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Minorities in Nursing Why Diversity Matters & What It Means for Underrepresented Nurses

In 2014, members of racial and ethnic minorities made up 34% of the U.S. population but only 17% of the nursing workforce. This increasing diversity means Americans need a healthcare industry that reflects this changing population and can address its range of needs. More diversity in nursing can reduce health disparities and, ultimately, improve overall healthcare for all patients. Learn more about why diversity in nursing matters and see what schools and students can do to help increase minority representation in all levels of nursing.

Meet the Experts

Erica Morse Caron Staff Developer at Eastern Maine Medical Center

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In School: How Nursing Programs Can Encourage Diversity

There’s been a recent push among nursing schools to diversify their student bodies and create pipelines into their programs. Here are some ways schools are nurturing diversity – from admissions to graduation.

A broader approach to admissions

“Empathy is the cornerstone of nursing practice,” says Erica Morse Caron, staff developer at Eastern Maine Medical Center. But with so many applicants to review, it can be easy to rely on GPA and test scores over interpersonal indicators that are harder to read. Caron encourages nursing colleges to take emotional intelligence into account. While this practice alone doesn’t create diversity, it is a step towards expanding the criteria beyond those that traditionally benefit white applicants.

Dan Willis, Associate Dean for Academic Affairs at the University of Wisconsin-Madison School of Nursing, says his school is actively taking a broader approach to admissions. “We have continued to evolve holistic admissions as part of our practice.” One of the ways that has manifested is through a new program designed to recruit, retain, and graduate more Native American Nurses into the workforce. The program is called Success Through Recruitment/Retention Engagement and Mentorship (STREAM). Dr. Willis explains, “It strives for student achievement by addressing the social determinants of educational success, which includes academics, finances, and psycho-social support. We have regular talking circles where students can check in with each other, as well as tailored programs that include a variety of support.”

Dr. Willis says, “One of the biggest challenges for minority students is that they don’t see themselves represented.” This lack of representation can cause some students to feel an acute sense of isolation. In addition to recruiting and retaining more students and faculty of color, those who are already at the college must take extra steps to help minority students feel connected and like they’re part of the campus community. Caron encourages getting to know students on a personal level to create a sense of connection.

With low numbers of minority nursing students, emotional isolation for those who are in programs is high. And loneliness is only part of it. Racism and discrimination – whether from other students, faculty or even patients – also deter students from continuing their education.

One way to provide emotional support is through mentoring. University of Cincinnati runs the Caring Through Sharing Mentoring Program. Exclusively for minority, low-income and first-generation students, the program connects them to working RNs. Caron says mentorship has worked with nurses in her hospital, especially those from the Caribbean. “That was the single most valuable resource for them.” Caron recalls wanting to support these students but not fully understanding what their needs were. The mentorship program helped bridge that gap.

Writing for the Robert Wood Johnson Foundation’s Culture of Health blog, nurse educator Lucia Alfano says, “I believe there are many young people who, like me, would thrive in nursing. But because of their background or existing challenges, they may believe that a career in nursing is not an option.” To counteract this, Alfano visits junior high and high schools with large minority populations to share her story and expose young students to careers in nursing early on.

Schools like The Ohio State University (OSU) use similar initiatives. OSU rolled out its Student Ambassadors for the College of Nursing program, which lets current Buckeyes lead nursing activities with junior high and high school students. The College of Nursing also leads a four-day Summer Institute for Discovering Nursing to attract high school freshmen, sophomores, and juniors from underrepresented populations to the field.

Dr. Willis says UW-Madison does this, but with current nursing students as the target audience. “At UW–Madison, we cultivate strong relationships with our students before they graduate so that they see a role for themselves in cultivating cultural competency in their workforce. We then invite them back to the school so that current diverse students can see what diverse alums are achieving in nursing practice,” he explains.

