Historically, both men and women have filled the challenging and rewarding role of a nurse. It wasn’t until the Civil War, when nearly 3 million men filled the ranks of two competing American armed forces, that women began to dominate the field.
Today, over 43 million Americans are aged 65 or older – a number that is expected to double over the next 35 years. A larger elderly population means a greater need for long-term health services, and as a result, the healthcare field is one of the fastest-growing industries.
Why does this matter?
1. The U.S. is already on the verge of a nursing shortage.
The American Association of Colleges of Nursing reports that the U.S. is experiencing a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows.
Did you know only 7 percent of nurses are currently men? According to the latest National Sample Survey of Registered Nurses conducted by the Health Resources and Services Administration, the percentage of male nurses has more than doubled in the past three decades, but still lingers at 7% today. This number is expected to triple within the next few decades as the need for both male and female healthcare professionals continues to grow.
2. A diverse population needs a diverse nursing staff.
According to the American Association of Colleges of Nursing (AACN), men are enrolling in nursing programs at a higher rate compared to the past. The IOM report states that there still need to be an emphasis on gender diversification and inclusion in the workforce.
The IOM Report also states that the nursing profession “needs to continue efforts to recruit men; their unique perspectives and skills are important to the profession and will help contribute additional diversity in the workforce.” The increase in men pursuing a nursing career will help create a more diverse healthcare environment.
3. Discrimination issues must be overcome.
The idea that men cannot be nurses will never be eradicated until men take to the profession in greater numbers. While nursing is seen as a nontraditional career for men today, the stereotype must change -- nursing is simply too important of a job, and too attractive of a career.
“There are just far too many benefits that come along with nursing, such as a flexible schedule, a secure position, and high pay,” notes the website NursingWithoutBorders.org, “and so it’s therefore difficult for anyone to refuse to pursue a field that only continues to grow.”
In a Johns Hopkins Outpatient Center exam room, medical interpreter Julie Barshinger is working with a Spanish patient, a woman in her early 40s with a stocky build and a dark ponytail, who is concerned about complications related to her recent nose surgery.
But first, the woman must complete a medical history form. “¿Qué significa vertigo?” (“What is vertigo?”) she asks, as Barshinger goes through the list of symptoms on the form, verbally interpreting them from English to Spanish. Then later, “No sé qué es un soplo cardiac … ” Barshinger interprets the question — “I don’t know what a heart murmur is” — for the nurse who is preparing a nasal spray for the patient that will allow the doctor to look inside her nose.
“If it doesn’t apply to her, don’t answer it,” the nurse says kindly.
“I just want you to know that I have to interpret everything she says,” explains Barshinger, who is one of 18 full-time interpreters in Johns Hopkins Medicine International’s Language Access Services office. Part of Barshinger’s job is educating providers about her role.
Later, the nurse starts to leave the room to see another patient before the woman has completed her medical history form. “I can’t continue if you’re not in the room with me,” Barshinger says. The patient is consistently giving additional information about her symptoms: She doesn’t see well since her operation; she has some nasal bleeding; she sees the room spinning when she lies down. It’s crucial for Barshinger to communicate these potentially important details to the nurse, who stays in the room, answering questions when needed, until the form is complete.
Throughout the interaction, Barshinger knows little about the full scope of the patient’s health history. But she doesn’t need to know. “I’m not in charge of her care,” she says. “I’m only her voice. I want to make sure her voice is being heard by the right people. I’m also the voice of the provider, so she can communicate the very necessary and important information that she has to the patient.”
While Johns Hopkins, like other hospitals that receive federal funding, has been providing interpretation services for 50 years — since passage of the Civil Rights Act of 1964, which prohibits discrimination based on national origin — requests for interpreters at The Johns Hopkins Hospital have grown dramatically since 2010, jumping from 23,000 to more than 50,000 annually.
This is due in part to the slightly rising limited English proficiency population in Baltimore City, which grew by about 4,000 people between 2000 and 2012, according to the U.S. Census. Today, the hospital also serves more refugees, about 2,500 of whom settled in Baltimore City between 2008 and 2012.
But Susana Velarde, administrator for Language Access Services at Johns Hopkins Medicine International, says the increase in requests is also due to the growing understanding among health care providers that they can do a better job treating their patients with limited English proficiency with the help of interpreters.
Because they prevent communication errors, certified interpreters improve patient safety. A 2012 study in the Journal of General Internal Medicine found that patients with limited English proficiency who did not have access to interpreters during admission and discharge had to stay in the hospital between 0.75 and 1.47 days longer than patients who had an interpreter on both days. Moreover, when the interpreter has 100 hours of medical interpretation training — a qualification that researchers have found is more important than years of experience — they made two-thirds fewer errors than their counterparts with less training, according to a 2012 Annals of Emergency Medicine study.
The Language Access Services office’s full-time interpreters—who speak Spanish, Chinese-Mandarin, Korean, Russian, Arabic and Nepali — participate in an extensive two-year training program, which includes classes, tests and shadowing. Fifty percent of the team is certified; the rest are working toward certification, if available in their language. The office also has 45 medical interpreter floaters, and interpretation services are available 24/7 in person, over the phone or through a video monitor for patients with limited English proficiency who live in the Baltimore area and international residents who come to Johns Hopkins for treatment.
“We are the conduit, but also the clarifier,” says Spanish interpreter Rosa Ryan. “We are not simply repeating words but making sure the message is understood.”
For example, at the end of her visit on the otolaryngology floor, Barshinger walks to the front desk with the ponytailed Spanish woman to help her make a follow-up appointment. With Barshinger interpreting, the woman learns that she must get a Letter of Medical Necessity from her current insurer or change insurance companies before coming back to Johns Hopkins. When the administrator walks away, Barshinger checks in with the woman to make sure she understands the instructions.
