DiversityNursing Blog

The U.S. has grown more diverse with every passing year, and healthcare is feeling that shift directly. Nurses are increasingly caring for patients whose cultural backgrounds, languages, and belief systems differ from their own. Many of these patients — particularly those from African, Latino, and Asian communities — face some of the steepest barriers to healthcare access and carry a disproportionate share of the country's health disparities. Since COVID-19, "disparity" has become a household word, but the underlying problem it names — that race and ethnicity still shape health outcomes across nearly every measure — is far from new.

Nursing sits at the center of this challenge. As the largest group of healthcare providers in the country, nurses show up in every setting where care happens: hospitals, outpatient clinics, rural health centers, detention facilities, and beyond. That reach means nursing education has an outsized role to play in whether the profession helps close health disparities or unintentionally reinforces them.

What Cultural Sensitivity Actually Requires

It's tempting to think of cultural sensitivity as simply knowing that different cultures exist. But real cultural sensitivity goes further — it means understanding and respecting each patient's background, from their religious practices to their family structure to their social circumstances, and letting that understanding shape how nurses communicate, what they recommend, and how they deliver care.

Cultural sensitivity is best understood as one piece of a larger picture that includes cultural competence and cultural humility. Competence is built through education, immersion experiences, and stronger communication skills — but a nurse's age, self-awareness, and training also shape how culturally attuned they become.

Nursing decisions are never made in a vacuum. Every day, nurses draw on core ethical principles — autonomy, justice, non-maleficence, and beneficence — to guide patient care. Cultural sensitivity training helps nurses apply those principles more effectively across diverse patient populations, and it fosters a more collegial workplace for an increasingly diverse nursing workforce.

The Weight of Bias

None of this works without confronting bias directly. Every person carries both implicit and explicit biases — attitudes shaped by upbringing, personal experience, and even social media exposure. Explicit bias is the kind we're consciously aware of holding. Implicit bias is trickier: it operates below conscious awareness, but it still shapes how caregivers treat patients and colleagues, often leading to unintentional discrimination and worse health outcomes.

Left unexamined, these biases calcify into stereotypes that damage both patient care and student-faculty relationships. That's not abstract — it plays out in real careers. Decades ago, as a pre-licensure nursing student struggling through my first college chemistry class, I sought guidance from my faculty advisor. Instead of support, I was told, "Maybe you should be a social worker." I pushed through, passed chemistry that summer, and more than forty years later, I hold a doctoral degree in nursing. I've heard nearly identical stories from other Black nurses — being warned the program "could be tough" for them, or that it "might be financially challenging" given their background. These aren't isolated incidents; they're a pattern underrepresented students still face, which is why mentorship and cultural sensitivity training need to be built into how we prepare the next generation of nurses.

Accrediting bodies have taken notice: The Joint Commission and the American Nurses Credentialing Center's Pathway to Excellence program now require healthcare organizations to assess their diversity, equity, and inclusion efforts. That accountability matters — but only if it's backed by real change in how nursing students are taught.

Take the DiversityNursing.com "Unconscious Bias" Quiz Today

Why Cultural Humility Matters More Than Checklists

At the heart of good nursing care is a simple idea: every patient deserves to be treated with dignity. Cultural humility is what makes that possible in practice, asking nurses to bring empathy and genuine curiosity into every patient interaction rather than imposing their own assumptions.

Cultural humility differs from a rigid, fact-based approach to competence: it treats self-awareness as an ongoing practice, not a box to check, requiring nurses to critically examine their own biases continuously. Done well, this fosters what researchers call cultural fluidity — a seamless exchange between a nurse's own values and those of the patients and colleagues around them.

Research backs this up. Arruzza and Chau (2021) found that nursing students are eager to learn about cultural competence but often start out without a clear sense of their own strengths and gaps; structured education leaves them more satisfied and better able to identify their own learning needs. Antón-Solanas and colleagues (2021) found something more sobering: unaddressed implicit and explicit bias can take a real toll on students' mental health and academic performance. This isn't only about patient outcomes — it directly affects whether nursing students, especially those from underrepresented backgrounds, succeed and stay in the profession.

What the Research Says About Getting This Right

The broader literature reinforces the same conclusion: nursing can genuinely help close healthcare disparities when academic programs fully integrate culturally competent education and invest in training faculty to teach it well. But the training itself has to evolve — early cultural competency education often leaned on stereotypes that have since been discredited, and outdated versions can do more harm than good.

Faculty can't be exempt from this work either. Nurse educators need their own cultural competency training to prepare students for multicultural patient care. Yet studies show students still witness racial stereotyping from academic and clinical staff, creating what researchers describe as pressure to be "exceptional to be considered average." Combine that with reduced social support and a shortage of diverse faculty role models, and it's easy to see how it wears down even capable students. Proposed remedies include focusing more on social determinants of health, building genuinely safe clinical learning spaces, and prioritizing the retention of diverse faculty.

Much of today's thinking traces back to Madeleine Leininger's Transcultural Nursing Theory, which established that nurses must recognize and respect the cultural backgrounds, beliefs, and practices of every patient. Programs built around this theory report stronger empathy, sharper critical thinking, and deeper commitment to the profession. The American Association of Colleges of Nursing has since built on this foundation with its Essentials framework. Not every intervention shows the same staying power, though — unconscious bias training shows mixed long-term results, suggesting deeply ingrained biases don't always shift easily.

There's also a broader accountability question. A health profession school's "social mission" should mean more than teaching science well; it means embedding equity into the curriculum itself. Yet a review by Orbán and colleagues (2021) of nine health profession accreditation standards found that none of the nursing accreditation bodies examined explicitly required curricula to address student diversity or health disparities — a real blind spot in how the profession holds itself accountable.

Moving Forward

Cultural competence is necessary, but it's not sufficient on its own. Real progress requires systemic change across healthcare organizations, academic institutions, and the broader socioeconomic conditions that shape health. Every nurse has a role to play: examining personal biases honestly, collaborating openly with colleagues and students, and creating space for students to speak up when something conflicts with cultural sensitivity — an act of patient advocacy in its own right. Clinical training programs should also make room for real-world exposure: rotations in community health clinics, neighborhood health centers, international clinics, and cultural immersion experiences give students something no textbook can — direct contact with the communities they'll eventually serve.

