CentraState Healthcare System located in Freehold, NJ is a nonprofit community health organization consisting of an acute-care hospital, an ambulatory campus, three-senior living communities, a family medicine residency program, and a charitable foundation. Over the years, CentraState has employed multiple family members from numerous families in NJ.
In this “Focus on Diversity” issue of our bimonthly eNewsletter, we are featuring 4 members of the Santos family who work at CentraState – 3 family members have worked at CentraState for over 24 years! Joe Santos is the spokesperson for the Santos family.
Pat Magrath from DiversityNursing.com recently had the opportunity to chat with Joe Santos, RN and Unit Manager at CentraState’s Manor Rehab Healthcare Center. Joe said “every day is a different day working in the Rehab Center. My patience is tested daily and I love it”.
Joe grew up in the Philippines and while living there, Joe’s father was diagnosed with cancer. Joe took care of his father. He loved taking care of him and discovered he had a passion for it. Joe was always interested in science and medicine, but medical school in the Philippines was too expensive, so he became a Mining Engineer. When Joe immigrated to the US in 1989, no one needed his mining engineer skills so he went to CentraState and applied for a job as an orderly. He was hired the next day.
Joe has worked at CentraState for 24 years. While working as an orderly, he went to school and became an LPN. CentraState encouraged him to further his education and paid his tuition fees to become an RN where he is now the Unit Manager at the Manor. Over the years, Joe has been appointed Acting Director of Nursing, not once, but twice. He was happy to help out, but he was not interested in the position on a permanent basis.
Many years ago, there was a pretty lady named Evangeline living in Joe’s apartment complex. She too grew up in the Philippines and was already an RN at CentraState. They met and soon married. Evangeline has also been at CentraState for 24 years! She worked in Orthopedics for 16 years, transferred to short-stay Surgery for 2 years and currently works at the CentraState Family Medicine Center. They have 2 daughters and are expecting their first grandchild. Perhaps like their parents, they’ll be working at CentraState too!
Joe’s brother, Teodoro started working at CentraState in 1989 -- the same year as Joe and Evangeline. His career started as a cook in the hospital and 9 years ago, he became the Senior Cook at the Manor where Joe works.
Joe’s niece, Charmaine, has worked as a Patient Care Technician in the 5 North Progressive Care Unit for 6 years.
Well there you have it… 4 members of the Santos family – Joe, Evangeline, Teodoro and Charmaine... all happily and productively working at CentraState.
I had to ask… What makes CentraState such a great place to work? Joe responded… When they all immigrated to the US, they lived close to the hospital which was much smaller at the time. The convenient location and the “one big happy family” feel at the hospital, gave the Santos family a terrific opportunity for employment. They grew in their careers among genuinely friendly and caring people.
As the years have gone by, CentraState has expanded and it still feels great to be working there with talented, caring staff and family. As Joe told me, “we live in the community, work in beautiful facilities, enjoy generous benefits, and appreciate the ability to continue to grow in our careers at CentraState where we have been supported and encouraged”.
Dolores N. Napolitano, Manager of Recruitment for CentraState Healthcare System stated “we value our employees and feel like they are our family members too. When individuals who are actually blood related family work here, it makes it even more special and unique. CentraState is their hospital in more ways than one because they live in the community and work here as well. The Santos’ are one of many multi-generational families working at CentraState and we embrace the concept and actuality of it. It is only a part of what we do to acknowledge and support the diverse staff we have and the community that we serve".
"We welcome you and your family to visit our website http://www.centrastate.com/Careers/Nursing-Career-Information and check out our job opportunities.”
This article is an excerpt from Diversity Best Practices' new book, the HR Executive Diversity Primer.
What’s the best way to structure a diversity function? The answer is as individual as companies themselves. Let’s look at three organizations—Sodexo, Johnson & Johnson, and Rockwell Automation—that have established different, yet equally effective, configurations of their diversity offices.
With 400,000 employees across the globe (125,000 in North America) and operations in 33,400 sites in 82 countries, Sodexo is among the world’s top 25 employers, as a provider of integrated food services and facilities management. Betsy Silva Hernandez, Sodexo’s senior director for corporate diversity and inclusion, describes the corporate culture as high touch with an orientation toward action. It’s a high-touch culture, because the company is very relationship based and uses the power of influence to drive its diversity efforts. Its action orientation shows up as the company’s business leaders push for quick results, yet they also want the diversity strategy to be customized to their local context.
Silva Hernandez explains how the company’s decentralized structure is reflected in the structure of the diversity office. Depending on the location of a regional market (North America, Europe, Central or South America, and others), the company uses multiple infrastructure models. The decentralized model is further intensified by its French ownership, which brings its own inclusion issues. While the structure has evolved over time, the formal diversity effort began in 2002 with the creation of the company’s diversity leadership council.
