DiversityNursing Blog

Establishing a Diverse Workplace Culture

Posted by Erica Bettencourt

Fri, May 18, 2018 @ 10:43 AM

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Promoting diversity and inclusion within your workplace is one of the best ways to foster an open-minded company culture. When you have a diverse work force, they provide unique employee perspectives and when that work force mirrors the population of patients they're treating they can give you the patient's perspective as well. These insights should give you a better understanding of those colleagues and patients.

Operating any business in this day and age, especially a health system, requires a large degree of diversity within the organization to help provide culturally competent care to an ever growing and changing patient population. Larger well-organized health systems have entire teams dedicated to diversity and inclusion efforts.

Sometimes recruiting and hiring managers unconsciously target diverse candidates who act like the majority rather than seeking to bring true differences to their organization. When you hire people who think and act like you do, it is comfortable. You know what they look and sound like, and uniformity feels easier to manage. However, doing so stifles diversity, a sense of belonging and innovation. When people who all think alike come together, they consistently dream up similar solutions. High levels of innovation only happen when you leverage the insights of people who see the world differently.

Try to get feedback about the hiring process from the applicants themselves. They are the people who have experienced bias and cultural misunderstandings. They know how it feels and will have ideas about positive changes that can be made within the organization.  
 
It is highly recommended that your organization provide all employees with diversity training. Employees should understand that hiring decisions are based on finding the best candidate and not only based on quotas. The recruiting process should be transparent to help ease the minds of skeptical employees. Also, be sure managers fully understand the benefits of a diverse workplace. They will be implementing HR policies and should be fully committed to supporting the practice.
 
Treat others the way they want to be treated. Understanding how different cultures… perceive a handshake, handle eye contact, and deal with the boundaries of personal space, can help to avert misunderstandings. When in doubt, ask. If you accidentally cause offense, apologize. Be respectful of personal and cultural boundaries. Encourage your colleagues to do the same through your example as this will make your workplace more welcoming and productive for everyone.

For diversity to bring strength, it must be valued and integrated into company practices and philosophy. This takes time and a commitment to celebrate diversity. It requires the willingness to be open-minded and non-judgmental about the value of differences.

Topics: cultural diversity, diversity in healthcare, Diversity and Inclusion, diverse workplace culture

How Health Systems Are Improving Their Diversity and Inclusion Efforts

Posted by Erica Bettencourt

Fri, Apr 27, 2018 @ 10:52 AM

diversity-inclusion-respect-767x362@2xMajor health care giants like Dana-Farber Cancer Institute and Massachusetts General Hospital have pledged to improve diversity recruitment of health workers. Reports showed a lack of diversity in hospitals and care discrepancies among patients. The hospitals plan to increase resources, hire executives focused on improving diversity and inclusion in their organizations, and more.

The lack of diversity in the healthcare workforce can impact patient care. Minority patients are more likely to seek out and follow advice from health professionals who look, sound, eat, worship and share the same cultural customs and values like they do. 

The U.S. population overall is changing and quite rapidly. In 2010, the number of residents age 5 and older speaking a language other than English at home had climbed 158% to 59.5 million from 23.1 million in 1980, according to the U.S. Census Bureau. By 2044, more than half the nation is expected to be made up of minority races or groups, according to a 2015 Census Bureau report.

Yet, statistics show healthcare isn't keeping pace with population changes. Minorities made up just 14% of hospital boards and only 11% of executive leadership positions in 2015, according to a survey from the American Hospital Association's Institute for Diversity in Health Management. This disparity exists even though minorities represent roughly 30% to 35% of patients in hospitals.

Dana-Farber Cancer Institute officials told Becker's Hospital Review they plan to hire a leader for diversity programs, and will require all faculty and administration to complete a bias awareness workshop, among other initiatives, as part of the institution's 2018 strategic plan.

Dianne Austin, workforce diversity program manager at Massachusetts General Hospital, told Healthcare Dive, "Mass General has an orientation where new employees attend a program on diversity and inclusion and learn about various resources available to employees, such as a citizenship program, careers days and school admissions officers. There are also multiple staff committees focused on improving diversity and inclusion."

Akron Children's Hospital supports a program that aims to improve Nursing diversity. The program's plan is to increase the number of interns in the program and provide tuition support during their senior year of college. The hope is that program participants will return to Akron Children's after graduation to begin their Nursing career.

 "Nursing diversity is vital to ensuring a positive experience for our patients," said William Considine, CEO of Akron Children's Hospital. "Not only does this program provide a valuable educational experience, it also helps Akron Children's recruit more prepared Nurses and helps our workforce reflect the diversity of the patients, families and communities we serve."

UC Health intends to contribute $1.5 million to create University of Cincinnati scholarships designed to diversify the medical profession. The hospital system hopes the scholarships will help all local health systems diversify their workforce when hiring doctors, Nurses, pharmacists and medical technicians. 

“We know through recent research that underrepresented adults in Cincinnati believe their race negatively impacts their treatment from medical professionals,” said Dr. Rick Lofgren, CEO of UC Health. “This investment is a step to improve health care for all of our patients and to foster a health care workforce that reflects the diversity of our population.”

Diversity & Inclusion initiatives can be difficult to sustain, but commitment to increasing D&I at all levels of your organization will bring new perspectives and values to your hospital/health system, which can help decrease health disparities across the board. Bravo to the healthcare leaders that are seriously acting on their D&I initiatives! Do you see progress in this area where you work or teach?

