Ildiko K. YuryevCleveland State University

MINORITIES IN NURSING

The lack of diversity in the nursing workforce is potentially

harmful to the profession and the population it serves.

Minority nurses provide a culturally diverse workforce that aims to

match the change in the population demographics.

Better use of the available diverse human capital is

imperative.

This presentation discusses current workforce statistics, accessibility

and recruitment of minorities in the field of nursing.

the lesser part of a smaller number

a racial, religious, political, national or other group that differs from the larger, controlling group

having little power or representation relative to the other groups in the society

(Webster’s New World Dictionary, 2003, p. 412).

MINORITY/MAɪˈNɒRƏTI/

Minorities in the field of nursing include, but are not limited to:

ethnic and racial minorities – ex. African American, Hispanic, Asian populations

underrepresented groups – men, LGBTQ

non-traditional students

those disadvantaged.

The American Association of Colleges of Nursing (AACN, 2011)

There is a clear link between the lack of diversity in

the nursing workforce and nursing's ability to

effectively address health disparities with high-

quality, culturally competent care.

(as cited in Melillo et al., 2013)

CULTURAL COMPETENCE

sensitivity to the cultural, philosophical, religious, and social preferences of people of varying ethnicities or nationalities

(Taber’s Cyclopedic Medical Dictionary,

2009, p. 555).

Code for Nurses (1985)American Nurses’ Association

the nurse provides services with respect for human dignity and the uniqueness of the client unrestricted by considerations of social or economic status, personal attributes or the nature of health problems.

Health care that is not sensitive

to differences in race,

specific health practices and

needs of different groups

is not quality care and can even be

harmful.

(as cited in ANA, Discrimination, 1998).

STATISTICS By the end of 2060:

1:3 U.S. residents will be Hispanic compared to 1:6 in 2012. the African American population will increase from 41.2 million to 61.8 million. the Asian population is expected to double. people who identify as multiracial will triple.

Phillips & Malone (2014)

WORKFORCE 1996

90% of the nursing workforce was white female U.S. Department of Health and Human Services

(as cited in ANA, Discrimination, 1998). 2008

3.0 million registered nurses (RNs) in the U.S: 83.2% were non-Hispanic white 5.4% African American 3.6% Hispanic 5.8% Asian/Native Hawaiian

0.3% American Indian/Alaska Native1.7% multiracial

National Survey of Registered Nurses (as cited in Phillips & Malone, 2014).

2013

CRITICAL NEEDBy 2020:

the demand for registered nurses is expected to exceed supply by over 800,000 positions

29% shortage in RNs to fill vacant positions.

While the size of the workforce is already inadequate to meet the demands, issues related to the composition of the nursing population are also of concern.

The National Center for Health Workforce (2002) (Samson, 2004)

PATIENTS

• ethnic minorities seeking care often have literacy deficits that interfere with their ability to access and comprehend a complex healthcare system

• their ability to attain and maintain a healthy lifestyle is somewhat limited.

Schloman et al. (2005)

• healthcare professionals’ awareness of ethic and minority patients’ health literacy level is critical in providing adequate care, thus decreasing health disparities in such populations.

Cutilli (2005)

involves obtaining, processing and understanding the basic health information needed to make appropriate healthcare decisions

requires adequate reading and language skills to be able to relay and comprehend pertinent information.

(as cited in Ingram, 2012)

HEALTH LITERACY

FACTS:

Minority patients often report receiving substandard care from healthcare providers, issues being attributed to language and cultural barriers, or simple lack of awareness.

They face the reality of discrimination when accessing health care.

Without culturally sensitive interventions health professionalsare not able to properly care for this type of population. 

A nurse’s non-judgmental attitudeexposure to different cultures and groups

is essential when incorporating efforts to understand patients’ world view, culture and communication patterns.

Respecting how different cultures perceive health and illness is also essential in efforts to enhance cultural competence.

Cutilli (2005) (as cited in Ingram, 2012)

Culturally competent nurses are critical for patient access to health care, and for patient–nurse relationships of trust and respect.

Mullins et al. (2005)(as cited in Ingram, 2012)

Direct interaction with clients from multiple cultural groups will prevent stereotyping, and refine one’s perception of diversity.

Exploring health related beliefs, treatment options, attitudes and behaviors with the client results

in quality healthcare

encounters that benefit both the patient and

the interdisciplinary team.

Nursing Workforce Diversity (NWD)U.S. Health Resources and Services Administration

(HRSA), Bureau of Health Professions, Division of Nursing

provides federal funding grants to colleges and universities in order to increase nursing education opportunities for individuals from disadvantaged ethnic, racial or socioeconomic backgrounds.

Melillo, 2013

RECRUITMENT AND RETENTIONCritical factors:

academic and financial supportmentoringcommunity partners support from minority nursing facultypeer-groupssocio-economic assistance

Dapemort (2013) (as cited in Phillips & Malone, 2014).

BRING DIVERSITY TO NURSING (BDN) PROJECT

• recruit and retain ethnic and racial minority students, and other underrepresented groups in order to better address the disproportionately high cultural, and socioeconomic gap of Lowell, MA area.

• 55% of high school students who responded to the survey had no interest in nursing as a career.

• Increasing awareness of the profession among students is an important factor that needs to be addressed when aiming to recruit the next generation of nurses.

University of Massachusetts Lowell (UML) Department of Nursing

(Melillo et al., 2013)

Opportunities to promote questions about the profession, and peak the interest of students:

books about nursing media career-day workshops

field visits mentors

BDN PROJECT FINDINGS Rigorous retention programs focus on providing academic, socio-cultural and financial assistance to the minority and disadvantaged student population, in order to seal the gap in need, and maintain access to education.

Students enrolled in UML’s program met with the academic counselors at least once a monthmaintained an academic portfoliosent an electronic journal weeklyidentified their goals for the week as well as how they planned to achieve them.

Participation in these rigorous academic services resulted in the improvement of studying, and test-taking skills.

Students rated tutoring as the most helpful aspect of the retention program.

(Melillo et al., 2013)

ADDITIONAL BARRIERS The limited number of minority nursing faculty to serve as role model, mentor and advisor.

Phillips and Malone (2014)

PERFORMANCE

Limited data linking nursing workforce diversification to reductions in health disparities. Gillis et al. (2013)

Basic awareness by health care providers of lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues and terminology was reported to be helpful by participants; the provider was aware that each person is different, and asked questions about patient preferences.

Rounds et al. (2013)

CONCLUSIONRacial and ethnic minority nurses have made great strides in advancing knowledge about health disparities and related interventions.

Minority nursing organizations are collaborating with other professional associations to achieve mutually determined diversity goals.

Members of such organizations hold influential positions, and sit on committees whose mission is to enhance diversity and eliminate health disparities.

Such leaders are able to influence others in impacting the nursing field of practice, shifting focus from simply meeting patients’ physical and psychological needs, to educating the next generations of nurses on cross-cultural care, and developing the behaviors and attitudes necessary for them to be culturally competent.

Phillips and Malone (2014)

The goal of achieving health equityby providing culturally competent care, and eliminating health disparities will not be realized without the ongoing engagement of minority nurses.

Therefore, preparing minority individuals, racial and ethnic groups, men, and those disadvantaged to successfully practice in the field of nursing, and assume greater leadership roles is imperative in order to reduce health disparities, and achieve health equity.

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