Along with the North American CEO, this council was charged with developing the diversity and inclusion strategy, setting priorities, and providing oversight for the effort. Later the strategy was broadened to include a committee of operational leaders comprised of members from the executive committee and market presidents. Their task was to implement the strategy and embed it throughout the organization by working with the company’s Cross Market Diversity Council (CMDC) and its employee business resource groups (EBRGs). The CMDC and EBRGs provide the grassroots support for inclusion initiatives. According to Silva Hernandez, this structure represents a top-down, middle-out, bottom-up approach to the inclusion strategy.
The efforts of Sodexo’s diversity and inclusion team on behalf of 125,000 North American employees, and influencing 270,000 other employees in locations around the world, are augmented by its EBRG members and other volunteers across the organization. Volunteer impact is monumental. For example, roughly 90 percent of Sodexo’s 25,000 North American managers participate in EBRGs. And the EBRGs are instrumental in how the company delivers its inclusion results.
Volunteers may provide the much-needed resources to drive the inclusion efforts. However, as Sodexo’s Chief Diversity Officer Rohini Anand explains, the inclusion strategy is also based on the shared services model. The corporation provides and funds support services for the entire corporation, with local operations furnishing additional resources. Yet, even a company as committed to diversity as Sodexo has had to face the realities of a global economy. For two consecutive years, Silva Hernandez has seen the diversity budget cut, while responsibilities have increased. The Sodexo diversity office has had to deliver more with less money.
While Sodexo’s North American diversity strategy is only 10 years old, it is considered a mature, highly regarded function. Companies across the globe use Sodexo as the benchmark they aspire to reach. The company also illustrates the evolving nature of the diversity function.
Initially, Anand reported to the senior vice president of HR. Soon after, diversity was repositioned so that she reported to North American CEO George Chavel, and now she has a bifurcated reporting relationship to both the North American CEO and Global CEO Michel Landel. Although her area no longer reports directly to HR, Anand explains that both areas enjoy a strong partnership. “We’re separate, but we’re strong partners,” she says.
The diversity department has changed in the past and Anand understands that it could change again. “Diversity was a part of HR, then separated from HR, and depending on the needs of the organization, we would certainly recalibrate that relationship,” she said. “Obviously, our effort continues to be a work in progress."
Johnson & Johnson
Johnson & Johnson (J&J) is a global leader in healthcare, consumer products, pharmaceutical products, and medical devices. It’s a 125-year-old company with $65 billion in revenues. J&J’s Smita Pillai, director of global diversity and inclusion, medical devices and diagnostics, explains that J&J’s culture is best considered a hybrid between a lean culture at its headquarters in New Brunswick, N.J., and a more high-touch culture in its 250 operating companies that span 57 countries across the globe.
J&J’s structure also mirrors its hybrid culture, which is decentralized at the regional and local levels but supported by a more-centralized core strategy in its corporate offices. In this way, J&J’s global diversity and inclusion office has the best of both worlds. The central office establishes an overall strategy and provides some independent funding, while the local companies roll out the strategy and allocate funding from their budgets to support diversity initiatives.
According to Pillai, the company’s CDO reports directly to the CEO, and manages six director-level direct reports. With an annual budget of $5 million, the diversity function numbers about 16 employees, including directors and administrative assistants. Pillai said Johnson & Johnson can’t run a global diversity operation with the current structure at the corporate level, so the diversity function works in close partnership with HR and its teams.
While J&J’s office of diversity and inclusion has a well-deserved reputation, internally and externally, as an established leading-edge operation, Pillai recognizes that its structure may evolve as the company adapts to an ever-changing global landscape.
With more than 20,000 employees, revenues of $6.2 billion and operations in 80 countries, Rockwell Automation is a business-to-business firm that is a leading provider of integrated systems for process manufacturing. According to Joan Buccigrossi, director of global inclusion and engagement, the diversity department was deliberately and strategically structured to serve as an inside consultant to the leaders and managers of the company. The responsibility for creating a culture of inclusion rests totally with the company’s leaders, not with HR.
With only two part-time staff members in the diversity office, Buccigrossi operates in a lean culture with a highly matrixed structure that leverages the power of influence across the organization. While she reports to the senior vice president of HR, Buccigrossi explains that her customers are the company’s business and function leaders, who initiate actions and develop the diversity direction. In this way, HR does not set the inclusion agenda or its engagement strategy. That’s done by Rockwell’s leaders and managers. “The danger of housing diversity in HR is that it can make the effort more of an initiative, something being done to leaders, rather than an effort they are intimately involved in,” Buccigrossi said.
“At Rockwell, leaders and managers are change agents.”
