared for, students are able to better focus on providing exceptional care for others. Putting each student at the forefront at each touchpoint and never letting them lose sight of their passion for health care, helps them become an extraordinary nurse who cares for others.
While minority enrollment in nursing programs have nearly doubled in the last twenty years, nursing has a long way to go in appropriately representing minorities in the United States (source). The current enrollment data is insufficient to address the needs of a future diverse nursing workforce. It is imperative to advocate for minority nurses in both higher education and the profession.
Diversity in Professional Nursing
Increasing diversity among nurses is a core value of the profession. The National League for Nursing promotes diversity by endorsing a culture of inclusion and excellence by celebrating a diverse population of professionals. The American Nurses Association has a professional commitment to awareness of diversity issues and the individual nurse’s biases and perceptions. For the culmination of a diverse nursing workforce to take root, schools must aim to recruit, enroll, and retain minority nursing students.
Diversity Among Student Nurses
Modern nursing programs work to disseminate a curriculum that concentrates on how to address health disparities among ethnic minorities and others who face socioeconomic barriers. Early recruitment programs that value diversifying nursing education can bolster student retention and graduation (source).
The Diversity Impact Program
For example, Frontier Nursing University increases student recruitment and retention through the Diversity Impact Program. This program offers cultural awareness and support through a social network, activities, and events during the year to connect students, including a Diversity Impact conference.
By implementing a model where student nurses embrace and encourage cultural awareness, student retention and satisfaction improves. Creating an engaging model that embraces cultural diversity is imperative to minimize student attrition. When student nurses support each other, it enhances the outlook for the entire nursing profession.
The University of Virginia (UVA) School of Nursing recently received a Health Professions Higher Education Excellence in Diversity Award from INSIGHT Into Diversity magazine, which covers diversity in higher education. This was the first time UVA’s nursing school has been honored and they were among 35 health professions schools nationwide to receive a 2018 HEED Award.
Lenore Pearlstein, INSIGHT Into Diversity’s publisher, tells News.Virginia.edu, “The Health Professions HEED Award process consists of a comprehensive and rigorous application that includes questions relating to the recruitment and retention of students and employees – and best practices for both; continued leadership support for diversity; and other aspects of campus diversity and inclusion.”
Since establishing an initiative on Diversity, Inclusion, and Excellence Achievement (IDEA) in 2014, UVA’s nursing school has shifted its recruitment, admissions, and retention strategies to welcome more underrepresented and first-generation applicants, established affinity groups for students of color, initiated expansive diversity training for faculty and staff, and urged professors to incorporate diverse perspectives and inclusive content into their courses.
UVA nursing faculty and graduate teaching assistants attend trainings across a variety of diversity-related topics, and all nursing students take part in cultural humility training and a plethora of regular activities to drive the school’s message of inclusivity. In 2018, nearly a third of enrolled students are from groups underrepresented in nursing, and more than 17 percent are male.
To learn more about UVA Nursing’s Health Professions Higher Education Excellence in Diversity Award from INSIGHT Into Diversity magazine, visit here.
Holly Forlenza and Eileen Forlenza, a nonverbal motivational speaker and her mother, both advocates for family involvement in health care, will present the January 2019 Vanderbilt University School of Nursing (VUSN) Dean’s Diversity Lecture on Monday, January 14, 2019.
Their lecture titled “From Try to Triumph: The Journey of a Nonverbal Young Adult” will be open to the Vanderbilt community. Holly Forlenza is unable to speak and was diagnosed with severe mental retardation, epilepsy, and failure to thrive when she was 2 years old. In 2011, when she was 22, she began using an iPad and keyboard to communicate and has since become an advocate for the empowerment of nonverbal people. Her book, Just Because I Can’t Talk Doesn’t Mean I Don’t Have Anything to Say, tells her story and calls for inclusion and compassion.
Her mother, Eileen Forlenza, has been Holly’s advocate from her birth. Her personal experience with parenting and dealing with the health care, education, care coordination, and insurance systems has made her an expert in speaking on the importance of family engagement. Her advocacy and support of policy development on behalf of children with disabilities resulted in an invitation from President Barack Obama to join him at the White House to mark the 20th anniversary of the Americans with Disabilities Act.
Linda D. Norman, DSN, FAAN, VUSN dean, and the Valere Potter Menefee Professor of Nursing, tells Nursing.Vanderbilt.edu, “Patient- and family-centered care improves patients’ health and the quality of health care. Yet as Holly and Eileen Forlenza can attest, sometimes people with disabilities don’t have a voice in their own care decisions – and sometimes the family’s knowledge and input aren’t utilized. I think the Forlenzas’ personal perspectives will challenge our assumptions and encourage us to consider patient and family care differently.”
The VUSN Dean’s Diversity Lecture Series was established in 2016 to explore the diversity of backgrounds, cultures, ideas, and viewpoints in our world today. It seeks to equip students, faculty, staff, and other community members with the knowledge and understanding needed to lead nursing forward in a global society.
To learn more about Holly and Eileen Forlenza, VUSN’s next diversity series lecturers, visit here.