The goal isn't a nurse who has memorized facts about every culture they might encounter. It's a nurse who walks into any room ready to listen, willing to be corrected, and committed to treating the person in front of them with the dignity they deserve.

References

American Association of Colleges of Nursing. (2023). The essentials: Competencies for professional nursing education [PDF]. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Antón-Solanas, I., Tambo-Lizalde, E., Hamam-Alcober, N., Vanceulebroeck, V., Dehaes, S., Kalkan, I., Kömürcü, N., Coelho, M., Coelho, T., Casa Nova, A., Cordeiro, R., Sagarra-Romero, L., Subirón-Valera, A. B., & Huércanos-Esparza, I. (2021). Nursing students' experience of learning cultural competence. PLOS ONE, 16(12), e0259802. https://doi.org/10.1371/journal.pone.0259802

Arruzza, E., & Chau, M. (2021). The effectiveness of cultural competence education in enhancing knowledge acquisition, performance, attitudes, and student satisfaction among undergraduate health science students: A scoping review. Journal of Educational Evaluation for Health Professions, 18, 3. https://doi.org/10.3352/jeehp.2021.18.3

Chae, D., Kim, J., Kim, S., Lee, J., & Park, S. (2020). Effectiveness of cultural competence educational interventions on health professionals and patient outcomes: A systematic review. Japan Journal of Nursing Science, 17(3). https://doi.org/10.1111/jjns.12326

Etienne, S., & Lewis, L. (2024). Racial implicit bias: Perspectives of nursing students. Journal of Professional Nursing, 50, 95–103. https://doi.org/10.1016/j.profnurs.2023.10.007

Hughes, V., Delva, S., Nkimbeng, M., Spaulding, E., Turkson-Ocran, R.-A., Cudjoe, J., Ford, A., Rushton, C., D'Aoust, R., & Han, H.-R. (2020). Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. Journal of Professional Nursing, 36(1), 28–33. https://doi.org/10.1016/j.profnurs.2019.06.005

Joseph, O., Flint, S. W., Raymond-Williams, R., Awadzi, R., & Johnson, J. (2021). Understanding healthcare students' experiences of racial bias: A narrative review of the role of implicit bias and potential interventions in educational settings. International Journal of Environmental Research and Public Health, 18(23), 12771. https://doi.org/10.3390/ijerph182312771

Key data on health and health care by race and ethnicity. (n.d.). KFF. Retrieved April 3, 2025, from https://www.kff.org/key-data-on-health-and-health-care-by-race-and-ethnicity/?entry=health-coverage-access-to-and-use-of-care-access-to-and-use-of-care

Nursing workforce fact sheet. (n.d.). Retrieved April 3, 2025, from https://www.aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet

Ogundipe, A., Hylton, D., & Alexander, P. (2023). Inclusion of cultural competence and racial awareness in nursing education: An exploration of the nurse educator role. Nurse Education Today, 120, 105611. https://doi.org/10.1016/j.nedt.2022.105611

Orbán, J., Xue, C., Raichur, S., Misak, M., Nobles, A., Casimir, J., & Batra, S. (2021). The scope of social mission content in health professions education accreditation standards. Academic Medicine, 97(1), 111–120. https://doi.org/10.1097/acm.0000000000004437

Pryce-Miller, M., Bliss, E., Airey, A., Garvey, A., & Pennington, C. R. (2023). The lived experiences of racial bias for black, Asian and minority ethnic students in practice: A hermeneutic phenomenological study. Nurse Education in Practice, 66, 103532. https://doi.org/10.1016/j.nepr.2022.103532

The future of nursing 2020-2030: Charting a path to achieve health equity. (n.d.). https://nap.nationalacademies.org/catalog/25982/the-future-of-nursing-2020-2030-charting-a-path-to

U.S. Census Bureau. (n.d.). 2020 U.S. population more racially, ethnically diverse than in 2010. U.S. Department of Commerce. Retrieved April 3, 2025, from https://www.census.gov/library/stories/2021/08/2020-united-states-population-more-racially-ethnically-diverse-than-2010.html

Vela, M. B., Erondu, A. I., Smith, N. A., Peek, M. E., Woodruff, J. N., & Chin, M. H. (2022). Eliminating explicit and implicit biases in health care: Evidence and research needs. Annual Review of Public Health, 43(1), 477–501. https://doi.org/10.1146/annurev-publhealth-052620-103528

Vella, E., White, V. M., & Livingston, P. (2022). Does cultural competence training for health professionals impact culturally and linguistically diverse patient outcomes? A systematic review of the literature. Nurse Education Today, 118, 105500. https://doi.org/10.1016/j.nedt.2022.105500

As America's population ages, one healthcare challenge is becoming impossible to ignore: the growing demand for nursing home care. With the oldest Baby Boomers now reaching their 80s, more older adults will require long-term care for dementia, chronic illnesses, and assistance with daily living. Unfortunately, the nursing home system isn't expanding to meet those needs, it's shrinking.

A recent perspective from researchers at Weill Cornell Medicine warns that the United States is heading toward a significant long-term care crisis unless policymakers, healthcare organizations, and providers begin thinking differently about how nursing home care is funded, staffed, and delivered.

The Demand for Long-Term Care Is Rising

Today, more than one million Americans live in nursing homes, but that number is expected to grow dramatically over the next decade. Researchers estimate that the population of adults aged 80 and older will increase by more than 45% by 2036, creating unprecedented demand for skilled nursing services. At the same time, nearly 10% of U.S. nursing homes closed between 2011 and 2021, leaving fewer facilities available to care for a growing number of older adults.

This growing imbalance means many families may struggle to find appropriate long-term care when they need it most.

The Workforce Shortage Is More Than a Staffing Problem

While discussions about nursing homes often focus on the number of available beds, the real issue is the people needed to care for residents.

A facility may technically have licensed beds available, but without enough registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs), those beds cannot safely be occupied. Staffing shortages directly limit access to care, increase workloads for existing staff, and contribute to burnout across the workforce.

For nurses working in long-term care, this reality is already familiar. Many have experienced:

• Higher patient assignments
• Difficulty recruiting and retaining staff
• Increased overtime
• Emotional exhaustion
• Challenges providing the level of individualized care residents deserve

Dementia Care Will Drive Much of the Need

People living with dementia make up a large percentage of nursing home residents, and that number will continue to rise as the population ages.