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Topics: Diversity and Inclusion, diverse workforce, hospital diversity, chief diversity officer, diversity recruitment

Diversity Impact

Posted by Frontier Nursing University

Thu, Mar 08, 2018 @ 09:55 AM

Diversity-Impact-2.jpgThe eighth annual Diversity Impact 2018 Student Conference will be held June 7-10, 2018, on FNU’s historic campus in Kentucky. This event is hosted by the Diversity PRIDE student organization and is open to all attendees who want to become part of FNU’s legacy of providing care to rural and underserved communities.

Join Us for an Impactful, Sight-Seeing, Cultural Excursion!

The Diversity Impact event opens the door for nurses to foster and strengthen collaborative discussions to address health disparities to improve minority health among underrepresented and marginalized groups. Students engage in cross-cultural and inter-cultural workshop activities, along with leadership strategies on current diversity healthcare trends as it relates to patient-provider care.

Click here for information on Diversity Impact 2018!

During the Diversity Impact weekend workshop, students will have the opportunity to:

  • Attend sessions hosted by nationally recognized nursing leaders and field experts;
  • Participate in inclusive teambuilding exercises and cultural awareness sessions;
  • Network with FNU students, faculty and staff to strengthen collaborative discussions; and
  • Engage in nurse-leadership strategies and cross-cultural activities…and much more!

Topics: Diversity and Inclusion

Meet FNU’s New Chief Diversity and Inclusion Officer

Posted by Frontier Nursing University

Wed, Feb 28, 2018 @ 02:02 PM

diversityandinclusion2-1.jpgMeet FNU's New Chief Diversity and Inclusion Officer Dr. Maria Valentin-Welch, DNP, MPH, CDP, CNM, FACNM.

Frontier Nursing University (FNU) is seeing yet another one of its diversity initiatives realized through Dr. Maria Valentin-Welch in her new role as Chief Diversity and Inclusion Officer. Maria’s new position, which she assumed on October 1, 2017, is designed to guide the institution on matters of equity, diversity and inclusion.

Dr. Valentin-Welch has over 30 years of teaching experience, including her role at Frontier as an assistant professor since 2013. Through extensive work with marginalized and underserved populations, Maria has garnered several awards and accolades. She completed her Doctor of Nursing Practice (DNP) at FNU in 2015. Her DNP capstone project was a national online tutorial pilot program for ethnically diverse student nurse-midwives.

Frontier spoke with Maria about her passion for diversity and inclusion, how she will strategize those initiatives at FNU, and the challenges she expects to face in her inaugural post as CDIO.

What has been your career path so far and how has it led you to your current role as Chief Diversity and Inclusion Officer?

“A medical encounter shaped my understanding of the need for diversity in the medical world. There was a man that was restrained; he was trying to pull his IV because he was trying to get to his true hospital. I advocated for this man, explained the situation…I was told, ‘Well, we don’t have a translator, so we didn’t understand him,’ which was unacceptable. We found a translator, and the man proceeded to have his IV removed and was transferred to the hospital where he belonged. This experience really taught me how to be a voice for the voiceless, and to be an advocate for those who need advocacy.”

How has your professional background influenced your passion for diversity and inclusion?

“While working with homeless pregnant women, I felt like I wanted to do more with my hands, and that was my inspiration, my calling, into nurse-midwifery. Also my love for education has influenced my passion for diversity and inclusion. I have always been a teacher in my heart. I have taught and precepted many students…teaching is in my blood.

Another changing encountered occurred during my first visit at Frontier. In 2012 I came to Frontier’s Diversity Impact Weekend for the Pride Program  as a keynote speaker, and there I not only fell in love with Frontier, but I also fell in love with the students who encouraged me to go back to school and go back to teaching. Now, I am an alumni of Frontier; I went to their doctorate program, and my capstone project was on tutoring and mentoring students of color. So, all of this was instrumental in bringing me to this point in my life.”

Learn more about Maria’s journey to Chief Diversity and Inclusion Officer in this video.

Where did your passion for diversity and inclusion begin?

“My passion for diversity and inclusion began really by being raised in New York City. It was a wonderful, diverse area to be brought up in, and it taught me that we are more alike than we are different. Another encounter in my life that really brought passion of diversity in my life was being moved from New York to Boston, Massachusetts in the seventies during the busing times. A historical era with  a lot of racism and hatred in Massachusetts which has definitely improved since. However, that time period was really sad and showed me how ugly division can be.

A school incident took place that taught me that I am neither white, nor black, nor ‘other.’ I am Maria, and no one can label me. I am myself and that goes for every single person; we are all each personally unique and individual.”

Learn more about Maria’s passion for diversity and inclusion in this video.

How do you define diversity and inclusion at Frontier Nursing University?

“When our differences come together in a respectful and appreciative way for what each of us bring to the table, that’s when we reach diversity and inclusion. Diversity and inclusion in a nutshell is the power of unity, and FNU will be more powerful for including it in its strategic plan.

Diversity is like a beautiful tapestry made up of each and every one of us. We are all different in so many ways, beautiful ways. However, when our differences are united in a positive way, we create a powerful, enhanced atmosphere that otherwise would be lacking due to missing parts. So, diversity and inclusion is the glue of unity.”

Learn more about how Maria defines diversity and inclusion in this video.  

