DiversityNursing Blog

In the wake of the COVID-19 pandemic, higher education is seeing a rise in demand for health and medical education.

According to Kaiser Health News, enrollment in baccalaureate Nursing programs increased nearly 6% in 2020, to 250,856, shown in preliminary results from an annual survey of 900 Nursing schools by the American Association of Colleges of Nursing.

“It’s unprecedented,” said Geoffrey Young, senior director for student affairs and programs at the Association of American Medical Colleges. In the past two decades, the average yearly increase for total applications to medical schools has been about 2.5%, he said. This year, applications are up 18% over all.

Glen Cornwall, the Dean of Tampa Bay’s Galen College of Nursing says as people see the need in the community, they’re enrolling in greater numbers. “With this pandemic, it’s that extra urge to say this is the time," he said.

Dr. Ken Kaushansky, Dean of Stony Brook University’s Renaissance School of Medicine believes the reasons behind the surge are inspired by the pandemic and the need for financial security during a time of job loss and unemployment.

"This is my 11th year and I don’t remember us going up by 14% in any year," he said. "More typical is a 3 to 4 percent increase year over year."

Dr. Demicha Rankin, Associate Dean of admissions at the Ohio State University College of Medicine believes the influx of applicants is also a factor of the growing awareness of systemic racism.

Rankin said, “It is not just the viral pandemic but also is the awakening of the dedication to addressing racism has also been a motivation for many to try to bring equitable care to their own community."

Most schools are conducting interviews virtually so students do not have to pay for in-person travel costs.

Dr. Beth Piraino, the Associate Dean of admissions and financial aid at the University of Pittsburgh School of Medicine said, "Now applicants don't have to pay to travel to interview, so they could easily interview at 20 places whereas before they may have had to restrict it."

In the midst of a global pandemic, the approach toward the academic year is very different from previous years. Nursing schools in 2021 will be a mix of online classes, in-person  clinicals, virtual and in-person simulated experiences, and some in-person and online testing.

Southern Illinois University Edwardsville School of Nursing Dean, Laura Bernaix, PhD, RN is encouraged by the increase in enrollments and believes the key to successfully adapting to this surge is the faculty.

“Great faculty, who not only are great educators in the classroom but also experts at curriculum design, are the key,” she said.

Last year, Chief Diversity Officer (CDO) hires grew by 84%, making it the fastest growing C-suite title, according to LinkedIn.

There has been a national wave of concern about racial inequities, especially in healthcare, with the arrival of the COVID pandemic.

Many healthcare organizations are increasing their Diversity, Equity and Inclusion (DEI) efforts. Leaders are addressing racial health disparities and finding ways to improve patient care for all. Part of their efforts include establishing a Chief Diversity Officer role.

Winifred King is Cook Children’s first ever Chief Diversity Officer. King said, “It is hard to put into words what this decision and investment means to people of color and anyone who has ever felt different or excluded. For all of us who may have experienced inequities and mistreatment in our lifetimes, it is comforting to be a part of an organization that accepts our differences, our failures, and is willing to look inward and truly examine what is at the heart of our culture.”

“COVID-19 is amplifying health disparities in communities of color,” said Quita Highsmith, the Chief Diversity Officer of biotech company, Genentech. “It is now time for us to stop tiptoeing around it and start thinking about what we are going to do.”

Education and awareness are playing a key role in improving health outcomes for diverse communities. The CDO coordinates efforts internally to provide staff with resources and courses, such as cultural competence training as well as finding ways externally to work with the community they serve.

In addition, the CDO helps to create recruitment programs that ensures their DEI message is reaching diverse candidates. As a member of the C-suite, the CDO can communicate to all leaders that diversity recruitment, for all position levels, should be a priority.

Studies suggest diversity in healthcare leadership enhances quality of care, quality of life in the workplace, community relations, and the ability to affect community health status.

The CDO helps to define, educate, and communicate the hospital/health system’s culture and DEI message to its staff, patient population and community.

Joseph Hill, was the first Chief Diversity Officer at Jefferson Health. He requested they establish focus groups with patients to better understand their expectations and view of the system. With the information provided by the focus groups, they found the areas that needed improvements.

HCA Healthcare created the BRAVE Conversations program, an ‘outside the box’ platform designed to facilitate interactive, inclusive, innovative and safe ways for employees to share their thoughts on issues that may be difficult to discuss.

It is imperative that leadership is committed to their DEI mission. Without it, the CDO cannot wave a magic wand and transform an entire organization overnight. It takes commitment, communication both internally and externally, resources, time, and effort from all areas of the health system.

Many health systems are focusing attention on the impact visitations and family communication has on reducing the suffering of patients and loved ones. It is traumatic for patients and families to be separated, to suffer or die alone. 

Hospitals are modifying guidelines and finding alternatives to help achieve that human connection in a safe way. 