“The patient might nod, but the information might not be registering,’” she says. “I try to check for clarification if I sense there is a disconnect.”
Interpreters are also cultural brokers. Yinghong Huang, a Chinese-Mandarin interpreter, remembers when a nurse in labor and delivery tried to give a Chinese patient a cup of ice water. “In China, for a woman who has just delivered a baby, we don’t want her to touch anything cold, let alone ice,” Huang explains. This is one of the many rules that Chinese women abide by for a month to help the body recover from childbirth. With Huang present, providers knew to give the patient hot water with her medicine instead.
Despite the increasing demand for interpreters, their expertise too often goes untapped, says Lisa DeCamp, assistant professor of pediatrics at the school of medicine. She is the lead author of a 2013 Pediatrics study that found that 57 percent of pediatricians who completed national surveys in 2010 still reported using family members as interpreters.
This is a bad practice for many reasons, she says. For one thing, family members often don’t have specialized knowledge of medical terminology. Moreover, both patients and family members may censor information. “If you’re talking about something that is intimate or personal and your son is translating for you, you might not want to disclose something about your sexual activity, your drug use or anything else sensitive that could be contributing to your problem,” says DeCamp, who is also a pediatrician at Johns Hopkins Bayview Medical Center.
Even physicians with basic skills in a particular language should use an interpreter to prevent misunderstandings. “I [know] some high school Spanish, but I’m nowhere near fluent, so I need an interpreter,” says Cynthia Argani, director of labor and delivery at Hopkins Bayview, where about 70 percent of her department’s patient population speaks Spanish. “It’s not fair to the patient not to use one. The message can get skewed.”
DeCamp, who has passed a test certifying her as a bilingual physician, offers a real-life example from the literature that shows how this can happen. A pediatrician with limited Spanish language skills instructed parents to use an antibiotic to treat their child’s ear infection. In Spanish, “if you use the preposition, it really means, ‘put in the ear,’” she says. “So the family was putting the specified amount of amoxicillin that should be taken by mouth in the ear. That child is not going to die from an ear infection, but he’s having pain and a fever, and the family doesn’t have clear instructions on how to provide medication.”
On Barshinger’s rounds, after her otolaryngology visit, she walks at an impressively fast pace to The Charlotte R. Bloomberg Children’s Center, where a mother recognizes her and asks her to be her interpreter. The provider who requested Barshinger’s services is not ready yet, so she has time to help.
A doctor carrying a sheaf of papers joins them in a busy hallway. She points to a long list of care instructions translated into Spanish, then begins to explain them to the mother. Because the doctor is verbally giving the instructions, Barshinger interprets. The mother needs to buy an extra-strength, over-the-counter medication and give her daughter a second medication three times a day, which she will need to “swish and spit,” the doctor says. A third medication will be applied to the daughter’s face two times a day, and a special shampoo is needed to wash her hair. Before an upcoming dentist appointment, she’ll also need to give her daughter three amoxicillin. When the doctor steps away, the mother asks Barshinger a question about her daughter’s dental visit, which Barshinger interprets when the doctor returns.
While interpreting, Barshinger stands to the side of the patient’s mother, allowing the doctor and the mother to face each other and communicate directly with one another. This simple tactic encourages providers to develop a rapport with their patients with limited English proficiency.
The goal? “To make the patient feel like the appointment is with him and not with the interpreter,” says Velarde. “The interpreter is just the voice. We want providers to have a bond with their patients, like they do when everyone is speaking English.”
Tapping the expertise of interpreters doesn’t have to complicate things for physicians, says Lisa DeCamp, a bilingual physician at Johns Hopkins Bayview Medical Center. Her advice for colleagues:
Educate the interpreter about what you’re doing so they’re not going in blind. Say a patient has severe abdominal pain. Providers can quickly explain to the interpreter that the first job is to rule out appendicitis.
Sit across from the patient, with the interpreter standing at the patient’s side, and talk directly to the patient. The goal is for the provider and the patient to feel like they have a relationship with each other despite language barriers. When possible, use short phrases to help the interpreter keep up with the conversation.
Found In Translation
Arabic translator Lina Zibdeh remembers the first time she saw the recommendation in a patient education document that leftover medications should be discarded in used cat litter or coffee grounds.
There isn’t a direct translation for this concept in Arabic, a language that is spoken in different dialects by 22 countries but written in one common form. “It can take hours and extensive research to make sure a concept like this is translated correctly,” says Zibdeh, who translates written materials, such as informed consent forms, welcome packets, care instructions, brochures, video scripts and more. In this case, Zibdeh had to add an additional sentence to explain that medications should be disposed of in this way so they are not enticing to children and pets.
While translation programs like Google Translate are readily available and easy to use, they often produce inaccurate translations, which can confuse patients and lead to poor health outcomes. This is because words in sentences can be organized in different ways from one language to another. Thus, when online programs translate those sentences from, say, English to Chinese, they can change the meaning, says Chinese-Mandarin interpreter and translator Yinghong Huang. Some English words, such as discharge, also have multiple meanings. “It’s very rare for a program to get the right meaning,” Huang says. Even Huang has to use tools, such as her cellphone and an online dictionary, to produce accurate translations.
Along with improving health outcomes, documents that are available in a patient’s own language can make him or her feel more comfortable and secure, says Zibdeh, who organized the American Translators Association’s first webinar for the Arabic Division on Arabic Medical Translation in early 2014. “It helps that patient feel closer to home,” she adds.
By JOANN S. LUBLIN
Is there such a thing as a diversity dividend?
