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Increasing diversity: Discussion leads to opportunities to expand the nursing workforce


RNs’ ethnicities can differ dramatically from those of the patients for whom they care, which can hamper patient care. Several nursing leaders participated in a Nurse-Family Partnership discussion in May to identify barriers to creating a more ethnically diverse workforce and opportunities for increasing the ranks of African-American and Hispanic nurses.

“The population of people we serve are looking for people who look like them,” said Beverly Malone, RN, PhD, FAAN, CEO of the National League for Nursing in New York and an NFP board member. “It adds to their comfort level, to their ability to feel safe.”

According to the U.S. Bureau of Labor Statistics, in 2008, 83.2% of RNs were white, 5.5% Asian, 5.4% African American and 3.6% Hispanic, yet 65.6% of the country is white, 15.4% Hispanic, 12.2% African American and 4.5% Asian.

“The nursing profession has some challenges representing the populations it serves,” said Kammie Monarch, RN, MSN, JD, COO at NFP, which provides home nursing visits to low-income pregnant women and new moms.

NFP invited nursing leaders to the symposium to discuss ways to further diversify the nursing workforce.

“It was thought-provoking,” Monarch said.

Barriers to nursing careers

Young people often develop their perceptions about nursing from the media and by not seeing ethnically diverse nurses on television, minority students sometimes do not believe nursing could be a career for them, said Martha Dewey Bergren, RN, DNS, NCSN, of Chicago, who represented the American Nurses Association at the symposium and is an adjunct assistant professor at UIC College of Nursing.

Even for those who view nursing as an option, “the door is not totally open,” Malone said, adding that young people possibly interested in nursing careers should concentrate on math and science in middle school and continue with those courses through high school.

“The solution is to start early, maybe as early as elementary or middle school, to get minorities interested in health science,” said Elerie Archer, RN, BSN, with the Eastern Colorado Council of Black Nurses in Denver. “A lot of minorities shy away because of the [lack of exposure to health science].”

The cost of a nursing education also presents barriers. Minority nurses often will begin their careers as CNAs or LPNs and work full time while studying. Then life events can distract them from their RN studies or continuing their education, Bergren said.
Archer said minority applicants need assistance with how to apply and write essays and to ensure the requirements align with the student’s goals.

Some students also must overcome cultural barriers. The profession is not held in high esteem in some cultures and, in others, family comes before education or a career.

“Professors often perceive [those students who put family ahead of their studies]as less serious,” Bergren said.

Minority nurses also can face challenges once on the job. The profession needs to open more doors for those nurses to advance their careers, Archer said. “It’s rare to find a minority nurse that our colleagues look up to as a leader,” she said. “We need mentoring.”

But, Archer added, the minority nurse also holds a responsibility to speak up, share his or her desire to move up, and serve on hospital committees to become known within the organization and to showcase his or her talents.

Sometimes minority nurses are not treated well in the workforce, Malone said. “It’s about culture, and whether you have a culture that is accepting of difference,” she said, suggesting that nursing must build a culture that embraces diversity in the workforce and is accepting of patients from all backgrounds.

Solutions offered

Malone believes the profession needs an infrastructure and systems that help schools admit more minority students and organizations willing to fill vacancies with minority applicants. “It has to be addressed at multiple levels,” Malone said. “We treat it like any problem. We put together a strategic plan. We put together a task force to get this done and hold people accountable.”

Archer suggested nursing organizations partner with schools to educate guidance counselors about what the profession requires and the importance of a background in math and science.

“Young people need to be advised to keep their options open and not to drop their math or hard sciences,” Bergren said. “We need to change the view of a nursing career with those talented students looking for a challenging career working with people.”

Those considering or pursuing nursing also require a mentor, someone who can help them keep their career goals on track. “It’s not just getting them in, but getting them through,” Malone said. “They need support throughout the program.”

NFP is working toward providing scholarships to nursing students and plans to award scholarships to nurses to continue their education. The organization will look into helping nurses connect with resources for developing leadership skills and advancing their careers. The organization also plans to sponsor more discussions about the topic.

“This is a beginning,” Archer said. “For so long, people were afraid to talk about it because they thought of it as a racial issue, not a diversity issue.” •


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Debra Anscombe Wood, RN, is a freelance writer. Post a comment below or email

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