As in many firms, HR provides needed metrics, encourages tough conversations, and challenges and supports leaders and managers, Buccigrossi said. It is the department heads and their employees who fund the strategy and take ownership to ensure it succeeds. She cites an example with the North America sales division. The department decided that all managers and employees receive specialized education in order for everyone to become change agents. The department funded the effort and played a key role in the design and implementation of the learning modules. “The education is much more effective than any ‘training’ pushed out from HR would have been” she added.
While Buccigrossi’s diversity function does not have a budget, for real, the company’s functional leaders are prepared to support diversity initiatives from their funds. This arrangement works well for Rockwell. Everyone remembers 2008 and 2009, when the global and national economies were reeling from the fiscal freefall and companies were tightening their belts. In 2009, Rockwell’s diversity office was able to spend significant dollars on inclusion initiatives for employees. How? The business functions believed that such training was valuable and provided the necessary funding.
While Rockwell’s inclusion and engagement (I&E) department is tiny, in reality, the diversity and inclusion team consists of everyone in the company. According to Buccigrossi, all diversity and inclusion work is done by the people in the businesses and functional areas. They created Inclusion Change teams, which are tasked with performing cultural assessments, identifying barriers to inclusion, planning and executing actions to remove those barriers, and measuring results. Rockwell also uses rotational staffing assignments in I&E for up-and-coming and established leaders, although participants keep their day jobs.
According to Buccigrossi, the consultant approach works well for Rockwell, because it blends in with the company’s culture and structure. This is how everyone works and business objectives are met. As a result, the consultant model reflects the current corporate environment and drives its inclusion strategy.
By Shantelle Coe RN BSN - Diversity and Inclusion Consultant
Creating an environment that embraces diversity and equality not only attracts the most qualified nursing candidates, but an inclusive environment also helps to assure that the standards of nursing care include “cultural competency.” Cultural differences can affect patient assessment, teaching and patient outcomes, as well as overall patient compliance.
Lack of cultural competence is oftentimes a barrier to effective communication amongst interdisciplinary teams, which can often trickle down to patients and their families.
With the increase in global mobility of people, the patient population has become more ethnically diverse, while the nursing forces remain virtually unchanged. Nursing staff work with patients from different cultural backgrounds. Consequently, one of the challenges facing nurses is the provision of care to culturally diverse patients. Hospitals and healthcare agencies must accommodate these needs by initiating diversity management and leadership practices.
According to Cross, T., Bazron, B., Dennis, K., and Isaacs, M. (1989); these are the 5 essential elements that contribute to an institutions ability to become more culturally competent:
- Having the capacity for cultural self-assessment.
- Being conscious of the dynamics inherent when cultures interact.
- Having institutionalized cultural knowledge.
- Having developed adaptations of service delivery reflecting an understanding of cultural diversity.
A culturally competent organization incorporates these elements in the structures, policies and services it provides, and should be a part of its overall vision.
From all levels, the nursing workforce should reflect the diversity of the population that it serves. A more diverse workforce will push for better care of underserved groups. It’s important to note that that diversity, inclusion, and cultural awareness isn't just about race or ethnicity. We must always keep in mind socioeconomic status, gender, and disability in our awareness.
Becoming more inclusive is a shared responsibility between nurses and healthcare agencies. Becoming an “agent of change” within your facility can inspire awareness and affect attitudes and perceptions amongst your peers.
Nurses and healthcare workers must not rely fully on the hospital and healthcare systems to institute an environment of cultural awareness.
Nurses can increase their own cultural competencies by following a few guidelines:
- Recognizing cultural differences and the diversity in our population.
- Building your own self-awareness and examining your own belief systems.
- Describing and making assessments based on facts and direct observation.
- Soliciting the advice of team members with experience in diverse backgrounds.
- Sharing your experiences honestly with other team members or staff to keep communication lines open. Acknowledging any discomfort, hesitation, or concern.
- Practicing politically correct communication at all times – avoid making assumptions or stereotypical remarks.
- Creating a universal rule to give your time and attention when communicating.
- Refraining from making a judgment based on a personal experience or limited interaction.
- Signing up for diversity and inclusions seminars.
- Becoming involved in your agencies diversity programs – find out what your resources are - most institutions have something in place.
By incorporating a few of these steps into your daily nursing practice, you are taking steps towards becoming culturally competent.
Inclusive nurses demonstrate that we are not only clinically proficient and culturally competent, but are the essence and spirit of the patients that we care for.
By Christina Orlovsky, senior writer, and Karen Siroky, RN, MSN, contributor
As the nation’s population becomes more diverse, so do the needs of the patient population that enters U.S. hospitals. As caregivers with direct contact with patients from a wide spectrum of races, ethnicities and religions, nurses need to be aware and respectful of the varying needs and beliefs of all of their patients.
