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Obama orders improved workforce-diversity effort

 

President Obama on Thursday issued an executive order requiring government agencies to develop plans for improving federal workforce diversity.

The long-awaited executive order directs a group of high-ranking officials to create a government-wide plan, followed by specific plans in each agency. It marks the highest-profile response to a problem that has been on the administration’s radar: Whites still hold more than 81 percent of senior pay-level positions.

“The federal government has a special opportunity to lead by example,” John Berry, director of the Office of Personnel Management, said in a conference call. “We will only succeed in our critical mission with a workforce that hails from, represents and is connected to the needs of every American community.”

The order creates a framework, but the details have not been worked out. Instead of creating a new administrative body, as with Obama’s 2009 executive order on veterans’ employment, this initiative will look to a council of deputy agency chiefs. OPM, the Office of Management and Budget and the U.S. Equal Employment Opportunity Commission will participate.

That group will be responsible for creating a government-wide plan within 90 days. According to the order, after that plan is released, each agency must present its own specific diversity plan within 120 days. The efforts must reflect initiatives on a number of fronts, including recruitment, training and promotion.

Berry said that the executive order elevates the issue of diversity to a level of attention that will prevent this initiative from falling by the wayside, as other efforts have. “Rather than create a new structure, the president has built upon an existing structure at the very highest level that will get attention and scrutiny,” he said.

Officials did not commit to specific goals or measures, which they said will vary by agency.

“We are trying to say that this is something that should be folded into and a part of everything you do,” Deputy Director Christine Griffin said.

According to the latest Federal Equal Opportunity Recruitment Program Report, women hold 31 percent of senior positions, African Americans 7 percent and Latinos 4 percent.

At an EEOC conference in Baltimore this week, the commission and OPM released a joint memorandum vowing “the most rigorous possible enforcement” of equal-pay laws for federal employees. The memo noted that while the gender pay gap had fallen from 28 cents on the dollar in 1987, it still stood at 11 cents in 2007.

Increasing workplace diversity has been among Berry’s top three long-term goals — alongside controlling health-care costs and improving the federal pay system — since he took office in 2009.

What do you think of this Executive Order? Please share your thoughts with us.

Federal projections for job openings through 2016. Registered Nurses lead the way.

 

The U.S. workforce is expected to become more diverse by 2018. Among racial groups, Whites are expected to make up a decreasing share of the labor force, while Blacks, Asians, and all other groups will increase their share (Chart 2). Among ethnic groups, persons of Hispanic origin are projected to increase their share of the labor force from 14.3 percent to 17.6 percent, reflecting 33.1 percent growth.

overview chart 02 small resized 600

July - August 2011. Largest Listings Out of 5,400,000 American Jobs Listed Across the Internet

• Physical Therapists
• Occupational Therapists
• Assistant Managers
• Registered Nurses - Licensed RNs
• Crew Positions - Casual Dining and Fast Food
• Salespeople
• Shift Supervisors - Food and Other Industries
• Cashiers/Sales Clerks
• Customer Service Jobs
• Pharmacy Technicians
• Merchandisers
• Event Specialists
• General Managers
• Photo Lab Supervisors
• Project Managers - IT

Federal Projections for "Most Job Openings" Expected through 2016

• Registered Nurses (RNs)
• Retail Salespersons
• Customer Service Representatives
• All Food Preparation & Service
• Office Clerks
• Personal & Home Care Aides
• Home Health Aides (HHAs)
• Postsecondary Teachers
• Janitors and Cleaners, except Housekeepers
• Nursing Aides & Orderlies
• Bookkeeping, Accounting, And Auditing Clerks
• Waitstaff
• Child Care Workers
• Executive Secretaries & Administrative Assistants
• Computer Software Applications Engineers

The CAN (Chinese American Nurses) Sisters

 

In 2003, a small group of Chinese-American nurses, all working in the Kansas City area, came together to share experiences, learn from one another and encourage each other. Today, the CAN (Chinese American Nurses) Sisters meet twice a month as we continue to share our nursing and American life experiences. Our common denominator is that English is our second language. We feverishly try to improve our listening, writing, and speaking skills in English. We especially want to reduce our translation and response time during conversations. We also have in common that we all work extremely hard; we are reliable, friendly, caring, and happy at work.
  Recently, we met for one of our regular meetings. We sat in a circle in my living room and began with introductions. On that particular night we had three overseas visitors from China who were part of an exchange program at Children’s Mercy Hospitals and Clinics in Kansas City. The evening turned out to be an especially moving night for all of us. We each told the story of our life’s challenges and triumphs. We all talked of our struggles to memorize the names of cells, medications, and tiny germs in English! It was fun night.

