DiversityNursing Blog

By RICHARD PÉREZ-PEÑA
New York Times (reprint)

THESE days, when a nursing student at the University of Iowa fields a question about a drug, “the answer is often, ‘I don’t know, but give me a few seconds,’ and she pulls out her phone,” according to Joann Eland, an associate professor there.

In just a few years, technology has revolutionized what it means to go to nursing school, in ways more basic — and less obvious to the patient — than learning how to use the latest medical equipment. Nursing schools use increasingly sophisticated mannequins to provide realistic but risk-free experience; in the online world Second Life, students’ avatars visit digital clinics to assess digital patients. But the most profound recent change is a move away from the profession’s dependence on committing vast amounts of information to memory. It is not that nurses need to know less, educators say, but that the amount of essential data has exploded.

“There are too many drugs now, too many interactions, too many tests, to memorize everything you would need to memorize,” says Ms. Eland, a specialist in uses of technology. “We can’t rely nearly as much as we used to on the staff knowing the right dose or the right timing.”

Five years ago, most American hospital wards still did not have electronic patient records, or Internet connections. Now, many provide that access with computers not just at a central nurse’s station but also at the patient’s bedside. The latest transition is to smartphones and tablet computers, which have become mandatory at some nursing schools.

“We have a certain set of apps that we want nursing students to have on their handheld devices — a book of lab tests, a database of drugs, even nursing textbooks,” says Helen R. Connors, executive director of the Kansas University Center for Health Informatics. Visiting alumni, she says, are shocked to see students not carrying physical textbooks to class.

But technology carries risks as well. So much data is available that students can get overwhelmed, and educators say that a growing part of their work is teaching how to retrieve information quickly and separate what is credible, relevant and up-to-date from what is not. (Hint: look for the seal of approval of Health on the Net.)

They also worry that students rely too much on digital tools at the expense of patient interaction and learning.“There’s a danger that having that technology at the point of care at the bedside creates a misperception that students don’t need to know their stuff,” says Jennifer Elison, chairwoman of the nursing department at Carroll College in Helena, Mont.

“I get worried when I hear about nursing programs that want to replace the person-to-person clinical experience with increased hours with simulation,” she says. “We hear sometimes that it feels to patients that the computers are more important than they are.”

Then there’s the patient privacy issue in the era of blogging, Facebook and Twitter. How to properly use social media has become standard in the curriculum, thanks in part to what is known in nursing circles as “the placenta incident.” Four nursing students at a community college in Kansas posted Facebook photos of themselves with a human placenta. The students were expelled in 2010, and later reinstated, but the episode showed how murky the boundaries of privacy and professionalism can be. The National Council of State Boards of Nursing recently published guidelines on social media.

“That is the new hot issue now,” Ms. Elison says. “That’s been hard, because this is a generation that immediately hits that send button.”

by Claire Theriot Mestepey

Whether you are interviewing a person with a disability for a job or meeting them for the first time at a party, here are some simple tips that will put you both at ease. It’s so important to remember that no matter what the disability is, whether blindness, deafness or wheelchair-users, they are people. Once you overcome preconceived notions about their outer appearance, it will pave the way to better communications, understanding, and acceptance.

1. When you first meet, always offer to shake hands. Most of us will offer the most controlled limb; it might even be a foot. For instance, because of my cerebral palsy, my left arm’s natural state is folded up, hand sitting on my shoulder. So if I had to extend my left arm to shake yours, it would take 13 minutes. But I can shake your right hand with little or no effort. Let the person with the disability take the lead, but do offer a friendly handshake. I think the first handshake sets the tone of how open one will be in the relationship. In other words, opened hand, opened heart.

2. Often people want to speak louder when they are addressing me. I am not deaf, but even if I was, how would shouting help us communicate better? Always try to talk in a normal tone. I do believe that disability etiquette is a two-way street and if the person with the disability would like you to speak louder they should just ask.

3. Most people are good Samaritans at heart; they like to help. As a woman with cerebral palsy I appreciate immensely when people offer assistance. Sometimes I accept with a nod and a thank you. Other times I don’t want help. I’m extremely independent and if I know the task is doable, however difficult it may seem, I like accomplishing it. On rare occasions overzealous Samaritans try to help, despite my pleas not to. I know people are just trying to help, but it borders on being disrespectful and can sometimes put the person with a disability on defense.

