Process and Outcomes Evaluation of Retention Strategies Within a Nursing Workforce Diversity Project

Lori A. Escallier, Ph.D., R.N., C.P.N.P., has been working to bring more diversity to the nursing workforce for more than a decade and says she’s learned through trial and error what works.

The design of her Robert Wood Johnson Foundation (RWJF) New Careers in Nursing program at the State University of New York Stony Brook’s School of Nursing reflects those hard-learned lessons. Her success with the program and with her other diversity efforts was recognized in April with the “Champions of Diversity” Award.

“I’ve been writing grant proposals and running programs to promote academic success of underrepresented minority students in nursing for the last ten years,” she says. “Along the way, we’ve really learned a lot about the challenges that underrepresented students face.”

Three major grants have supported Escallier’s programs in recent years: two from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services and, most recently, a series of four one-year grants from RWJF New Careers in Nursing (NCIN) scholarship program.

The NCIN grants have so far funded scholarships for 33 Stony Brook minority or underrepresented students, with an additional 10 scholarships funded by the most recent grant, awarded in April. The scholarship students all participate in a one-year, comprehensive and accelerated program of study for students who have already earned a bachelor’s degree in a discipline other than nursing.

Escallier particularly stresses the importance of mentoring for students in the program. “When I first set up a mentorship program, we matched mentors and mentees based on ethnicity,” she says. “I’d recruited non-faculty health care leaders to mentor the students, and thought it was a good program.” Escallier had expected that providing mentors of the same ethnicity would help create trusting relationships and facilitate role modeling. “It just didn’t work,” she concluded. “The students didn’t particularly want to be matched up by ethnicity. What they really wanted and needed was someone to provide support and nurturing.” In short, the support non-faculty mentors provided was not the kind of support students needed most.

Escallier’s diagnosis: Many of the students needed a mentor who would boost their self-confidence and help them navigate the many challenges of the degree program in a way that non-faculty mentors could not, whatever their ethnicity. So she overhauled the approach. In the current formulation, she now mentors each of the students personally, meeting with them in groups of ten, more frequently than in the previous program, and in informal settings—lunchtime meetings, for example—that are relaxed and social, but also educational. “We also provide leadership training for the students to help build self-esteem, and make them more confident,” she adds. “It’s entirely consistent with our mission of creating nurse leaders.” (Escallier went on to publish an article on the role of mentoring and other student recruitment and retention issues in The Journal of Nursing Education.)

Toward that same end, NCIN also provides grantee institutions with a leadership development toolkit that features a nursing leadership curriculum—a series of lesson plans for teachers to implement in the classroom. In 2010, NCIN created a Pre-Entry Immersion Program (PIP) designed to help institutions prepare NCIN scholarship students for the academic rigors of the accelerated program by focusing on time-management skills and self care, and by emphasizing the importance of mentoring.

The extra effort pays off for Escallier’s students. So far, 28 students have graduated from the program in its first three years. But the faculty gets its reward as well. Explains Escallier, “It’s a wonderful feeling at graduation to see students who you know came in feeling vulnerable, and they walk across that stage filled with pride and a new diploma.” She says, too, that the NCIN students develop a deep bond with the institution. “The relationships that I’ve had with these students are lasting. They’re the students who come back or call, and they’re the ones who want to give back. They say, ‘I’d love to come and meet the new group, talk about the challenges I faced. Can I come back?’”

“I love hearing that!,” Escallier says.

The Robert Wood Johnson Foundation New Careers in Nursing scholarship program is a joint initiative with the American Association of Colleges of Nursing.