A new study of 366 public companies in the U.S., Canada, U.K., Brazil, Mexico and Chile by McKinsey & Co., a major management consultancy, found a statistically significant relationship between companies with women and minorities in their upper ranks and better financial performance as measured by earnings before interest and tax, or EBIT.
The findings could further fuel employers’ efforts to increase the ranks of women and people of color for executive suites and boardrooms — an issue where some progress is being made, albeit slowly.
McKinsey researchers examined the gender, ethnic and racial makeup of top management teams and boards for large concerns across a range of industries as of 2014. Then, they analyzed the firms’ average earnings before interest and taxes between 2010 and 2013. They collected but didn’t analyze other financial measures such as return on equity.
Businesses with the most gender diverse leadership were 15% more likely to report financial returns above their national industry median, the study showed. An even more striking link turned up at concerns with extensive ethnic diversity. Those best performers were 35% more likely to have financial returns that outpace their industry, according to the analysis. The report did not disclose specific companies.
Highly diverse companies appear to excel financially due to their talent recruitment efforts, strong customer orientation, increased employee satisfaction and improved decision making, the report said. Those possible factors emerged from prior McKinsey research about diversity.
McKinsey cited “measurable progress” among U.S. companies, where women now represent about 16% of executive teams — compared with 12% for U.K. ones and 6% for Brazilian ones. But American businesses don’t see a financial payoff from gender diversity “until women constitute at least 22% of a senior executive team,’’ the study noted. (McKinsey tracked 186 U.S. and Canadian firms.)
The study marks the first time “that the impact of ethnic and gender diversity on financial performance has been looked at for an international sample of companies,’’ said Vivian Hunt, a co-author, in an interview. Yet “no company is a high performer on both ethnic diversity and on gender,’’ she reported.
And “very few U.S. companies yet have a systematic approach to diversity that is able to consistently achieve a diverse global talent pool,” Ms. Hunt added.
McKinsey has long tracked workplace diversity. A 2007 study, for instance, uncovered a positive relationship between corporate performance and the elevated presence of working women in European countries such as the U.K., France and Germany.
The UCLA Health Interpreter/Translation and Deaf Services program provides services to all UCLA Health inpatients, outpatients, and their relatives at no cost. Every attempt is made to provide services in any language. The service will be provided by an in-person interpreter, video conference or by telephone.
By Caitlyn Coverly
A few weeks ago, senior vice-president Laszlo Bock took to Google’s official blog to publicly share the company’s employee demographics, revealing a predominately white male workforce and admitting a reluctance to come forward with the data earlier.
The announcement was deemed a groundbreaking disclosure, because U.S. companies are not obligated to make their workforce demographics public. However, citing that transparency is key to finding a solution, Mr. Bock wrote, “Simply put, Google is not where we want to be when it comes to diversity … our efforts, including going public with these numbers, are designed to help us recruit and develop the world’s most talented and diverse people.”
In Canada, many companies have come to realize the strategic importance of a diverse workforce and, much like Google, have initiated comprehensive diversity strategies. But developing and executing those strategies is no easy feat.
Financial institutions were among the first organizations to act on the long-term demographic and labour-market significance of Canada’s Employment Equity Act, which requires special measures and the accommodation of differences for four designated groups in Canada: women, aboriginal peoples, persons with disabilities and members of visible minorities.
“As a regulated organization, we looked at diversity from a compliance perspective at first,” said Norma Tombari, director of Global Diversity at the Royal Bank of Canada. “However, with the appointment of Gordon Nixon as CEO in 2001, came the revitalization of a very robust diversity strategy; what we refer to as our Diversity Blueprint.”
RBC has been recognized in recent years for its achievements in diversity and inclusion practices. Its 2013 Diversity and Inclusion Report shows RBC’s workforce is comprised of 64% women, 31% visible minorities, 4.6% people with disabilities and 1.5% aboriginal persons — numbers that are fairly representative of the general workforce in Canada.
So, how do companies reach this level?
“Education becomes key when you are managing a multicultural and multigenerational workforce,” Ms. Tombari said. “There will be unconscious bias and blindspots, as well as a lack of cultural understanding and awareness throughout all levels of the organization, so it is our job to put programs in place that counter those attitudes.”
RBC takes a multifaceted approach, offering employees various workshops and webcasts on raising cultural acumen, as well as access to self-assessment tools where employees can rate their own level of understanding.
“The goal is to provide learning that is focused on the topic of diversity and inclusion and the rest is about embedding it in the cultural landscape of an organization,” Ms. Tombari said.
Canada’s energy giant Suncor is at a different stage of the diversity and inclusion-implementation process. After merging with Petro-Canada in 2009, changes in corporate structure created a tidal wave of new systems and strategies.
“With so much change and turnover, some things — such as our diversity strategies — got pushed to the side,” said Kelli Stevens, a company spokeswoman.
The company’s 2012 diversity report shows Suncor’s workforce is comprised of 23% women, 11.1% visible minorities and 2.7% Aboriginal persons. “We don’t look at our current percentages and think that’s okay,” Ms. Stevens said. “We are, and always will be, trying to improve them.”
Suncor, similar to Google, faces the uphill battle of recruiting from a rather homogenous talent pool. “We are a male-dominated field,” Ms. Stevens said.
In 2011, women earned only 16.5% of degrees/diplomas categorized within the fields of architecture, engineering and related technologies, Statistics Canada data shows. In fields relating to mathematics, computer and information sciences, women earned only 27% of degrees/diplomas. However, out of those pursuing post-secondary education, women account for more than half at 58%.
Suncor is in the process of developing a strategy that makes those desires a reality. Part of that strategy is supporting various programs that work to broaden the talent pool.
In March 2013, the Suncor Energy Foundation approved a five-year, $1.5-million program aimed at helping Women Building Futures (WBF), an organization that specializes in encouraging and preparing women for careers in skilled trades, to refine its business model and expand its impact.