The researchers emphasize that improving access to quality dementia care should be a national priority. Without adequate nursing home capacity, hospitals may experience longer stays for patients awaiting placement, while families face increasing caregiver responsibilities at home.

Five Strategies That Could Help

Rather than simply calling for more funding, the researchers propose several practical approaches to strengthen long-term care.

1. Invest in the Workforce

Competitive wages, career advancement opportunities, and ongoing education can improve recruitment and retention for nurses, nursing assistants, and other direct care professionals.

2. Modernize Payment Models

Current Medicare and Medicaid reimbursement structures often make it difficult for nursing homes, particularly those serving large Medicaid populations, to remain financially stable. Updating payment models could encourage facilities to invest more in staffing and resident care.

3. Support Rural Nursing Homes

When rural nursing homes close, families may have to travel long distances to visit loved ones, and hospitals can struggle to discharge patients who need long-term placement. Stabilizing these facilities is essential for maintaining access to care in underserved communities.

4. Strengthen Hospital–Nursing Home Partnerships

Cross-training staff, sharing workforce resources, and improving communication between hospitals and long-term care facilities can help create smoother transitions for patients while improving staffing flexibility.

5. Expand Access for People Living With Dementia

Policies that improve funding and coordination for dementia care can help ensure patients receive appropriate services earlier and reduce unnecessary hospitalizations.

What This Means for Nurses

Nurses are central to the future of long-term care.

Whether you work in acute care, rehabilitation, home health, or skilled nursing, you'll likely care for more older adults with increasingly complex needs throughout your career.

Beyond bedside care, nurses can help drive change by:

• Advocating for policies that strengthen the long-term care workforce
• Mentoring new nurses interested in geriatric care
• Supporting quality improvement initiatives
• Participating in interdisciplinary care planning
• Educating families about long-term care options

As demand continues to grow, nursing expertise will be critical in shaping a healthcare system that can provide safe, compassionate, and sustainable care for older adults.

Looking Ahead

America's nursing home challenges cannot be solved overnight. However, addressing workforce shortages, improving reimbursement models, strengthening partnerships, and investing in caregivers can help prepare the healthcare system for the future.

For nurses, this issue extends far beyond nursing homes. It affects hospital capacity, care transitions, patient outcomes, family caregivers, and the overall health of our aging population.

The decisions made today will influence how millions of older adults receive care for decades to come, and nurses will play an essential role every step of the way.

For many patients and their families, leaving the hospital can feel overwhelming. They may receive pages of discharge instructions, medication changes, follow-up appointments, and home care guidance all at once. Even when nurses provide thorough education, patients may still leave unsure about what they need to do next.

That's where health literacy makes all the difference.

A recent nurse-led quality improvement initiative highlighted by the American Association of Critical-Care Nurses(AACN) demonstrated that tailoring discharge education to a caregiver's health literacy level significantly improved understanding, increased satisfaction, and even reduced hospital readmissions.

What Is Health Literacy?

Health literacy is a person's ability to find, understand, and use health information to make informed decisions about their care. It goes beyond simply being able to read. It includes understanding medical terminology, following medication instructions, recognizing warning signs, and knowing when to seek medical attention.

According to research, limited health literacy is associated with poorer health outcomes, increased emergency department visits, and higher hospital readmission rates.

A Nurse-Led Initiative That Made a Difference

Nurses in the Pediatric Cardiothoracic Intensive Care Unit at Loma Linda University Children's Hospital recognized that many caregivers struggled to understand complex discharge instructions following pediatric heart surgery.

Rather than assuming every family needed the same educational materials, the nursing team implemented a personalized approach.

Within 24 hours of admission, caregivers completed a brief health literacy assessment available in both English and Spanish. This helped nurses identify each family's educational needs early in the hospitalization instead of waiting until discharge day.

The results showed that more than one-third of caregivers had limited or low health literacy, reinforcing the need for individualized education.

Personalized Education Improves Understanding

After assessing health literacy, nurses used educational materials designed for different literacy levels. These resources included:

• Plain language instead of complex medical terminology
• Visual aids such as pictures and illustrations
• Step-by-step instructions
• Easy-to-follow take-home packets

Before discharge, nurses reviewed five essential areas of care:

• Medication administration
• Wound care
• CPR basics
• Nutrition
• When to seek additional medical care

Most importantly, nurses used the teach-back method, asking caregivers to explain the information in their own words. This simple communication technique confirms understanding and allows nurses to clarify misconceptions before patients go home.

The Results Speak for Themselves

The initiative produced measurable improvements.

Caregiver satisfaction with nurse communication increased dramatically. In follow-up surveys one week after discharge, families reporting that nurses explained things in an easy-to-understand way improved from 80% to 100% over the course of the project. The hospital also saw a reduction in 30-day readmission rates following pediatric heart surgery.

These findings reinforce what many nurses already know: effective communication is just as important as clinical expertise.

Practical Ways Nurses Can Improve Discharge Education

Whether you work in acute care, outpatient clinics, long-term care, or home health, there are simple strategies that can make discharge teaching more effective.

Use Plain Language

Replace medical jargon with everyday words whenever possible.

Instead of saying:

"Administer this medication twice daily."

Try:

"Take one pill in the morning and one before bed."

Small language changes can dramatically improve understanding.

Don't Ask, "Do You Understand?"

Most patients will say "yes" even if they are confused.

Instead, ask:

• "Can you show me how you'll change this dressing?"
• "Can you tell me when you'll take this medication?"
• "What symptoms would make you call your healthcare provider?"

These questions encourage patients to demonstrate understanding rather than simply agreeing.

Start Education Early

Discharge teaching should not begin the hour before a patient leaves.

Introducing education throughout the hospital stay gives patients and caregivers time to absorb information, ask questions, and practice skills.

Use Visual Resources

Pictures, diagrams, medication schedules, and illustrated handouts often improve comprehension more than text-heavy documents alone.

Include Family and Caregivers

Many patients rely on family members after discharge. Including caregivers in education sessions helps ensure everyone understands the care plan.

Health Literacy Is a Patient Safety Issue

Poor communication can lead to medication errors, missed follow-up appointments, preventable complications, and unnecessary readmissions.

By recognizing that every patient learns differently, nurses can create safer transitions from hospital to home while building confidence in patients and families.

Health literacy isn't about simplifying care. It's about making sure patients have the knowledge and confidence they need to successfully manage their health after discharge.

