DiversityNursing Blog

Erica Bettencourt

There is a need for diversity in the health industry, especially Nurses. Having more diverse nurses will improve access to healthcare for racial and ethnic minority patients. Also those patients will be more comfortable and have higher satisfaction. Diversity must be increased at all levels especially educational institutions. More cultural healthcare programs and initiatives should be offered for students.

By: By Debra Wood

As America becomes increasingly diverse, the health care field is seeing more men and minorities in nursing, albeit at a slower pace than the country as a whole.

Christine T. Kovner, PhD, RN, FAAN, a professor at New York University College of Nursing and a lead investigator on the RN Work Project, a Robert Wood Johnson Foundation-funded longitudinal study of newly licensed nurses, agreed that the profession is making progress, particularly with increasing the number of men in nursing. But she added that changes occur gradually, because even when schools graduate high numbers of male or minority nurses, the overall percentage for the entire profession rises slowly due to its size, about 3 million.

“We’re going in the right direction, but have we made even remotely measurable strides? Absolutely not,” added Patrick Robinson, PhD, RN, ACRN, dean of undergraduate curriculum and instruction at Chamberlain College of Nursing, headquartered in Downers Grove, Ill. “Any gain is a positive, but we are nowhere near where we need to be. There has to be a concerted effort to recruit and retain highly qualified men and minorities in the nursing profession at all levels.”

Robinson indicated that the lack of diversity in nursing drives a wider wedge in health disparities as minority populations and language barriers grow.

 “We, as a profession, need to keep up with what is happening in the population,” agreed Patrick R. Coonan, EdD, RN, NEA-BC, FACHE, dean of the Adelphi University School of Nursing in Garden City, N.Y. “We have to actively work at it.” 

More men in nursing 

The U.S. Census Bureau released the findings from its Men in Nursing Occupations study in February 2012, which showed the number of male registered nurses has tripled since 1970, increasing from 2.7 percent to 9.6 percent.

Making the profession more attractive to men increases the pool of potential candidates, Kovner said. In addition, she added, “There is some evidence male and female brains work differently. In terms of what research we do, how we teach students, and how we deliver care in health care settings, it’s critical we have that view.”

 Kovner’s data from the 2010-2011 study of newly licensed RNs found about 11 percent of the sample is male, a higher percentage of new graduates are male than 10 years ago. 

The American Association of Colleges of Nursing (AACN) 2012 State of the Schools report, based on responses from 87.5 percent of schools with nursing baccalaureate and graduate programs, found that 11.4 percent of students in BSN programs are men, as are 9.9 percent of students in master’s nursing programs, 6.8 percent of students in research-focused doctoral programs and 9.4 percent in practice-focused doctoral programs.

Evans said that second-degree accelerated programs are bringing in more men.

 Dina A. Faucher, PhD, MSN, RN, OCN, western regional nursing and health professions director for Corinthian Colleges in Las Vegas, also reported an increase in males in the schools’ accelerated programs. At one of the campuses, males represent nearly half of the students.

“Everyone’s going in it for job security,” Faucher said.

Coonan reported that 12.5 percent of students in Adelphi’s program are male. He attributes much of that increase to less gender stigma about the men in the profession, changes to the male role and to the economy.

The U.S. Census Bureau reported that because of the high demand for skilled nursing care, the profession enjoys low unemployment rates, 1.8 percent for RNs and 0.8 percent of nurse practitioners and nurse anesthetists. It also found men’s representation highest among nurse anesthetists at 41 percent. Male nurse anesthetists earned more than twice as much as the male average for all nursing occupations: $162,900 annually vs. $60,700.

Nick Angelis, CRNA, MSN, author of How to Succeed in Anesthesia School (And RN, PA, or Med School), said male nurses, like himself, are initially attracted by the growing role of advanced practice nurses, but he added that those advanced roles are lacking minority role models.

Robinson agreed the lack of men and minority nurses in advanced and leadership roles is a problem.

“People need to see people like themselves in those positions, so they know what they can be,” Robinson said.

Representation of minorities in nursing 

Evans indicated that patients find it reassuring to receive care from someone who comes from the same ethnic or racial background. Yet recruiting more ethnically and racially diverse students requires a concerted effort to reach out to them, at schools or community organizations, and educate them about the opportunities available in nursing.

 “Diversity is critical to the profession from many perspectives,” said Kathleen Potempa, PhD, RN, FAAN, dean of the University of Michigan School of Nursing in Ann Arbor. That includes to “better match the changing face of U.S. demographics; to provide diversity of thought, life experience and culture in health policy and decision making; and to provide opportunity to all Americans to participate in the health professions, an enduring job sector in the U.S.”

The 2010 U.S. Census found 72 percent of Americans self-identified as white, 16.3 percent Hispanic or Latino, 12.6 percent black or African American, and 4.8 percent Asian.

The 2012 Bureau of Labor Statistic’s Current Population Survey (CPS) reported of the 2.875 million nurses in the United Sates, 6.1 percent were Hispanic, 11.5 percent black and 7.3 percent Asian. That compares to more than 2.4 million nurses in the 2003 CPS, of which 3.9 percent were Hispanic, 9.9 percent black and 7 percent Asian. 