The Johns Hopkins School of Nursing (JHSON) has received the 2018 INSIGHT Into Diversity Higher Education “Excellence in Diversity” Health Professions award for its committed efforts to support and sustain diversity and inclusion through education, programs, and outreach. The award is a national honor recognizing individual health institutions showing outstanding achievement in making diversity a top priority.
Diversity, equity, and inclusion are embedded into the strategic plan and overall mission at JHSON. Faculty, students, and staff are provided opportunities for collective cultural exchanges and experiences through encouragement from leadership and the school’s Diversity and Inclusion Committee. Efforts to promote respect for differing views and backgrounds are weaved into curriculum development, scholarships, recruitment, partnerships, and strategy.
Gloria Ramsey, JD, RN, FNAP, FAAN, who was appointed to serve as inaugural associate dean for diversity, equity, and inclusion to further the school’s diversity and its impact on innovation, education, practice, research, and service, tells Newswise.com:
“Our commitment to diversity, equity and inclusion is clearly evident and well integrated into the operations of the school. Our entire community should feel proud and honored to receive the HEED Award because it represents a collective effort and underscores our values and commitment to inclusive excellence for 21st century nursing. As we celebrate the progress we have made, we continue to hold ourselves accountable to continue important work, be open to new ideas, and think forward toward creating a more diverse and inclusive environment in the future.”
JHSON also focuses on advancing social justice in the community, cultural competence education, and minority awareness celebrations. Currently, 25% of faculty and 37% of students are from racial and ethnic minorities.
To learn more about the Johns Hopkins School of Nursing receiving the INSIGHT Into Diversity Higher Education “Excellence in Diversity” Health Professions award, visit here.
Our Nurses of the Week are UCLA School of Nursing professors Christine Samuel-Nakamura and Mary Rezk-Hanna who have both received grants from the UCLA Academic Senate Council on Research to conduct research projects inspired by their heritage. After earning their doctorate degrees at UCLA Nursing, both nurses were welcomed as assistant professors at the university.
Samuel-Nakamura grew up on the Diné (the indigenous name for Navajo) Nation reservation in New Mexico where she was the youngest child in a large family that raised its own livestock and crops. Her experience growing up on the reservation made Samuel-Nakamura aware of the challenges facing her tribe, including poverty and chronic health problems like diabetes and cardiovascular disease. She later decided to help address these issues by becoming a nurse.
Samuel-Nakamura earned her Bachelor of Science in Nursing at the University of New Mexico, then pursued her Family Nurse Practitioner Master of Science in Nursing degree at UCLA. She tells Newsroom.UCLA.edu:
“I wanted to be able to work with communities on their health issues and empower people to help themselves…As a researcher, you investigate and explore what you see in clinical practice and develop some type of explanation for it and find a way to address it. Clinical practice informs research which, in turn, informs clinical practice.”
Samuel-Nakamura worked for several years in the clinical setting in the federally run Indian Health Service and in tribal hospital clinics on the Diné reservation in Arizona where community elders appreciated her ability to speak with them in their native tongue. She recently received two one-year grants to re-evaluate environmentally contaminated sites in Los Angeles County (home to the largest urban American Indian population in the United States). One grant comes from the American Indian Studies Center in the UCLA Institute of American Cultures and the second is from the UCLA Academic Senate Council on Research.
Mary Rezk-Hanna found inspiration for her research program growing up in Alexandria, Egypt, where both of her parents worked as physicians. She shadowed them as they treated patients, which influenced her decision to become a nurse. One thing she remembers from growing up in Alexandria is looking down from her apartment balcony and being fascinated by the popular hookah cafes across the street.
Rezk-Hanna’s family moved to the US when she was 13 and she later earned her associate degree in nursing and worked as a registered nurse where she became interested in the physiological effects of smoking in young adults with tobacco-related illnesses. She then obtained her Bachelor of Science in Nursing from George Mason University, and while pursuing a Family Nurse Practitioner Master of Science degree at UCLA, she was selected to conduct a community research project about a local population health concern.
Rezk-Hanna found that two of the largest hookah lounges in LA are within one mile of UCLA and considered a major community health concern. She noticed most customers were young adults, with a large portion of them being females, and decided to conduct a study to assess young adult hookah smokers’ attitudes, perceptions, and beliefs toward their choice of smoking, and to identify predictors of hookah smoking. She found that the majority of subjects believed that hookah smoking is not harmful to one’s health.
Rezk-Hanna tells Newsroom.UCLA.edu, “These data could be used to inform young adults about the dangers of hookah smoking as well as provide evidence to guide policy specific to hookah and other alternative tobacco products and nicotine delivery systems.”
Rezk-Hanna is building on her recent findings by studying other evolving hookah tobacco products and their effects on heart health. She has received three grants to investigate the potential cardiovascular toxicity of electronic hookah use among young adults: one from the National Heart, Lung, and Blood Institute, one from the UCLA Clinical and Translational Science Institute, and one from the UCLA Academic Senate Council on Research.
To learn more about UCLA Nursing professors Christine Samuel-Nakamura and Mary Rezk-Hanna and how their heritage has inspired their research, visit here.