As this nurse-led initiative demonstrates, a few thoughtful changes in how education is delivered can have a lasting impact on patient outcomes, caregiver satisfaction, and overall quality of care.

Nurses with disabilities take home significantly smaller paychecks than their non-disabled colleagues, even after accounting for hours worked and demographic differences, according to new research.

The Study

The research letter, titled "Wage Gaps Between US Nurses With and Without Disabilities," was authored by Laurin Bixby, K. Jane Muir, Michelle Kephart, and Mihir Kakara. It was published June 27, 2026, in Health Affairs Scholar (Bixby et al., 2026).

The team drew on a large, long-running federal dataset — the American Community Survey — covering 473,850 employed nurses ages 20 to 65 between 2008 and 2023. Within that group, 17,425 nurses, or 3.5%, reported having a disability.

Key Findings

• A 12.2% annual wage gap. Nurses with disabilities earned 12.2% less in annual wages than nurses without disabilities, even after the researchers adjusted for demographic characteristics and hours worked.
• Lower hourly pay and fewer hours. Nurses with disabilities earned 7.4% lower hourly wages and worked roughly 27 fewer hours per year than their non-disabled peers.
• The gap held across roles. Registered nurses with disabilities earned 11.6% less, while advanced practice registered nurses with disabilities earned 6% less than their counterparts without disabilities. The disparity was most pronounced among nurses reporting multiple disabilities, cognitive disabilities, or independent living disabilities.

Why It Matters

The study's authors point to workplace factors including: accommodations, scheduling flexibility, and organizational support, as likely contributors to the disparity and call for further research to pin down the underlying causes.

The findings arrive at a notable moment for the nursing workforce. As the field continues to diversify and age, the number of nurses managing disabilities or activity limitations is expected to grow, making pay equity an increasingly pressing workforce issue.

The Bottom Line

Nearly one in 30 nurses in the sample reported a disability, and those nurses consistently earned less than their peers, a gap that persisted across nursing roles and could not be fully explained by hours worked or demographics alone. The authors' call for more research on workplace accommodations and suggests hospitals and health systems have concrete levers to potentially close this gap.

Source: Bixby, L., Muir, K. J., Kephart, M., & Kakara, M. (2026). Wage Gaps Between US Nurses With and Without Disabilities. Health Affairs Scholar, qxag161. https://doi.org/10.1093/haschl/qxag161

Additional reporting details via: Jeffries, E. (2026, July 13). Nurses with disabilities earn 12% less: 4 study notes. Becker's Hospital Review. https://www.beckershospitalreview.com/quality/nursing/nurses-with-disabilities-earn-12-less-4-study-notes/

For many nursing students, summer break feels like it just began. The longer days, warm weather, and freedom from exams can make the season seem endless. But as July turns into August, the reality of a new semester slowly starts to creep in. Clinical rotations, lectures, care plans, skills check-offs, and study schedules are waiting just around the corner.

The good news is that you do not need to spend the rest of your summer buried in textbooks to be successful. In fact, one of the healthiest things you can do before nursing school starts again is find a balance between preparation and rest. Nursing school is demanding, and taking time to recharge is just as important as getting organized.

Here are a few things nursing students should start thinking about as the semester approaches, while still making the most of summer.

Reflect on Last Semester

Before jumping into preparation mode, take a few minutes to think about what went well and what was challenging during your last semester.

Ask yourself:

• Which study habits actually worked?

• Where did you struggle the most?

• Did you manage your time effectively?

• What would you like to improve this semester?

Reflection can help you start the next term with a clearer plan instead of repeating habits that may not have served you well.

Get Organized Early

A little organization now can save a lot of stress later.

Consider:

• Checking your school email for updates.

• Reviewing your upcoming course schedule.

• Ordering required textbooks.

• Making sure your laptop, tablet, or other study tools are working.

• Updating any clinical requirements such as immunizations, CPR certification, or background checks if needed.

Many nursing students feel overwhelmed during the first week of classes. Handling these tasks ahead of time can make the transition much smoother.

Refresh Key Nursing Concepts

You do not need to spend hours studying every day, but a light review can help ease you back into an academic mindset.

Focus on:

• Basic anatomy and physiology.

• Medical terminology.

• Dosage calculations.

• Vital signs and assessment basics.

• Common medications and safety principles.

Even 20–30 minutes a few times a week can help rebuild confidence before classes begin.

Think About Your Clinical Goals

As you move through nursing school, each semester brings new opportunities to grow.

Consider questions such as:

• What skills do I want to become more confident in?

• How can I improve my communication with patients?

• What type of nursing interests me most right now?

• Are there clinical experiences I want to seek out?

You do not need to have your entire career figured out, but thinking about your goals can make clinical experiences feel more meaningful.

Prepare Financially

Nursing school often comes with expenses that appear all at once.

Try to plan for:

• Textbooks and online access codes.

• Scrubs and clinical shoes.

• Transportation and parking.

• Meals during long clinical days.

• Licensing or testing fees that may arise later.

Creating even a simple budget can reduce financial stress once the semester starts.

Protect Your Mental Health

One of the biggest mistakes nursing students make is treating summer as a race to become “ahead.” Remember that rest is productive, especially before a demanding semester.

Use some of your remaining summer to:

• Spend time with family and friends.

• Go to the beach/pool/lake, hike, travel, or explore your local area.

• Read a book for fun.

• Get consistent sleep.

• Exercise in ways you enjoy.

• Disconnect from school-related stress for a while.

Burnout can begin long before graduation. Taking care of yourself now is an investment in your future nursing career.

Remember Why You Started

As the start of the semester gets closer, it is normal to feel a mix of excitement and anxiety. Nursing school can be challenging, but it is also preparing you for a profession that has the opportunity to make a real difference in people’s lives.

When the stress of upcoming exams and clinicals starts to build, take a moment to remember why you chose nursing in the first place. Whether your motivation is helping patients, supporting your community, pursuing a lifelong dream, or creating a better future for yourself and your family, that purpose can help carry you through the difficult days ahead.

A Simple Summer Checklist for Nursing Students

🔲 Review last semester’s strengths and challenges.

🔲 Check school emails and course schedules.

🔲 Order books and supplies.

🔲 Complete any clinical requirements.

🔲 Refresh basic nursing concepts.

🔲 Set one or two goals for the new semester.

🔲 Create a simple budget.