In its position statement on cultural diversity in nursing practice, the American Nurses Association (ANA) states that: “Knowledge of cultural diversity is vital at all levels of nursing practice…nurses need to understand: how cultural groups understand life processes; how cultural groups define health and illness; what cultural groups do to maintain wellness; what cultural groups believe to be the causes of illness; how healers cure and care for members of cultural groups; and how the cultural background of the nurse influences the way in which care is delivered.”
Additionally, the Joint Commission requires that all patients have the right to care that is sensitive to, respectful of and responsive to their cultural and religious/spiritual beliefs and values. Assessment of patients includes cultural and religious practices in order to provide appropriate care to meet their special needs and to assist in determining their response to illness, treatment and participation in their health care.
There are a number of ways to comply with the requirements for providing culturally diverse care.
First, be self-aware; know how your views and behavior is affected by culture. Appreciate the dynamics of cultural differences to anticipate and respond to miscommunications. Seek understanding of your patients cultural and religious beliefs and values systems. Determine their degree of compliance with their religion/culture, and do not assume.
Furthermore, respond to patients’ special needs, which may include food preferences, visitors, gender of health care workers, medical care preferences, rituals, gender roles, eye contact and communication style, authority and decision making, alternative therapies, prayer practices and beliefs about organ or tissue donation.
Kathleen Hanson, Ph.D., MN, associate professor and interim executive associate dean for academic affairs at the University of Iowa, summarized the importance of learning cultural diversity in nursing education.
“Cultural competency is threaded throughout the nursing school curriculum. We teach every course with the idea that there’s content that may need to be explained for a diverse student group,” Hanson said. “In nursing, cultural competency has been around for a long time. I think that’s probably something that the nursing profession recognized maybe a bit before some other disciplines. We’ve always worked in public health, so we have always seen the diversity of America.”
Hanson concluded: “We need to be able to care for diverse populations because our country is growing increasingly diverse. Oftentimes persons who are in minority groups or who are underrepresented have different health care needs. It’s important for us to have a student population that is as equally diverse as our client; we need to prepare a workforce that not only knows how to work with diverse peoples, but also represents them.”
By: Robert Rosseter
Nursing’s leaders recognize a strong connection between a culturally diverse nursing workforce and the ability to provide quality, culturally competent patient care. Though nursing has made great strides in recruiting and graduating nurses that mirror the patient population, more must be done before adequate representation becomes a reality. The need to attract students from under-represented groups in nursing – specifically men and individuals from African American, Hispanic, Asian, American Indian, and Alaskan native backgrounds – is gaining in importance given the Bureau of Labor Statistics’ projected need for more than a million new and replacement registered nurses by 2016.
Diversity in the Nursing Workforce & Student Populations
- According to the U.S. Census Bureau, the nation's minority population totaled 102.5 million or 34% of the U.S. population in 2007. With projections pointing to even greater levels of diversity in the coming years, nurses must demonstrate a sensitivity to and understanding of a variety of cultures in order to provide high quality care across settings.
- According to data from the 2008 National Sample Survey of Registered Nurses (NSSRN), nurses from minority backgrounds represented 16.8% of the registered nurse (RN) workforce. Considering racial/ethnic backgrounds, the RN population is comprised of 5.4% African American; 3.6% Hispanic; 5.8% Asian/Native Hawaiian; 0.3% American Indian/Alaskan Native; and 1.7% multi-racial nurses.
- Though men only comprise 6.2% of the nation’s nursing workforce, this percentage has climbed steadily since the NSSRN was first conducted in 1980. The number of men in nursing has increased from 45,060 nurses in 1980 to 189,916 nurses in 2008. http://bhpr.hrsa.gov/healthworkforce/rnsurvey04
- According to the National Sample Survey, RNs from minority backgrounds are more likely than their white counterparts to pursue baccalaureate and higher degrees in nursing. Data show that while 48.4% of white nurses complete nursing degrees beyond the associate degree level, the number is significantly higher or equivalent for minority nurses, including African American (52.5%), Hispanic (51.5%), and Asian (75.6%) nurses. RNs from minority backgrounds clearly recognize the need to pursue higher levels of nursing education beyond the entry-level.
- According to AACN's report on 2010-2011 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, nursing students from minority backgrounds represented 26.8% of students in entry-level baccalaureate programs, 26.1% of master’s students, and 23.3% of students in research-focused doctoral programs. In terms of gender breakdown, men comprised 11.4% of students in baccalaureate programs, 9.5% of master’s students, 7.5% of research-focused doctoral students, and 9.0% of practice-focused doctoral students. Though nursing schools have made strides in recruiting and graduating nurses that reflect the patient population, more must be done before equal representation is realized.
