Case Study, Chapter 9, Diversity in the Nursing Workforce

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Chapter 9 Diversity in the Nursing Workforce

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Diversity #1

Differences among groups or between individuals

Many forms

Increasing diversity (ethnic, culture) in the United States

Nursing workforce fairly homogeneous in gender, ethnicity

White

Female

Middle-aged

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Diversity #2

Need for nursing workforce to be at least as diverse as population served

Lack of diversity linked to health disparities

Minority health care professionals more likely to work in underserved communities

Need for a connection between diversity and corporate social responsibility

IOM (2010): need for greater emphasis on making nursing workforce diverse especially in gender and race/ethnicity

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Ethnic Diversity

Ethnic diversity in the United States

Hispanics: largest minority group and fastest growing population group

Blacks: 2nd largest minority group

Ethnic diversity in nursing

Rising numbers from minority backgrounds but still considerably lower than the general population (see Table 9.1)

Need for aggressive recruitment, retention of minority students

More minorities pursuing baccalaureate and higher degrees in nursing

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Recruitment of Minority Students into Nursing

Creation of corporate environment in schools integrating diversity, cultural competence across academic programs, research, practice, public policy

Increase in career interest in medicine for underrepresented ethnic minority students from economically disadvantaged backgrounds

Low rates of recruitment and retention possibly due to groups being at greater risk of economic disadvantage resulting from inferior preparatory education

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Question #1

Is the following statement true or false?

The number of nurses from minority backgrounds has risen, but this number is still lower than the minority representation of the general population.

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Answer to Question #1

True

Although the number of nurses with minority backgrounds has increased, this number is still considerably lower than the minority representation in the general population.

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Retention of Minority Students in Nursing

Greater barriers faced in completing nursing education (see Box 9.1)

Nursing Workforce Diversity (NWD) program

Provision of grants/contracts to projects to:

Improve diversity of nursing workforce

Contribute to basic preparation of disadvantaged, minority nurses for leadership positions

Students from educationally or economically disadvantaged background expressing interest in becoming RNs

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Question #2

Is the following statement true or false?

The NWD provides grants to any individual expressing a desire to become a nurse.

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Answer to Question #2

False

The NWD provides grants to students from economically or educationally disadvantaged backgrounds who express an interest in becoming a registered nurse.

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Ethnic Diversity in Education and Health Care Administration

Minority nurses underrepresented in leadership positions

Academia

Service areas

Exact numbers not known

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Minority Nurse Educators

15.9% of all full-time instructional faculty come from diverse backgrounds and only 7% are male

The percentage of diverse faculty is only half that of diverse nursing students (29.5%)

Campaign for Nursing’s Future (ANA, Johnson and Johnson): national scholarship program to increase number of nursing faculty from ethnic minority backgrounds

Minority Faculty Fellowship Program grants

Free online database of minority nurse educators by Thomas Edison State College School of Nursing

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Minority Nurse Administrators #1

While 31% of patients are minorities, only 12% of executive leadership positions and 14% of board members are currently filled by minorities

Lack of minorities, women in health care leadership positions possibly due to CEOs not having enough time to mentor women, minorities for such roles

Different ways for developing leadership roles for women, minorities in health care

“Demographic invisibles”; “stylistic invisibles”

Ongoing need to further improve diversity in the C-suite; multiple barriers exist slowing efforts to diversity health care management teams (see Research Fuels the Controversy 9.1)

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Minority Nurse Administrators #2

Efforts needed

Intentional succession planning

Direct organizational involvement and commitment essential for diverse succession planning

Removal of career advancement barriers

Need for special developmental programs for women and minorities

2011 Equity of Care Committee best practices for building a leadership diversity program

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Ethnic Professional Associations in Nursing

Professional associations for almost every ethnic group in nursing

National Black Nurses Association

National Association of Hispanic Nurses

Philippine Nurses Association of America Inc.

National Alaska Native American Indian Nurses Association

Asian American/Pacific Islander Nurses Association Inc. (see Box 9.2)

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Gender Diversity in Nursing #1

Numbers increased since 1980

Still just 9.6% of nation’s 3.2 million nurses were men in 2013

The American Assembly for Men in Nursing hopes to bump that statistic up to 20% by 2020

Slow progress due to stereotyping

Public’s view of nursing as female occupation

Media perpetuation of nurse as female

Paradox between public call for more men, repercussions due to stereotype

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Gender Diversity in Nursing #2

Gender differences in expressions of care

Sexism

Negative media portrayals of male nurses

Suppression of contributions men have made to the field of nursing

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Male Advantage in Nursing?

Hiring, promotion

Stereotyping superseded by quest for professional, personal power promoting career advancement (organizations favoring male dominance)

Professional development advantages

Economic advantages (out-earn female counterparts)

Question of more full-time employment career paths versus females with career gaps due to child bearing or family rearing

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Men Leaving Nursing

Disproportionate numbers leaving as compared with female nurses

Possibly due to lack of social approval, acceptance, adequate role models

Length of time working as male nurse as most influential condition on acceptance by female counterparts

Male nurses more dissatisfied than female counterparts

Lack of status

Degraded by other health care professionals

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Recruiting Men into Nursing

National, local campaigns

Men-only study groups; discussion groups to reduce feelings of isolation for male students

Corporate partnerships with professional organizations

Possible affirmative action efforts; national initiatives to enhance professional climate for men

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Generational Diversity in Nursing

According to a 2013 survey conducted by NCSBN and The Forum of State Nursing Workforce Centers, 55% of the RN workforce is of age 50 or older

Nurses in their 50s have become the largest segment of the nursing workforce

Different generations with different value systems impact settings of work

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Generational Groups #1

Veteran generation (silent generation): born 1925 to 1942

Risk averse, respect for authority, support hierarchy, disciplined

Support for status quo

Baby boomers: born 1943 to 1960

Traditional work values; more materialistic, individualistic, present oriented

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Generational Groups #2

Generation X: born 1961 to 1981

Lack interest in lifetime employment at one place; value greater work flexibility, opportunities for time off

Less economically driven; pragmatic, self-reliant, amenable to change

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Generational Groups #3

Generation Y (Millennials): born 1982 to 1999

Optimism, self-confidence, relationship oriented, volunteer mindedness, social consciousness

“Digital natives”

Demand different organizational culture

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Question #3

An RN who was born in 1972 belongs to which of the following generations?

A. Veteran generation

B. Baby boomer

C. Generation X

D. Generation Y

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Answer to Question #3

C

Generation X nurses were born between 1961 and 1981. The Veteran generation nurses were born between 1925 and 1942, the Boom generation nurses were born between 1943 and 1960, and Generation Y nurses were born between 1982 and 1999.

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Professional Organizations Speak Out

Position statements on recommendations for diversity

Joint Commission report (2008): One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations

AACN (2015): New set of competencies and online faculty tool kit; RWJF Doctoral Advancement in Nursing (DAN) Project

National League for Nursing vision statement (2016)

ANA position statement on discrimination and racism in health care (1998)

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End of Presentation

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