Suncor also provides funding for Actua, the Ottawa-based national science, technology engineering, and mathematics (STEM) program, to help develop and deliver STEM programs to Aboriginal youth across Canada.
“Many of the communities we have a strong presence in have a high representation of aboriginal people,” Ms. Stevens said. “We want to be reflective of where we work and build strong relationships with those communities.”
Echoed in both companies’ strategies is the hard fact that implementing a diversity strategy is not easy; it is a long-term commitment with results as well as challenges at all stages.
Susan Black, managing partner at Crossbar Group, and Keith Caver, North America practice leader for talent management and organizational alignment at Towers Watson, offer the following advice for corporations undergoing a significant change in workforce demographics:
Inclusion is about making the numbers count: “Companies tend to jump right into programs without clearly defining their goals,” Ms. Black said. “This is often the result of a disconnect in their understanding of their own issues. In an ideal world, having a 50/50 split between male and female employees would be considered success, however, companies really need to look at their corporate structure and their client base to determine if that is what is best for their organization.”
Don’t define diversity too narrowly: “Companies tend to frame all diversity efforts around the four groups and they end up leaving a lot of white space,” Ms. Black said. “As a result people get left out of the diversity conversation. We are all a part of diversity and the thoughts and opinions of everyone should be valued in an organization.”
Culture isn’t something you can change overnight: “It typically goes one of two ways,” she said. “Either organizations declare victory too soon or they fall prey to diversity fatigue. The fact is it takes a long time to change workplace cultures. Don’t rush the process.”
You must address cultural differences and unconscious bias: “It is not good enough to just have the people in place,” Mr. Caver said. “There is an array of information available about shifting demographics and leveraging human capital. There must be an unwavering commitment to educating and preparing leaders so companies are not held back by hidden biases.”
By: Alice Park
People who speak more than one language tend to score higher on memory and other cognitive function tests as they get older, but researchers haven’t been able to credit bilingualism as the definitive reason for their sharper intellects. It wasn’t clear, for example, whether people who spoke multiple languages have higher childhood intelligence, or whether they share some other characteristics, such as higher education overall, that could explain their higher scores.
Now, scientists think they can say with more certainty that speaking a second language may indeed help to improve memory and other intellectual skills later in life. Working with a unique population of 853 people born in 1936 who were tested and followed until 2008-2010, when they were in their 70s, researchers found that those who picked up a second language, whether during childhood or as adults, were more likely to score higher on general intelligence, reading and verbal abilities than those who spoke one language their entire lives. Because the participants, all of whom were born and lived near Edinburgh, Scotland, took aptitude tests when they were 11, the investigators could see that the effect held true even after they accounted for the volunteers’ starting levels of intelligence.
Reporting in the Annals of Neurology, they say that those who began with higher intellect scores did show more benefit from being bilingual, but the improvements were significant for all of the participants. That’s because, the authors suspect, learning a second language activates neurons in the frontal or executive functions of the brain that are generally responsible for skills such as reasoning, planning and organizing information.
Even more encouraging, not all of the bilingual people were necessarily fluent in their second language. All they needed was enough vocabulary and grammar skills in order to communicate on a basic level. So it’s never too late to learn another language – and you’ll be sharper for it later in life.
2014 Diversity Holidays
The United States is rich with diversity, which is reflected in the observances celebrated by its various cultures and populations. Knowledge of the following diversity holidays and celebrations can enhance your workplace diversity and inclusion efforts. (Please note: All dates are for 2014.)
January 6 is Epiphany, a holiday recognizing the visit of the three wise men to the baby Jesus 12 days after his birth. The holiday is observed by both Eastern and Western churches.
January 14 is Makar Sankranti, a major harvest festival celebrated in various parts of India.
January 14 is also Eid Milad Un Nabi, an Islamic holiday commerating the birthday of the prophet Muhammad. During this celebration, homes and mosques are decorated, large parades take place, and those observing the holiday participate in charity events.
January 15 (sunset) – January 16 (sunset) is Tu B'shvat, a Jewish holiday recognizing "The New Year of the Trees." It is celebrated on the fifteenth day of the Hebrew month of Shevat. In Israel, the flowering of the almond tree usually coincides with this holiday, which is observed by planting trees and eating dried fruits and nuts.
January 16 is Mahayana New Year celebrated on the first full-moon day in January by members of the Mahayana Buddhist branch.
January 19 is World Religion Day. This day is observed by those of the Baha’i faith to promote interfaith harmony and understanding.
Third Monday in January (January 20) is Martin Luther King Day, commemorating the birth of Martin Luther King, Jr., the recipient of the 1964 Nobel Peace Prize and an activist for non-violent social change until his assassination in 1968.
January 18-25 is the Week of Prayer for Christian Unity. During the week, Christians pray for unity between all churches of the Christian faith.
January 26 is Republic Day of India. This day recognizes the date the Constitution of India came into law in 1950, replacing the Government of India Act of 1935. This day also coincides with India's 1930 declaration of independence.
January 31 is the birthday of Guru Har Rai, the seventh Sikh guru.
January 31 also marks the start of the Asian Lunar New Year, celebrated by many Asian groups including Chinese, Vietnamese, and Koreans. This year is the Year of the Wooden Horse.
January 31-February 14 marks the Chinese New Year. This year is the Year of the Wooden Horse. Chinese New Year is the most important holiday in the Chinese lunisolar calendar and is recognized by gift giving, parades, decorations, and feasting. The celebration culminates with the Lantern Festival on February 14.
February is Black History Month in the United States and Canada. Since 1976, the month has been designated to remember the contributions of people of the African Diaspora.
