DiversityNursing Blog

Major 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?

Healthcare organizations strive to provide culturally competent care for individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). Recent changes in society, including the legalization of gay marriage have raised public awareness of LGBTQ issues. Yet many healthcare professionals lack knowledge in some areas when caring for LGBTQ patients.

Michael Johnson, PhD, RN, understands the barriers faced by LGBTQ patients and the assumption often made by healthcare professionals that all patients are heterosexual. 

According to a Nurse.com article, Johnson said, “Some members of the LGBTQ community avoid seeking healthcare services because of previous negative experiences in which they faced discrimination. Studies have shown most LGBTQ patients want to be able to share their sexual orientation or gender identity with their healthcare provider, but are often reluctant to open up because they fear they may be treated badly or even refused care."

LGBTQ individuals have a long history of discrimination at the individual and institutional levels, including the healthcare system. They may check to see if the environment is a safe place to reveal personal information, especially about sexuality. Some things an individual may take note of during their time in your waiting room area include:

• Your organization’s nondiscrimination policy: Is it in a visible location?
• A rainbow flag, pink triangle, or other symbol of inclusiveness
• Availability of unisex restrooms
• Health education literature with diverse images and inclusive language, including information about LGBTQ health
• Posters announcing days of observance such as World AIDS Day, Pride, and National Transgender Day of Remembrance

To understand LGBTQ populations and their health needs, it is important to first define the distinct core concepts of sexual orientation and gender identity. You can read about key LGBTQ terms here.

LGBTQ health requires specific attention from health care and public health professionals to address a number of disparities, including:

• LGBT youth are 2 to 3 times more likely to attempt suicide.
• LGBT youth are more likely to be homeless.
• Lesbians are less likely to get preventive services for cancer.
• Gay men are at higher risk of HIV and other STDs, especially among communities of color.
• Lesbians and bisexual females are more likely to be overweight or obese.
• Transgender individuals have a high prevalence of HIV/STDs, victimization, mental health issues, and suicide and are less likely to have health insurance than heterosexual or LGB individuals.
• Elderly LGBT individuals face additional barriers to health because of isolation and a lack of social services and culturally competent providers.
• LGBT populations have the highest rates of tobacco, alcohol, and other drug use.

 

Nurses should avoid asking any unnecessary questions. People are sometimes curious about LGBTQ people and their lives, which can lead them to want to learn more by asking the patient questions. However, like everyone else, LGBTQ people want to keep their medical and personal lives private. Before asking any personal questions, first ask yourself: “Is my question necessary for the patient’s care, or am I asking it for my own curiosity?" If for your own curiosity, it is not appropriate to ask. Think instead about: “What do I know? What do I need to know? How can I ask for the information I need to know in a sensitive way?"

Effectively serving LGBTQ patients requires you to understand the cultural context of their lives, and to modify your procedures, behavior, and language to be inclusive, non-judgmental, and helpful at all times. By doing this, healthcare staff can help ensure that LGBTQ patients receive the level of care that everyone deserves. What helpful information can you add regarding this topic?

Change is a constant in the healthcare environment, and employees’ needs change as new generations with different attitudes, values, and beliefs join the workforce. Leaders must view employee engagement as an ongoing journey that demands intentional interventions. During the past decade, healthcare agencies have experienced unusually low turnover, but this is changing, and turnover rates are beginning to increase. Engaging and retaining staff is a high priority. Below are a few ways to improve employee engagement.

Value

Leaders must create a positive work environment where employees feel valued and supported. It is essential to provide support such as material, human, and emotional resources. Genuinely acknowledge the significance and complexity of the work provided by caregivers. Recognition does not always have to involve rewards. Effective recognition can be as simple as showing empathy or acknowledgment in a sincere way such as a statement like “I understand what you went through today.”

Team-building Activities

Nursing is a stressful field. Working with the same group of people every day in a stressful environment can lead to conflict. Organizing team building activities helps staff blow off steam in a healthy manner. Having a department-specific holiday party, summer picnic, cookie exchange, etc. are just a few things that help promote teamwork while having fun.

Be Available

Skillful leaders are visible, available, and approachable in the workplace. Effective leaders engage with staff, patients, and families—not  to check up on employees, but rather to genuinely interact and converse and to be available to team members. Many managers proclaim to have an open-door policy, which generally refers to extending an open invitation for employees to visit and share ideas with the manager in his or her office. However, a better way to view this policy is to have the manager open the door and walk through it on his or her way to spending meaningful time in the workplace to build goodwill and engage with staff.

