DiversityNursing Blog

For many years, the healthcare field has struggled with staffing issues, including the Nursing shortage. The COVID-19 pandemic brought these issues front and center. Everyone including Patients, Nurses, and Health Systems benefit from higher staffing rates.

Improved staffing levels reduce:

• Mortality rates
• Length of stay
• Readmission rates
• Preventable health care associated injuries and illnesses such as falls, infections, and pressure injuries

According to research:

• Higher numbers of patients per Nurse was strongly associated with the administration of the wrong medication or dose, pressure ulcers, and patient falls with injury.
• Short-staffing increases patients’ risk of death by between 4% and 6%. This risk is higher within the first five days of admission.

Five organizations came together in 2018 to form the Partners for Nurse Staffing in a collaborative effort to explore new solutions for Nurse staffing issues. In early 2022, they launched the National Nurse Staffing Think Tank. 

The Partners for Nurse Staffing includes:

• American Association of Critical-Care Nurses (AACN)
• American Nurses Association (ANA)
• American Organization for Nursing Leadership (AONL)
• Healthcare Financial Management Association (HFMA)
• Institute for Healthcare Improvement (IHI)

The think tank made recommendations to address the Nurse staffing crisis within a 12-18 month implementation timeframe.

The recommendations include: 

Healthy Work Environment

• Elevate clinician psychological and physical safety to equal importance with patient safety through federal regulation.
• Specialty Nursing organizations should investigate evidence related to scope of practice and minimum safe staffing levels for patients in their specialty.

Diversity, Equity and Inclusion (DEI)

• Implement Inclusive Excellence, a change-focused iterative planning process whereby there is deliberate integration of DEI ideals into leadership practices, daily operations, strategic planning, decision-making, resource allocation and priorities.

Work Schedule Flexibility

• Build a flexible workforce with flexible scheduling, flexible shifts and flexible roles.

Stress Injury Continuum

• Address burnout, moral distress, and compassion fatigue as barriers to Nurse retention.
• Incorporate well-being of Nurses as an organizational value.

Innovative Care Delivery Models

• Implement tribrid care delivery models that offer a holistic approach with three components, including onsite care delivery, IT integration of patient monitoring equipment, and ambulatory access and virtual/remote care delivery. This approach will improve access, patient and staff experience, and resource management, with continuous measurement for improvement and adjustment for sustainability and support.

Total Compensation

• Develop an organization-wide formalized and customizable total compensation program for nurses that is stratified based on market intelligence, generational needs and an innovative and transparent pay philosophy that is inclusive of benefits such as paid time off for self-care and wellness and wealth planning for all generations.

The time for action is Now. Nurses, and their patients, must have proper staffing levels in order to provide the best care possible! 

One of the greatest benefits of the Nursing profession is that there are always new and emerging ways to improve our skills and reach new occupational heights. Medicine is ever-changing and with that, Nurses are also ever-changing. We must learn to adapt to new procedures, medications, technology, and equipment. These changes often unlock the potential we have to grow within the Nursing profession and there are many opportunities to grow right at our fingertips. Wherever you are in your Nursing journey there is always room to grow professionally.

Continuing Education Opportunities

Most states require Continuing Education Units (CEUs) for Nurses to renew their RN licenses. Although many Nurses may feel that completing CEUs can be a tedious and unnecessary task, they are a great opportunity to advance knowledge and skills. There are many different ways to fulfill CEU requirements including conferences, online classes, on-the-job training, independent study programs, and post-secondary degree programs. Completing CEUs with the intention to advance your skillset can be a great step in advancing your career.

 Seek a New Certification

Getting a Nursing certification is an excellent way to advance your career. There are hundreds of Nursing certification options available to all Nurses regardless of their current Nursing position. Holding certain certifications will make you more marketable to employers and allow for more opportunities. There is no limit to the number of certifications you can hold as a Nurse and each certification can help you gain a competitive advantage in your Nursing field. Some of these certifications include basic life support (BLS), advanced cardiovascular life support (ACLS), trauma Nursing core course (TNCC), and Wound Care Certification (WCN-C).