February 8 is Nirvana Day, the commemoration of Buddha’s death at the age of 80, when he reached the zenith of Nirvana. February 15 is an alternative date of observance.
February 17 is President’s Day, originally established to honor Presidents Washington and Lincoln, it now serves as a reminder of the contributions of all U.S. presidents.
February 26 – March 1 are Intercalary Days for people of the Baha’i faith. At this time, days are added to the Baha’i calendar to maintain their solar calendar. Intercalary days are observed with gift giving, special acts of charity, and preparation for the fasting that precedes the new year.
February 27 is Mahashivratri, a Hindu holiday that honors Shiva, one of the Hindu deities.
March is Women’s History Month. Started in 1987, Women’s History Month recognizes all women for their valuable contributions to history and society.
March is also National Mental Retardation Awareness Month, which was established to increase awareness and understanding of issues affecting people with mental retardation and other developmental disabilities.
March is National Multiple Sclerosis Education and Awareness Month. It was established to raise public awareness of the autoimmune disease that affects the brain and spinal cord and assist those with multiple sclerosis in making informed decisions about their health care.
March 2 is Losar, the Tibetan Buddhist New Year. Losar, which means new year in Tibetan, is considered the most important holiday in Tibet.
March 5 is Ash Wednesday, the beginning of Lent in the Christian faith. As a display of atonement, ashes are marked on worshippers. Lent, which is observed during the seven weeks prior to Easter, is a time of reflection and preparation for the Holy Week and is observed by fasting, charitable giving, and worshipping.
March 8 is International Women’s Day. First observed in 1911 in Germany, it has now become a major global celebration honoring women’s economic, political, and social achievements.
March 13 – April 15 is Deaf History Month. This observance celebrates key events in deaf history, including the founding of Gallaudet University and the American School for the Deaf.
March 15 (sunset)- March 16 (sunset) is Purim, a Jewish celebration that marks the time when the Jewish community living in Persia was saved from genocide. According to the Book of Esther, King Ahasuerus’s political advisor planned to have all the Jews killed; however, his plot was foiled when Esther, one of the king’s wives, revealed her Jewish identity. On Purim, Jewish people offer charity and share food with friends.
March 16 is Magha Puja Day, a Buddhist holiday that marks an event early in the Buddha’s teaching life when a group of 1,250 enlightened saints, ordained by the Buddha, gathered to pay their respect to him.
March 17 is St. Patrick’s Day, a holiday started in Ireland to recognize St. Patrick, the patron saint of Ireland, who brought Christianity to the country in the early days of the faith.
March 17 is also Holi, a Hindu and Sikh spring religious festival observed in India, Nepal, and Sri Lanka, along with other countries that have large Hindu and Sikh populations. People celebrate Holi by throwing colored powder and water at each other. Bonfires are lit the day before in the memory of the miraculous escape that young Prahlad accomplished when Demoness Holika carried him into the fire.
April is Celebrate Diversity Month, started in 2004 to recognize and honor the diversity surrounding us all. By celebrating differences and similarities during this month, organizers hope that people will get a deeper understanding of each other.
April is Autism Awareness Month, established to raise awareness about the developmental disorder that affects children's normal development of social and communication skills.
April 2 is World Autism Awareness Day, created to raise awareness of the developmental disorder around the globe.
April 8 is Ram Navami, a Hindu festival commemorating the birth of Lord Rama, a popular deity in Hinduism. People celebrate the holiday by sharing stories and visiting temples.
April 13 is Palm Sunday, a holiday recognized by Christians to commemorate the entry of Jesus in Jerusalem. It is the last Sunday of Lent and the beginning of the Holy Week.
April 14 (sunset)- April 22 (sunset) is Passover, a Jewish holiday celebrated each spring in remembrance of the Jews’ deliverance out of slavery in Egypt in 1300 B.C. On the first two days of Passover, a traditional Seder is eaten and the story of deliverance is shared.
April 18 is Good Friday, celebrated by Christians to commemorate the execution of Jesus by crucifixion and is recognized on the Friday before Easter.
April 20 is Easter, a holiday celebrated by Christians to recognize Jesus’ return from death after the crucifixion. It is considered to be the most important Christian holiday.
May is Asian-American and Pacific Islander Heritage Month in the United States. The month of May was chosen to commemorate the immigration of the first Japanese to the United States on May 7, 1843, and to mark the anniversary of the completion of the transcontinental railroad on May 10, 1869. The majority of the workers who laid the tracks on the project were Chinese immigrants.
May is also Older Americans Month, established in 1963 to honor the legacies and contributions of older Americans and to support them as they enter their next stage of life.
May 21 is World Day for Cultural Diversity for Dialogue and Development, a day set aside by the United Nations as an opportunity to deepen our understanding of the values of cultural diversity and to learn to live together better.
May 25 is Lailat al Mairaj. On this day, Muslims celebrate Prophet Muhammad’s night journey from Makkah to Jerusalem and his ascension to heaven.
June is Lesbian, Gay, Bisexual, and Transgender Pride Month, established to recognize the impact that gay, lesbian, bisexual, and transgender individuals have had on the world. Gay, lesbian, and bisexual groups celebrate this special time with pride parades, picnics, parties, memorials for those lost to hate crimes and HIV/AIDS, and other group gatherings. The last Sunday in June is Gay Pride Day.
June 12 is Lailat al Bara’a, celebrated as the night of forgiveness by Muslims.
June 14 is Flag Day in the United States. This day is observed to celebrate the history and symbolism of the American flag.
June 15 is Native American Citizenship Day. This observance commemorates the day in 1924 when the United States Congress passed legislation recognizing the citizenship of Native Americans.