Kovner’s data from 2010-2011 showed 79 percent of newly licensed nurses were white, less than historical percentages. But racial categories, she cautions, are difficult to define with many people stating they fall into more than one demographic group. However, her data shows that nonwhites are going back to nursing school at higher than historical rates.

The AACN study found an increase in minority BSN students, with 72 percent identifying as white, 7 percent Hispanic, 10.3 percent black and 8.8 percent Asian.

Calling health care cultural, Coonan emphasized that nurses from similar backgrounds as patients can more completely understand the culture and could lead to better outcomes.

Coonan has significantly increased minority students at Adelphi during the past nine years, boosting it from 10 percent to 57 percent from under-represented groups by reaching out into communities with higher minority populations without lowering the school’s standards. About a third of its graduate students come from minority groups.

“Then my challenge was to hire faculty from under-represented groups, and that was a lot harder,” Coonan said. But now 40 percent of Adelphi’s faculty fit that description. 

The AACN survey found only 5.1 percent of full-time faculty members are male and 11.8 percent are from racial or ethnic minority groups.

“The pool of individuals who represent ethnic and racial minorities and are prepared to teach is low,” said Evans, who called the minority faculty shortage a tremendous problem. Texas Tech actively recruits minorities into its master’s education program in an effort to grow its own more-diverse faculty.

© 2013. AMN Healthcare, Inc. All Rights Reserved. 

Source: NurseZone.com

Adrian Espinosa is part of a still extremely small but growing trend in nursing. He’s a man.

Espinosa, now a student at the University of San Francisco School of Nursing, said he quickly became aware that he is a man in a field that continues to be dominated by women.

“From the first day I started nursing school last year, as one of seven males in a class of 77, I realized that I would have to find my fit in a predominately female profession,” Espinosa said. His goal is to become a nurse practitioner “to fulfill a huge gap in primary care for under-represented populations.”

 In a 2012 essay written for the American Assembly for Men in Nursing Scholarship, Espinosa said his route to his chosen career was anything but direct.

“My journey into nursing wasn’t immediate, but my path was illuminated when I began working in community public health,” Espinosa wrote. “Watching nurses and nurse practitioners work with diverse populations inspired me to pursue the nursing culture in the hope of providing accessible care for marginalized communities.

 The nursing community knows it needs more people like Espinosa in its ranks and it is working hard to increasing nurse diversity.

According to the American Association of Colleges of Nursing, in 2008, there were 3,063,163 licensed registered nurses in the United States. Only 6.6% of those were men and 16.8% were non-Caucasian. Despite efforts from nursing schools across the nation to recruit and retain more men and minorities, the results have been fairly modest.  In 2010, approximately 11% of the students in BSN programs were men and 26.8% were a racial/ethnic minority.

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This is one reason why the University of Mary in Bismarck, ND prides itself on  providing "a nursing education for leadership and moral courage" and places an emphasis on diversity.

“U-Mary is a community of learners that recognizes and respects diversity and the richness it brings to the college experience,” according the catalog of the private, Catholic university that offers degree completion and advanced nursing degrees online and on campus.

University of Mary prides itself as “community that fosters diversity through hospitality and dialogue so as to learn to live in an interconnected world.”

Why are more men and people of color needed in today’s nursing ranks? To help meet the medical and personal needs of the United States’ increasingly diverse patient population that is adding varied ethnic, racial and cultural traditions to the country. Patient stories such as these from the University of California, San Francisco are good examples.

• Selena Martinez was diagnosed with Lynch Syndrome, a genetic disease that can lead to a wide-range of cancers. It wasn't until 2008 that the Martinez family, which in just 16 years had 13 cancer diagnoses among nine people, received a conclusive diagnosis of Lynch Syndrome.
• Simone Chou, was in her last year at the University of California, Berkeley when she learned she had lupus and that her immune system was attacking her kidneys. After nine years of treatment failed to slow the deterioration, Chou and her doctors launched a nationwide search to find a compatible kidney donor. They didn’t have far to look. Michael Wong, a college friend, stepped up. Wong, a practicing Buddhist, had read many stories about Buddhist saints who donated their body parts to other people. "When I first heard Simone talk about needing a kidney transplant, I remembered those stories."
• Doris Ward is one of the pioneering African-American politicians in the San Francisco Bay Area. She started her career as a trustee of the San Francisco Community College District, became a County Supervisor in 1980, President of the Board of Supervisors in 1990 and finally moved on to spend the last 10 years as the San Francisco County Assessor. She is also a breast cancer survivor. Ward now helps other African-American women through their own journey with cancer by sending them information and helping them understand their options.

“Nursing’s leaders recognize a strong connection between a culturally diverse nursing workforce and the ability to provide quality, culturally competent patient care,” according to a policy statement by the American Association of Colleges of Nursing.

 “Though nursing has made great strides in recruiting and graduating nurses that mirror the patient population, more must be done before adequate representation becomes a reality,” the association statement added.

The University of Mary is ready to help ensure that the nursing ranks reflect the diversity of our nation. For a welcoming environment, online or on campus, to get your advanced practice nursing degree, contact the University of Mary.

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