Organize or Join a Unit-Based Council

Unit-based councils are a professional practice model that facilitates shared decision-making between staff Nurses and Nursing management. These councils can impact policies, procedures, and processes in everyday patient care. Organizing or joining a unit-based council will promote evidence-based practices, improve patient-centered care, increase job satisfaction, improve Nurse retention, and foster professional growth and development. Participating in a unit-based council also looks great on a resume.

Join a Professional Organization

There are many benefits to joining a professional organization that can support your advancing career. Whatever your Nursing specialty, there is most likely a professional organization you can join to support your growing skills and knowledge. These organizations help Nurses achieve personal growth and development by supplying educational opportunities such as CEUs, education conferences, occupational networking, and academic scholarships. Taking an active part in these types of organizations can offer Nurses professional development opportunities including mentoring and leadership development. To choose an organization that will be the right fit for you look for a group that focuses on your chosen specialty or area of interest. 

Consider Specialization

Nurses have the opportunity to become specialized in their chosen Nursing field. Nursing certifications are a formal process in which clinical knowledge and skills are tested to demonstrate competence in a chosen specialty. Nurses can become specialized in various fields including but not limited to emergency Nursing, medical-surgical Nursing, rehabilitation Nursing, and critical care. Achieving board certification in your chosen specialty demonstrates that you are an expert in your chosen field and can lead to increases in pay, management positions, and more.

Take the Next Step in Your College Career

Educational advancement in the Nursing profession is endless and there is always room to climb the professional ladder. The Nursing profession offers a wide variety of job opportunities and with every new degree achieved, new doors can be opened. Going back to school is a big decision to make and there are many aspects to consider. There are many different paths that can be taken to advance your degree. Classes can be taken online or in-person as well as part-time or full-time. These options allow Nurses the flexibility they need to continue working while achieving their degrees.

Registered Nurses who have achieved a bachelor’s degree can decide to enroll in a graduate Nursing program and receive a master’s degree in Nursing. There are several different areas of focus Nurses can choose including a Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Leader (CNL), and Certified Nurse-Midwife (CNM). The benefits of obtaining a graduate degree in Nursing include a pay increase as well as teaching and leadership opportunities.

In closing

Knowledge, skill, and passion are what can really drive a Nurse forward in the Nursing profession. What is most important is that you find what you are passionate about and go for it with integrity. By doing this, you will find yourself opening the door to new opportunities that will lead to your own personal journey of growth and development in Nursing.

Each year during Nurses Week we take the time to show our appreciation for Nurses and all of the amazing hard work they do. Companies have also taken this opportunity to show their appreciation by offering special discounts and freebies for healthcare heroes. 

To save Nurses some time, we compiled a list of companies who are participating in special offers. 

Applebee’s is offering Nurses with a verifiable ID a free appetizer with any entree purchase through May 15. However, each Applebee’s franchise may offer something different or extra. Call toll-free at 888-592-7753 to see.

Chipotle is giving 2,000 health care professionals free burritos for a year. Until May 6th, people can nominate healthcare heroes by tagging them on Chipotle’s official social channels, and give a brief description of the amazing work they do.

Texas de Brazil is offering a 15% discount with a valid badge or ID.

ASICS is providing Nurses with 40% off ASICS products. When you verify your healthcare worker status using SheerID, you will receive a one-time-use promo code.

Great American Cookies is giving a free Original Chocolate Chip Cookie through Friday, May 6, with any purchase and valid ID.

Amazon is offering four free medical drama books, specially curated to celebrate Nurses.

Outback Steakhouse is offering 10% off your bill when you show your industry identification. The discount is not available via online ordering.

Adidas has offers of 30% off in-store and on the Adidas website, and 20% off at factory outlet stores, when you verify your status as a Nurse with ID.me.

Ring is offering 20% savings on select Ring Doorbell products.

Brooklyn Bedding wants you to get the best sleep possible with 25% off and free shipping on your entire order of mattresses, pillows, sheets and/or foundations. Verify your eligibility via ID.me during checkout.

Lululemon is giving 15% off in-store or online purchases.

Budget is offering a discount of up to 25% for Nurses. Create an ID.me account, or sign in to enjoy this offer.

Enterprise Rent-a-Car is also offering 25% off their rental car costs. An ID.me account is required to access this discount.