After my guests left, I started cleaning the dishes. As I did, I suddenly was struck with the thought: How could I ever take these amazing, beautiful nurses for granted? I am so lucky to know them! At the end of every meeting, we feel charged and ready to face the world together. CAN nurses only need opportunities to prove themselves as great nurses. Here are a few of their stories:

SS – She was a nurse in China. After arriving in the United States, she started studying for the nursing board while also raising a child and working at local restaurants to help support her family. She studied hard and passed the nursing board. She then enrolled at Johnson County Community College for an RN refresher course. She completed her clinical RN training at a local specialty hospital. Her clinical instructor noticed how hard she worked and her solid knowledge of nursing. The instructor’s immediate supervisor then hired her as soon as she completed her clinical training practice. SS has being doing very well at that local specialty hospital for more than five years. Doctors trust her and her nursing judgment. She consistently receives praise from the doctors and other staff members.

FF – She also was a nurse in China. She studied and passed the nursing board soon after SS passed the board. FF went on and studied many more nursing specialties, and earned herself national certification in infusion nursing and wound care. She was a supervisor at a local nursing home with multiple certified nursing skills. She was doing an outstanding job in nursing.

GG – She practiced medicine in China. As soon as she arrived in the United States, she went to nursing school, studied extremely hard, and she passed the nursing board. She does not practice nursing yet; she is still waiting for her green card and permission to work. She is ready to serve.

HH – She was a nursing instructor in China. Right after arriving in the United States, HH started studying for the nursing board, even while she was caring for her premature baby. She passed the nursing board exam, and then went to work at a hospital. For many years, she has been a well liked and well respected weekend night nurse. She turned down a promotion opportunity, as her nurse manager suggested, to become a night charge nurse.

MM – When she arrived in Kansas City, MM was hired as a nurse technician even though she was a RN in China. She was living in an empty apartment so learning English was difficult. A phone book became her best tool to learn conversational English. For eight to 10 hours a day, she would turn the pages and randomly pick a person or a store from the phone book, call them and ask questions;  when she flapped on “W” section and saw a water bed shop, she would ask  “what is water bed? How much cost for a water bed” --- etc. She listened attentively and tried to learn as much as possible. Alone in her apartment, the phone book connected her to her new world; this is how she learned and improved. She wanted to work as a nurse as soon as possible. Eventually, she passed her nursing board, and earned two master degrees and four national nursing and nurse management certifications. She is working at a hospital today as a Hospital Shift Supervisor.

ZZ – She was a nurse in China. Months of hard studies for boards, she passed her nursing board a few months ago. She sent out many applications to many hospitals. She received only one reply, requesting a phone interview. After the phone interview, she never heard from the hospital again. Personally, I believe a telephone interview can be a form of discrimination, especially for a nurse for whom English is her second language. We loss over 50% of effective communication tools in a telephone interviewing. Phone interviews don’t always allow us the opportunity to show how much we can do and how well we can be as a great nurse.

KK – She was an experienced nurse in China. She is now taking care of a child with multiple allergies. She would like to work as a nurse in United States.

DD – In China, DD majored in English. She worked in a non-nursing field in the United States for a while and then decided she wanted to be a nurse. She went to LPN school, and then to an RN bridge program. Soon she became a RN. In her nursing student training, she worked at a telemetry unit. She was well-liked in her nursing practice and she was hired by that unit as soon as she completed her clinical training. The staff in that unit love her, and she loves nursing.

WW – She came to the United States with her husband. At that time, her husband was an owner of a local restaurant. WW did not want to work in the restaurant, she went on to study nursing as a new fresh beginning foreign student, and passed the nursing board. She worked as a nurse at a large local hospital for a few years, and then she earned her advanced nursing degree to become a nurse practitioner. She works as a nurse practitioner as soon as she completed school. She was alone and struggled for a long time in learning what was the nursing about, but she made it.

One of our visitors, Janice, asked, “Was there anyone who did not make it? Did anyone go back China?” Without pause and without knowing who else was going to respond, the CAN sisters answered in one voice in the spirit of our sisterhood:

“No, that  was not an option for us.”

