DiversityNursing Blog

Diversity, Equity, and Inclusion (DEI) in the workplace is beneficial for employers, staff, and patients. More hospitals and health systems are recognizing the importance and are rolling out new DEI programs. 

Diversity is the range of human differences, including but not limited to race, ethnicity, gender, gender identity, sexual orientation, age, social class, physical ability or attributes, religious or ethical values system, national origin, and political beliefs.

Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome.

Inclusion is an organizational effort and practice in which different groups or individuals having different backgrounds are culturally and socially accepted and welcomed.

The United States will continue to grow more diverse, so it is imperative the Nursing workforce reflects its patient demographic. 

Historically underrepresented groups, combined, are projected to account for the majority of the U.S. population by 2044.

The Nurse.com 2022 Nurse Salary Research Report findings display a lack of Diversity in the nation's Nursing workforce. 

The report found that although Hispanics make up 17% of the total population, only 3.5% out of the more than three million Registered Nurses in the U.S. are Hispanic.

Also only 2% of the survey’s respondents were Black or African American men, whereas Black or African American women made up 8% of female Nurses. By contrast, Asian men made up 10% of male Nurses, and Asian women made up only 5% of female Nurses.

Having a diverse Nurse population improves patient care and satisfaction while also reducing healthcare disparities. 

Research shows, when patients see themselves within the healthcare workforce, they are more likely to trust their provider, thus making the patient feel more comfortable. 

This also breaks down communication barriers. When patients can't easily communicate their needs or fully express their concerns and issues, dire mistakes can be made.

When a Nurse has a lot in common with their patients, they can better advocate for them. 

“Diversity in Nursing ultimately enhances the Nursing workforce,” says Lorrie Davis-Dick, Nursing faculty member at Purdue University Global. “Nursing education and Nurse leaders recognize there's a link between a culturally diverse workforce and the ability to provide quality, competent patient care."

DEI is beneficial for patients, but also for healthcare professionals. 

According to Built In, Diversity creates a stronger feeling of Inclusion and community for healthcare workers, which makes the workplace feel safer and more enjoyable. Surveys show that more than 3 out of 4 workers prefer diverse companies.

While Diversity is important, Diversity without Equity and Inclusion won't work. Healthcare teams must represent all backgrounds, while also giving each member a voice and the opportunities to grow.  

Increasing Diversity in Healthcare is vital. It won't happen overnight, but it's crucial to create an environment where everyone is celebrated and appreciated. It requires dedicated leadership and staff who are looking to better the Nursing field.

Creating a workplace with a strong Diverse, Equitable and Inclusive culture is not only the right thing, it’s also crucial for your retention and improving patient care.

A study from Press Ganey shows health systems with strong Diversity, Equity, and Inclusion (DEI) values have less risk of staff potentially leaving the organization.

The study also found:

• Healthcare organizations had twice as many employees at risk of leaving if the workforce perceived diversity and equity weren’t prioritized versus work forces that do.  
  
  
• The risk of leaving within 3 years is more than 4 times higher for healthcare workers who believe their organization doesn’t value employees from different backgrounds versus workers who do.  
  
  
• If offered another job, healthcare workers are 4 ½ times more likely to leave an organization if they believe different backgrounds aren’t valued, or if the organization isn’t committed to workforce diversity, versus workers who do.   
  
  
• Perceptions of diversity & equity are a bigger indicator of intent to stay with an organization among security personnel, nurses and physicians than other ancillary staff. 

Having a strong DEI culture allows employees to be comfortable and confident in who they are. This allows them to focus on providing the best patient care possible.

Research shows, 77% of employees and 80% of leaders who are disabled chose not to share their disability in their workplace. For LGBTQ workers, 46% are closeted at their place of work. And across all diverse characteristics, 75% of employees feel the need to mask their differences or downplay them during work.

Employees masking or hiding aspects of themselves during shifts affects their confidence, motivation, feelings of safety and hinders their job performance.

It’s important for healthcare workers to have mentors they can look up to throughout their careers. A lack of diversity can make it difficult for minority healthcare workers to find role models they identify with. This can impact their professional growth and their ability to provide optimal patient care.

A strong DEI culture isn’t something that can be achieved overnight. It requires a leadership who is dedicated to promoting cultural awareness and inclusion. It requires staff who are willing to take the time to learn about and understand each other. It also means being willing to identify and address biases.

The tragic events of the past year has brought an increased awareness to Diversity, Equity, and Inclusion (DEI). As a result, healthcare organizations are hiring Chief Diversity Officers (CDO’s), implementing initiatives, providing educational programs, and using new recruitment strategies to increase diversity in medicine.

Increasing diversity in healthcare organizations benefits both the healthcare provider and the patient populations they serve.

To increase diversity and lower racial healthcare disparities, many hospitals and health systems are looking to their CDO for guidance moving forward.

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

Some health systems are going beyond hiring a CDO and are creating entire teams or councils to implement and foster best practices. 

Northwell Health formed the Emerging Leaders Diversity & Inclusion Council which is responsible for analyzing current conditions within the health system while seeking to implement best practices in 3 key areas:

• Onboarding
• Mentoring
• Succession Planning

Englewood Health assembled a Diversity and Inclusion Education Council consisting of 12 team members across all departments and leadership levels.  