Work/Life Balance

Some Nurses, on the other hand, prefer to continue some type of work or activities after retirement. Here are some job ideas for the retired Nurse who still wants to work a little bit.

reviewer for Nursing Licensure Exams

To be considered a full-fledged registered Nurse you need to pass the Licensure exam. Being a reviewer comes with flexible hours and good pay. Not only that, you gets to help out a new generation of Nurses fulfill their dreams of being professional nurses.

Freelance Nursing Writer

Nursing writers create content for test prep courses, instructional manuals, and other training materials. If you're interested in this sort of work, other terms to search for are, Nurse Certification Writers, Nurse Research Writers, Learning Development Writers, and Medical Writers.

Teach Health Classes In Schools

Nurses teaching health classes in high schools is common. They know the topic and have first-hand experience with actual cases and are just about the most qualified in teaching subjects like sex education and nutrition.

This can be a very rewarding job for a retired Nurse since he or she doesn’t need to take on fully loaded schedules and can also work part-time in the school clinic.

School or summer camp nurse

Nurses who love kids couldn’t ask for a better position. Schools and summer camps often hire RNs to provide basic care for their staff and students. They will avoid the hectic atmosphere of hospitals but still practice their medical skills in an energized environment.

Nurse Educator

Many opportunities exist for Nurse educators outside of the hospital setting. Common settings for Nurse educators include medical device manufacturing companies, community clinics and government offices, pharmaceutical companies, research facilities, textbook publishing companies, and, of course, colleges and universities. The opportunities are rapidly expanding due to the growth of online jobs, and the possibilities for self-employment.

Nurse Bill Auditor

Perform audits of medical records to identify over-payments/underpayments. Must be a licensed RN with excellent communication skills, 3+ years’ clinical experience, and at least one year of reviewing/auditing experience. Mostly remote, freelance role.

There are many opportunities for Nurses thanks to all the life skills and experiences that the profession provides. So long as you keep your eyes peeled and your spirit positive, the right opportunity will come your way.

“Unless you really have a passion and a desire to be a Nurse educator, we don’t see people migrating to that field, because of the pay,” said Ron Moore, the recently retired vice president for Nursing at Charleston Area Medical Center. Moore said without qualified Nursing faculty to teach the people who want to be in a Nursing program, states like West Virginia aren’t going to be able graduate enough Nurses to meet the needs of its aging population. “So without an adequate workforce, hospitals can’t function to their capacity."

Nursing shortages are forcing hospitals to close beds, hire temporary Nurses at great expense to fill the gap and possibly provide less than optimal care to patients.

According to Benedictine University, with the amount of Nurses approaching retirement, there are a variety of concerns that there will not be enough Nursing professionals to fill this void. Demographic changes and the aging population are expected to become more serious as Nursing demands grow. Individual’s lifespans are increasing and require more attention to long-term care. Nurses educators are sought after for guidance and teaching to prepare seniors for long-term home care and educate future Nurses who will be the care providers.

“The average age of a Nurse is around 50,” says Dr. Knestrick. “It’s estimated that over 50% of Nurses that are practicing are over the age of 50. This means that within 10 to 20 years they will be retiring from Nursing, which will further add to the shortage.”

In some states, there are already strategies in place to address the shortage of Nurse educators. According to indeed.com, the Nurses for Wisconsin initiative provides fellowships and loan forgiveness for future Nurse faculty who agree to teach in the state after graduation. Some Nursing schools have formed strategic partnerships to help boost student capacity. The University of Minnesota has partnered with the Minnesota VA Health Care System to expand enrollment in the schools Bachelor’s of Science in Nursing program.

Nursing programs should emphasize the invaluable role of Nurse faculty, step up recruitment efforts for the next generation of Nurse faculty and provide Nursing education tracks that address the healthcare needs of today’s multicultural and growing society.

Good Communication

Emotional stability

Empathy

Attention to detail

Physical Endurance

Desire to continue learning

SENSE OF HUMOR

When it comes to healthcare, technology is not only convenient, but also life-saving. It is also constantly changing. We compiled a list of tech trends you should expect to see in the near future.

telehealth

Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and patients can manage their health care. They can use an online patient portal to see their test results, schedule appointments, request prescription refills or email their doctor. 