What are you most excited about with your new position?

“I am most excited about the programs I hope to establish for students. Initially, these programs that I’ll be implementing will be pilot programs for our nurse workforce diversity grant students. We’ll work out the kinks and basically expand them to all students.

I’m also excited about bringing diversity to the forefront of Frontier. Our Community of Inquiry model will be stronger for it.”

What strategies do you feel will have the most positive impact on the FNU community?

“The strategies that I feel will have the most positive impact on Frontier are building these excellent student services, as well as diversity and inclusion training strategies and tactics to enhance our courses by threading diversity and inclusion issues along the way. We want to thread the subject matter even further throughout the curriculum. We will be stronger individually and as a whole because of the introductions of these plans.”

Learn more about  Maria’s planned strategies as CDIO in this video.

What are the biggest challenges that you will face in your new role?

“Uniting folks while our nation is receiving messages of division and promoting actions of division and lack of compassion – to me, that will be my biggest challenge. However, I feel midwifery and nursing have always held an important role in not only listening to people, but also advocating for what is right. Frontier is better and stronger than the division being promoted across the nation.”

Learn more about the challenges Maria anticipates in her new role in this  video.

What is a fun fact about you?

“My intersectionality is a fun fact. What is intersectionality? Intersectionality is a diversity term that basically explains that an individual has many hats that they bring to the table, not just what you see in front of you. So I’m not just a latina, female professor of a certain age. I’m also a mother, a wife, grandmother, and – here’s the fun fact – I’m even a great-grandmother of three great-grandchildren!”

Learn more about Maria in this video.

Topics: Diversity and Inclusion, Frontier Nursing University, chief diversity officer

Frontier Nursing University Hires Chief Diversity and Inclusion Officer

Posted by Frontier Nursing University

Thu, Oct 05, 2017 @ 02:25 PM

Header_712x230.jpgHyden, KY -- Frontier Nursing University (FNU), a graduate school offering nurse-midwifery and nurse practitioner programs through distance education, has hired Dr. Maria Valentin-Welch, DNP, MPH, CNM, FACNM, as its first chief diversity and inclusion officer to lead the University on matters of equity, diversity and inclusion. Dr. Valentin-Welch is a certified nurse-midwife and has served as a course coordinator at FNU since 2013. She will assume the new role on October 1, 2017. 
 
officer.jpgFNU’s chief diversity and inclusion officer (CDIO) will lead the development of a vision and strategy that champions the importance of a diverse and inclusive environment that values and supports all members of the University community. The addition of the CDIO position is the most recent of a number of diversity initiatives implemented as part of FNU’s strategic plan to heighten the focus on diversity and inclusion for all faculty, staff and students. The CDIO will serve on the executive team along with the president, dean, chief operations officer and the executive vice president for finance and facilities.
 
“Research tells us that in order to incorporate an effective culture of diversity and inclusion, you must have top administrators at the highest level in the organization leading the charge,” says FNU President Dr. Susan Stone. “We have done so much to foster a culture that values diversity and inclusion; this was the natural next step for our University.”  
 
Dr. Valentin-Welch has worked on diversity and inclusion efforts throughout her career. One of her first assignments at FNU will be leading the implementation of a four-year program to increase the recruitment, enrollment, retention and graduation of students from disadvantaged backgrounds, made possible by a HRSA Nursing Workforce Diversity Grant totaling $1,998,000 that was awarded to FNU earlier this year.
 
Dr. Valentin-Welch joined the Frontier Nursing University faculty four years ago and has served as a co-chair of FNU’s Diversity and Inclusion Committee. She will be moving to Kentucky in 2018 to join other administrative staff at FNU’s campus, which will be relocating from Lexington to Versailles next year.
 
“I am very excited to get started in this new role because focusing on diversity and inclusion will only strengthen Frontier’s roots, as well as our mission and vision,” said Dr. Valentin-Welch. “The birthplace of nurse-midwifery in the United States stems from the roots of Frontier Nursing University. Therefore, I am humbled and honored to become FNU’s first chief diversity and inclusion officer. Together, hand in hand, we will bring our FNU Community to higher heights.”
 
Additionally, Dr. Valentin-Welch will offer leadership support to FNU’s Diversity PRIDE Program which has been in place since 2010 and was designed to promote diversity in nursing and midwifery by recruiting more underrepresented students. She will also focus on collaborative opportunities with other organizations to facilitate the goals of diversity and inclusion at FNU.
 
“I believe our founding mother, Mary Breckinridge, is smiling down at Frontier as we open this new historical chapter… a chapter made up of many different pages creating a wonderfully diverse and inclusive book,” said Dr. Valentin-Welch. 
 
Contact: Brittney Edwards, Director of Marketing and Communications
859-899-2515, Brittney.edwards@frontier.edu
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Topics: chief diversity officer, Diversity and Inclusion, Frontier Nursing University

Hospitals Should Aspire To Have a Diverse Workforce Throughout Entire Organization

Posted by Erica Bettencourt

Mon, Aug 14, 2017 @ 10:39 AM

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Healthcare organizations must know in order to be successful, you need a diverse workforce. The key to success in this area is retaining that staff and knowing how to defuse conflicts. This is especially true in settings like hospitals, where mistakes can mean life or death.