On June 16, Sikhs observe the Martyrdom of Guru Arjan Dev. Guru Arjan Dev was the fifth Sikh guru and the first Sikh martyr.
June 19 is Juneteenth, also known as Freedom Day or Emancipation Day. It is observed as a public holiday in 14 U.S. states. This celebration honors the day in 1865 when slaves in Texas and Louisiana finally heard they were free, two months after the end of the Civil War. June 19, therefore, became the day of emancipation for thousands of Blacks.
June 19 is also Corpus Christi, a Catholic celebration in honor of the Eucharist.
The last Sunday in June (June 29) is Lesbian, Gay, Bisexual, Transgender (LGBT) Pride Day in the United States.
June 29 marks the beginning of Ramadan, the Islamic month of fasting. Muslims abstain from eating, drinking, and sexual activity from dawn until sunset, in efforts to teach patience, modesty, and spirituality. This year, the observance lasts until July 29.
On July 9, the Martyrdom of the Bab, Baha'is observe the anniversary of the Bab's execution in Tabriz, Iran, in 1850.
July 11 is World Population Day, an observance established in 1989 by the Governing Council of the United Nations Development Programme. The annual event is designed to raise awareness of global population issues.
July 13 is Asala–Dharma Day, which celebrates the anniversary of the start of the Buddha’s teaching.
July 23 is the birthday of Haile Selassie I, the Emperor of Ethiopia, who the Rastafarians consider to be God and their Savior.
July 26 is Disability Independence Day, which marks the anniversary of the 1990 signing of the Americans with Disabilities Act.
July 29 is Eid al Fitr, the Muslim celebration commemorating the ending of Ramadan. It is a festival of thanksgiving to Allah for enjoying the month of Ramadan. It involves wearing one's finest clothing, saying prayers, and nurturing understanding of other religions.
August 4 (sunset) - August 5 (sunset) Tisha B’ Av, an annual fasting day, is observed to commemorate the tragedies that have befallen the Jewish people.
August 6 is Transfiguration, a holiday recognized by Orthodox Christians to celebrate when Jesus became radiant, and communed with Moses and Elijah on Mount Tabor. To celebrate, adherents have a feast.
August 9 is International Day of the World's Indigenous Peoples. The focus this year is "Indigenous peoples building alliances: Honouring treaties, agreements and other constructive arrangements."
August 10 is Raksha Bandhan, a Hindu holiday commemorating the loving kinship between a brother and a sister. Raksha means protection in Hindi, and symbolizes the longing a sister has to be protected by her brother. During the celebration, a sister ties a string around her brother's (or brother-figure’s) wrist, and asks him to protect her. The brother usually gives the sister a gift and agrees to protect her for life.
August 12 is Pioneer Day, observed by the Mormons to commemorate the arrival in 1847 of the first Latter Day Saints pioneer in Salt Lake Valley.
August 17 is Marcus Garvey Day, which celebrates the birthday of the Jamaican politician and activist who is revered by Rastafarians. Garvey is credited with starting the Back to Africa movement, which encouraged those of African descent to return to the land of their ancestors during and after slavery in North America.
August 26 is Women’s Equality Day, which commemorates the August 26, 1920 certification of the 19th Amendment to the United States Constitution, which gave women the right to vote. Congresswoman Bella Abzug first introduced a proclamation for Women’s Equality Day in 1971. Since that time, every president has published a proclamation recognizing August 26 as Women’s Equality Day.
August 28 is Janmashtami, a Hindu holiday recognizing Krishna’s birthday. Krishna is the highest god in the Hindu faith.
September 10 is Paryushana, the most revered Jain festival comprising eight or ten days of fasting and repentance.
September 11 is the Ethiopian New Year. Rastafarians celebrate the New Year on this date and believe that Ethiopia is their spiritual home, a place they desire to return to.
September 15 – October 15 is Hispanic Heritage Month. This month corresponds with Mexican Independence Day, which is celebrated on September 16, and recognizes the revolution in 1810 that ended Spanish dictatorship.
September 24 (sunset) – September 26 (nightfall) is Rosh Hashanah, a holiday recognizing the Jewish New Year. It is the first of the Jewish High Holy Days, and is marked by abstinence, prayer, repentance, and rest.
October is National Disability Employment Awareness Month. This observance was launched in 1945 when Congress declared the first week in October as "National Employ the Physically Handicapped Week." In 1998, the week was extended to a month and renamed. The annual event draws attention to employment barriers that still need to be addressed.
October is also LGBT History Month, a U.S. observance started in 1994 to recognize lesbian, gay, bisexual, and transgender history and the history of the gay rights movement.
October 3 (sunset)- October 4 (sunset) is Yom Kippur. This holiday is the holiest day on the Jewish calendar and is a day of atonement marked by fasting and ceremonial repentance.
October 4 marks the beginning of Dussehra (Dasera), a ten day festival celebrated by Hinus to recognize Rama's victory over evil.
October 8 (sunset)- October 15 (sunset) is the Jewish holiday of Sukkot. It is a time of rememberance of the fragile tabernacles that Israelites lived in as they wandered the wilderness for 40 years. The first day of the holiday is celebrated with prayers and special meals.
October 11 is National Coming Out Day. For those who identify as lesbian, gay, bisexual, or transgender, this day celebrates coming out and the recognition of the 1987 march on Washington for gay and lesbian equality.
Second Monday in October is National Indigenous People’s Day, which recognizes 500 years of resistance and the continued existence of North American Indigenous people. This is celebrated in lieu of Columbus Day.
October 20 is Birth of the Bab, a holiday celebrated by the Baha'i recognizing the birth of the founder of the Baha'i faith.
October 23 marks the beginning of Diwali (the festival of lights), celebrated by Sikhs, Hindus, and Jains. The holiday is observed with decorating homes with lights and candles, setting off fireworks, and distributing sweets and gifts.
