Minorities in Nursing
By Staff Writers
Published on September 21, 2021
Underrepresented in the Nursing Profession
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.
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.
“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.
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
Prioritize programs with flexible scheduling
More and more nursing programs are popping up online, in evening/weekend formats, or in part-time cohorts. Such educational shifts cater to working students, which many minority students are. If a student needs to pick up hours to support their families and pay the bills, flexible schedules can be the difference between earning a degree and dropping out.
Look for programs that offer mentorships
As Caron previously said, mentors have been the single most valuable resource for working nurses from international backgrounds. This is especially true for minority nursing students, who are more likely to be the first in their family to attend college. If your program doesn’t have a mentorship program, take the initiative to find your own mentor. It can be someone in the program, a faculty member or a nurse at a local hospital.
Dr. Willis stresses this point. “It is very important that students seek out and engage with mentors who help them recognize and build upon their strengths and who recognize the value of individual differences as part of a collective whole,” he says.
Identify colleges that prioritize diversity
Colleges that prioritize diversity often make it clear that their goal is to help minorities succeed in the classroom and after graduation. You’ll usually find it in their mission statement, in the courses they offer, or in the support services they provide. As an example, University of Washington School of Nursing has a “director of admissions and student diversity.” Titles such as this are by no means standard across campuses, so seeing them indicates that the school takes the issues its minority students face seriously. However, minority students should also make sure the school puts its money where its mouth is and employs a diverse faculty and staff.
Explore financial aid
Worrying about money can interact badly with academic pursuits. As mentioned, minority students are more likely than the general population to be first-generation college students. Because of this, they and their families may not be aware of the breadth of financial aid options available. Prospective students should speak with financial aid counselors to learn more. There are a variety of incentive programs, including forgivable loans, designed to attract students to areas with acute nursing shortages.
Seek out academic support
One common theme in research about minority nursing students is that they have been underserved academically up through high school, which means they don’t have the same academic foundation as other students when they enter college. Dr. Willis notes, “It is also important for nursing students to seek out resources that support their success.” Some students may feel embarrassed to seek out tutoring or academic help, but those services are available for a reason and students shouldn’t be embarrassed about wanting to improve their abilities. Another way to brush up on math, English and other essentials is at a community college.
Get family buy-in
As noted earlier, minority students generally have greater family demands, which can interfere with classroom time. Choosing schools with flexible scheduling should lessen some of the overlap, while selecting a school with diverse staff may ensure a more understanding instructor. Still, some minority nursing students can be criticized by their families for putting their studies ahead of family commitments. In some instances, keeping the lines of communication open may work. In others, asking a mentor to meet with your family may help them understand that achieving your goals can be a benefit to the entire family.
Budget more time for studying than you think
Many aspiring nurses underestimate the amount of work they’ll need to do. An RN or BSN program is about much more than learning how to give shots and take blood pressure. You’ll also have to do well in math, science and English. It’s important for students to overestimate the amount of time they need to study.
Become a mentor
Mentorship isn’t a one-way street. The top nursing students do more than ace tests – they develop their relationship skills and empathy and give back to others. “Being a mentor will help prepare you for skills needed in the working world,” says Caron.
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:
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. 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. 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. 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. 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.”
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