🔲 Make time for rest, fun, and the people you love.

Summer break is not over yet, and you do not need to choose between being prepared and enjoying yourself. The most successful nursing students are often the ones who learn how to balance responsibility with self-care.

As nursing school slowly gets closer to starting again, take small steps to get organized, refresh your knowledge, and set your goals. Then give yourself permission to enjoy the sunshine, the slower pace, and the moments that help you recharge.

Because once the semester begins, you will be glad you prepared—but you will also be glad you took time to enjoy the summer while it was still here.

Every July, the United States observes National Minority Mental Health Month, a time dedicated to raising awareness about the unique mental health challenges experienced by racial and ethnic minority communities. The observance also highlights the importance of improving access to culturally responsive mental health care and reducing disparities that continue to affect millions of Americans.

Originally established in 2008 and inspired by the legacy of author and mental health advocate Bebe Moore Campbell, National Minority Mental Health Month encourages healthcare professionals, organizations, and communities to recognize the barriers that many people face when seeking mental health support. These barriers may include stigma, discrimination, language differences, financial limitations, and a shortage of culturally competent providers.

Why Mental Health Equity Matters

Mental health is an essential part of overall health. It influences how people think, feel, manage stress, build relationships, and make decisions. Mental health conditions are common and treatable, yet many individuals do not receive the care they need.

According to the Centers for Disease Control and Prevention (CDC), nearly 1 in 4 U.S. adults lives with a mental illness, but people from racial and ethnic minority groups often face greater challenges accessing quality mental health services. These disparities can contribute to delayed diagnoses, untreated conditions, and poorer long term health outcomes.

Understanding Mental Health Disparities

Mental health disparities are influenced by many factors beyond an individual's symptoms. Social determinants of health, historical inequities, and systemic barriers all play important roles in shaping mental health outcomes.

Some common challenges include:

• Limited access to affordable mental health services
• Lack of insurance coverage or financial resources
• Shortages of providers who understand cultural backgrounds and lived experiences
• Language and communication barriers
• Fear of stigma within families or communities
• Experiences of racism, discrimination, and trauma

The National Institute on Minority Health and Health Disparities (NIMHD) notes that National Minority Mental Health Month is an opportunity to recognize these challenges while promoting education, awareness, and emotional well-being across diverse communities.

The Importance of Culturally Responsive Care

Culturally responsive mental health care recognizes that culture, identity, values, and lived experiences influence how individuals experience mental illness and seek treatment.

Healthcare organizations can improve outcomes by:

• Recruiting and supporting a diverse behavioral health workforce
• Offering interpreter and translation services
• Providing culturally informed training for clinicians
• Building trust through community partnerships
• Addressing bias and discrimination within healthcare systems

Patients who feel understood and respected are often more likely to seek care, remain engaged in treatment, and achieve better health outcomes.

Reducing Stigma Through Education

One of the greatest barriers to mental health care remains stigma. In some communities, mental illness may be misunderstood or viewed as a personal weakness rather than a medical condition.

Education plays a critical role in changing these perceptions. Open conversations about anxiety, depression, trauma, substance use disorders, and other mental health conditions can encourage individuals to seek help earlier.

Healthcare professionals, employers, educators, and community leaders all have opportunities to normalize discussions about mental health and promote available resources.

How Nurses and Healthcare Professionals Can Help

Nurses are often among the first healthcare professionals to recognize signs of emotional distress. Their ability to build trusting relationships places them in a unique position to support patients from diverse backgrounds.

Healthcare professionals can make a difference by:

• Screening patients for mental health concerns during routine visits
• Listening without judgment
• Respecting cultural beliefs and preferences
• Connecting patients with community resources and behavioral health specialists
• Advocating for equitable access to mental health services

Small actions can help create healthcare environments where every patient feels safe, heard, and valued.

Supporting Minority Mental Health Beyond July

National Minority Mental Health Month serves as an important reminder that mental health equity requires year round commitment. Expanding access to care, reducing stigma, supporting culturally responsive services, and addressing social barriers are all essential steps toward improving health outcomes for everyone.

By working together, healthcare organizations, providers, policymakers, and communities can help ensure that every individual has the opportunity to receive compassionate, high quality mental health care regardless of race, ethnicity, language, or background.

Resources

• National Institute on Minority Health and Health Disparities: https://www.nimhd.nih.gov/
• Centers for Disease Control and Prevention Minority Mental Health Resources: https://www.cdc.gov/minority-health/features/minority-mental-health.html
• National Institute of Mental Health: https://www.nimh.nih.gov/

There's a moment almost every nursing student experiences. You're standing at the bedside, maybe it's your first clinical day, maybe it's your first week on the floor as a new grad, and a small, cold voice whispers: "What are you doing here? Everyone else knows exactly what they're doing. You're going to hurt someone. You don't belong here."

That voice has a name. It's called imposter syndrome. And I want you to know something important before we go any further:

That voice is lying to you.

What Is Imposter Syndrome, Really?

The term was coined in 1978 by Psychologists Pauline Clance and Suzanne Imes to describe high-achieving people who are convinced their success is a fluke, that they've fooled everyone around them, and it's only a matter of time before they're "found out."

In nursing, it shows up in specific, painful ways:

• Attributing a successful patient interaction to luck, not skill
• Assuming every other student in your cohort "gets it" and you alone do not
• Apologizing before speaking in clinical
• Feeling like asking questions proves you shouldn't be there
• Dreading the moment a patient, family member, or preceptor "realizes" you're incompetent
• Studying longer than anyone else but feeling less prepared than everyone else

Here's what's important to understand: imposter syndrome is not a sign that you're in the wrong field. In nursing, it is often a sign that you are deeply, appropriately conscientious about the weight of your work. 

Why Nursing Is Especially Fertile Ground for Imposter Syndrome

Nursing attracts people who care enormously, about doing things right, about not harming anyone, about being good enough. And then we put those people into an environment that is:

• High-stakes by definition. People's lives are literally in your hands. Of course that feels enormous.
• Constantly exposing your knowledge gaps. Medicine is vast. No one, not the 30-year ICU Nurse, not the CNO, not the attending Physician, knows everything. Nursing school just makes your gaps feel uniquely shameful.
• Full of comparison. Clinical rotations, simulation labs, and group study all put your learning on display next to everyone else's.
• Emotionally exhausting. When you're depleted, that critical inner voice gets louder.
• Hierarchical. New Nurses are often afraid that admitting uncertainty will be perceived as incompetence rather than honesty.