National another car rental company, “lets you choose any car in the aisle and go” with up to 25% off.

Thank you Nurses for all you do! We hope you enjoy your special week! 

As a Nurse, you always have essentials in your pockets or bag to help you get through a shift and day-to-day life as you never know when your experience and skills will be needed. Here are some of the essential items Nurses have on hand.

IIPHONE & CHARGER

Your iphone is a useful tool especially when you fill it with apps such as Eponyms, Nursing Dictionaries and Drug Handbooks. You can also use it to set alarms for important reminders.

LOTION & SANITIZER

Nurses are constantly washing their hands throughout the day, leaving their skin dry. That's why having lotion in their bags is important to keep skin in good condition. Meanwhile, the sanitizer helps them steer clear of those pesky germs.

STETHOSCOPE & CLEANER

Every Nurse needs their stethoscope! It's important to keep your stethoscope sanitized, so it's a good idea to keep stethoscope cleaner in your bag. It's an even better idea to have a cleaner with a rubber protecting agent to prevent cracking, keeping it in tip top shape.

EXTRA MASKS

You can never have enough masks and gloves!

FACE CREAM, CHAPSTICK AND MINTS

Wearing face PPE can cause skin irritation, acne and cracked lips. You can use face creams and lip balms to keep skin healthy. Wearing masks all day can sometimes cause bad breath, try keeping mints or a travel size mouth wash in your bag.

SCISSORS & TAPE

Nurses need to have these in their pockets for emergency use, especially for wound care. Micropore tape is also important and should be readily available, for example, when your patient accidentally pulls his/her IV.

SALINE FLUSHES

Nurses are frequently administering medications via IV so having saline flushes on hand is a smart move. 

SMALL NOTEBOOK

Mini notebooks are great for taking notes from Doctors and writing down important observations of your patients to remember for charting.

WATER BOTTLE & SNACKS

Staying hydrated is super important as well as eating healthy during your shift. Have a reusable bottle to keep your favorite beverage nearby and toss easy to eat and healthy snacks in your bag.

RETRACTABLE PEN HOLDER

No more losing your pens and markers. The retractable holder keeps badges, IDs, pens, markers and more attached to you for easy access and safe keeping.

What are some of your favorite items you keep nearby?

The American Association of Nurse Practitioners (AANP) reported more than 355,000 Nurse Practitioners (NPs) are licensed to practice in the U.S. This is up 9% from the estimated 325,000 reported in May 2021.

This increase in NPs will help aid the healthcare provider shortages and ease burnout from the COVID-19 pandemic. 

“Nurse Practitioners are answering the call to provide vital health care services to all Americans,” said AANP President, April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN. “With the challenges of the pandemic and the demand for more accessible and equitable care, NPs continue to enhance health care delivery across all settings. Today’s Nurse Practitioner count indicates that demand for these highly-qualified clinicians continues to be on the rise — and for good reason.”

Nurse Practitioner holds the first spot on U.S. News and World Report's 2022 Best Health Care Jobs list and second on the 2022 100 Best Jobs list. 

Kapu said, “These rankings highlight what we have known for some time: the NP role is not just a job, it’s a calling for more than 325,000 NPs who are working tirelessly on the front lines of health care, from hospitals to primary care clinics, in patients’ homes and via telehealth. NPs are highly trained and committed health care providers improving the health of their patients and communities. As we enter the third year of the COVID-19 pandemic, America’s NPs will continue delivering high-quality care in every health care setting and expanding access to care in vulnerable and underserved communities. Their dedication makes me proud to be an NP.”

As of May 2021, the Bureau of Labor Statistics (BLS) lists these 5 states as having the highest employment levels for Nurse Practitioners:

• California
• New York
• Texas
• Florida
• Tennessee 

Nurse Practitioners in the U.S. make an average of $118,040 annually, according to the BLS. 

Currently, more than 25 states allow NPs to practice independently. This means they can open their own clinics and treat their own patients without needing a Physician to oversee the practice.

A career as an NP is very rewarding and allows more freedom and flexibility than many other types of Nursing positions. 

There is a dire need for healthcare professionals to care for America's incarcerated patient population. The U.S. has the highest incarceration rate in the world, according to the World Prison Brief. With approximately 2.1 million people behind bars. 