Warren Geller, President and CEO of Englewood Health said, “Our country’s history of racism and current inequalities have impacted every aspect of life and, most importantly, our health and well-being. With the establishment of a Diversity and Inclusion Education Council we are committing to doing more and doing better for the communities we serve.”

More hospitals are providing educational resources and training programs for their staff members.

At Ochsner Health in Louisiana, they’ve rolled out training to address implicit bias across the organization. Melissa Love, VP of Professional Staff Services and The Office of Professional Well-Being said, “People are really curious. I’m seeing people be very surprised by their lack of knowledge, even those that think they’re very knowledgeable.” 

Hospitals are also participating in evaluation programs to help improve their DEI efforts. 

The HRC Foundation's Healthcare Equality Index (HEI) evaluates healthcare facilities nationwide based on non-discrimination & staff training, LGBTQ patient services & support, employee benefits & policies, and LGBTQ patient & community engagement. 

Last year, a record 765 healthcare facilities participated in the HEI survey. These organizations recognize the importance of implementing LGBTQ-inclusive practices alongside their foundational non-discrimination policies.

When it comes to diversifying the hiring process, Daniel Benavides, Manager of Talent Acquisition at CHG Healthcare, suggests hospitals increase the number of people who select candidates. 

Benavides noticed only one or two people were filtering candidates for interviews. He determined that having a larger mix of individuals looking at applications would result in a greater diversity — and higher quality — of selected candidates.

It’s critical healthcare organizations improve diversity within their staff to reduce healthcare disparities. They must ensure ALL people are equally represented. 

Age discrimination involves treating an applicant or employee less favorably because of his or her age, defined by the U.S. Equal Employment Opportunity Commission (EEOC).

The Age Discrimination in Employment Act (ADEA) forbids age discrimination against people who are age 40 or older.

Ageism in the Workplace

According to a 2018 AARP survey, about 3 in 5 older workers have seen or experienced age discrimination in the workplace. Also 76% of these older workers see age discrimination as a hurdle to finding a new job.

A diverse workplace is fundamental in providing the best patient care possible. But age is usually left out of an organization's Diversity, Equity and Inclusion (DEI) strategy.

Patients feel more comfortable talking with a Nurse who understands and can relate to them and their issues. Nurses who understand what ageing patients are going through can provide better care. 

Physical Strength - There is a perception older Nurses aren't physically strong enough to handle certain responsibilities such as restraining a combative patient or assisting someone into a bed or wheelchair.

Technology - Another misconception is older Nurses can't keep up with the changing technologies and medications.

Pay - An article by Arkansas State University discusses salary-based ageism in Nursing saying, "As Nurses accumulate experience, they also accumulate pay increases. As a result, employers sometimes discriminate against more experienced Nurses by hiring or promoting younger, less experienced, and therefore, less expensive Nurses."

This type of stereotyping and discrimination often leads to poor morale, job dissatisfaction, burnout and early retirement.

How You Can Reduce Ageism at Work

To combat ageism in healthcare organizations, there should be DEI policies that include a focus on age.

According to the Society for Human Resource Management (SHRM) the EEOC recommends organizations follow these strategies:

• Assess your organization's culture, practices or policies that may reveal outdated assumptions about older workers. The Center on Aging & Work at Boston College and AARP partnered to develop an assessment tool.
• Examine your recruitment practices. Does your website include photos of an age-diverse workforce? Do your job applications ask for age-related information such as date of birth or when a person graduated? Is your interview panel age-diverse? Train recruiters and interviewers to avoid ageist assumptions.
• Include age as part of your diversity and inclusion programs and efforts. Offer learning and development, including anti-bias training and courses.
• Foster a multi-generational culture that recognizes ability regardless of age and rejects age stereotypes, just as it would reject stereotypes involving race, disability, national origin, religion or sex.

Ageism in Your Patient Population

Ageist stereotypes and discrimination are also barriers to health equality for this patient population.

An article from Lippincott Nursing Center states, Older adults represent 13% of the total population in the United States, but account for over 40% of U.S. hospitalizations.

Ageism can negatively affect the care older adults receive. It's often healthcare providers attribute signs and symptoms of illness to normal aging, missing important indicators that need to be addressed.

A lot of ageist behaviors may not be intentional and will take conscious efforts to identify and change. For example, talking slowly and loudly, or assuming someone can’t comprehend what you are telling them, is common behavior around older patients and is considered ageism.

How You Can Reduce Ageist Attitudes Toward Patients

The Alliance for Aging Research warned "that unless ageist attitudes are recognized and rooted out of our healthcare system, the next generation of Americans under Medicare, the largest generation in U.S. history, will likely suffer inadequate care."

The Alliance released recommendations to address the problem of ageism:

• More training and education for healthcare professionals in the field of geriatrics.
• Greater inclusion of older Americans in clinical trials.
• Utilization of appropriate screening and preventive measures for older Americans.
• Empowerment and education of older patients.

The older patient population deserves the same quality care and attention as younger patients. Organizations must acknowledge ageism as an obstacle in providing the best care possible and take action to make healthcare more equitable and inclusive.