- The need to attract diverse nursing students is paralleled by the need to recruit more faculty from minority populations. Few nurses from racial/ethnic minority groups with advanced nursing degrees pursue faculty careers. According to 2010 data from AACN member schools, only 12.6% of full-time nursing school faculty come from minority backgrounds, and only 6.2% are male. www.aacn.nche.edu/IDS
Recognizing the Need to Enhance Diversity
- All national nursing organizations, the federal Division of Nursing, hospital associations, nursing philanthropies, and other stakeholders within the health care community agree that recruitment of underrepresented groups into nursing is a priority for the nursing profession in the U.S.
- Nursing shortage reports, including those produced by the American Hospital Association, the Robert Wood Johnson Foundation (RWJF), the Joint Commission, and the Association of Academic Health Centers, point to minority student recruitment as a necessary step to addressing the nursing shortage. media-relations/fact-sheets/nursing-shortage
- Besides adding new clinicians to the RN workforce, a diverse nursing workforce will be better equipped to serve a diverse patient population. According to an April 2000 report prepared by the National Advisory Council on Nurse Education and Practice, a culturally diverse nursing workforce is essential to meeting the health care needs of the nation and reducing the health disparities that exist among minority populations. http://bhpr.hrsa.gov/nursing/nacnep/reports/first/5.htm
- A report released by the Sullivan Commission on Diversity in the Healthcare Workforce in September 2004 stated: “The fact that the nation’s health professions have not kept pace with changing demographics may be an even greater cause of disparities in health access and outcomes than the persistent lack of health insurance for tens of millions of Americans. Today’s physicians, nurses, and dentists have too little resemblance to the diverse populations they serve, leaving many Americans feeling excluded by a system that seems distant and uncaring.” Download the entire report, titled Missing Persons: Minorities in the Health Professions.
Strategies to Enhance Diversity in Nursing Education
A lack of minority nurse educators may send a signal to potential students that nursing does not value diversity or offer career ladder opportunities to advance through the profession. Students looking for academic role models to encourage and enrich their learning may be frustrated in their attempts to find mentors and a community of support. Academic leaders are working to address this need by working to identify minority faculty recruitment strategies, encouraging minority leadership development, and advocating for programs that remove barriers to faculty careers.
AACN, in collaboration with leading foundations and stakeholders, has taken the following steps to enhance diversity in nursing education:
- In January 2010, AACN published a new set of competencies and an online faculty tool kit at the culmination of a national initiative funded by The California Endowment titled Preparing a Culturally Competent Master’s and Doctorally-Prepared Nursing Workforce. Working with an expert advisory group, AACN identified a set of expectations for nurses completing graduate programs and created faculty resources needed to develop nursing expertise in cultural competency. This work complemented a similar project for undergraduate programs which resulted in the publication of the document Cultural Competency in Baccalaureate Nursing Education and the posting of an online toolkit for faculty.
- In April 2008, the Robert Wood Johnson Foundation joined with AACN to launch the RWJF New Careers in Nursing Scholarship Program. This program is designed to alleviate the nation’s nursing shortage by dramatically expanding the pipeline of students from minority backgrounds in accelerated nursing programs. Scholarships in the amount of $10,000 each will be awarded to 1,500 entry-level nursing students over the next three years. Preference will be given to students from groups underrepresented in nursing or from a disadvantaged background.
- AACN and the California Endowment are collaborating on a three-year program to offer the Minority Nursing Faculty Scholarship Program to increase the number of nurse educators from underrepresented minority groups. This program provides financial support and mentoring to students pursuing graduate degrees who are committed to teaching in a California school of nursing after graduation. To date, 23 graduate nursing students have been selected to receive scholarship funding.
- AACN and the Johnson & Johnson Campaign for Nursing’s Future launched the Minority Nurse Faculty Scholars Program in 2007 which is modeled after the California Endowment program. In addition to $18,000 in scholarship funding, the program also features mentorship and leadership development components to assure successful completion of graduate studies and preparation for a faculty role. Ten scholars are currently receiving funding through this program.
- AACN is collaborating with a variety of national nursing organizations to advocate for more federal funding for Nursing Workforce Development Programs, including funding for Nursing Workforce Diversity Grants. This program provides funding for projects to increase nursing education opportunities for individuals from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses. In FY 2007, these grants supported the education of 32,847 nurses.
- AACN’s Executive Director Polly Bednash serves as the representative from Nursing on the Sullivan Alliance to Transform America’s Health Professions. Composed of national leaders in health professions education, this interprofessional working group focuses on advancing strategies to increase the number of healthcare providers from minority populations. The Sullivan Alliance’s latest initiative focuses on establishing statewide collaborative groups to coordinate efforts to enhance diversity in the health professions.
With the battle over immigration raging on and racial and ethnic minorities surpassing whites for the first time, there's no question the U.S. is getting more diverse.