These are just three common disability etiquette tips. Upon reflection, these suggestions works for anyone, disabled or not. Many people want to learn disability etiquette, which is quite admirable. Taking the time to know someone, though, is more important than any etiquette training. Moving beyond stereotypes and learning each person’s limitations (because we all have them) and abilities are essential to understanding what an individual can offer your organization.

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Have you ever felt unsure of what to do meeting someone with disabilities? How did you handle the situation?

Have you ever tried any of Ms. Mestepey's suggestions? Did it help? Do you have additional behaviors you find helpful?

Majority of healthcare professionals say diversity in hospital leadership improves patient satisfaction, according to Witt/Kieffer survey

(HealthNewsDigest.com) - Oak Brook, IL, January 24, 2012 – Less than 15 percent of healthcare professionals believe that hospitals have closed the diversity gap in leadership within the last five years, according to a new national report by Witt/Kieffer, the nation’s leading executive search firm specializing in healthcare and higher education. The report, Diversity As A Business Builder In Healthcare, also reveals that only 35 percent of professionals agree that healthcare organizations consistently hire minority candidates. Witt/Kieffer partnered with Institute for Diversity in Health Management, Asian Health Care Leaders Association, National Association of Health Services Executives and the National Forum for Latino Healthcare Executives to survey 470 experienced professionals on how the state of healthcare diversity leadership is evolving.

With minorities accounting for 98 percent of the population growth in the nation’s largest metropolitan areas during the last decade, this demographic shift has vast implications for healthcare organizations, especially as they adapt to healthcare reform. A majority of industry leaders surveyed feel that diversity in the workplace improves patient satisfaction and clinical outcomes and supports successful decision-making. While healthcare professionals also report that the pool of diverse candidates for leadership positions has grown over the last five years, minority representation is still weak, with perceived barriers to advancement differing based on the respondent’s race and ethnicity.

“It is remarkable that even though a majority of professionals see the value of different cultures in the workplace, there is still not enough happening to close the leadership gap,” said James Gauss, senior vice president and senior advisor to Witt/Kieffer’s CEO. “Healthcare professionals appear to agree on what steps are necessary in order to improve the success of minorities, but there is a falloff when it comes to results. If institutions build and implement an effective diversity strategy, it will benefit their business and their patients, who must come first at healthcare organizations.”

Key findings also include:

• Twenty-four percent of Caucasian professionals believe the diversity gap has been closed, but only 11 percent of minority professionals agree.

• Nearly half of CEOs feel their organization has been effective in closing the diversity gap.

• More than half say the pool of diverse candidates for healthcare leadership positions has grown over the last five years. However, only 38 percent say it has grown in their own organizations.

• Healthcare professionals are more positive about how well minorities are represented within their own organizations compared to the industry as a whole.

• Nearly a quarter surveyed feel that their own management teams had a good representation of cultural diversity, but only 9 percent felt that way about representation across the entire industry.

• However, more than 40 percent of CEOs feel management teams had a good representation of cultural diversity.

• A sharp contrast exists between what Caucasian professionals feel needs to happen in order to achieve diversity in the workplace and what minority professionals see as the barriers to success.

• Caucasian professionals zero in on a lack of diverse candidates, while minority leaders focus on upper management’s lack of commitment to diversity.

• 60 percent of Caucasian leaders see their organizations’ cultural diversity programs as effective, while only 33 percent of minority professionals agree.

• There is a gap between hospitals’ efforts to recruit diverse candidates and how many minorities are actually hired and how well they are trained.

• Fifty-one percent of healthcare professionals agree that organizations take diversity recruiting seriously, but only 38 percent feel that their institutions trained for success in diversity recruiting efforts.

While the survey shows varying viewpoints across race, generation and career title, it is clear that diversity is seen as a valuable business asset, leading to improved patient satisfaction, improved clinical outcomes and more successful decision-making.

Witt/Kieffer is the nation’s eighth largest executive search firm and the only national firm that specializes in healthcare, higher education and not-for-profit organizations. Founded in 1969, our mission is to identify outstanding leadership solutions for organizations committed to improving the quality of life. Clients include hospitals, health systems, academic medical centers, medical schools, physician groups, colleges, universities and community service and cultural organizations. The firm conducts 400 search assignments each year for presidents, CEOs, COOs, CFOs, CIOs, physician executives, medical school deans, clinical chairs and other senior executives. Visit www.wittkieffer.com for more information.

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What do you think? How is your organization compared to the industry? What can organizations do to improve diversity in hiring? For students, what do you think of the diversity the student body? How do you think this relates to hiring and ability to rise in organizations?