According to the United States Bureau of Labor Statistics, the number of people who work as Registered Nurses, including Correctional Nurses, could rise by 9% from 2020 to 2030.

Correctional health care requires a compassion that sees beyond a person's criminal record and can provide quality care in a unique setting.

According to Indeed, some of the skills a Correctional Nurse should have are similar to a Nurse in any professional environment, with 1 additional skill:

• Critical thinking skills
• Problem-solving skills
• Attention to detail
• Interpersonal skills
• Communication skills
• Organizational skills
• Emergency response
• Knowledge of how to interact with inmates

As a Correctional Nurse, you provide a wide variety of care including intake and testing, treating preexisting conditions such as high blood pressure and diabetes, chronic illnesses ranging from influenza to AIDS, and emergency injuries such as broken bones and puncture wounds. 

Some patients may need to be taken through detox due to substance abuse and others may have symptoms of mental illness. With such a range of health issues, it's important to have a broad set of skills and be able to act quickly. 

Dodge Correctional Institution's Nursing Supervisor, Paula Stelsel said, "Working here, I’ve touched on everything from dialysis to post-op to hospice care. You’re getting a little bit of everything, and if you enjoy patient education, what a great place to come and work." 

Many people have the notion that working in a correctional facility would be unsafe, however these facilities follow strict security protocols to ensure safety. In any hospital or healthcare setting, Nurses face safety risks. 

“There’s a perception out there that prisons are like people seen on TV, dirty and dangerous. But that’s not the case. They’re really not that far from a regular clinic that everyone and anyone goes to. The clientele is just a bit different. A lot of inmates haven’t had care, so you can enact meaningful change just by providing your compassionate care as a Nurse. Their health literacy is pretty low, and a lot of them are very appreciative of the help that you give them, the compassion that you show them, the empathy. They’ve just never experienced those things." said, Registered Nurse Robert Frank.  

According to PayScale, the average annual base salary for Correctional Nurses is $54,000 and total pay ranges from $38,000 to $78,000. Correctional Nurse salaries are determined by many factors such as experience, credentials, and location.

Overall, Correctional Nursing is an interesting healthcare option that provides a different, rewarding experience each day. 

Check out the video below to see a day in the life of a Correctional Nurse.

In the United States, drug overdose deaths have reached historical rates. From September 2020 to September 2021, more than 104,000 Americans died due to a drug overdose. 

Harm reduction services play a key role in preventing death, injury, disease, overdose, and substance misuse or disorder.

According to DrugPolicy.org, harm reduction is based on acknowledging the dignity and humanity of people who use substances and bringing them into a community of care in order to minimize negative consequences and promote optimal health.

Nurses can assist with different types of harm reduction programs. Some of these programs are:

Needle Exchange Programs

People who inject drugs face a greater risk of contracting HIV and hepatitis C. Research shows that 1 in 23 women and 1 in 36 men who use drugs intravenously will contract HIV at some point during their lifetimes, according to American Addiction Centers.

Sterile syringe access programs, also known as needle exchange programs, help lower these risks by limiting syringe sharing and providing safe disposal options.

These programs also provide disease testing, referrals to drug treatment, detoxification, social services, and primary health care.

According to the CDC, nearly 30 years of research has shown that comprehensive Syringe Services Programs (SSPs) are safe, effective, cost-saving, and do not increase illegal drug use or crime. Research also shows that new users of SSPs are 5x more likely to enter drug treatment and about 3x more likely to stop using drugs than those who don’t use the programs.

Supervised Injection Facilities

Also known as overdose prevention centers, these facilities offer a safe space for people to consume pre-obtained drugs under the supervision of medically trained professionals.

Facility staff members do not assist in consumption or handle any drugs brought in by clients.

Healthcare providers are there to offer sterile injection supplies, test for the presence of fentanyl in drugs, answer questions on safe injection practices, administer first aid if needed, and monitor for overdose.

Years ago, the American Medical Association vouched for these facilities stating, studies from other countries have shown that supervised injection facilities reduce the number of overdose deaths, reduce transmission rates of infectious disease, and increase the number of individuals initiating treatment for substance use disorders without increasing drug trafficking or crime in the areas where the facilities are located.

