By: Robert Rosseter
Nursing’s leaders recognize a strong connection between a culturally diverse nursing workforce and the ability to provide quality, culturally competent patient care. Though nursing has made great strides in recruiting and graduating nurses that mirror the patient population, more must be done before adequate representation becomes a reality. The need to attract students from under-represented groups in nursing – specifically men and individuals from African American, Hispanic, Asian, American Indian, and Alaskan native backgrounds – is gaining in importance given the Bureau of Labor Statistics’ projected need for more than a million new and replacement registered nurses by 2016.
Diversity in the Nursing Workforce & Student Populations
- According to the U.S. Census Bureau, the nation's minority population totaled 102.5 million or 34% of the U.S. population in 2007. With projections pointing to even greater levels of diversity in the coming years, nurses must demonstrate a sensitivity to and understanding of a variety of cultures in order to provide high quality care across settings.
- According to data from the 2008 National Sample Survey of Registered Nurses (NSSRN), nurses from minority backgrounds represented 16.8% of the registered nurse (RN) workforce. Considering racial/ethnic backgrounds, the RN population is comprised of 5.4% African American; 3.6% Hispanic; 5.8% Asian/Native Hawaiian; 0.3% American Indian/Alaskan Native; and 1.7% multi-racial nurses.
- Though men only comprise 6.2% of the nation’s nursing workforce, this percentage has climbed steadily since the NSSRN was first conducted in 1980. The number of men in nursing has increased from 45,060 nurses in 1980 to 189,916 nurses in 2008. http://bhpr.hrsa.gov/healthworkforce/rnsurvey04
- According to the National Sample Survey, RNs from minority backgrounds are more likely than their white counterparts to pursue baccalaureate and higher degrees in nursing. Data show that while 48.4% of white nurses complete nursing degrees beyond the associate degree level, the number is significantly higher or equivalent for minority nurses, including African American (52.5%), Hispanic (51.5%), and Asian (75.6%) nurses. RNs from minority backgrounds clearly recognize the need to pursue higher levels of nursing education beyond the entry-level.
- According to AACN's report on 2010-2011 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, nursing students from minority backgrounds represented 26.8% of students in entry-level baccalaureate programs, 26.1% of master’s students, and 23.3% of students in research-focused doctoral programs. In terms of gender breakdown, men comprised 11.4% of students in baccalaureate programs, 9.5% of master’s students, 7.5% of research-focused doctoral students, and 9.0% of practice-focused doctoral students. Though nursing schools have made strides in recruiting and graduating nurses that reflect the patient population, more must be done before equal representation is realized.
- The need to attract diverse nursing students is paralleled by the need to recruit more faculty from minority populations. Few nurses from racial/ethnic minority groups with advanced nursing degrees pursue faculty careers. According to 2010 data from AACN member schools, only 12.6% of full-time nursing school faculty come from minority backgrounds, and only 6.2% are male. www.aacn.nche.edu/IDS
Recognizing the Need to Enhance Diversity
- All national nursing organizations, the federal Division of Nursing, hospital associations, nursing philanthropies, and other stakeholders within the health care community agree that recruitment of underrepresented groups into nursing is a priority for the nursing profession in the U.S.
- Nursing shortage reports, including those produced by the American Hospital Association, the Robert Wood Johnson Foundation (RWJF), the Joint Commission, and the Association of Academic Health Centers, point to minority student recruitment as a necessary step to addressing the nursing shortage. media-relations/fact-sheets/nursing-shortage
- Besides adding new clinicians to the RN workforce, a diverse nursing workforce will be better equipped to serve a diverse patient population. According to an April 2000 report prepared by the National Advisory Council on Nurse Education and Practice, a culturally diverse nursing workforce is essential to meeting the health care needs of the nation and reducing the health disparities that exist among minority populations. http://bhpr.hrsa.gov/nursing/nacnep/reports/first/5.htm
- A report released by the Sullivan Commission on Diversity in the Healthcare Workforce in September 2004 stated: “The fact that the nation’s health professions have not kept pace with changing demographics may be an even greater cause of disparities in health access and outcomes than the persistent lack of health insurance for tens of millions of Americans. Today’s physicians, nurses, and dentists have too little resemblance to the diverse populations they serve, leaving many Americans feeling excluded by a system that seems distant and uncaring.” Download the entire report, titled Missing Persons: Minorities in the Health Professions.
Strategies to Enhance Diversity in Nursing Education
A lack of minority nurse educators may send a signal to potential students that nursing does not value diversity or offer career ladder opportunities to advance through the profession. Students looking for academic role models to encourage and enrich their learning may be frustrated in their attempts to find mentors and a community of support. Academic leaders are working to address this need by working to identify minority faculty recruitment strategies, encouraging minority leadership development, and advocating for programs that remove barriers to faculty careers.
AACN, in collaboration with leading foundations and stakeholders, has taken the following steps to enhance diversity in nursing education:
- In January 2010, AACN published a new set of competencies and an online faculty tool kit at the culmination of a national initiative funded by The California Endowment titled Preparing a Culturally Competent Master’s and Doctorally-Prepared Nursing Workforce. Working with an expert advisory group, AACN identified a set of expectations for nurses completing graduate programs and created faculty resources needed to develop nursing expertise in cultural competency. This work complemented a similar project for undergraduate programs which resulted in the publication of the document Cultural Competency in Baccalaureate Nursing Education and the posting of an online toolkit for faculty.
- In April 2008, the Robert Wood Johnson Foundation joined with AACN to launch the RWJF New Careers in Nursing Scholarship Program. This program is designed to alleviate the nation’s nursing shortage by dramatically expanding the pipeline of students from minority backgrounds in accelerated nursing programs. Scholarships in the amount of $10,000 each will be awarded to 1,500 entry-level nursing students over the next three years. Preference will be given to students from groups underrepresented in nursing or from a disadvantaged background.
- AACN and the California Endowment are collaborating on a three-year program to offer the Minority Nursing Faculty Scholarship Program to increase the number of nurse educators from underrepresented minority groups. This program provides financial support and mentoring to students pursuing graduate degrees who are committed to teaching in a California school of nursing after graduation. To date, 23 graduate nursing students have been selected to receive scholarship funding.
- AACN and the Johnson & Johnson Campaign for Nursing’s Future launched the Minority Nurse Faculty Scholars Program in 2007 which is modeled after the California Endowment program. In addition to $18,000 in scholarship funding, the program also features mentorship and leadership development components to assure successful completion of graduate studies and preparation for a faculty role. Ten scholars are currently receiving funding through this program.
- AACN is collaborating with a variety of national nursing organizations to advocate for more federal funding for Nursing Workforce Development Programs, including funding for Nursing Workforce Diversity Grants. This program provides funding for projects to increase nursing education opportunities for individuals from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses. In FY 2007, these grants supported the education of 32,847 nurses.
- AACN’s Executive Director Polly Bednash serves as the representative from Nursing on the Sullivan Alliance to Transform America’s Health Professions. Composed of national leaders in health professions education, this interprofessional working group focuses on advancing strategies to increase the number of healthcare providers from minority populations. The Sullivan Alliance’s latest initiative focuses on establishing statewide collaborative groups to coordinate efforts to enhance diversity in the health professions.