By: Mark E. Dixon
The nursing shortage isn't going away, but a federal commission had discovered one positive side effect - the shortage has helped make nursing one of the most ethnically diverse of the healthcare professions.
That's relatively speaking, of course.
Nurses are 50 percent more likely than physicians to be minorities, according to the final report of the Sullivan Commission on Diversity in the Healthcare Workforce.
Even so, Blacks, Hispanics and American Indians together total only 9 percent of nurses, despite representing about 25 percent of the U.S. population. By comparison, only 6 percent of physicians are minorities.
Minorities make up about 10 percent of nursing baccalaureate faculties and 4.2 percent of medical school professors. Nurse educators are more than twice as likely to be members of a minority group as are medical school professors.
The problem with a disproportionately white healthcare workforce is that it cannot adequately serve a population that is increasingly non-white, according to the commission report.
"Diversity in the health workforce will strengthen cultural competence throughout the health system," the commission said. "Cultural competence profoundly influences how health professionals deliver healthcare."
According to the commission, language barriers in particular are a critical issue; 20 percent of Americans speak a language other than English at home.
Minority groups receive poorer quality healthcare and experience higher mortality rates from heart disease, HIV/AIDS, diabetes, mental health and other illnesses. Minority children are more likely to die from leukemia than white children.
An increase of more than 20,000 minority nurses is needed to increase their proportion of the nursing workforce by 1 percent.
By the middle of this century, the U.S. population could be more than 50 percent nonwhite, according to the commission's report.
Recommended Strategies
Established in 2003, the Sullivan Commission was formed to recommend strategies to improve access to care and dismantle barriers to health professions' education.
Chaired by former U.S. Secretary of Health and Human Services Louis W. Sullivan, the 15-member commission consists of experts from the health, higher education, business and legal arenas.
The Sullivan Commission's findings were endorsed by the American Association of Colleges of Nursing, whose president, Jean E. Bartels, PhD, RN, called on legislators, nursing practice leaders and nurse educators to implement the commission's recommendations.
Bartels said: "National nursing organizations, the federal Division of Nursing, hospital associations, nursing philanthropies, and other stakeholders within the healthcare community agree that recruiting under-represented groups into nursing is a priority for the profession and an important step toward addressing the nursing shortage."
Commission recommendations included:
· Health profession schools should hire diversity program managers and develop plans to ensure institutional diversity.
· Colleges and universities should provide an array of support services to minority students, including mentoring, test-taking skills and application counseling.
· Schools granting baccalaureate nursing degrees should provide "bridging programs" that help graduates of 2-year programs transition to 4-year institutions. Associate nursing graduates should be encouraged to enroll in baccalaureate programs.
· Professional organizations should work with schools to promote enhanced admissions policies, cultural competence training and minority student recruitment.
· To remove financial barriers to nursing education, funding organizations should provide scholarships, loan forgiveness and tuition reimbursement programs.
· Congress should substantially increase funding for diversity programs within the National Health Service Corps and Titles VII and VIII of the Public Health Service Act.
Diversity Friendly
Meanwhile, nursing seems to be friendly to workers who are minorities.
A study by Vanderbilt University nursing researcher Peter Buerhaus, PhD, RN, FAAN, showed that part of the 9 percent increase in the nursing workforce from 2001 to 2002 was due to nurses over 50 returning to the hospital.
Hospitals are making work environments more supportive for older workers. For example, some offer scheduling flexibility and reduced physical requirements.
In addition, the acute nursing shortage and innovations such as talking thermometers have enabled nursing programs and employers to hire people with vision and hearing loss or impaired mobility.
A 2003 Bureau of Labor Statistics survey showed that Hispanics - 13.7 percent of the U.S. population - comprise just 4.4 percent of all medical records and health information technicians, 2.8 percent of pharmacists and 1.3 percent of emergency medical technicians and paramedics. Blacks (12.8 percent) comprise 2.6 percent of physical therapists, 1.3 percent of opticians and less than 1 percent of dental hygienists.
Asians, who make up 4.2 percent of the U.S. population, are represented at that rate or higher in most healthcare segments - particularly physicians and surgeons (16.1 percent), and clinical laboratory technologists and technicians (12.3 percent). However, they are underrepresented as licensed practical and vocational nurses (3.6 percent), dental hygienists (1.4 percent) and dispensing opticians (1.3 percent).
Source: Advance for Nurses