In 2021, New York City became the first in the nation to open an overdose prevention center.

Some community-based harm reduction examples are:

Naloxone Distribution Programs

Naloxone (also called Narcan®) is an inexpensive, FDA-approved generic drug that works to reverse an opioid overdose, including fentanyl overdose, by restoring breath to unconscious overdose victims. It is simple to administer, making it safe and easy for laypeople to use.

Good Samaritan Laws

The chance of surviving an overdose can depend heavily on how fast medical services are provided. Often, witnesses of an overdose are hesitant to call 911 due to fear of police involvement.

In an effort to prevent this from happening, the majority of US states have passed Good Samaritan laws. Many of these laws provide protection from prosecution for low-level drug offenses, like the sale or use of a controlled substance or paraphernalia, for the person seeking medical assistance as well as the person who overdosed. 

With rising cases of overdoses and drug-related diseases, the US continues to search for new and innovative approaches to drug use, drug treatment, and drug policy based on science and research.

Here's some advice for keeping your cool with difficult visitors.

First Impressions

To start off on the right foot, get to know the visitors in the room by introducing yourself and building rapport. Be proactive and explain what everyone should expect, who else may be assisting in the process, and how often someone will be by to check in. Naturally, family members will worry and feel helpless. It's important to address any questions or concerns they have.

Listen and Acknowledge

When you start to recognize a visitor's behavior shifting in a negative direction, try to get to the root of the problem so you can diffuse the situation. Let them express their feelings and acknowledge their concerns. Try to understand the situation from their perspective.

Remain Calm

If tensions start to rise and the visitor becomes angry or aggressive, it is best to remain calm and keep a physical distance. Try to maintain a composed voice, speak slowly, and use a low volume tone.

It is easy to get defensive, but it is best not to escalate the problem with more negative energy.

Don’t interrupt them. Wait for them to take a break from venting, acknowledge that you’ve heard them and jump in. This gives you the opportunity to take back control of the conversation and guide them to a solution. Master De-escalation Instructor, Myra Golden, calls this ‘the jump rope technique’.

Draw The Line

If inappropriate behavior occurs, it is important to stand up for yourself and set boundaries. If you feel the environment is becoming unsafe, remove yourself and call security.

Not sure what to say? Resilient Nursing has some good examples:

• “I am here to help. I will answer your questions and address your concerns, but I can’t do that if you are yelling at me.”
• “We are in a hospital. I need you to stop. You are disrupting patients and visitors right now.”
• “What you just did/said was not acceptable. If you continue, I will have to ask you to leave.”

Document

If any issues occur on the floor, you should let the Charge Nurse know about it. Also document the event, summarizing what took place and how you handled it. Not only is this good to have for legal reasons, it also makes other healthcare providers aware for the future.

Self-Care

Being involved in a conflict or altercation can take a toll on your stress levels. Be mindful of how you feel and take time to process your feelings. Do what you need to do to feel better. Try talking to a friend or coworker or try journaling.

But most importantly, don't take it personally. You are doing the best you can and are not responsible for someone else's bad reaction to stress. 

A key tool to reducing health disparities in patient care involves diversifying the Nursing field. The Nursing population should be as diverse as the patient population they serve.

According to research, the majority of Nurses in the US are White/Caucasian at 73.3% and only 7.8% are African American. 

Jennifer Coleman, a Samford University Professor and Pediatric Nurse, is one of several National Black Nurses Association (NBNA) members working toward increasing diversity in Nursing. To help accomplish this goal, the association created a program called NBNA Mini Nurse Academies, which encourages elementary school students of color to consider a career in Nursing. 

"The purpose of this innovative program is to increase student awareness of Nursing as a career option and to provide students with knowledge and skills related to professional Nursing practice," said UAB School of Nursing Associate Professor Loretta Lee, PhD, CRNP, FNP-BC, CNE. "In these academies, students in third through sixth grades from school districts where there are large communities of color will be introduced to the Nursing profession by professional Nurses who share similar backgrounds and lived experiences."

The NBNA represents approximately 200,000 African American Nurses from the USA, Canada, Eastern Caribbean, and Africa, with 115 chartered chapters nationwide. They recognize the need to increase diversity within the Nursing field and are being proactive to do something about it.