Poor communication is one of the leading causes of medical errors, according to the Joint Commission. Medical errors are the 3rd leading cause of death in the United States—right after heart disease and cancer, and it’s more prevalent than respiratory ailments, stroke and Alzheimer's disease—according to a study out this year from The BMJ. Author Martin Makary, MD, of Johns Hopkins University, and colleagues estimate that 251,000 Americans die each year from such mistakes. Some instances have nothing to do with interpersonal conflict, but employees at odds with one another are less likely to spend time making sure they understand each other during crucial events like a patient hand-off.

Dianne Austin, workforce diversity program manager at Massachusetts General Hospital, told Healthcare Dive, creating robust support networks is key to helping employees identify and deal with tension or potential discrimination from other employees. They also need to be able to talk freely with others who may be in similar situations. “There’s a lot that we do to really try to help employees feel that they have a voice and that they’re important,” she said.

How conflict happens

Susan Woods, a workplace consultant, says there are a few major dynamics in diversity-related conflict, including respect and disrespect, as well as recognition and identity.

1) Respect and Disrespect

Disrespect may be gross and blatant, but it is also subtle, communicated in the little

ways someone is told they don’t belong, are not good enough, are not expected to

achieve, or that they can be overlooked and don’t count.

 

Remarks like the ones below convey messages about respect.

“Not a bad job, for a woman.”

“You don’t have to worry about your appointment. You’re a minority.”

“That company is very traditional. I’m surprised they even hired you.”

 

A reasonable person could interpret disrespect in each of these messages. The

harmful message may be unintended and unrecognized by the offending party, even

as it is deeply felt by the offended party.

 

When disrespect is communicated in unintended and unconscious ways, bringing

this perspective to the surface creates an opening for learning and improved

relations. Regardless of how the incident in question is settled, failure to understand

the dynamics of respect and disrespect from more than one perspective perpetuates

the underlying conflict.

 

2) Recognition and Identity

A second dynamic often present in diversity-related conflict resolution is

recognition and identity. Recognition and identity are complicated dynamics, full of

opportunity for misunderstanding and tension. These may have a negative effect,

but may not have been communicated with consciously malicious intent.

 

We hear it below:

“I’m always asked to be in the photo or meet with visitors because I’m one of the few people of color

they have. It has nothing to do with my accomplishments.”

“I hope you’re not asking me to take the minutes because I’m the only woman in the group.”

“You’re not like the others. I feel I can talk with you.”

“Those people …”

 

The old days of the “great melting pot,” where everyone was expected to conform

to the dominate group, are gone. Hopefully, we’ve moved past assimilation to

realize that inclusion is about recognizing diverse identity. It’s about understanding

individuals as unique persons and, at the same time, as members of groups.

Either/or logic is misleading. This is a both/and phenomenon. The ambiguity can

be unsettling, especially when the challenge is so deeply personal and emotional as

with identity.

Research shows that conflict can be frequent in healthcare organizations because of the high workload volumes, pressures to move quickly and the importance of decisions being made. These conflicts can affect companies in many ways, including high staff turnover rates, reduced productivity and litigation costs.

Dealing with conflicts

The best processes start early and attempt to prevent conflict. Austin said Massachusetts General has an orientation where new employees attend a program on diversity and inclusion and learn about various resources available to employees, such as a citizenship program, careers days and school admissions officers. There are also multiple staff committees focused on improving diversity and inclusion.

Healthcare managers can help ease conflict by listening carefully to employees, quickly addressing the source of the problem, instituting strict and clear policies and educating staff about those policies, she wrote.

Massachusetts General has multiple ways for an employee to bring any concerns to light, including an anonymous hotline, Austin said. The HR department will review whatever is submitted and the relevant department head is told the details. “We really try to pull managers and the appropriate people in so we can get to the bottom of it based on the information provided,” she said.

Sometimes, the problem starts with a patient who refuses to be cared for by a certain nurse or doctor, and may use racial slurs or other inappropriate language. The nurse manager will respond and tell the patient all providers are equally trained and capable. The patient is then told they can go to another hospital if they will not be respectful to all employees. The affected employee can decide whether or not to continue working with the patient.

Diversity is needed at higher ranks

Diversity and inclusion efforts should reach all the way up the ranks to the executives, making sure their C-suites and boardrooms are also diverse and reflective of the surrounding community.

The American Hospital Association's Institute for Diversity in Health Management released a comprehensive report titled Diversity and Disparities: A Benchmarking Study of U.S. Hospitals in 2015. The results of the survey were not exactly positive. In fact, the survey found that minority representation on healthcare boards across this nation stood at just 14%—precisely the same percentage reported in a similar survey two years earlier and a similar study conducted in 2011.

Deborah Bowen, president of the American College of Healthcare Executives said the best ways to remedy poor diversity in C-suites is to start cultivating a diverse group of people who have an interest in leadership early on in their careers. Post-graduate fellowship programs and scholarship for mid-level executives can be helpful. Hospitals should provide leadership development and training as well as other career resources, she said.

“It’s a matter of finding mentors, for example,” she said. “Have a mentorship network to find somebody who has gone through something similar.”

The diversity of people in the US has changed considerably. As stated at the beginning of this article, our hospital and healthcare system employees need to reflect their patient population at all levels within their organization(s). Sensitivity to language, cultural, sexual, and physical differences in both your staff and patients is critical for a harmonious and productive environment.