And for Nurses who are also navigating first-generation college student status, racial or gender minority identity, or returning to school after years in a different field, the weight of feeling like you don't quite fit the mold can be even heavier.

Practical Strategies That Actually Work

Name it out loud

The single most powerful thing you can do is say it. Tell a trusted classmate, your clinical instructor, your mentor, or a counselor: "I'm really struggling with feeling like I don't belong here." You will be shocked by how many people look you in the eye and say, "Me too. I thought I was the only one."

Imposter syndrome thrives in isolation and silence. Naming it out loud is the beginning of defusing it.

Keep a "wins" journal

Our brains are wired to hold onto negative experiences and let positive ones slide by. This is especially true when we're anxious. A wins journal is a direct counter to that wiring.

At the end of each clinical day or shift, write down three things you did well, no matter how small. "I gave my first IM injection and the patient said I had a gentle touch." "I noticed the patient's BP was trending down before anyone else flagged it." "A family member thanked me for taking time to explain the discharge instructions."

Read these entries when the voice gets loud. That is evidence. Real evidence. Work with it.

Reframe "I don't know" as a clinical skill

In nursing school, we are taught that not knowing an answer is dangerous. That lesson is meant to keep patients safe, but it gets distorted: students start to believe that not yet knowing something means they shouldn't be Nurses.

Here's the truth: the most experienced Nurses I know ask more questions, not fewer. They verify things. They say "let me double-check that" without shame. Knowing what you don't know and knowing where to find the answer is one of the most important safety behaviors in nursing.

Start practicing saying: "I'm not certain, let me look that up and come right back to you." Say it to your preceptor. Say it to patients. It is not a sign of weakness. It is how errors are prevented.

Find your "mirror" person

Find someone who looks or sounds like you, who has already walked the path you're walking, and watch them work. This is not superficial. Representation genuinely matters to our nervous systems. When you can see that someone from your background, your generation, your story is doing this work with skill and grace, your brain starts to accept: then I can, too.

If you can't find that person on your unit, look for nursing organizations, podcasts, and communities that center voices like yours. They exist.

Separate feeling from fact

Imposter syndrome is a feeling, not a diagnosis and not a verdict. Feelings are real,  they are not always accurate.

When the voice says "you don't know what you're doing," ask yourself: What is the actual evidence for and against that claim? You passed your courses. You completed your clinicals. Your preceptor signed off on your competencies. Your instructor didn't call you aside out of concern,, you are doing it.

Feelings deserve acknowledgment. They do not deserve to run the show unchallenged.

Get a mentor and be honest with them

One of the greatest gifts you can give yourself as a student or new Nurse is a mentor who will be honest with you. Not someone who flatters you, and not someone who crushes you, someone who will tell you what you're genuinely doing well and where you still need to grow.

When you have that relationship, you don't have to rely solely on your own (often distorted) self-assessment. You have someone who can say, "You're doing better than you think you are", and who you'll actually believe.

Give yourself the timeline you actually need

New Nurses are often shocked by how long it takes to feel competent. Research consistently suggests it takes 12 to 18 months in a specialty to feel genuinely confident, sometimes longer. If you're six weeks into your first job and you don't feel like you've "got it," that is completely normal. That is not evidence of failure. That is just where you are in the process.

Competence is not a switch that flips. It is a slow accumulation.

You Were Not Admitted by Accident

You were admitted to your nursing program, or hired for your nursing job, by people who reviewed your record, your essay, your interview, your references, and decided: this person has what it takes.

They did not make a mistake.

The patients who are going to cross your path in this career, they need you specifically. They need your particular kind of attention, your particular questions, your particular presence. There is no one else who will bring exactly what you bring.

Imposter syndrome will tell you otherwise. It will be persistent, and it will be convincing, and it will choose its moments carefully, usually the hardest ones.

But here's the thing, the ones who feel it most deeply are often the ones who become the very best. Because they never stop asking whether they're doing right by their patients. Because they never assume they already know everything. Because the discomfort of uncertainty keeps them sharp and humble and searching.

So when that voice shows up, and it will, I want you to say this back to it:

I know you. I see you. And I'm going to keep going anyway.

Because that is exactly what Nurses do.

If you're struggling with imposter syndrome, anxiety, or burnout, please reach out to your school's counseling services, your employee assistance program (EAP), or a trusted mentor. You don't have to navigate this alone.

I've been a Nurse long enough to remember when "burnout" wasn't something we talked about openly. You pushed through a brutal shift, grabbed a lukewarm coffee from the break room, and did it all again the next day. Admitting you were struggling felt like weakness, or worse, like you weren't cut out for the job you'd worked so hard to get.

That culture hasn't entirely disappeared. But at least now, we have data, real numbers that force healthcare institutions and policymakers to look at what's happening to the people caring for their patients. The 2026 Nurse Salary and Work-Life Report from Nurse.com is the latest entry in that conversation, and while it holds a few cautious bright spots, it mostly confirms what those of us on the floor already know in our bones: this is still a crisis.

Let me walk you through what stands out to me, Nurse to Nurse.

The Headline Number: 53% And Why That's Not Actually Good News

More than half of all Nurses surveyed, 53% reported experiencing burnout in the past two years. I want to acknowledge the modest improvement: that's down from 59% in 2024. Progress is progress, and I'll take it.

But let's be honest with each other. When more than one in two Nurses say they're burned out, that isn't a workforce that's recovering. That's a workforce that's been running on fumes for so long that fumes have started to feel normal.

And here's the number that hits harder than the burnout rate itself: 62% of Nurses said they felt overwhelmed. Overwhelmed is burnout's waiting room. It's where you sit before the exhaustion becomes too deep to shake off with a long weekend or a few yoga classes your hospital system email promoted in a "wellness newsletter."

Prolonged stress (53%), ethical dilemmas and moral injury (51%), compassion fatigue (46%), these aren't just words on a survey. These are what you feel when you've been the one holding a patient's hand as they died because their family couldn't get there in time, then gone straight to answering call lights for the next four hours.

