Why Diversity in the Nursing Workforce Matters
Adejoke Ayoola, PhD, RN, is an assistant professor with the Calvin College Department of Nursing in Grand Rapids, Michigan, and a Robert Wood Johnson Foundation Nurse Faculty Scholar. This is part of a series of posts looking at diversity in the health care workforce.
Nurses in the United States are caring for a progressively more diverse population. In 2008, ethnic and racial minority groups accounted for about one third of the United States population. According to the United States Census Bureau, people from ethnic and racial minority groups— namely Hispanic, black, Asian, American Indian, Native Hawaiian and Pacific Islander—will together outnumber non-Hispanics over the next four decades. Minorities, now 37 percent of the U.S. population, are projected to comprise 57 percent of the population in 2060. The total minority population would more than double, from 116.2 million to 241.3 million over the period (U.S. Census Bureau, 2012). So it is essential to have a nursing workforce that will reflect the population of the United States so as to deliver cost-effective, quality care and improve patients’ satisfaction and health outcomes, especially among ethnic and racial minorities.
The importance of promoting diversity in the nursing workforce is acknowledged by various nursing agencies and health organizations, including the American Association of Colleges of Nursing (AACN, 2013). Diversity in the nursing workforce provides opportunities to deliver quality care which promotes patient satisfaction and emotional well-being.
When I take my students to the hospital for their clinical rotations in acute care, I often assign those who are Spanish-speakers to Spanish-speaking patients. It has often been a win-win situation for both my students and the patients. Recently we cared for a Hispanic patient who did not speak English and had just given birth to her first baby. Her face lit up when my student spoke to her in Spanish! There was no one else with the woman, so the student’s ability to interact with her in a language she understood made a big difference. We noticed positive progress in the patient’s emotional and physical state as a result of her interaction with the student during the shift.
The positive impact of promoting diversity in the nursing workforce transcends clinical care, and is evident in all areas of nursing, including nursing education and research. If recruitment of minority students is increased through strategies proposed by RWJF and AACN to address the nursing shortage, it is essential to have equally diverse nurse educators to prepare these future nurses. The presence of a nursing educator from an ethnic or racial minority that matches a student’s can bring a different perspective to student learning. This nurse educator serves as a role model (Lowe and Archibald, 2009) to nursing students. In addition, the educator is equipped with knowledge and experiences that may be similar to those of the student. This nurse educator is well positioned to share experiences and guide students of the same race or ethnicity as the students negotiate the American nursing education system.
Significant health disparities exist among ethnic and racial minorities for various health outcomes including maternal mortality (Martin, Hamilton, Sutton, Ventura, Mathews, Kirmeyer, & Osterman, 2010; Rosenberg, Geller, Studee, & Cox, 2006). The Healthy People 2020 goal of reducing/eliminating health disparities in health outcomes will only be achievable if we have a proper understanding of the factors associated with the poor health outcomes. Nurse researchers from ethnic and racial minority groups have lived experiences and understanding of the experiences of others in their ethnic and racial groups, which positions them to make relevant contributions to designing and conducting studies among the minorities. It is especially important to include such nurses in designing studies and interventions that are culturally relevant and acceptable.
For all those reasons, and from my own experience as an immigrant to the United States from Nigeria, I am convinced that a nursing workforce that is more diverse will help improve health and health care in this country.
American Association of Colleges of Nursing (2013). Fact sheet: Enhancing diversity in the nursing workforce. Retrieved from https://www.aacn.nche.edu/media-relations/diversityFS.pdf
Lowe, J., AND Archibald, C. (2009) Cultural diversity: The intention of nursing. Nursing Forum 44(1), 11-18. doi: 10.1111/j.1744-6198.2009.00122.x.
U.S. Census Bureau (2012). U.S. census bureau projections show a slower growing, older, more diverse nation a half century from now. Retrieved from http://www.census.gov/newsroom/releases/archives/population/cb12-243.html
Martin J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Mathews, T. J., Kirmeyer, S., & Osterman, M. J. K. (2010). Births: Final data for 2007. National Vital Statistics Reports 58(24), 1-8.
Rosenberg, D., Geller, S., Studee, L., & Cox, S. (2006). Disparities in mortality among high risk pregnant women in Illinois: A population based study. Annals of Epidemiology 16(1), 26-32.