The Peer Advisor Program, which pairs upper-class students with first-year students to help them get acclimated to and thrive at U.Va., became her extended family. Students in the program came to rely on her like a mother away from home.

On the occasion of her retirement, Terry sat down for an interview with UVa Today's Anne Bromley and talked about the philosophy behind the Peer Advisor Program and her roles at the University.

…

UVa Today: Did you feel like you were creating something new here at U.Va., changing its history?

Terry: I didn’t think of it so consciously at that time. I thought of it more as exposing more people, more children, more students about possibilities about college. 

The great thing about those sessions is that not only were we talking with high school juniors and seniors, but the families were there. I remember creating a series of leaflets for children. We called it "Steps to College." In it we were suggesting things for them to think about for that particular year. 

It makes me feel very proud, being in the Office of Admission for almost 10 years, from 1980 to 1989, and seeing the numbers of black students increase. When I look at the alumni who come back, many of them were students in high school when I met them. That makes me feel older, but it also makes me feel proud because of the things that they are doing. 

Those days at admissions laid the foundation in terms of this work for the Peer Advisor Program. 

I often tell the story of my second year in admissions when the vice president for student affairs, Ernie Ern, invited me and others to a meeting he was holding of black students. The thing that touched me the most was a young man, and I remember his words: "U.Va. has done everything to get me here, but now that I’m here, nobody seems to care." I never forgot that, because here was a student who had been recruited and who had come, but who was experiencing what I’ll call disappointment, experiencing isolation.

When I left that meeting, I went back to my office and I sat down and I looked at the black student admissions committee that I had organized. One of the things I immediately thought is, I'm going to add a subcommittee to check on students we had had contact with. I assigned members of the committee to the different residence halls, and they picked up where we left off – after two or three weeks, we were gone – but the students were there to check on the welfare of other students, and that was one of the forerunners of the Peer Advisor Program.

I found, probably about a year or two ago, a note that I had written Jean Rayburn, who at the time was dean of admission. She had sent out a note to the staff to ask if any of us had any ideas about ways of retaining students. I actually wrote – and I have it hand-written because we didn't have the computers then – several things, and one of them was what I called a "Big Brother, Big Sister program." I smiled when I read it because number one, I had forgotten about it; number two, when I read it, it was exactly the kinds of things I have done with the Peer Advisor Program. 

UVa Today: How did you come over to the Office of African-American Affairs?

Terry: I applied for the position because I wanted to have more time with my children. Did that happen? No. Looking at this office and that it had developed this program that I'd actually proposed, this was something I was excited about. It was the program that attracted me. 

Everybody makes sacrifices, and when I look at U.Va. and some of the sacrifices, it's not just been me, it's been my family. 

Shawna, when she was real little, she thought every person who was a teenager or a young adult was a peer adviser. I remember being in church one Sunday and U.Va. students talking to me. Shawna got antsy because she'd been good, she had sat through service, and she beckoned me and said, "Mommy, Mommy, can't we go home? Can't you stop talking to all these peer advisers?" 

I think in our household, it almost has been that I have three children as opposed to two – the Peer Advisor Program is actually the same age as my son, 24. So they have grown up around peer advisers. I'd have peer advisers over for dinner, we would do things together, so it's just been that other presence in our house.

…

UVa Today: Have people asked you, "Shouldn't every first-year student have this kind of program?" Are there things that are specific issues or challenges to black students, or has that changed over time?

Terry: The latter part hasn't changed. I have peer advisers do mid-year interviews. We have questions about the disappointments you have experienced, the joys you've had; what is the best academic experience you've had, what is the worst? I do find that students still talk about, sadly, some racial insensitivity. If one asks, "Is this program still needed?", it is still needed, though this program is not about separating, it's about providing support. 

Should every student have a peer adviser? I think every student should. The way I have always seen it is every student has a peer adviser through the role of residence life. I think the difference is peer advisers don't have to manage an environment within a dorm setting, so I know peer advisers don't have to enforce rules. With [resident advisers], there are certain rules they have to enforce. RAs are on call 24 hours; so, too, are peer advisers. 

Where I see the difference is, if there is some racial insensitivity – it's not to say that an RA cannot address that at all, an RA can – I have additional support here. If I have experienced something, then I can be of more assistance, perhaps, than someone who may not have experienced it. 

… 

— By Anne Bromley

The following is a Diversity Statement written and signed by numerous colleges and universities and taken from the University of Virginia's website for their Office of African American Affairs. It provides good insight into the value that diversity adds in higher education, which almost always applies to professions, like nursing, as well.