A newly released study from Brown University has pinpointed just where the most diversity is taking place, scoring metro areas by how evenly each city's population is spread across the five racial groups: Non-Hispanic whites, Hispanics of any race, African-Americans, Asians and an “other” category comprised of Native Americans, Alaska Natives and people of two or more races.
According to the US2010 Project, immigrants from Latin America, Asia, and elsewhere have expanded the population of minority residents beyond African Americans, a trend that experts say will eventually lead to as many "minority" as "non-minority" residents, if it continues.
As of 2010, western, southern and coastal metropolitan areas continue to be the most diverse, with California's Vallejo-Fairfield claiming the top spot.
In addition to location and how evenly a city's population was distributed across racial groups -- a perfectly diverse place would have a population with exactly 20 percent of each category and a total score of 100 -- the community characteristics researchers correlated with diversity were: large total and foreign-born populations; high rental occupancy, as a community needs a supply of rental housing to accommodate newcomers; a range of occupational options, including entry-level jobs; and a low minority-to-white income ratio.
Check out this
article to see the most and least diverse cities in the U.S.
By: Shantelle Coe
Without cultural diversity amongst healthcare providers, it is almost impossible to provide quality nursing care to people from different ethnic and socioeconomic backgrounds. A multicultural representation of nurses, physicians and clinicians is important to ensure the healthcare being delivered is sensitive and meets the physical and holistic needs in our “patient palette”.
In the United States, a rise in the population and increase in minorities further challenges our healthcare system to provide appropriate care to the ever changing population it serves.
Some of the major findings in a study on the changing demographics and the implications for physicians, nurses and other healthcare workers conducted by the US Department of Health and Human Resources are bulleted here:
- Minorities have different patterns of health care use compared to non-minorities. Disparities in access to care account for part of the difference in utilization.
- Demand for health care services by minorities is increasing as minorities grow as a percentage of the population. Between 2000 and 2020, the percentage of total patient care hours physicians spend with minority patients will rise from approximately 31percent to 40 percent.
- Minorities are underrepresented in the physician and nurse workforce relative to their proportion of the total population. As minorities constitute a larger portion of the population entering the workforce, their representation in the physician and nurse professions will increase. The U.S. will increasingly rely on minority caregivers.
- Minority physicians have a greater propensity than do non-minority physicians to practice in urban communities designated as physician shortage areas. An increase in minority representation in the physician workforce could improve access to care for the population in some underserved areas.
The study also summarizes: “Advocates for increased minority representation in the health workforce argue that increasing the number of minority physicians will improve access to care for minorities and vulnerable, underserved populations. These advocates argue that increased representation of minorities in the health workforce not only will increase equity, but will also improve the efficiency of the health care delivery system”. (HRSA 2000)
Men (of all backgrounds) are also far under-represented in nursing. Less than 1 percent of the population are male nurses.
As our nursing population lacks diversity, statistics show that the US population is becoming more diverse and will continue on through the decades.
Below are projections for the increase in diversity amongst minorities in the United States:
Source: Modified version of Census Bureau middle series projections.
As our demographics continue to change, one of our greatest challenges is getting hospital organizations along with healthcare administration to realize that, in order to provide the best care and ensure successful patient outcomes, we have to embrace diversity. This is especially challenging to nurses because they will be expected to deliver care that encompasses these differences. Many nursing task force teams and associates have been organized to address this issue of healthcare diversity, such as:
- Asian American/Pacific Islander Nurses Association, Inc. (AAPINA)
- National Alaska Native American Indian Nurses Association, Inc. (NANAINA)
- National Association of Hispanic Nurses, Inc. (NAHN)
- National Black Nurses Association, Inc. (NBNA)
- Philippine Nurses Association of America, Inc. (PNAA)
For nursing care of all cultures and backgrounds, we owe it to our profession to increase our awareness and get involved to ensure delivery of the best care possible. One of the most important steps any of us can take is to first embrace diversity.
About the Author: Shantelle Coe RN, BSN, has 14 years of nursing experience and is currently a Senior Manager (US Commercialization) for one of the largest international biotechnology sales and education companies. She manages a team of Clinical Nurse Educators that provide medical device training to hospitals and physicians in the US and abroad.
By Carolina Madrid
August 31, 2012
We tend to categorize every ethnic community outside of Whites as a minority or diverse population group, but there’s a gray area that we’re failing to pay close attention to: the bicultural and multiracial population. It was the fastest-growing youth group in the country in the last decade, increasing almost 50 percent to 4.2 million, according to Census 2010.
As our nation’s population becomes more diverse, the bicultural population will continue growing and the segregated communications approaches that have worked in the past will not work with this audience any longer. Use the guide below as an overview to understanding biculturalism and how you can think about it in an upcoming campaign.