Not only do these restricted visitation policies effect the patients and their families, it also has an effect on health care workers. 

According to STAT news, Nurses experienced intense moral distress over having to enforce these policies, which conflicted with their sense of just and humane care. 

Darlene Randolph, a registered dietician, lost her husband, Dr. Dave Rudolph, to Covid-19 and wished she could have been there for him. Working in hospitals, she knew the protocols and restrictions that had to be enforce but hoped she could do something about it. 

On Christmas Eve, Darlene wrote to Dr. Anthony Slonim, President and Chief Executive Officer of Renown Health in Reno, NV. She expressed her gratitude and thanked the staff working under dangerous circumstances and risking their lives to care for others. 

When financial resources are too thin to hire extra staff, hospitals have looked to medically trained volunteers to provide patients some comfort.

Michigan Medicine’s created the No One Dies Alone (NODA) program, where volunteer medical students bring comfort to patients who find themselves alone at the end of their lives.

“It’s not just the institutional limitations on visitors. The travel restrictions make it more difficult for those coming from far away,” said Social Work Program Manager, Amanda Schoettinger. “Some people aren’t working and might not have the money to travel. Some are sick themselves. A lot of people are afraid to come to the hospital, which is understandable."

Some health care workers are volunteering time after their long shifts to be with patients who are suffering alone.  

Ben Moor works in a Massachusetts hospital and has started volunteering since he received his vaccinations. In a STAT news article he wrote, "Shielded behind an N95, visor, gown, and gloves, I reckon I’m now about as safe as I can be. So when my day’s work as an anesthesiologist is done, I’ve started sitting with Covid-19 patients. At first I tried chatting with them, but when someone is breathing 30 times a minute through an oxygen mask, it’s difficult to be a great conversationalist. Now I talk to them, hold a hand, get them water, arrange their pillows. Sometimes I just sit there because I have this nagging, incompletely explored belief that just a human presence, someone bearing witness to their ordeal, has value. Afterward, I call the family because they are victims of this virus too."

According to research, there are risks of depression, anxiety, and post-traumatic stress disorder, in family members of patients who die in ICUs. Now there is extra stress of having to wait by the phone for terrible updates, not being able to see your loved ones, and not being able to say final goodbyes. Health systems, as busy and well-intentioned as they are, must continue to find ways to provide family-centered care. It benefits them, their patients, and the patient’s families.

Chief Nursing Officers have a wide variety of responsibilities. Their role has become more complex with the COVID-19 pandemic, social injustices, and systemic racism in the United States.

The pandemic is straining the healthcare profession. Nurses are under immense stress and Nursing leaders need to use best practices to address the mental and emotional trauma their teams are enduring.

In an article by HealthLeaders, Penn Medicine Princeton Health Chief Nursing Officer, Sheila Kempf, PhD, RN, NEA-BC said they are implementing many strategies to care for Nurses' mental health.

Some of those strategies include training staff to recognize the signs of being at high risk for emotional distress, and when peers should be referred to the Employee Assistance Program (EAP).

Also the hospital has contracted a trauma clinical Psychologist to talk with staff and run support groups with the EAP and the Ministries department.

CNO's should recommend frequent breaks or a quiet space for Nurses to retreat to.

Nurse leaders are also facing the challenges of short staffing, low resources, and supplies.

According to a survey by Inspire Nurse Leaders, 53% of Nurse Leaders reported difficulty meeting work and family needs due to inadequate staffing.

Risley-Gray also said, health systems need to hire outside help when Nurses become infected or get exposed to the virus. Aspirus is offering Nurses who have at least one year's experience a $15,000 signing bonus, as well as employing contract Nurses via private staffing companies.

2020 not only brought forth a pandemic, it also put a spotlight on systemic racism and racial health disparities.

Sharon Hampton, PhD, RN and Director of Clinical Operations at Stanford Health said, "We've discussed our ethical and moral responsibilities to deal with this crisis. Nursing is really in this position to help the public understand and to advocate."

Healthcare systems and Nurse leaders should be promoting diversity and inclusion at all levels of the workplace.

Kelly Hancock, RN, DNP and Executive CNO of the Cleveland Clinic Health System, said more diversity would help the Nursing workforce “provide more customized, culturally-sensitive and safer care” and “better assess, accommodate and cater to the healthcare needs of different minority groups.”

Those in leadership positions should reflect the diverse patient populations they serve.

According to HealthLeaders Media, a study by the Institute for Diversity and Health Equity found that racial minorities represented 32% of patients in hospitals that participated in the study, but similar representation wasn't found among the health care leadership. According to the study, 19% of first- and mid-level management positions, 14% of hospital board membership positions, and 11% of executive leadership positions were held by racial minorities.

Hospitals and health systems must commit to increasing diversity within their leadership to improve patient outcomes, reduce racial health disparities, and build stronger communities.