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Topics: diverse workforce, Diversity and Inclusion

Frontier Nursing University Awarded $1,998,000 Nursing Workforce Diversity Grant

Posted by Pat Magrath

Tue, Jul 25, 2017 @ 11:46 AM

blobid1_1500648981783.jpgHyden, KY -- Frontier Nursing University (FNU) has been awarded the Nursing Workforce Diversity grant from the Health Resources and Services Administration (HRSA). The grant totals $1,998,000 in funding in support of a four-year project that will be led by FNU with assistance from several key partner organizations.

The goal of the Nursing Workforce Diversity (NWD) program is to increase access to high quality, culturally-aligned advanced practice nurses and midwives that reflect the diversity of the communities in which they serve. The grant, which provides $499,500 per year, supports a proposed project in which FNU will implement a comprehensive systems approach to implementing five evidence-based strategies to support disadvantaged advanced practice nursing students from recruitment through graduation. The social determinants of education will be used as a framework to assess student needs and guide activities throughout the course of the project.

The overall aim of the program is to increase the recruitment, enrollment, retention, and graduation of students from disadvantaged backgrounds. Through education and training in Frontier Nursing University’s advanced nursing and midwifery programs, these students will be prepared to provide advanced practice nursing and midwifery health care services across the U.S.

Findings from an American Association of Colleges of Nursing policy brief (2016) found that racial and ethnic minority groups accounted for 37% of the country’s population, yet minority nurses represent only 19% of the total registered nurse workforce (National Council of State Boards of Nursing Survey, 2013).  As minority population growth rises, so does the likelihood of these populations experiencing greater health disparities such as increased rates of maternal morbidity and mortality related to childbirth, infant mortality, chronic diseases, and shorter life spans compared to the majority of Americans. There is growing evidence that greater racial diversity in the health care workforce is an important intervention to reduce racial health disparities.  

“We are extremely proud and excited to receive this grant and to be a part of such an important project,” said FNU president Dr. Susan E. Stone. “We are deeply committed to the goals of the NWD program and helping to overcome barriers that hinder the success of our underrepresented students, from recruitment through graduation.”

The project’s primary objectives are: 1) to achieve minimum of 30 percent minority student enrollment by June 2021, the end of the project period; 2) to increase the racial and ethnic minority retention rate and 3) to graduate an average of 100 new nurse-midwives and nurse practitioners representing racial and ethnic minorities underrepresented in nursing each year of the project period. 

Grant funding will support personnel, consultants, and diversity training for faculty and staff.  Retention activities, including mentor programs and writing support will also be funded.  FNU students will also benefit from substantial scholarship support and professional development opportunities.  To achieve the goals of the program, FNU will formally partner with the American Association of Colleges of Nursing (AACN), the American College of Nurse-Midwives, Midwives of Color Committee (ACNM-MOCC), the National Black Nurses Association (NBNA) and Mona Wicks, a multicultural sensitivity and diversity training expert consultant.

View the grant announcement on Frontier Nursing University's website.
 
Contact: Brittney Edwards, Director of Marketing and Communications
 
###
 
About Frontier Nursing University:
FNU is passionate about educating nurse-midwives and nurse practitioners to serve women and families in all communities, especially rural and underserved areas. FNU offers graduate Nurse-Midwifery and Nurse-Practitioner distance education programs that can be pursued full- or part-time with the student’s home community serving as the classroom.  Degrees and options offered include Doctor of Nursing Practice (DNP), Master of Science in Nursing (MSN) or Post-Graduate Certificates. To learn more about FNU and the programs and degrees offered, please visit Frontier.edu.

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Topics: Frontier Nursing University, Nursing Workforce Diversity Grant, Health Resources and Services Administration, FNU, funding, Diversity and Inclusion

Diversity Impact 2017- Moving Forward: Uniting Through Diversity

Posted by Frontier Nursing University

Tue, Jun 06, 2017 @ 02:20 PM

fnu2.jpeg

First article written by Frontier Nursing University
Second article Written by Marissa Silver

Frontier Nursing University believes in increasing awareness of the importance of cultural competency and decreasing health disparities. This article is about their 7th annual Diversity Impact Event. FNU states “Diversity Impact is designed to open the door for nurses to foster and strengthen collaborative discussions to address health disparities to improve minority health among underrepresented and marginalized groups.” Enjoy this informative article.

In a rapidly-changing, sometimes divided world, Frontier Nursing University (FNU) emphasizes the value of respecting and honoring diversity.

In the United States, there is a wide gap in health outcomes. Several populations face greater obstacles in obtaining good health based on their racial or ethnic group, religion, socioeconomic status, gender, age, mental health, sexual orientation, physical or mental disability, or geographic location. These disparities may exist because of social and economic inequality, inadequate health care providers or systems, and bias on the part of health care providers or patients.

The gap forming in the health of women before and during pregnancies is also a source of concern. Determinants of a mother’s health may include social factors, ethnic or racial group, or her previous health statufnu1.jpegs. An infant child is also impacted by factors such as nutrition, family income, and the geographic location of their homes and neighborhoods.

Additionally, consider this: women living in rural areas have less access to health care than women living in urban areas. Where 22.8% of women live in what is defined as a “rural” area in the U.S.¹, there is a significant disparity between the health care they receive and the health care received by the “urban” population of women.