A cultural tug of war
Being bicultural, multicultural or multiracial means that you have ties to different cultures. It can mean that you grew up in the United States with roots in another country or that you have parents from distinct ethnic backgrounds. Either way, there’s usually a sense of being pulled in two different directions while trying to maintain both or assimilate into another. Why does this matter? Because someone who you thought was a Hispanic, Spanish-speaking person may not be receptive to messaging that speaks solely to Latinos.
Inglés or Spanish?
The language preference of bicultural individuals varies. Younger populations who went to school in the United States tend to prefer English, while older populations will favor their native language. There’s also the second-generation population who doesn’t prefer one or the other. The language you use will largely depend on the demographic.
What am I?
The degree to which individuals associate themselves with a given cultural background also varies. Just as there are those who believe in maintaining a sense of heritage, there are those who don’t want to stay in touch with their roots and prefer to assimilate into only one culture. This is why it’s important to stay away from explicit cultural messaging that would isolate or turn off the bicultural or multiracial population.
Univision or CNN?
Just because someone speaks Spanish doesn’t mean he or she watches Univision, the nation’s largest Spanish-language network. In fact, he or she will likely prefer to watch English-language TV. Still, on CNN, there is an opportunity to reach the bicultural population with messaging about the Hispanic or Asian population.
Fusion cuisine is a perfect example of the adaptation and merging of two different cultures. You appreciate the base flavor of the dish, while adding in contemporary ingredients and spices for a blend that’s the best of both worlds. Don’t be afraid to also use this approach in your communications programs, using a mix of messages.
How you communicate with a bicultural population will also depend on the message that you’re trying to convey. Different scenarios will call for the incorporation of cultural messaging, while other times, this might seem forced. But what is certain is that early awareness and the ability to use it wisely will reap the rewards of a genuine connection.
by Mareisha Winters
Let’s talk about work.
There is a lot of attention being paid to our increasingly diverse workplace. There are all types of differences including race, gender, generations and thinking styles, just to name a few. LTAW’s focus this month is on some of the key diversity dimensions and how to navigate them for greater productivity and engagement.
The increasingly diverse global workforce has made cultural competence an imperative to sustain and enhance workplace performance and engagement. What is culture and what is cultural competence? Culture is the behavioral interpretation of how a group lives out its values in order to survive and thrive; the set of shared attitudes, beliefs, behaviors, values, goals, and practices that characterizes an institution, organization or group. Cultural competence is the capability to shift cultural perspective and adapt behavior to cultural commonalities and differences. Ongoing, continued learning is required for cultural competence.
The three largest minority groups in the US workforce today are: Hispanic/Latino (14.7%), Black/African-American (11.6%), and Asian American (4.6%). The more different cultures work together, the more cultural competence is essential to avoid problems ranging from miscommunication to actual conflict. These problems can compromise effective worker productivity and performance.
Developing cultural competence results in an ability to understand, communicate with, and effectively interact with people across cultures. The purpose of this post is to understand the different barriers and hurdles that minority groups tend to face in the workplace. Managers must understand that their style cannot necessarily be “one size fits all” if they have a multi-cultural team. Below are some characteristics of the three main minority groups in the workplace.
Hispanic culture tends to be risk adverse and more of a “we” vs. “I” culture. This can negatively impact them in the workplace if it is not understood. Their risk avoiding nature may not afford them the same chances to show their abilities and skills. By not self-promoting as much as others, Hispanics may not be rewarded for their contributions.
Cultural competence can help Hispanics reach their full potential in the workplace. Many employees make sweeping stereotypes about Hispanics. Some are criticized for their accents, leading to assumptions on their abilities, level of education, and intelligence. Hispanics tend to speak Spanish with each other because of comfort, but this can be confusing or seen to be exclusionary by others.
Mentoring can make the difference in retaining Hispanics. Hispanic mentors serve as role models and better understand some of the cultural nuances of being Latino in the workplace. Hispanic employees need formal and informal ways to connect with each other in order to maintain the relationship bonds they value.
Studies tell us that there is greater corporate flight amongst minorities, especially among African Americans. Research conducted by the WP Carey School of Business showed that the predicted quit rate for whites was 3.73%, compared to 4.79% for African Americans. Discriminatory environments and micro-behaviors are often cited as reasons African Americans leave an organization. So what can a company do to make these employees feel more engaged? Based on findings from focus groups conducted by the Future Work Institute, the top five characteristics of an organization that retains African American employees include:
A climate of inclusion
Supportive interactions with leaders
Offer of profit and loss responsibilities
Opportunities for development and advancement at all levels
Community involvement and social responsibility
As with Hispanics, mentoring is a key factor in the career development and retention of Blacks/African Americans. Studies have shown that mentoring of African Americans leads to: increased performance, faster promotion rate, early career rate of advancement, greater upward mobility, higher income, job satisfaction and perceptions of great success and influence in an organization.