The Direct Relief’s Fund for Health Equity awarded the NBNA with a $248,000 grant for the Mini Nurse Academy. The Fund was created to increase access to health care and improve health outcomes for marginalized communities. 

With this grant more mini academies will be able to offer learning modules that include class discussions, guest presentations, interactive hands-on activities and ongoing mentorship. It will also address social determinants of health by educating students about healthy lifestyles, according to the, University of Alabama at Birmingham. 

In a Direct Relief article Lee said, “Students in our communities probably don’t see people who look like them very often as Nurses. I believe you have to role model, meaning if a Black student or Brown student sees a Registered Nurse, has interactions with a Registered Nurse throughout their youth, then they are more apt to become a Registered Nurse if they can get information, if they can know what that profession is about. And they’re more apt to want to emulate what they see.” 

New programs will begin in the Fall of 2022 in Florida, Louisiana, Missouri, Illinois, Connecticut, Oregon, and South Carolina. 

The National Commission to Address Racism in Nursing defines racism as "Assaults on the human spirit in the form of biases, prejudices, and an ideology of superiority that persistently cause moral suffering and perpetuate injustices and inequities."

The Commission surveyed over 5,600 Nurses and found racism to be a significant problem in the field. Results show:

63% of Nurses personally experienced an act of racism in the workplace with the transgressors being either a peer (66%), patients (63%), or a manager or supervisor (60%).

56% of Nurses say racism in the workplace has negatively impacted their professional well-being.

“We are still living through the structural racism that is embedded in America,” says Quanna Batiste-Brown, DNP, RN, Chief Nursing Officer in Ambulatory Care at UCLA Health. “I think addressing it in Nursing is one of the things we can do to move forward.”

Along with addressing the issue, health systems are using various strategies to help eradicate Racism in Nursing.  

Establishing A Task Force

A task force or Council is usually a group consisting of healthcare leaders such as Chief Nursing Officers (CNO), Chief Diversity Officers (CDO), clinical and non clinical staff.

Seattle Children's task force is comprised of Nurses, coaches, Inclusion Network members, Physicians, support staff, scientists and leaders who developed the Health Equity and Anti-Racism Action Plan. 

Nurses at UCLA Health established a council called Unity in Diversity (UID). The primary purpose of UID is to assess, plan, implement and continuously improve actions toward establishing an authentic environment of equity, diversity, and inclusion for patients, trainees, and Nursing staff. 

Karen Grimley, PhD, MBA, RN, Chief Nursing Executive for UCLA Health told Becker's Hospital Review, "That group dovetails into the health system steering committee that's been created by our Chief health, Equity, Diversity and Inclusion Officer. So, we've tried to put a system in place that's going to identify and begin to address cultural norms that may be contributing to systemic bias and racism."

Education And Training

Mount Sinai Health System created the United in Solidarity Resource Guide. This guide is a catalogue of educational articles and resources to learn about racism, prejudice, and bias in America as well as causes to support the fight against injustice. 

Mass General Brigham launched its first system-wide anti-racism educational program, titled Stepping Stones. Stepping Stones was designed to allow viewers to understand how racism exists and functions in our society - and how they can combat it.

RWJ Barnabas Health compiled a list of educational anti-racism resources such as implicit bias tests, white privilege checklist, and a systemic racism video series. 

Diverse Leadership

Hiring Nurses that represent diverse communities is essential. They provide opportunities to administer quality care because of their understanding of various cultures, languages, gender identities, ethnicities, etc. Having diverse Nurses in leadership positions can play a crucial role in breaking down barriers such as discrimination in Nursing.

Staff from diverse backgrounds with histories of discrimination in healthcare may feel reassured when they see people who look like them in leadership positions. They may also feel more comfortable coming forward and reporting an incident of racism or discrimination.

No matter which initiatives a hospital implements, it must start with awareness and identifying any structural biases or barriers.

Marcus Henderson, MSN, RN, lecturer from the University of Pennsylvania’s Department of Family and Community Health, said “To adequately and effectively address health inequities and social determinants of health, Nursing must first look inward to address the inequity, lack of diversity, discrimination, and racism that lies within the profession. It’s not hiding. It has always been in plain sight.”