They continued:

“Nobody said it was not hard.”

“We were determined to make it in this world together.”

“We were not going to quit.”

“We appreciate each other.”

“We learn from each other.”

“We are going to be strong, stand up straight, and shine.”

Our visitors were very impressed and encouraged. They also said they were very proud of their countrymen who are “making a difference in their new world.”

CAN, yes we can. CAN, yes we can.

This article was written for DiversityNursing.com by:

Mai Tseng RN, BSN, MPA, EMBA, NE-BC, LNC, CRNI.
Hospital Shift Supervisor
Children's Mercy Hospitals & Clinics
2401 Gillham Road
Kansas City, MO 64108

A Day in the Life of A Patient

 
​A Day in the Life of A Patient

By Stephanie Wilborne, APRN FNP
Contributing author to DiversityNursing.com

            John takes five pills every day.  He does not know the names of all his medications, but he recognizes each pill by its shape and color. Taking medications every day is a struggle for John.  Sometimes he forgets to take his pills.  Frequently, he has problems paying for his prescriptions. John missed two appointments to see the eye doctor.  He forgot about the first appointment and was so late for the second, they refused to see him.    He's been told in the past that people with diabetes have a "higher risk" of eye problems.  John still does not understand why he needs to see an eye doctor.

            John is your patient today.  His blood pressure reading is high again.  And unfortunately, his hemoglobin A1c readings are still too high.  His diabetes and hypertension are poorly controlled.    You ask what pills he takes.  He can’t remember.  Reading in his chart, you see at his last visit he was given a list of all his medications.  Trying to figure out why his high blood pressure and diabetes are uncontrolled, you ask tons of questions. "Are you taking your medication every day?  Why did you miss the second eye appointment,” you ask him?  Frustration sets in.

            The term health literacy refers to a set of skills people need to effectively manage their health.   More than two decades of research has associated poorer health literacy skills with less frequent screening for diseases such as cancer, higher rates of disease, mortality and worse health outcomes.  It is important for health care providers to understand that patients with poorer health literacy skills may struggle at times with health related tasks.

Taking Medications: May have difficulty reading prescription bottles and understanding when, how and how often to properly take medications.

Disease Self Management Skills:  May have less knowledge concerning their disease or condition resulting in poorer disease and self management skills.  For example, diabetic patients with poorer math skills are more likely to have problems interpreting glucometer readings and therefore miss that blood sugars are too high, low or normal.

Risk:  May have difficulty understanding the concept of risk and how it may impact their health.

Navigation:  Patients with poorer reading skills may have difficulty reading a bus schedule, following directions and other hospital or healthcare signage.

Communication:  Patients with poorer health literacy skills are more likely to report problems understanding and following conversations and verbal instructions of health care providers.

  In 2003 the National Assessment of Adult Literacy for the first time measured the health literacy level of more than 26, 000 American adults.  Only 12% of Americans were found to have proficient health literacy skills.  Based on this data, the majority of adults may have problems functioning in our current healthcare system at different times of their life.  Unfortunately, health information that patient's receive from health care professionals is often too complex for them to understand.  The United States government, American Medical Association, Joint Commission and many other agencies are advocating that all health care professionals incorporate clear communication techniques and strategies into clinical practice with ALL patients.

John’s nurse turned her frustration into action.   How many times a day he needs to take his medication was reduced to once a day.  His prescriptions are now written for a 90 day supply.  To help John manage his diabetes and hypertension better, John sees a nurse or clinician more often.    His health care team has completed training on utilizing clear communication techniques and strategies into clinical practice.   John now receives verbal and print instruction that incorporates plain language principles with less medical jargon. Teach back is used to confirm understanding.  Brief conversations with John revealed he didn’t know that much at all about diabetes or hypertension.  His clinician and nurse devised a plan to provide short bursts of education for future appointments.  They are also trying to coax John into attending diabetes self management classes   And yes, John finally had an eye appointment.  His nurse arranged for a family member to take him to his appointment.

All of the interventions mentioned above are based on more than two decades of research on how to improve the health care delivery and health outcomes for patients with poorer health literacy skills.  How health care providers communicate and deliver care can improve the ability of patients with poorer health literacy skills to manage their own health.  Nurses, we have the power to transform our healthcare system.  Learn more about health literacy and incorporate clear communication into your clinical practice.

Stephanie Wilborne, APRN FNP

www.health-lit.com/
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