A 2012 review of research on barriers to success for minority nursing students found financial support to be a big problem. According to several studies, minority students didn’t have usable information on scholarships, which pushed them toward loans. Second, students had to work part-time to pay bills, which meant less time to focus on academics. While many nursing candidates initially cope with financial limitations by completing prerequisites at community college, four-year universities must do more to help minority students navigate the complex financial aid system or offer funding specifically for diverse students. For example, Xavier University School of Nursing maintains a minority scholarship fund worth $500,000.

It’s important for schools to recognize that embracing diversity needs to come across in everything they do. Dr. Willis says, “At the University of Wisconsin–Madison School of Nursing, we strive for a diverse faculty and staff who understand and advance cultural competency, so students see not only racial diversity but also messaging about health equity and social justice in all of their classrooms, textbooks and lectures.” He also notes that instructors and faculty need to be aware of minority students’ unique backgrounds and perspectives. “Given that learning is developmental, instructors and faculty need to make clear that everyone approaches questions differently and there is value in that discovery,” he says.

In the Classroom: Thriving as a Nursing Student

While some barriers are beyond a student’s control, there are other obstacles that minority nursing students can tackle head-on. The above looked at what schools can do to increase recruitment and retention of minority students. Now, let’s talk about what nursing students themselves can do – from choosing the right nursing school to making it through to graduation.

In the Workplace: Advancing Your Career & Increasing Earning Potential

A 2013 survey from the National Advisory Council on Nurse Education and Practice found that job titles such as “nurse executive” or “nurse faculty” had less diversity than standard RN jobs. In other words, minority nurses are even less represented further up the job ladder. And it’s a vicious cycle – that lack of minority nurses in leadership positions means that minority students have fewer mentors and role models, lessening their chances of career advancement.

Here are some things minority nurses can do to overcome barriers and advance their careers:

Start now

The earlier you’re on the job market, the more experience you’ll gain and the more chances you’ll have to be promoted. Some people wait because they don’t know the exact field or specialty they want to work in, but getting real hands-on experience can help you learn what you like – and don’t like – which can help you create a clearer career path.

Get a summer internship

This is a step you can and should take as a student. For starters, it’s a great way to gain hands-on experience and may even lead to a full-time position. But even if it doesn’t lead to a job, it’s still something that can go on your resume. Plus, some internships pay a small stipend.

Utilize your strengths

Many minority nurses are bilingual, which is a great asset when working with patients and other healthcare professionals, especially in underserved communities. “Communication skills are key,” says Caron – and being able to communicate well with patients and staff in multiple languages can work to your advantage.

Be flexible and adaptable

One reason it’s hard to anticipate what you’ll want to do 10 or 20 years from now is that the healthcare industry is far from stagnant. Caron says, “Flexibility and adaptability is key. Healthcare is an ever-changing, dynamic environment, and if you aren’t willing to embrace change, you’ll struggle.” Being open to learning new things or volunteering for assignments outside of your departments can increase your adaptability, widen your breadth of knowledge, and set you up for promotion.

Get creative and take risks

Caron notes that nursing school is dominated by Type A personalities but that the professional world requires outside-the-box thinking. “Bringing ideas for solution rather than just bringing problems forward is key.” Candidates for promotion aren’t “simply task-oriented,” but creative thinkers.

Dr. Willis echoes this sentiment. “Students need to take risks and be okay with not always getting it right. Taking risks and even failing can result in great development and advancement potential.”

Build leadership skills

Dr. Willis says nursing students “need exposure to leadership principles. At UW–Madison, we infuse leadership throughout the program. All students graduating from our programs have been exposed to leadership development and, therefore, possess some leadership skills. This helps them see themselves advancing in their careers and gives them the tools to do it.”

However, Caron points out that leadership development can continue into employment. “Community-based professional development programs are really important,” she says, “for expanding that emotional skillset.”

Choose mentors carefully

A great mentor will have experience at multiple levels of nursing. This person can advise you on how to stand out in a sea of job applicants – and outline what steps you should be taking to move your career forward.

Earn an advanced degree

Nursing degrees go all the way to the doctoral level. And, although there’s a national nursing shortage, the standard rules for academics still apply – a BSN or MSN may be necessary to qualify for leadership roles.