On the Importance of Diversity in Higher Education

America's colleges and universities differ in many ways. Some are public, others are independent; some are large urban universities, some are two-year community colleges, others small rural campuses. Some offer graduate and professional programs, others focus primarily on undergraduate education. Each of our more than 3,000 colleges and universities has its own specific and distinct mission. This collective diversity among institutions is one of the great strengths of America's higher education system, and has helped make it the best in the world. Preserving that diversity is essential if we hope to serve the needs of our democratic society.

Similarly, many colleges and universities share a common belief, born of experience, that diversity in their student bodies, faculties, and staff is important for them to fulfill their primary mission: providing a quality education. The public is entitled to know why these institutions believe so strongly that racial and ethnic diversity should be one factor among the many considered in admissions and hiring. The reasons include:

Diversity enriches the educational experience. We learn from those whose experiences, beliefs, and perspectives are different from our own, and these lessons can be taught best in a richly diverse intellectual and social environment.

It promotes personal growth and a healthy society. Diversity challenges stereotyped preconceptions; it encourages critical thinking; and it helps students learn to communicate effectively with people of varied backgrounds. 
It strengthens communities and the workplace. Education within a diverse setting prepares students to become good citizens in an increasingly complex, pluralistic society; it fosters mutual respect and teamwork; and it helps build communities whose members are judged by the quality of their character and their contributions. 
It enhances America's economic competitiveness. Sustaining the nation's prosperity in the 21st century will require us to make effective use of the talents and abilities of all our citizens, in work settings that bring together individuals from diverse backgrounds and cultures.

American colleges and universities traditionally have enjoyed significant latitude in fulfilling their missions. Americans have understood that there is no single model of a good college, and that no single standard can predict with certainty the lifetime contribution of a teacher or a student. Yet the freedom to determine who shall teach and be taught has been restricted in a number of places, and come under attack in others. As a result, some schools have experienced precipitous declines in the enrolment of African-American and Hispanic students, reversing decades of progress in the effort to assure that all groups in American society have an equal opportunity for access to higher education.

Achieving diversity on college campuses does not require quotas. Nor does diversity warrant admission of unqualified applicants. However, the diversity we seek, and the future of the nation, do require that colleges and universities continue to be able to reach out and make a conscious effort to build healthy and diverse learning environments appropriate for their missions. The success of higher education and the strength of our democracy depend on it.

Meg Beturne MSN, RN, CPAN, CAPA
Denise Colon, RN
Baystate Health System, Springfield, MA

This article was submitted by Meg Beturne RN, MSN, CPAN, CAPA,  Assistant Nurse Manager @ Baystate Orthopedic Surgery Center in Springfield, MA.  Meg became a mentor and participated in "Baystate Health’s Diversity Leadership Initiative, Mentoring Across Differences" Program. A Dimensions of Diversity Exercise (copyrighted in 2011 by Washington Orange Wheeler Consulting firm http://wow4results.com) was offered as part of the Program.

The exercise is a puzzle that shows the complexity of mentoring across differences. Understanding how these differences have impacted us and others helps to create a container for meaningful dialogue. Consider how various differences could impact your mentoring relationship. To participate in this exercise, you identify a few  dimensions of diversity that have had an important role in impacting who you are, how others see you, and how you see the world. You then figure out how the dimensions shaped who you are personally and professionally. Finally, how might these dimensions impact your mentoring relationship? 

Meg, a Caucasian Catholic, mentored Denise who has a Latina background with strong family ties and a culture that is filled with traditions that are vital to her life and that of her family and extended family. Denise is Roman Catholic and she works to maintain a healthy balance between work and home as she has a young family. Here is their mentoring story…

Impact on Differences 

As I began the mentoring relationship with Denise, I realized the importance of recognizing and understanding the differences and similarities that existed between us. Equipped with this knowledge, I felt that we could tackle the complexities of mentoring across differences. The Dimensions in Diversity exercise offered the perfect opportunity to explore key, diverse components that have made us the women and nurses that we are today. To that end, we made this a priority and discussed it at our very first meeting and then confirmed our thoughts and feelings at our next time together.