A 2021 list ranking the best-paying states for Nurses has been released by Business.org. They calculated this list by comparing the average Nursing salary to the average income to find the percentage difference. Then they calculated how many hours Nurses must work to afford rent.

Here are some key points from the report:

Over 2.9 million Nurses work in the United States, and make an average salary of $77,460 per year.

Nationally, Nurses make 45% more than the average salary for all other occupations. And in 15 states, Nurses make more than the national average. 

Hawaii topped the list, with Nurses making 89% more than other occupations for a total salary of $104,060.

Washington DC ranks last on the list. Nurses in DC make only 5.6% more than the average salary for all other occupations.

California boasts the highest wage per hour for Nurses, at $54.44. South Dakota has the lowest wage per hour for Nurses at $28.63.

Nationally, Nurses work an average of 29.5 hours to be able to afford a month’s rent. The national average income requires 42.7 hours of work to afford rent. 

Following Hawaii, the other top states for Nursing salaries are Nevada, California, Oregon, and New Mexico. 

To view the full list of best salaries by state, click this link.

According to a U.S. News & World report, Nurse Practitioners made a median salary of $109,820 in 2019. The best-paid 25 percent made $127,030 that year, while the lowest-paid 25 percent made $92,790. 

The best paying states for Nurse Practitioners: 

• California- $138,660

The need for in-home care has grown since COVID-19 because many fear contracting the virus in hospitals and clinics, especially among the elderly population.

With no security like hospitals usually have, home visiting Nurses put themselves at risk whenever they enter a patient's home alone. 

Ha Do Byon, Assistant Professor of Nursing at the University of Virginia School of Nursing mentions in a  STAT news article, "Even before the pandemic struck, I heard Nurses’ stories of home visits — some during my time as a visiting Nurse, and others as part of a study I am conducting to understand violence faced by home visiting Nurses. They told me about patients who blared pornography, or being groped while administering care. About patients who waved handguns and hurled racial insults. About being bitten, punched, kicked, or slapped. About dealing with screaming fits, intoxicated family members, and dogs that bit them or threatened to."

According to a 2015 study by BMC Public Health, the threat of workplace violence was one of home health workers’ top concerns, ranking above transportation issues or environmental hazards.

Developing a safety program for your home care workforce is crucial in reducing health care worker stress and turnover.

The rate of patient-on-Nurse violence among home visiting Nurses is unknown.

An article in Home Care Magazine states, only one-fifth of violent incidents “are ever reported in part due to embarrassment, organizational culture, tolerance or excusing the behavior of ‘ill’ clients." Nurses have cited fear of retribution from supervisors, the complexity of the legal system and disapproval from administrators as barriers to reporting workplace violence.

Nurses and providers can take measures to prevent violent situations.

We view Nurses and healthcare workers as heroes and we should appreciate the essential work that home visiting Nurses provide by making sure they can safely do their job and feel comfortable enough to notify management when they aren't safe.

The Foundation of the National Student Nurses’ Association is delighted to announce a new diversity scholarship award sponsored by Johnson & Johnson. Funding may be used for tuition, fees, and books. Use the same application to apply for all FNSNA scholarships. 

Students must complete the race/ethnicity question to qualify. There is $225,000 available. Awards up to $7,500.

Click here for more information: https://www.forevernursing.org/2021-online-scholarship-applicationinstructional-sheet.html

Click here for the application: https://app.mykaleidoscope.com/scholarship/fnsna2021

Deadline is February 15, 2021

The COVID-19 pandemic has brought forward many new innovations and ways of delivering healthcare. New technology will give healthcare workers new opportunities to keep their patients and themselves safe.

According to Accenture, the use of artificial intelligence within the healthcare industry is expected to grow rapidly at an annual rate of 40% through 2021 – to $6.6 Billion, from approximately $600 Million in 2014.

Keeping hospitals more sanitary is a top priority. Hospitals have started to use LightStrike robots from Xenex Disinfection Services to decontaminate rooms. Each robot can sanitize a space in as little as 10 to 15 minutes without human contact by deploying wavelengths of germ-killing UV rays.

Another tool that is great for sanitizing is RFID technology. RFID tools use wireless communication to identify and keep tabs on items such as scrubs and people like newborn babies. But now these tools can be used to ensure frequent and thorough hand-washing.

According to a HealthTech magazine article, by installing an RFID reader at a hand-washing station that can read badges or tags on healthcare workers’ uniforms, leadership teams can use that information to track when and how often employees are washing their hands.

We need to free up hands now more than ever. Voice assisted technology like Dragon Medical One, will help healthcare workers enter real-time data into electronic health records (EHRs) by simply talking with the patient.

According to Becker's Healthcare, Saykara also launched a new voice assistant that operates both ambiently and autonomously, so it can listen to and understand the context of a patient-physician conversation without being prompted by voice commands.

