Jun 21 2013
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"My Definition of Diversity Was Altered When I Had the Opportunity to Experience Life Differently"

Cindy Anderson, PhD, RN, WHNP-BC, FAHA, FAAN, is a professor and associate dean for research at the College of Nursing & Professional Disciplines, University of North Dakota. A Robert Wood Johnson Nurse Faculty Scholar, she received a Bachelor of Science degree in Nursing from Salem State College, and both a Master of Science degree in parent-child nursing and a PhD in physiology from the University of North Dakota. This is part of a series of posts looking at diversity in the health care workforce.

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I was born and raised in the Boston area which we always referred to as the “melting pot.”  My grandparents emigrated from Eastern Europe and I grew up hearing stories of the “Old Country” which included both fond memories and atrocities that drove them to leave their homes and find a better way of life in America. As a second-generation American, I have always embraced the common and unique perspectives of others from a variety of backgrounds.

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I began my career as an Air Force nurse, advancing my opportunity to engage with others from varied backgrounds and cultures. In the course of my career, I found myself stationed at the Grand Forks Air Force Base in North Dakota. My initial perceptions were based upon the stereotype that North Dakota was a rural, isolated state with little diversity. My misperceptions were quickly reversed when I had a chance to engage with the community. My awareness and respect for the unique diversity of rural North Dakota has steadily grown over the last three decades which I have been fortunate to spend in this great state.

In North Dakota, as in most places, people go about their business without a focus on the cultural context in which they live and work. On my arrival to North Dakota, I recognized characteristics that are often taken for granted by those who possess them, but are highly coveted by others. Perhaps because of the difficulty of homesteading and farming encountered by early immigrants drawn to North Dakota, one of the most well-known characteristics of North Dakotans is their work ethic.  Prestigious educational institutions from around the country seek our graduates for the hard work, persistence, and integrity demonstrated by the young people of our state. 

The sense of community is strong, with people stepping up readily to provide assistance when needed.  I was truly shocked when I had my first child and experienced a coordinated parade of meals delivered to my home by neighbors, some that I hardly knew!  It was also my first exposure to the world-renowned hotdish and jello salad staples of the area! 

With a population of less than 700,000 spread across 69,000 square miles, low population density represents a significant challenge to health care access for rural residents. Nurses living in rural areas are committed to their communities, bound by family ties and recognized value of rural life. They provide an essential workforce to help hospitals and clinics across the state deliver health care to members of rural communities, many of whom are of advanced age. 

The nurses who choose to leave North Dakota state and practice in locations across the country take with them the attributes developed while growing up here, providing dedicated and quality nursing care to the people they serve.  These characteristics are exemplified by North Dakota’s best known nurse, Mary Wakefield, PhD, RN.  Wakefield served North Dakota and the nation as the Director of the Rural Assistance Center and Director of the Center for Rural Health at the University of North Dakota, advancing solutions to rural health issues, analyzing health policy, strengthening local capabilities, and developing community-based alternatives that provide rural residents the tools needed to address changing rural health care environments. 

When he appointed her as director of the Health Resources and Services Administration, President Obama described the factors that contributed to her selection as one of his top health advisers:  "As a nurse, a PhD, and a leading rural health care advocate, Mary Wakefield brings expertise that will be instrumental in expanding and improving services for those who are currently uninsured or underserved." 

My definition of diversity was altered when I had the opportunity to experience life differently. Once a stranger in a perceived strange land, now I am proud to consider myself a North Dakotan—if not by birth, then by choice. Embracing diverse ideas and perspectives in multiple contexts provides benefits for all, particularly those we care for in the communities where we live.

Learn more about Anderson’s work.

Tags: Access and barriers to care, Diversity, Human Capital, Medically underserved areas, North Dakota (ND) WNC, Nurse Faculty Scholars, Nurses, Nursing, Rural, Toward a More Diverse Health Care Workforce, Voices from the Field