Virtual appointments enable them to see their doctor or Nurse via online live video. These appointments let them receive ongoing care when an in-person visit isn't required or possible. These web-based "visits" can also be used for minor illnesses, similar to the services available at a drop-in clinic. 

Health care chat bots

Chat bots can help patients with a number of things such as book appointments, remind them to take their pills or assist them in refilling their prescriptions. Here are a few examples of health care chat bots and what they do.

• Florence — this chatbot Nurse tells patients to take their medicine, gives them instructions if they forgot to take a pill, monitors their health (and periods for women) and can help them find specialists and book appointments in their area.
• Your. MD — it replaces the assistant of a GP, asks about symptoms and puts enough questions approved by health professionals to identify a condition probabilistically then sets up appointments, referring patients to physicians.
• Safedrugbot — this messaging app helps doctors take notice of possible side effects of drugs during breastfeeding and helps to keep mothers safe.
• Babylon Health — another conversational healthcare assistant with the feature of booking a doctor.
• SimSensei — still in its experimental phase, it uses voice and face recognition to mimic a therapist, also interacting with the patient at deeper levels.
  
  

Smart Beds

Smart beds are continuing to gain popularity. For example, the Stryker S3 bed is a popular acute care/MedSurg that many hospitals use currently. The Stryker safety solution is called iBed. iBed allows the user to set up conditions for the settings on the bed and if the bed is set outside those parameters, visual indicators notify the user that the bed must be put back to the safest condition for that patient. Also, the beds are set up to be wireless, removing the need to remember to plug the bed into the wall and no more damaged 37-pin connectors. The bed is loaded with sensors including weight, brake, rails, and head-of-bed angle. This makes bed related patient safety easy requiring very little upkeep.

Patient and Staff identification systems

Patient and staff identifiers in the hospital setting have become increasingly important in light of patient mix-ups and unauthorized people entering a facility or accessing patient records.

According to an article by Americanmobile.com, "Bar codes, wristbands and radio frequency identification (RFID), all work to track and identify patients in an effort to reduce errors while also keeping the hospital population safe. New palm vein technology, eye scans and microchips have also been introduced as a way to identify both patients and healthcare professionals, and to cut down on unauthorized access to patient files."

Digital Patient Room Whiteboards

Interactive Digital Whiteboards integrate with a hospital’s real-time location services. It provides patients with their daily schedule, introduces staff as they walk into the room and logs which clinicians visited the patient.

According to NewYork-Presbyterian, "patient electronic boards digitize and improve upon traditional whiteboards. Instead of requiring providers to erase and re-write any new information, the boards integrate with the patient’s Electronic Medical Record (EMR) data to display any updates as they happen. Patients and providers can immediately see accurate pain scores, fall risks, and scheduled tests, and family members can see important phone numbers. The boards display data visually wherever possible, including pictures of a patient’s entire care team in real time.

Cloud Computing

Personalized medicine

How do you feel about the impact technology has on healthcare? Do you use any of these in your work place? If so, do you think it positively or negatively effects your work? Please share your comments below! 

Find a work buddy

In any job, especially Nursing, it’s easier to cope with emotional stress when you have a work buddy to help you through tough shifts. You can vent to your friend, share your frustrations and they understand what you're going through. If you haven’t found your best friend at work yet, don’t worry, you will.

Eat well

Most Nurses work in a fast-paced environment and are often short on time, which can lead to relying on fast food that is high in fat, sodium, sugar, and additives. Look for ways to add more lean proteins, fresh fruits, vegetables and whole grains. Try meal prepping for the week.

Meditate or find a quiet space

Try to find peace for at least 10 minutes in a quiet room or in a quiet place outside with no electronic distractions. Ten minutes of quiet is longer than you think, but you'll feel more refreshed afterwards. Just take a moment to focus on breathing and calming positive thoughts to boost you through draining times.

Mentors are there for experience-based guidance and honest advice. In some areas up to 60% of new Nurses leave their first position and some leave the Nursing profession entirely within two years. A stressful work environment combined with a lack of support from fellow Nurses can make it difficult to transition from Nursing school to the professional ranks of Nursing. Nurses should use mentors as a resource. Not only when they have a problem but in any stage, whether they are aspiring to take on a new role, grow in their current role, or become a stronger leader.