What's Actually Driving Burnout (Hint: It's Not That We Need More Resilience Training)

The report asked Nurses what workplace factors most negatively affect their mental health and well-being. Here's the top five:

• Dissatisfaction with salary and wage increase policies (49%)
• Lack of responsive leadership (48%)
• Unmanageable Nurse-to-patient ratios (48%)
• Documentation workload (43%)
• Not being heard (41%)
  
  

I have spent years listening to administrators tell Nurses to practice self-care and reach out to employee assistance programs. And while I'm not dismissing those resources entirely, notice what's on this list: pay. Leadership. Staffing ratios. Paperwork. Feeling invisible.

These are systemic problems. They are not fixed by a mindfulness app or a free smoothie in the break room during Nurses Week.

We cannot document our way out of short staffing. We cannot deep-breathe our way through a 1:7 Nurse-to-patient ratio on a Med-Surg floor. And we absolutely cannot feel valued when leadership doesn't respond to our concerns and our paychecks don't reflect the weight of what we carry.

Workplace Violence: The Number That Should Disturb Everyone

I need to spend a moment on this, because it doesn't get enough attention outside nursing circles.

83% of Nurses experienced verbal abuse from patients or family members. Nearly one in three Nurses (35%) experienced physical assault or abuse. And 15% of Nurses reported that workplace violence happened to them on a weekly basis.

Weekly.

Let that sit for a moment. We are talking about Nurses going to work knowing they may be hit, screamed at, or threatened, regularly, and still showing up. Because the patient in bed 4 still needs their medication. Because someone has to be there.

These numbers are reportedly higher than what was recorded in 2024, which means this trend is moving in the wrong direction. Workplace violence doesn't just cause physical harm. It fuels the emotional exhaustion that sits at the core of burnout. It erodes psychological safety. It makes people ask themselves, "Why am I doing this?"

And speaking of that question...

Nearly One in Four Nurses Is Thinking About Leaving

Twenty-four percent of Nurses in this survey said they are considering leaving the profession. Among male Nurses, that number climbs to 30%. LPNs and LVNs are also at 25%. Baby Boomers, many of whom are approaching retirement age, sit at 30% as well.

The top reasons Nurses left their last position? Better pay, dissatisfaction with management, and family or personal responsibilities.

This matters far beyond individual career decisions. Research has consistently linked burnout to increased turnover, greater staffing shortages, higher absenteeism, and impacts on patient care quality. When Nurses leave, the Nurses who stay absorb more. That makes the remaining Nurses more likely to burn out. Which makes more Nurses leave. You can see the cycle.

Demographics Most Impacted

The data breaks down in ways that are worth paying attention to, particularly for those of us who work in or lead diverse teams.

Asian Nurses reported the highest burnout rate of any racial or ethnic group surveyed, at 59%. They were also most likely to express concerns about patient data privacy in the context of AI,  a reminder that emerging technology is not a neutral stressor; it lands differently depending on who you are and what communities you serve.

Hispanic, Latinx, and Spanish Nurses reported the highest rates of feeling overwhelmed, at 67%. Nearly seven in ten Nurses in this group are carrying that weight.

Black or African American Nurses were more likely to report receiving pay increases after earning certifications, a meaningful finding about what can support career growth and satisfaction for Nurses from this community.

White Nurses were most likely to report considering leaving the profession at 25%, and were the most represented group in the survey.

There is no one-size-fits-all approach to addressing burnout. The data makes that clear. Solutions need to be attentive to who is experiencing what, and why.

The Mental Healthcare Stigma That Still Lives Among Us

Here's something that stopped me: 21% of Nurses said they avoided seeking mental health services because they feared it would harm their careers.

I understand this fear. Deeply. The concern that disclosing mental health struggles could affect your license, your standing, your reputation, it is not irrational. It exists because of real historical patterns in how healthcare systems have treated Nurses who came forward.

But what it means in practice is that Nurses who need support aren't getting it. And that has consequences for the Nurses themselves, for their colleagues, and for their patients.

Healthcare institutions need to build genuinely confidential, destigmatized pathways to mental health support, not just list an EAP phone number in an employee handbook that nobody opens. And 20% of Nurses said they want more wellness resources from their employers, which tells us the desire is there.

A Few Cautious Signs of Hope

I don't want to leave you without acknowledging what the data also shows: things are, in small ways, getting better.

Burnout is down six percentage points since 2024. Feelings of overwhelm dropped from 68% to 62%. Concern about the job's effect on physical health fell from 49% to 40%. These aren't massive swings, but they are movement, and movement in the right direction matters.

What's less clear is why. Has hospital leadership genuinely improved? Have staffing models shifted? Are more Nurses setting firmer boundaries? The report doesn't tell us definitively, and the honest answer is probably that it's a combination of factors, some of which we control and many of which we don't.

What We Need to Say Out Loud

If you're a Nurse reading this and recognizing yourself in these numbers, the exhaustion, the overwhelm, the quiet wondering whether you can keep going, I want you to know that what you're experiencing is real, it is not a personal failure, and you are not alone.

The data shows clearly that this is a systems problem masquerading as an individual one. Burnout is not what happens when Nurses aren't tough enough. It's what happens when the conditions of nursing work are allowed to remain unsustainable.

And if you're a healthcare leader, an administrator, a policymaker reading this: the evidence is in front of you. Nurses are telling you, through surveys, through resignation letters, through the 15% who are experiencing violence every single week, what needs to change.

Pay Nurses fairly. Fix the staffing ratios. Create actual psychological safety where Nurses can speak up without fear. Stop the documentation burden from swallowing the time Nurses need to care for patients. Listen when Nurses tell you something is wrong.

That's not a resilience workshop. That's the work.

Data cited in this article is drawn from the 2026 Nurse Salary and Work-Life Report, published by Nurse.com, based on a survey of over 500 Nurses conducted nationally between September and October 2025.

DiversityNursing.com marks two decades as the nation's premier inclusive nursing community — far more than a job board, a home for every Nurse.

DiversityNursing.com is proud to celebrate its 20th anniversary, marking two decades of serving as an indispensable bridge between Nurses, nursing students, and the healthcare employers who depend on their exceptional talent. What began in 2007 as a career job board and information resource has grown into a thriving, purpose-driven community for Nurses of every background, regardless of age, race, gender, religion, national origin, sexual orientation, disability, or physical characteristics.

"We have always believed that nursing is for everyone, and that every Nurse deserves a place to belong, grow, and be celebrated. Twenty years on, that belief has never been stronger."