Healthcare workers need ways of collecting vital signs and other data points from remote locations since more people are relying on telemedicine.  Remote patient monitoring (RPM) tools such as internet-connected blood pressure cuffs, scales, IoT glucose meters, IoT thermometers, the Blood Oxygen sensor in the Apple Watch Series 6, and sleep monitoring devices can provide patient data remotely.

Mobile health is continuing to advance.  According to an article from arkenea, Apple has launched its open source software frameworks like Carekit and Researchkit which are great platforms for app developers to build healthcare based medical apps and contribute to medical research.

Healthcare technology is always evolving and advancing and will continue to revolutionize the way care is provided.

Nurses are a critical part of healthcare and make up the largest section of the health profession. According to The American Nurses Association (ANA), more Registered Nurse jobs will be available through 2022 than any other profession in the United States.

As predicted by health officials, the United States is seeing surges of Coronavirus cases from the holiday season. As health systems and hospitals deal with the surges, they are worried about finding enough medical workers to meet the demand.

“What we see now is just the beginning of the post-Thanksgiving peak,” said Eric Toner, senior scholar with the Johns Hopkins Center for Health Security. “It’s going to be huge, and it’s going to be awful.”

The problem is especially dire in intensive care units which are overcrowded with a record number of critically ill patients.

An article from the New Yorker stated, at least half of all states are now facing staff shortages, and more than a third of hospitals in states such as Arkansas, Missouri, New Mexico, and Wisconsin are simply running out of staff. Usually, an ICU Nurse might care for two critically ill patients at a time. Now, some are caring for as many as eight patients at once.

In some situations, patients have been transported hundreds of miles for an open bed. Some patients have been moved from Texas to Arizona as well as central Missouri to Iowa.

According to ABC News, hospitals in some states are enlisting retired Nurses and Nursing students. In Alabama, more than 120 students and faculty members from the University of Alabama at Birmingham’s Nursing school began helping with care last week at UAB Hospital.

In some states, health officers have amended orders that allow health care workers who tested positive for COVID-19, but are asymptomatic to continue working.

To free up healthcare workers, hospitals are asking medical and Nursing students, firefighters, and EMTs to administer Coronavirus vaccines.

According to Reuters, nearly 10 million doses have been delivered across the country, but only about 1 million administered due to staffing shortages at hospitals and the special requirements for preparing the shots.

Nancy Foster, the American Hospital Association’s vice president of quality and patient safety, said she’s heard from two dozen hospital leaders over the past two weeks, warning her of staffing shortages.

Travel Nurses are usually a good option to help fill open positions, but the pool of available travel Nurses is drying up as demand for them jumped 44% over the last month.

Dr. Mark Ghaly, California’s Health and Human Services secretary, said the state is “lucky to get two-thirds” of its requests for travel Nurses fulfilled right now.

The main hope here is for cases to decrease by people following COVID-19 guidelines such as quarantining and wearing masks.

Rebecca Moses, the fashion designer and artist painted 46 portraits of Mount Sinai's Nurses and named the exhibition “Thank You, Mount Sinai Nurses.”.

The large-scale portraits can be seen at Mount Sinai’s Guggenheim Pavilion on upper Fifth Avenue in Manhattan.

2020 is designated the Year of the Nurse and Midwife by the World Health Organization in honor of the 200th anniversary of the birth of Florence Nightingale.

“To have all of our Nurses traumatized in the Year of The Nurse and not do anything about it, it was literally keeping me up at night,” Linda Valentino, the Vice President and Chief Nursing officer at Mount Sinai Health System said.

Rebecca Moses, mostly known for her fantastical and fashionable drawings teamed up with Ms. Valentino and Linda Levy, the President of the Fragrance Foundation and came up with the idea for the art project.

The designer would paint the Nurses' portraits and donate the original artworks to the hospital to be featured in an exhibition. Each Nurse would also receive a print. Linda Levy would donate 5,000 fragrance and beauty products, all filed under self-care, to those whose job is to care for others.

After labor and delivery Nurse, Vanessa Joseph saw her portrait she said she was “blown away that someone paid attention to me and wanted to paint me. I’m just a Nurse.”

Joseph said, “Sometimes you feel like you’re in the trenches. We put on the full P.P.E. and no one can even recognize you anymore. I’m just trying to guess what Rebecca saw, and it’s so much life and vibrancy. It gives people hope that we’re going to get back to that again.”

Only women were chosen for this project, it's nothing personal against men. Moses simply stated “I don’t draw men. It’s not my strength. I love men, but I don’t draw them well.”

This is a thoughtful and remarkable collaboration to honor the Nurses at Mount Sinai. Nurses all over the world are going through an extremely challenging time. We applaud all efforts in recognizing the invaluable service, professionalism, and kindness all Nurses give every day. Thank you!