Mentoring a fellow Nurse takes leadership skills and experience, of course, but also much more. According to Dale Beatty, DNP, RN, NEA-BC, Standford Health Care’s Chief Nursing Officer and Vice-President of Patient Care Services, there are basic core values that mentors need to have: honesty, integrity, trust, and confidentiality. A mentee should be able to trust their mentor enough to be vulnerable with them, and the mentor should foster that environment of safety and trust. 

Mentors have much to gain personally and professionally by helping new Nurses adjust to their role.  While Nurse mentors are helping people understand and practice the standards of Nursing, they are also reviewing the processes and procedures and are in a position to facilitate changes or make improvements if needed.  Also, inexperienced Nurses will have been exposed to the newest technologies and trending issues and can give a different perspective to the experienced Nurse who might not be as exposed to these current developments.

Have you ever thought you could be a better leader or manager than the person who was in charge? You should seriously consider being a mentor. When mentoring others, you are actively working on your coaching, communication, and leadership skills.  Working with different individuals from various backgrounds helps you to develop the relatable skills necessary to handle many personality types.  Being a mentor first is a great way to find out if management is something you want your future to evolve into.

Magnet Program Director Anita Girard, DNP, RN, NEA-BC said, "For student Nurses and recent graduate Nurses, a mentor is a resource that could help guide them to their future careers and shape them along the way, but figuring out where to find one is the first step. A great place to start is to visit websites for state Nursing associations and student Nursing associations. Additionally, getting involved in professional organizations can help, since these are usually full of Nurse leaders that could be potential mentors.

Becoming a mentor is a big decision to make.  While the personal and professional benefits far outweigh the challenges, mentoring has to be something you are emotionally and professionally ready to handle. 

Have you ever been a mentor or mentee?  We would love to hear your stories! Please share your experiences in the comment section below.

Diversity in the Nursing field is necessary to progress health equity and improve patient outcomes. As a result of efforts in recent years, the Nursing workforce today is more diverse than it was a decade ago, but there is still work to be done. The goal is to have a health workforce that mirrors the nation’s diverse population.

“Latinos make up 17.3 percent of the U.S. population,” said Norma Cuellar, PhD, RN, FAAN, professor of Nursing at The University of Alabama, director of the BAMA-Latino Project, and president-elect of NAHN. “Unfortunately, as the number of Latinos continue to rise, the number of Latino RNs does not. According to the Bureau of Labor statistics, there are about 2.9 million RNs in the country, and just three percent are identified as Latinos. This results in a failure to provide culturally congruent care, language barriers, and health disparities in the Latino population.”

As the principal investigator over the NIH-SEPA grant, Angie Millan, RN, DNP, FAAN, NAHN project director and the Nursing director of Children’s Medical Services for the County of Los Angeles Department of Public Health, aims to inform new generations of Latinos to consider Nursing as a worthy and rewarding career, and provide the guidance, support and resources needed to achieve Nursing career aspirations.

“The Hispanic community is very young, with an average age of around 26, and our numbers continue to increase,” Angie said. “However, the number of Hispanic Nurses is not keeping up with the growth.  We need help in communicating with parents, students, teachers, and counselors that Nursing is a great career, and that to be prepared, students need to know the math and science requirements.”

Teri Murray, Ph.D., dean of the School of Nursing at Saint Louis University said, “Racially diverse students, from populations currently underrepresented in Nursing, will be paired with peer mentors, faculty mentors and seasoned Nurse mentors who are out working in the field. “Mentoring has been shown to be effective for students from underrepresented backgrounds in serving as role models, assisting students to navigate college life and the profession, and in general showing the student the ropes,” Murray told the American.

2018 marks the fourth year of the NAHN Hispanics in Nursing campaign to increase the number of Hispanic Nurses, which is made possible through a grant received from the National Institutes of Health (NIH) Science Education Partnership (SEPA). In addition to providing information about which classes to take in high school to prepare for Nursing prerequisites and highlighting the profiles of Latino Nurse role models, the campaign also provides access to Mentors Connection, a database of Latino Nurses who can provide career guidance, advice, and cultural perspective to prospective Nurses.

“It is imperative that we encourage these Latino students not only to obtain their degree in nursing, but to pursue advanced degrees. There is a dire need to increase the number of Latino nurses who are academically prepared to be leaders in a variety of healthcare roles,” said Dr. Cuellar. “In this ever-changing healthcare landscape, it’s more important than ever for Latino nurses to have a seat at the table. We have to be leaders in nursing, and we have to be the voice for the Latino population.”