From its earliest days, DiversityNursing.com was built on a simple but powerful idea: that diversity in nursing makes healthcare stronger. Over two decades, that vision has been realized through a platform that connects thousands of Nurses and nursing students with career opportunities, educational resources, peer support, and the professional recognition they deserve.

20 YEARS OF SERVICE

$90K GIVEN IN EDUCATION AWARDS

70K+ FACEBOOK FOLLOWERS

More Than a Job Board: A Community

While DiversityNursing.com remains a leading destination for Nurse recruitment, its identity has long extended beyond job listings. The platform is a full-service community ecosystem, offering Nurses and nursing students a rich array of tools and resources to support every stage of their careers and education.

Nurses visiting the site can search open positions nationwide, post their resumes directly to healthcare employers, explore detailed employer profiles, and access the platform's extensive blog covering topics from clinical practice to workplace wellness and beyond.

The site's comprehensive resources section provides Nurses with practical, interactive tools, including a Nurse Self-Assessment Burnout Quiz, an Unconscious Bias Quiz, and a Workplace Safety Survey, all reflecting the platform's deep commitment to Nurse well-being and professional development.

Regular newsletters, a digital eZine, a curated nursing conferences calendar, and an annual Nurse Appreciation Dates Calendar round out an offering that keeps Nurses informed, inspired, and engaged year-round.

Social media has been central to building the DiversityNursing.com community, with an audience of more than 70,000 followers on Facebook alone, a testament to the genuine connections forged across Facebook, Instagram, LinkedIn, X, Pinterest, and YouTube.

The $5,000 Annual Education Award: Investing in the Future of Nursing

Each year, DiversityNursing.com awards $5,000 to a deserving nursing student or licensed Nurse to support their continued education. Over 20 years, $90,000 has been given directly to Nurses and future Nurses pursuing their academic goals.

Now in its 19th annual cycle, the Education Award has become one of the nursing community's most anticipated programs. Year after year, recipients represent the extraordinary commitment Nurses make, not only to their patients but also to their own professional growth.

A Trusted Partner for Healthcare Employers

For healthcare systems, hospitals, and other employers seeking to build highly qualified nursing teams, DiversityNursing.com offers a uniquely powerful platform.

Employers can post open positions, create detailed profile pages that showcase their culture and nursing environment, and reach a vast, engaged audience of active and passive Nurse candidates across all 50 states.

Premier employer partners, including leading health systems, children's hospitals, VA facilities, and major academic medical centers, benefit from a community that values transparency, inclusion, and authentic connection.

Looking Ahead: The Next 20 Years

As DiversityNursing.com celebrates this milestone anniversary, the platform looks forward to deepening its commitment to the nursing community it has proudly served since 2007.

With new content, expanded resources, continued Education Award programs, and an unwavering dedication to Nurses of all backgrounds, DiversityNursing.com remains the home for every Nurse and every future Nurse in America.

Contact Information
Joanie Barton
Email: jbarton@diversitynursing.com

# # #

A group of the nation's leading nursing organizations have joined forces to file a lawsuit against the U.S. Department of Education, challenging a recent rule change that affects how nursing degrees are classified for federal student loan purposes. The outcome of this legal battle could have far-reaching consequences for nursing education, workforce development, and patient care across the country.

What Changed — and Why It Matters

Under the new policy, set to take effect July 1, 2026, graduate nursing programs are classified as standard graduate degree programs rather than professional degree programs. That distinction is significant because it determines how much students can borrow through federal loan programs.

Students in programs with a professional degree designation can borrow up to $50,000 per year with a lifetime cap of $200,000. Those in graduate degree programs are limited to $20,500 annually and $100,000 over their lifetime — a substantial difference for Nurses pursuing advanced practice roles that often require expensive master's or doctoral programs.

Who's Behind the Lawsuit

The eleven organizations that filed suit represent a broad cross-section of the nursing profession:

• American Nurses Association (ANA)
• American Association of Nurse Anesthesiology (AANA)
• Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN)
• American College of Nurse Midwives (ACNM)
• American Holistic Nurses Association (AHNA)
• Association of Pediatric Hematology/Oncology Nurses (APHON)
• Chi Eta Phi Sorority, Inc.
• The Health Ministries Association (HMA)
• National Association of Clinical Nurse Specialists (NACNS)
• National Association of Nurse Practitioners in Women's Health (NPWH)
• The American Association of Nurse Attorneys (TAANA)

This lawsuit is separate from a similar legal challenge filed by a coalition of states, though both aim to block portions of the new borrowing restrictions.

Four Key Concerns for the Nursing Workforce

Fewer Nurses may pursue advanced practice roles. Many Registered Nurses return to school mid-career to become Nurse Practitioners, CRNAs, Nurse Midwives, or Clinical Nurse Specialists — often while managing jobs, families, and existing financial obligations. If federal loan options shrink, some may decide that graduate school simply isn't financially feasible. The AANA has noted that restricting the pipeline of CRNAs is especially concerning given growing patient demand and the critical role these providers play in rural and underserved areas.

The nursing faculty shortage could get worse. Nursing schools are already struggling to find enough qualified educators. According to the American Association of Colleges of Nursing, more than 80,000 qualified nursing applicants were turned away in 2024 — not for lack of interest, but for lack of faculty. Since most Nurse Educators hold graduate or doctoral degrees, any reduction in the number of Nurses pursuing advanced education could shrink the future pool of faculty, creating a cycle that limits both educational capacity and workforce growth.

Rural and underserved communities could be hit hardest. Advanced Practice Nurses are a lifeline in areas where Physician shortages are most severe. Projections from the Health Resources and Services Administration suggest that by 2028, rural areas could face a nursing shortage nearly five times greater than metro areas. Fewer Nurses entering advanced practice roles would disproportionately affect the communities that already have the least access to care.

Employers may be left to fill the financial gap. As federal support shrinks, health systems may face growing pressure to expand tuition reimbursement programs and academic partnerships to attract and develop talent. While employer-sponsored education can be a valuable tool, it also introduces new disparities — Nurses working for organizations with generous benefits fare far better than those who don't.

What's Next

The courts will ultimately decide whether the Department of Education's classification holds up to legal scrutiny. In the meantime, nursing leaders are urging policymakers to recognize that decisions about graduate education financing are inseparable from the broader challenge of building a sustainable healthcare workforce. Access to affordable advanced education isn't just a student issue — it's a patient care issue.