Although health care needs around the nation are diverse, health care providers do not reflect the population. In 2008, only 16.8% of Registered Nurses residing in the United States represented diverse racial and ethnic backgrounds². Additionally, underrepresented groups make up less than 10% of nursing school faculty³. The nursing profession faces the challenge of recruiting and retaining a culturally diverse workforce that mirrors the nation's demographics.

With these challenges in mind, it is important that our education system equips nurse practitioners, nurse-midwives and other healthcare professionals with the resources they need to eliminate these disparities, and ultimately achieve health equity.FNU would like to see the Frontier community impact health equity and move forward by uniting through diversity.

On June 1- 4, 2017, Frontier Nursing University held the 7th annual Diversity Impact Student Conference. Diversity Impact is designed to open the door for nurses to foster and strengthen collaborative discussions to address health disparities to improve minority health among underrepresented and marginalized groups. Students will engage in cross-cultural and intercultural workshop activities, along with leadership strategies on current diversity healthcare trends as it relates to patient-provider care.

This year’s Diversity Impact theme is Moving Forward: Uniting Through Diversity. Students will attend sessions hosted by nationally recognized nursing leaders; participate in teambuilding activities, cultural competency awareness training, and open dialogues; network with available FNU students, community leaders, faculty and staff; and learn more about the world with FNU’s International Food Menu.

fnu3.jpegFrontier Nursing University conference discusses healthcare diversity

Factors such as someone's age, race, gender and ethnicity can all play a role in their healthcare.

This weekend, Frontier Nursing University students attended a conference, to learn how those factors and other differences between populations may impact a patient's health and treatment. One factor, which may impact patients in Eastern Kentucky is living in rural communities.

"It's like a totally different population than what you see in urban areas," Vaishu Jawahar who attended the conference said. "Even though we think that sometimes urban populations have it bad, the sheer lack of resources that's out here makes being in a rural area that much harder."

Another topic discussed during the conference was caring for those in the Lesbian, Gay, Bisexual and Transgender (LGBT) community.

"As healthcare providers, no matter what your political views are you have to be able to take care of everyone or at least make them feel comfortable enough to seek out your care," said Jawahar.

As part of the discussion on serving the LGBT community, two Frontier Nursing University students talked about their experience treating patients during last year's mass shooting, at Pulse, a Gay nightclub in Orlando, Florida.

Overall, those who attended the conference said taking the time to get to know the patient and their background can make a difference.

"It's so easy for us to get caught up in our way of life, we forget there's very different realities for everyone," Wilvena Bernard, Diversity Pride Program Coordinator, Frontier Nursing University said.

More than 50 students and faculty attended the conference from across the country.

Last month, University officials announced they are moving student activities from the Hyden campus to Versailles by Fall of 2018.

Interested in learning more about Frontier Nursing University? Check out their Employer Profile! Just Click Here.

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Topics: Diversity and Inclusion, diversity, cultural competence, cultural competency, minority health, health disparities, health care providers

Diversity in Healthcare for Patients and Nurses

Posted by Erica Bettencourt

Thu, Jun 01, 2017 @ 11:24 AM

Diversity-Blog-Image.pngUnique challenges encompass the delivery of quality healthcare in the entire world as a whole. People of all ages are terminally ill -- with approximately half the American population fighting hypertension, diabetes, cardiovascular diseases, arthritis and mental related illness.

As a Nurse, you are required by the healthcare profession to be sensitive, demonstrate cultural awareness and behavioral competence necessary to ensuring healthcare issues are handled effectively. 

Medical professionals worldwide have voiced sentiments on the importance to further diversify the healthcare workforce. This is mainly because the entire healthcare profession is focused on transitioning to a patient-centered healthcare system in which patients demand more personalized care, high level rapport and open communication. 

Discrimination, stereotyping, prejudice and racism are the most common barriers toward achieving diversity in healthcare for patients and Nurses. There are multiple scenarios when you may show lack of sensitivity without even noticing it, unintentionally offending patients. You should for instance:

  • Ask the patient how he or she may wish to be addressed or simply addressing him or her by their last name as a show of respect.
  • Inquire of the patient’s knowledge on treatments and health problems.
  • Forge the patient’s trust so as to establish a formidable nurse-patient relationship.

Diversity awareness in healthcare is however an active, continuous conscious process through which Nurses recognize the differences and similarities within various cultural groupings. As Nurses, we can only achieve diversity in healthcare by carefully evaluating and appreciating cultural group(s) differences.

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Topics: diversity in healthcare, Diversity and Inclusion, diversity in nursing, patient care

A More Diverse America Needs Health Care Adjustments

Posted by Erica Bettencourt

Wed, Feb 15, 2017 @ 04:02 PM

0209-tiled-flag-of-american-diversity.jpgHow can you properly care for a patient if you don’t understand their personal needs? Communication is key. Making a patient comfortable goes far beyond providing warm blankets. It is about the patient trusting you and knowing you have things in common that show them you understand how they feel and what they need. 

Many healthcare providers are seeing how important diversity and inclusion is to delivering quality patient care. Hospitals are providing language services by hiring a diverse staff, many of whom are bilingual or multilingual. Culturally appropriate care strategies are also key. Religious views may alter the way staff would normally provide care. That means you might assist a patient who needs to move in order to pray or work out special blood testing times to allow the patient to fast. The population is rapidly changing and by 2050, the white population will no longer be the majority.