It was interesting to realize that both of us equally valued traditions and observances, but from a different perspective. We both enjoy sharing the particulars of the holiday traditions through the years and reminisced on who was present, the activities that took place, the photos that were taken and the memories that were made and cherished by future generations. Denise however was vocal that many persons that she has interacted with over time do not have a real understanding of the ethnic backgrounds that are celebrated in the various holidays. That being said, there is a lack of appreciation from culture to culture on the meaning and purpose of observances involving family and relatives. I had to admit that since I had grown up in a small mill town in Connecticut that was homogenous with regard to ethnicity and religion (Caucasian Catholics), I was not exposed to comments, conversations or messages that demonstrated anything but allegiance to the existing cultural observances and inclusion of the small numbers of diverse ethnic and religious populations that resided close by.

Denise chose accent and dialect as another dimension of her diversity. She relayed the fact that many individuals and groups do not make an attempt to understand or accept anyone who speaks in a certain way. This scenario creates feelings of self-doubt. In addition, it allows feelings of rejection to creep in that ultimately results in further retreat into one’s own ethnicity which is considered supportive and safe. As a registered nurse, Denise has encountered many patients and caregivers from all corners of the globe. Working with a team of professionals, Denise has gained acceptance and recognition as a caring and compassionate care giver and over time, interactions and conversations have focused on quality care rather than on accent or dialect.

I then shared that communication was a vital personal and professional dimension that affects my life in so many ways. Even though my communication style is open, friendly and positive, I have learned that being a good listener is actually a more important skill. I found myself connecting with Denise’s story and promised myself to be even more in tune with people I meet on a daily basis who might sound different than me. In my own way, I will seek to eliminate self-doubt by encouraging others to use their native voices to raise questions, contribute ideas and feel reassured that they will be understood.

As I reflect on this meeting with Denise, I am amazed at the information that was willingly shared and the conversation which was free-flowing and enjoyable.  Most importantly, after completion of this exercise, I feel more prepared then ever to be the type of mentor that will enable Denise to move forward in both her professional career and her personal life!

A special thank you to Denise Colon, RN for her participation.

from insideWorcester.com
By Dave Greenslit CORRESPONDENT

WORCESTER —  The city is diverse and becoming more so, presenting both challenges and opportunities.

That was the consensus of several speakers today at a forum called “The Changing Face of Worcester,” sponsored by the City Manager's Coalition on Bias and Hate and held at Worcester Public Library.

“Worcester remains a vibrant city made up of people from just about everywhere in the world,” said Edgar Luna, who works in the city's Department of Planning and Regulatory Services and gave an overview of 2010 census data.

That data show Worcester's white population has dropped from 70.8 percent in 2000 to 59.6 percent in 2010, while the Hispanic and black populations have grown from 15.1 percent to 20.09 percent and from 6.2 percent to 10.2 percent, respectively.

Ravi K. Perry, an assistant professor of political science at Clark University, said Worcester has always been a city of immigrants, but today's arrivals are from Southeast Asia, Central America and Africa, instead of Italy, Ireland and Armenia.

Medium-sized cities have been slow to respond to their changing populations, he said, but that doesn't have to be the case in Worcester. Calling the city one of the most diverse in the country, he said, “Worcester has the opportunity to be a model if we pay attention to these local demographics” and learn how minority interests can be represented.

School Superintendent Melinda J. Boone noted that 65 percent of students in Worcester schools are minorities and that 80 different languages are spoken by students in the system. Under a 2009 agreement with the federal Justice Department, all major school documents are translated into several of the major languages.

“We have a very diverse school population, and that's a real asset,” she said, adding that the changing demographics also present a challenge in achievement, especially because so many students are poor.

“We want to expose students to programs and opportunities that will close that gap,” Ms. Boone said. “An undereducated citizenry will cause Worcester to shrink and shrivel.”

Education will break the cycle of poverty by preparing students for the type of jobs that will be available to them, she said.

Mark Bilotta, chief executive officer of the Colleges of Worcester Consortium, said area colleges, with 30 percent minority enrollment, have some catching up to do to match the percentage in the city.

The consortium is working, he said, to retain talent for the regional workforce and to ensure students are prepared to work in a global economy, something enhanced by Worcester's diversity.

Luis G. Perez, a retired juvenile court judge, also stressed the importance of education. He said the dropout rate and the number of minority students expelled eventually results in many people being sent to prison.

“I believe in prevention,” Judge Perez said. “And the most important tool in prevention is education.”

“If the School Department doesn't do their job, where do people turn to? They turn to the courts,” he said.

Also speaking at the forum were Dr. Matilde Castiel of the UMass Memorial Medical Center and Stephen Hill of the city's Department of Neighborhood Services/Economic Development.