November is National Native American Heritage Month, which celebrates the history and contributions of Native Americans.
November 3 is Ashura, a holiday recognized by Muslims to mark the martyrdom of Hussain. It also commemorates that day Noah left the ark and Moses was saved from the Egyptians by God.
November 11 is Veterans Day, an annual U.S. federal holiday honoring military veterans. The date is also celebrated as Armistice Day or Remembrance Day in other parts of the world and commemorates the ending of the first World War in 1918.
November 12 is the Birth of Baha’u’llah, a day on which members of the Baha’i faith celebrate the birthday of the founder of the Baha’i religion.
November 20 is Transgender Day of Remembrance, established in 1998 to memorialize those who have been killed as a result of transphobia and raise awareness of the continued violence endured by the transgender community.
November 23 is Feast of Christ the King, the last holy Sunday in the western liturgical calendar. This day is observed by the Roman Catholic Church, as well as many Anglicans, Lutherans, and other mainline Protestants.
December 1 is World AIDS Day, which was created to commemorate those who have died of AIDS, and to acknowledge the need for a continued commitment to all those affected by the HIV/AIDS epidemic.
December 8 is Bodhi Day, a holiday observed by Buddhists to commemorate Gautama’s enlightenment under the Bodhi tree at Bodhgaya, India.
December 10 is International Human Rights Day, established by the United Nations in 1948 to commemorate the anniversary of the Universal Declaration of Human Rights.
December 12 is Feast Day at Our Lady of Guadalupe. This day commemorates the appearance of the Virgin Mary near Mexico City in 1531.
December 16-24 is Las Posadas, a nine-day celebration in Mexico commemorating the trials Mary and Joseph endured during their journey to Bethlehem.
December 16 (sunset) - December 24 (sunset) is Hanukkah (Chanukah). Also known as the Festival of Lights, it is an eight-day Jewish holiday recognizing the rededication of the Holy Temple in Jerusalem. It is observed by lighting candles on a Menorah—one for each day of the festival.
December 25 is Christmas, the day that Christians associate with Jesus’ birth.
December 26 – January 1 is Kwanzaa, an African-American holiday started by Maulana Karenga in 1966 to celebrate universal African-American heritage. It is observed by lighting candles to represent each of the holiday’s seven principles, libations, feasting, and gift giving.
Source: Diversity Best Practices
Barbara Nichols, a national nurse leader who broke through color barriers to become the first Black president of the American Nurses Association, likes to point out that she entered the profession in its dinosaur days—before the advent of cardio-pulmonary resuscitation, intensive care units, and pre-mixed narcotics.
It was also prehistoric in another way; Nichols became a nurse in the 1950s, when a national system of institutionalized discrimination kept minorities from entering and advancing in nursing.
In those days, many hospitals were segregated, as were many nursing schools. Those schools that weren’t often capped the number of students from racial, ethnic, and religious minority backgrounds with rigid quota systems. Few minority nurses earned baccalaureate or advanced degrees, and fewer still rose to become leaders of the profession.
But Nichols overcame those hurdles and eventually made history as the first Black nurse to hold national and state-level nursing leadership positions. Throughout her career, she has been helping others from underrepresented backgrounds enter and advance in the profession—a mission she continues at the age of 75 as director of a diversity initiative in her home state of Wisconsin.
“My whole career has been spent raising the issue of the need for racial and ethnic inclusion and looking for specific ways to involve and include more minorities in nursing,” she says. “That has been my passion.”
Born during tail end of the Great Depression and raised in Maine, Nichols was active in children’s theater and considered becoming an actor; but she ultimately decided against it because of limited professional acting roles for Blacks. Instead, she pursued a different, more “practical” dream, and became a nurse. “I was born in the late 30s, and the job market and occupations for Blacks were very limited,” she recalls. “Pragmatically, nursing was one of the fields you could go into.”
Not that it was easy. Nichols landed a highly coveted spot at Massachusetts Memorial School of Nursing in Boston, where she was one of only four Black students in her class. She went on to earn her bachelor’s degree in nursing at Case Western Reserve University, where she was one of two Black students in her class. She took a job at Boston Children’s Hospital, where she was the only Black registered nurse (RN) on staff. She then joined the U.S. Navy, where she was one of a handful of Black nurses on a staff of 150.
But life as “a speck of pepper in a shaker of salt,” as one reporter put it, never held her back; rather, it propelled her forward as a nurse leader and advocate for diversity in nursing. As a young staff nurse, she recalls, her suggestions were ignored because of her race. “Nurses would say, ‘Well, who are you to tell us what to do,’” she recalls. “That’s when I decided to get into a leadership role. It was a direct result of being ignored, and of the impression I got that my ideas weren’t worthy of consideration because I was Black.”
And lead she did. In 1970, Nichols became the first Black woman to serve as president of the Wisconsin Nurses Association. To this day, she is still the only ethnic minority to serve as the organization’s president in its more than 100 years of existence. In 1979, Nichols went on to become the first Black president of the American Nursing Association—an organization that once banned Blacks—and served for two terms. In 1983, she became the first Black woman to hold a cabinet-level position in the state of Wisconsin when she was appointed to serve as secretary of the Wisconsin Department of Regulation and Licensing. She was named a Living Legend by the American Academy of Nurses in 2010.
“I’ve been a role model who says that Blacks can achieve and can participate in meaningful ways in issues that are central to the profession,” she says.
A Long Way to Go
A lot has changed since Nichols first entered the profession. Nursing schools are no longer segregated and no longer use quotas. Employers are working harder to recruit and retain nurses of color, she adds, and more nurses from underrepresented backgrounds are seeking higher degrees.