On any given day at the Salud Clinic, Lucrecia Maas might see 22 patients. They come to the community health center tucked away in an office park here needing cavities filled, prescriptions renewed and babies vaccinated. When they start to speak, it’s rarely in English. Sometimes it’s Hindi. Or Dari. Or Hmong. Or Russian.

Maas is fluent in English and Spanish, but that gets her only so far. She often has to hop on the phone with a medical interpreter, who relays her questions to the patient and then translates the patient’s answers. “It just takes a little more time,” the nurse practitioner said. 

The future of American health care looks a lot more like the Salud clinic than Norman Rockwell’s iconic small-town doctor’s office. The country is on course to lose its white majority around 2050. That future is already visible in Sacramento County and neighboring Yolo County, where West Sacramento is located: by 2013 the combined population of Hispanic, black, Asian and other nonwhite residents had edged out whites. In West Sacramento, a historically working-class county across the river from the state capital, more than 2 out of 5 public schoolchildren already speak a language other than English at home.

Sacramento-area hospitals, community health centers and doctor’s offices have had to adapt. They’ve hired more multilingual, bicultural staff. They’ve contracted with interpretation services. The medical school at the University of California, Davis, is trying to figure out how to recruit more Latino students to a profession that remains largely white and Asian. And doctors are being trained to deliver culturally appropriate care to patients of many backgrounds. 

When a diabetic pregnant Afghan woman wanted to fast during Ramadan, the Salud Clinic’s nutritionist recalculated the best time of day to measure her blood sugar. If Mexican mothers say they’re rubbing gentian violet on their baby’s umbilical cord area to keep it clean — a harmless natural remedy — doctors encourage them to keep doing so.

Similar stories are playing out across California, which became majority minority in 2000. Health systems are using new data tools to get a better handle on just who they’re serving — and where the trend lines are pointing. County health departments, nonprofits and clinics have invested in recruiting and training bilingual community health workers.

Insurance doesn’t always pay for the extra costs of services like translation. Patient visits take extra time, straining schedules for doctors and nurses. “You can’t really help somebody if you don’t understand how they value health, and how they understand health and the health care system,” says Robin Affrime, CEO of CommuniCare Health Centers, the nonprofit that operates the Salud Clinic.

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Immigrants Drive Change

Most of the nation’s population growth since the 1960s has come from the immigration of nearly 59 million people from foreign countries who settled in the U.S. in that time, mostly from Latin America and Asia, according to the Pew Research Center. (The Pew Charitable Trusts funds the Pew Research Center and Stateline.)   

Hispanic, black, Asian and multiracial babies in the United States already outnumber white babies. In three years’ time, a majority of U.S. children and teenagers will be some race other than non-Hispanic white. And in about 30 years, whites will cease to be the national majority, demographers say.

A more diverse patient population may mean a different mix of health conditions, because some are linked to country of origin. People who were born in Asia are particularly prone to hepatitis B, for instance. African-Americans are more likely to have sickle cell anemia, an inherited blood disorder more common in Africa, the Middle East, India, and parts of southern Europe and Latin America. 

Asians and Hispanics — the groups likely to drive population increase going forward — have longer life expectancies than whites. Hispanics are less likely to suffer from many chronic conditions than whites even though they’re typically poorer and less educated.

Yet second- and third-generation Hispanic-Americans are often less healthy than their immigrant parents. One theory is that with assimilation, younger generations pick up bad American habits such as eating fast food and not getting enough exercise. And health continues to vary by subgroup. For instance, Californians with roots in Mexico are much more likely to be obese than Californians with roots in Puerto Rico, survey data show.

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Health Challenges

One of the challenges facing health care providers is obvious: many new immigrants can’t speak English. About 60 million Americans speak a language other than English at home and about 25 million can’t speak English very well, according to the U.S. Census Bureau.

Salud doesn’t typically bring in in-person interpreters, because they’re more expensive. But it does contract with a phone interpretation service, a business that’s growing rapidly across the county. The service provides real-time translation between English and at least 12 other languages. Interpretation of some of the less common languages, like Hmong, needs to be scheduled in advance. And there have been instances in which the interpreter speaks the wrong dialect of a language like Dari, spoken in several countries in Central Asia.

Often a staff member can help. The health center has doctors and nurses who speak Hindi, Urdu, Punjabi, Tagalog and Spanish, and has hired administrative staff and medical assistants who speak Hmong and Mien, a language spoken by some Indochinese refugees who fled to the United States during the Vietnam War.

But Mien has no written language. And some cultures and languages have concepts that defy easy translation. “There are some words where we really cannot use the translator,” said Rubina Saini, a Salud physician who speaks several South Asian languages.

Other clinics don’t do as well as Salud. Under federal civil rights law, hospitals, nursing homes and other providers that receive federal funding must take reasonable steps to accommodate patients who can’t speak English well. But the legal requirement isn’t well-enforced and services can be spotty. “Where people need language services isn’t necessarily where they’re being offered,” says Melody Schiaffino, an assistant professor at San Diego State University’s Graduate School of Public Health.  

In a recent study, Schiaffino found that about 30 percent of all hospitals nationwide don’t offer translation services. The share is even larger for public safety-net and for-profit hospitals, even in diverse cities. That’s because the government hospitals can’t afford to do so, she said, and for-profit hospitals tend to serve well-insured patients who speak English.