In the Community: How Diversity in Nursing Helps Others

Increasing diversity in nursing and better supporting minority nursing students benefits more than just the nursing students themselves – it also helps patients and the larger community. Here are four reason increasing diversity in nursing is crucial:

  1. 1. There is already a nursing shortage in the U.S.

    Because of an aging population, declining birthrate and legislation designed to increase healthcare access, the demand for nurses is greater than the supply. The U.S. faces a serious problem. Hospitals will need to hire qualified nurses from all backgrounds if they truly intend to have enough nurses in 2022, when the shortfall of RNs is expected to reach 1.2 million. And when nursing programs fail to retain minority students, the gap between supply and demand only becomes larger.

  2. 2. It improves the quality of healthcare while also increasing access

    Health outcomes are better when patients and healthcare providers can adequately communicate. Yet when it comes to the percent of Latinos within the nursing population, for instance, it’s in the single digits. Spanish-speaking patients may not get the care they need – or, worse, may not seek treatment at all. But that can change if more Latino nurses joined the workforce.

  3. 3. Minority healthcare providers are most effective at working with minority and underserved populations

    “Underrepresented patient populations have better health outcomes when they have health professions with similar backgrounds,” says Dr. Willis, and several studies back this up. He goes on to explain, “When people see themselves reflected in their health care providers, they often find a way to connect that removes barriers to care. It may be that patients are able to share more information because they see someone who understands their culture, their food or their roles.”

    Caron agrees. “If you don’t have diversity in your workforce, then it’s really hard to be empathetic with that diverse patient population. It’s hard to identify with people’s struggles.” She points out, for instance, that some nurses face ethical dilemmas when treating minority patients with strong religious belief that conflict with standard procedures. Indeed, patients get better care when their caregivers share their religion, or at least understand it.

  4. 4. A more diverse nursing workforce may lead to more and diverse treatment methods

    Research by Sherry Ann Koenigsman shows that nurses from various cultural backgrounds can lead to more holistic practices in the U.S. In her dissertation to the College of Saint Mary, she says, “It is important to recognize that while Western medicine has much to offer other cultures, it does not have all the answers. With the introduction of more minority nurses in the profession will come the opportunity to expand nursing care beyond traditional, western methods.”


  • Discover Nursing

    Johnson & Johnson’s nursing campaign website aims to attract more people into nursing programs and careers. In addition to featuring a scholarship search tool, the site’s comprehensive financial assistance tool scours hospitals for loan repayment opportunities, tuition reimbursement policies, residencies and grow-your-own programs (in which hospitals train their own future staff).

  • Diversity Nursing

    The best feature of this website is the job board. Members who post their resume can register for a $5,000 scholarship, handed out annually. Other parts of the website are hit or miss. The Employer Profiles and School Profiles pages, for instance, lack usable information, but the blog regularly features interesting articles on everything from National Black Nurses Day to tips on conflict resolution.

  • Minority Nurse

    Like Diversity Nursing, Minority Nurse also features a job board. Many of the positions are in academia or management roles. Readers can access its quarterly magazine through the website, and articles are cleverly categorized so that readers can see the latest pieces on, say, “Black and African Nurses” or “Native American Nurses.”

  • National Association of Hispanic Nurses (NAHN)

    The Hispanic Nursing Mentors Connection tool alone is worth a visit to the NAHN website. Mentees can find a Hispanic nurse mentor by signing in. While they’re there, they should read one of the many profiles of working nurses. Or they can peruse the video section to get advice from real nurses on paying for college, making friends at school, and a dozen other issues that Hispanic nurses may have questions about.

  • National Black Nurses Association (NBNA)

    This membership organization’s website contains free links to the NBNA’s quarterly magazine, and plenty of information on how to join one of its nearly 100 local chapters. Like the NAHN website, its best feature may be the NBNA Collaborative Mentorship Program, which is broken down based on the mentee’s needs. Students get different mentors than managers. Prospective mentees can apply via the website.