But there’s still a ways to go before the nursing workforce reflects the increasingly diverse population it serves. The RN workforce is 75 percent White, almost 10 percent Black. and less than 5 percent Latino, according to a 2013 report by the Health Resources and Services Administration. A more diverse nursing workforce is needed to provide culturally relevant care, improve interaction and communication between providers and patients, and narrow health disparities, according to the Institute of Medicine (IOM).
After six decades in nursing, Nichols is not giving up. A visiting associate professor at the University of Wisconsin-Milwaukee College of Nursing, Nichols recently took a position as project coordinator for the Wisconsin Action Coalition to help diversify the state’s nursing workforce. Action Coalitions are the driving force of the Future of Nursing: Campaign for Action, which is backed by the Robert Wood Johnson Foundation and AARP and aims to transform the nursing profession to improve health and health care. It is grounded in anIOM report on the future of nursing released in 2010.
“Our goal is to embed, and ground, all our activities with a diversity component,” Nichols said. To do that, she and her colleagues are gathering data about the diversity of Wisconsin’s nursing workforce, partnering with interested parties, raising money to sustain efforts to diversify the profession, and analyzing ways to promote diversity through policy and practice.
She also supports the Campaign’s national efforts to implement diversity planning, recruit and retain students and faculty from underrepresented groups, and promote advanced education and leadership development among minority nurses.
“We have a big job ahead of us,” Nichols says, adding: “Prejudice is still out there.”
by Crystal Loucel
Because minorities are more likely to receive less and lower-quality health care and suffer higher mortality rates from cancer, heart disease, diabetes, HIV/AIDS and mental health illnesses than their Caucasian counterparts, there have long been calls to increase the number of minority providers to reduce these health disparities. Numerous studies have shown that patients are more likely to receive quality preventive care and treatment when they share race, ethnicity, language and/or religious experience with their providers.
The 2010 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health found that a diverse workforce – and the diverse perspective it provides – contributes to enhanced communication, health care access, patient satisfaction, decreased health disparities, improved problem solving for complex problems and innovation. Moreover, the Health Resources and Services Administration (HRSA) has found that minorities could improve access to care in underserved areas more than nonminority providers (see The Rationale for Diversity in the Health Professions: A Review of the Evidence [HRSA, 2006]).
Yet minorities are still under-represented in the health care workforce generally and in nursing in particular. In 1908, when Israel Zangwill popularized the term melting pot to describe the American population, it was 89 percent white, 10 percent black and less than 1 percent Indian, Chinese, Japanese and “others.” Today’s melting pot is considerably more diverse, composed of more than one-third racial and ethnic minorities; moreover, the United States Census Bureau expects that portion to be more than half by 2050.
“Today the nursing workforce does not adequately reflect the diversity in the population including gender,” says Beverly Malone, CEO of the National League for Nursing. Latinos, African Americans, American Indians and Native Alaskans compose only 7.6 percent of the nursing workforce, a dismal figure compared to the 25 percent in the general population. UCSF’s nursing student population is doing a bit better – in 2009, the latest year for which data are available, these same groups composed 16 percent of the UCSF nursing student body – but there is certainly room for improvement. When Asian Americans are included, a 2008 HRSA report showed that minorities make up 35 percent of the total population but only 17 percent of the nursing population.
UCSF has been trying to respond to the 2004 Sullivan Commission Report, titled Missing Persons: Minorities in the Health Professions, which recommended that health profession schools hire diversity program managers and develop plans to ensure institutional diversity, including providing educational support, commitment, role modeling and dedicated recruitment. Currently, Judy Martin-Holland serves as associate dean for Academic Programs and Diversity Initiatives at UCSF School of Nursing, a role in which she recruits minority students, seeks to integrate more diversity in the curriculum, and offers support programs for minority students. In addition, after years of medical student advocacy, Renee Navarro, vice chancellor Diversity and Outreach, created the School’s first Multicultural Resource Center. Though the center currently has no budget, its director, Mijiza Sanchez, hopes to advocate for the types of programs that the commission has recommended, such as the mentoring that Sanchez herself offers students.
It’s also important to remember that minorities often face barriers to financing their education and would benefit from scholarships, loan forgiveness and tuition reimbursement programs.
In addition, universities should link to minority professional organizations to promote enhanced admissions policies, cultural competency training and enhanced minority student recruitment. For example, as volunteer past president of the San Francisco Bay Area chapter of the National Association of Hispanic Nurses (NAHN), I am proactively connecting to the UCSF student group Voces Latinas Nursing Student Association (VLNSA) to do just that. VLNSA is open to students of all ethnicities who are interested in working with the Latino community; the ability to speak Spanish is not required. And organizations like NAHN typically offer reduced student membership and benefits such as mentoring, résumé revision, job postings, volunteer opportunities, networking and more for students, without requiring them to be from any particular racial or ethnic background.
That last point is important, because no matter how diverse your workforce, the goal is to create an environment that is inclusive and allows everyone to express themselves. As minorities, we cannot address our specific health issues alone; rather, this is a challenge for all health care providers. Given what we know about diversity and its importance to health care, we must partner to creatively address and embrace an ever more diverse future.
Crystal Loucel is a second-year master’s student at UCSF School of Nursing and past president of the San Francisco Bay Area chapter of the National Association of Hispanic Nurses. She has a master’s in public health, specializing in global health, from Loma Linda University; has served as an AmeriCorps and Peace Corps volunteer in Honduras; was one of eight RNs chosen in 2012 for a General Electric-National Medical Fellowship in primary care; and is a 2012 scholarship recipient from the Deloras Jones Kaiser Foundation. An earlier version of this piece appeared in the UCSF student newspaper, Synapse.