State policy helps determine who gets interpretation and translation help. Only 15 states directly pay for interpreters needed by Medicaid patients. California isn’t one of them, although a 2009 task force created by the state Department of Health Services recommended the change. (California does require private health insurers to provide — although not necessarily pay for — language services. The state also requires health plans in its state Medicaid program, Medi-Cal, to translate certain written materials into common languages.)

Most Salud Clinic patients have a Medi-Cal insurance plan that will cover the cost of interpretation, Donna Paul, the clinic manager, says. If a patient doesn’t have coverage, CommuniCare Health Centers absorbs the cost.

Then there’s the need to navigate cultural differences. The front-office staff knows that Southeast Asians may be uncomfortable making direct eye contact, and that Russians may speak loud and fast, Paul said. They’ve learned not to take such things personally.

Ethnic Disparities     

Treating a more diverse population also means confronting gaps in care that go beyond socioeconomic status. African-Americans, and in some cases Hispanics, tend to receive lower-quality care than whites even after controlling for income, age and symptoms, according to an often cited 2003 report by the Institute of Medicine (now the National Academy of Medicine). Black patients are less likely to be prescribed pain medication than white patients, for instance, and less likely to receive antiretroviral drugs if they’re HIV positive.

There’s no simple reason for the gap in quality, which still persists, although researchers say unconscious bias or stereotyping by physicians, cultural and language gaps, and even geography play a role. “Race and ethnicity matter, whether you like it or not,” says David Acosta, associate vice chancellor for diversity and inclusion at the University of California, Davis, health system.

To erase the gap, medical schools are adopting strategies to better prepare the next generation of doctors. One of these is to recruit and train more minority students. The second is to train all students to examine their own biases and be more sensitive to cultural differences.

In California, where almost 40 percent of residents are Latino, 4 percent of physicians are. Nearly 20 percent of all physicians in the state speak Spanish, but Acosta says bilingualism isn’t enough. As a Latino physician, he says he’s bilingual and bicultural, familiar with his Hispanic patients’ approach to health, such as the folk remedies they might try. That kind of cultural match improves trust between doctors and patients.

Black and Hispanic physicians are also underrepresented in the physician workforcenationwide. Increasing their numbers could also help ease the shortage of primary care physicians, Acosta said, because black and Hispanic physicians are more likely than white and Asian physicians to provide primary care to low-income minority communities desperately short on doctors.

UC Davis launched an effort to recruit more Latino students to health careers last summer, funded by the Permanente Medical Group, a physician group that works with Kaiser Permanente.

The UC Davis program, called Prep Médico, is aimed at undergraduates from northern and central California and starts with a summer session at the UC Davis medical school. Participants get ongoing support from mentors, access to research opportunities, and help studying for the medical school admissions exam.

Once students reach medical school, they need to be trained to treat patients of a different race, ethnicity, culture, sexual orientation or socioeconomic status than their own. Twenty-one states, including California, have adopted health equity standardsthat help guide physician training.

But there’s a debate over how best to teach so-called cultural competency. The concept is often presented to students like another task to master or acronym to memorize, said Jann Murray-García, an assistant adjunct professor at UC Davis’ school of nursing. But it’s not something you can memorize with flashcards. “There’s just no way to master the complexities of other people’s lives and personhoods,” she says. And recognizing one’s own racial biases and stereotypes, and learning how to deliver good care despite them, can be a lifelong process, she says.

Crunching Data

Kaiser Permanente has turned to data, to make sure these new populations are getting the care they need.

For more than a decade, the organization has broken down its quality of care data by race, gender and ethnicity and used it as a guide to drive health care priorities, with a goal of narrowing health care disparities.

For example, African-Americans are more likely than whites to have very high blood pressure and — partly as a result — to suffer from strokes, heart disease and end-stage kidney disease. First, Kaiser’s analysts figured out what the gap looked like for their own patients. Then they created a new set of instructions for care teams, informed partly by patient focus groups.

Among other changes, physicians were asked to prescribe African-Americans medications proven to be more effective for them. Physicians, nurses and other health workers took additional care to listen to patients, follow up, and nudge them to stay on top of their treatment plan. The effort has paid off: Since 2013, Kaiser has cut the high blood pressure control gap between its African-American and white patients in half.

Health systems can use data to improve their language services, too, says Glenn Flores, a physician and chair of health policy research at Medica Research Institute, a nonprofit research group. All it takes is asking new patients a few questions to check their English fluency, and noting what other languages they speak. That way clinics and hospital systems can arrange for in-person interpreters ahead of time for patients who need them and figure out which languages are essential when they are hiring staff or contracting for medical translation services. “Very few hospitals around the country do this,” he says. 

Nationally, health data need to more accurately capture racial and ethnic subgroups, says Kathy Ko Chin, president and CEO of the Asian & Pacific Islander American Health Forum. The “Asian and Pacific Islander” category used by the U.S. Census Bureau, for instance, encompasses everyone from third-generation Chinese-Americans to Pakistani engineers to Cambodian refugees. People with origins in the Middle East have no U.S. Census designation of their own, and can self-identify as white, Asian, African or “other.” Without more specific data, it’s hard to know what problems local communities have and what services they need, Ko Chin says.

California policymakers have unusually detailed data at their fingertips thanks to the California Health Interview Survey, conducted by the University of California, Los Angeles. Researchers have been able to tease out findings that can inform better care, such as the fact that Korean women are much less likely to receive mammograms than Japanese women in the state.

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