African Americans place a high value on interpersonal relationships with supervisors and co-workers, which impacts both job satisfaction and employee commitment. Supportive work environments for African Americans include: collectivist (focus on group rather than individual outcomes) approaches to work, agreeableness and teamwork.
The same Future Work Institute focus group study revealed the major hurdles for Asian Americans in the workplace. The primary reasons that Asian Americans feel excluded in the workplace include:
Lack of mentors with Asian perspective. Because of the small number of Asian Americans in the US workforce, mentors with Asian perspective are limited. Similar to Hispanics and African Americans, Asian Americans would benefit greatly from having mentors in the workplace.
Glass ceiling. Asian Americans who wish to move up the career ladder feel limited because they do not see Asian representation at the top.
Lack of transparency. The need for constructive feedback is essential for career development.
Life is out of balance. Often caught between the demands of kids, parents and work, Asian Americans feel their work and life is out of balance. According to AARP, 73%of Asian Americans believe that children in their families should care for elderly parents, compared with 49%of the general population.
Cultural differences. The sentiment from many Asian Americans is that, “Our culture is very different from the _______ culture.” There is a lack of cultural understanding which is a barrier for them in the workplace.
It is important to note that the data presented above does not apply to every person within that subgroup and that any generalizations should not be viewed as stereotypes. We offer this information to provide guidance to leaders on how the differences in values and culture might influence workplace behaviors and needs and why cultural competence is such a vital skill for leaders to effectively manage the increasingly diverse workforce.
Value differences! Live inclusively!
from USA Today
COCOA BEACH, Fla. -- Yvonne Yacoub has been a nurse for half a century.
In 50 years, she has seen her profession redefine itself to meet the challenges of change, yet continue to struggle with shortages of new practitioners.
Yacoub, 72, who has worked at Cape Canaveral Hospital here for 36 years, is decades older than the 46-year-old average age of employed registered nurses. Some veteran nurses continue to work, but many more have hung up the scrubs for good or are counting the days until retirement.
"In several years, we will see many nurses semi-retire or retire completely," said Bonnie Rudolph, vice president/chief nursing officer for Holmes Regional Medical Center in Melbourne, Fla., and Health First's chief nursing officer. "Nursing is a very physical job, and many nurses cannot continue to stand, lift patients and continue to work the required shifts."
As baby boomers age, the need for nurses will increase. Even though the number of licensed registered nurses in the United States has grown from 1.7 million in 1980 to 3.1 million today, the total is not enough to meet the expected demand. Registered nurses remain at the top of the list when it comes to employment growth, so hospital systems are being proactive in trying to retain older employees.
Recruiting more male nurses, now only 7 percent of the work force, could help ease the shortage.
Most male nurses, such as baby boomer Jim Carberry, a nurse supervisor in the intensive care unit at Holmes, enter the field as a second career. Carberry was a respiratory therapist for 20 years before becoming a nurse.
"I wouldn't say it's harder to be a nurse today. It's just different," Carberry said.
"With so much specialty nursing, we all have had to learn so many new ways of doing things," he said. "It's not just one nurse doing all of a patient's care in a day. It can be several with special skills."
While nursing schools are graduating highly skilled individuals, the experience of older workers is impossible to teach in a classroom.
Registered nurse Rebecca Madore, 23 on her third day on the job at Wuesthoff Medical Center -- Rockledge, Fla., acknowledges that the reality of nursing can be daunting.
"I learned a lot at school, but it's totally different when you're actually working the floor," she said.
Madore knew she wanted to be a nurse since she was a little girl, but for many of her colleagues, the profession is a career, not a calling.
"Each group's work ethic is different," said Suzanne Woods, vice president and chief nursing officer for Health First's community hospital division.
"The veterans and baby boomers feel almost total responsibility for the workplace and will come in on short notice and cover difficult shifts. This has always been their practice. The Gen X and Millenniums are more cognizant of home-and-life balance and strive to keep this in check."
Each generation also brings different skills, all needed to best serve patients.
"The younger nurses are very technologically advanced, but the older nurses are more connected with the patients," said Rosemary Walter, director of the medical/surgical unit at Wuesthoff in Rockledge.
Technological savvy, a given for new nursing grads and necessary for survival in the health care field today, can be difficult for older nurses to embrace.
"I feel we have an advantage over older generations in the new advancements of paperless systems, computer charting and the new diagnostics," said Michele McCray Miller, 26. "Throughout nursing school, we were constantly using simulated mannequins, computer programs and other electronic devices to master skills such as NG (nasogastric) tubes, catheters and IV skills. Older generations were not as lucky to have those resources in the classroom."
Allison Rogers has been a nurse for two years. Rogers' mother was a nurse. This member of Generation X had no doubts about her career choice.
"I know how important my job is, and I consider it an honor to care for patients the way I would want my family to be taken care of," Rogers said.