Diversity in the Workplace
The United States is facing the need to provide nursing care to an increasing diverse patient population with a nursing workforce that, in itself, is impacted by generational, ethnic and gender differences. The purpose of this paper is to present the importance of diversity in the workplace and delivering culturally competent nursing care, the impact of gender diversity, and the misrepresentation of minorities in the nursing profession.
Importance of diversity in the workplace
America is a kaleidoscope of cultures, religions, races, and nationalities. The USA Quick
Facts from the US Census Bureau shows the following 2011 population statistics: White 63.4%,
Hispanic/Latino 16.7%, Black/Afro-American 13.1%, Asian 5.0%, American Indian & Alaska
Native 1.2%, and Native Hawaiian/Pacific Islanders. 0.2%. In 2012 minority population increased to 37% and is projected that minorities will be the majority by 2043. Mason, Leavitt &
Chaffee (2012) pointed out that as our population “continues to grow and increase its diversity, it is important that the nursing workforce reflect these changes to effectively meet patient care needs and ensure cultural competency” (p. 378). Cultural assessments must be part of the nurse’s health assessment. To be culturally competent nurses need to be aware of their own culture, and the diverse culture of their colleagues and patient populations (Maier-Lorentz,
2008). Culturally competent nursing care is important for positive patient outcomes and patient satisfaction. Summary of one aspect of diversity
Traditionally nursing has been considered a woman’s job and television shows still portray most nurses as females. Huston (2010) points out that men in nursing have existed for many years, but they have been stereotyped as homosexuals or effeminate (p. 152-153). It should
DIVERSITY IN THE WORKPLACE 3 not be a surprise men do not choose nursing as a career and have become a gender minority.
Huston (2010) writes that the number of male nurses has increased significantly in the last 30 years, but “just 5.8% of the nation’s 2.9 million nurses are men” (p. 152). As a labor & delivery nurse in our local county hospital, I frequently witnessed female patients and/or their husbands requesting the assigned male nurse be changed for a female nurse, mostly due to religion practices. Some departments tend to be more appealing to male nurses such as ED, surgery, trauma, and ICU while pediatrics and obstetrics are not usually seen as appropriate for male nurses (Huston, 2010). Men in nursing have certain advantages when it comes to hiring, career advancement and compensation. The “2008 Advance Salary Survey showed that male nurses continue to earn-out their female counterparts, with an average salary of $53,792 versus $50,615 for female nurses” (as cited by Huston, 2010, p. 155). However, male nurses are leaving the profession at a much faster rate than female nurses reporting gender discrimination and job dissatisfaction (Huston, 2010, p. 156). Efforts to recruit men into the profession are made by nursing schools presenting conferences for male nurses and encouraging instructors to be more open to the needs of the male nursing student (Huston, 2010). Mason, Leavitt & Chaffee (2012) emphasize “increasing the visibility of men in nursing is a crucial first step” (p. 378) to bring more men into the nursing profession.
Underrepresentation of minorities in nursing
There is a significant disparity between the racial and ethnic demographics of the population in America and that of the nursing workforce. The Fact Sheet of April 17, 2013 by the American Association of Colleges in Nursing (AACN) reports that in 2008 minority nurses represented 16.8% of the RN workforce consisting of African Americans 5.4%, Hispanics 3.6%,
Asian/Native Hawaiians 5.8%, American Indian/Alaskan Native 0.3%, and multi-racial nurses
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1.7%. Even though, the U.S. Census shows that Hispanic population is the largest minority in
America at 16.7%, Hispanic nurses only account for 3.6% of the nursing workforce. This presents a serious challenge to employers and nursing schools from recruitment to retention.
Huston (2010) points out only 10.8% of full-time faculty members come from minority groups, and even lower numbers are reported in leadership positions. Another important issue for consideration is that minority nurses frequently work in communities with a large concentration of minorities and immigrants that usually have limited access to healthcare (Huston, 2010).
Education is vital to attract and retain minorities and to provide on-going transcultural training
(Maier-Lorentz, 2008). A diverse nursing faculty is critical to encourage enrollment of minorities in nursing programs. In 2009, the AACN indicated “only 10% of nursing faculty members are from minority backgrounds compared to 34% for the national population” (as cited in Mason,
Leavitt, & Chaffee, 2012). Many professional organizations, universities, and corporations have formed partnerships to offer scholarships to minorities entering the nursing profession or seeking higher degrees. One recent partnership was formed between Walden University and the National
Association of Hispanic Nurses (NAHN) that will support higher education of Hispanic nurses and meets NAHN commitment to “provide equal access to education, professional, and economic opportunities for Hispanic nurses and to improving the health and nursing care for
Hispanic consumers” (NAHN, 2012).
Influence of diversity on nursing care
As a member of an ethnic minority, I very much identify with this paper’s topic. In my birth country of Cuba, I was a minority because my grandparents were immigrants from Spain and we spoke Spanish with an “accent”. Then, at the age of 14, I came to America as a political exile and once again I am a member of a minority with different customs and speak English with
DIVERSITY IN THE WORKPLACE 5 an accent. As a patient, I have experienced the fear of not been understood; as a family member of a dying patient, I have experienced the lack of support for end-of-life decisions, and lack of knowledge of our Catholic faith and bereavement preferences. More than once I have been told
“you are too sentimental because you are Hispanic” and heard other nurses refer to a Hispanic woman in labor as “a typical hysterical Latin female”. As a registered nurse, I have experienced the challenge of the language barrier when caring for Haitian, Asian, or Native American patients, or a Guatemalan Indian woman that does not speak Spanish but an unknown dialect, or when working with people with speech and hearing impairments. Yes, this is nursing in South
Florida, a microcosm of life in America in the 21st century! Culturally competent nursing care requires that nurses be aware of their own culture and the cultures existing in their communities in order to provide effective patient-centered nursing care. Cultural insensitivity, the result of lack of empathy or lack of knowledge, can result in patient’s decreased compliance or physiological adverse reactions resulting from medication interactions and alternative medicine practices or dietary customs. More than just differences in race, religion, and gender, other issues such as ethnic group and cultural differences can result in lack of compliance, patient’s misunderstanding of medication regimen, as well as impacting end of life decisions and hospice care (Schim, Doorenbos & Borse, 2006). Nurses must be open to diversity and open to examine our own diversity. It is our responsibility to pursue higher degrees, to grow professionally, be a role model to the younger generation, and encourage minorities to join our profession, but most of all, to be truly respectful of each other differences.
Summary
The growing population in the United States, the shift in diversity, and the dynamics of healthcare reform will impact how medical care is provided in our country for years to come. If
DIVERSITY IN THE WORKPLACE 6 the projections are correct, minorities will be the majority by the year 2050. The nursing workforce needs to be ready to welcome diversity in the workplace, to provide culturally competent nursing and patient-centered care to all patient populations, and proactively work to increase the recruitment and retention of men and minorities in nursing education and in the nursing workforce to mirror the diverse population they serve.
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References
American Association of Colleges of Nursing. 2013, April 17. Fact sheet: Enhancing diversity in the nursing workforce. Retrieved from http://www.aacn.nche.edu/media-relations/ diversityFS.pdf Huston, C. J. (2010). Professional issues in nursing: Challenges and opportunities (2nd ed.).
Baltimore: Lippincott Williams & Wilkins.
Maier-Lorentz, M. (2008). Transcultural nursing: Its importance in nursing practice. Journal of
Cultural Diversity, 15(1), 37–43.
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2012). Policy and politics in nursing and health care. (6th ed.). St. Louis, MO: Elsevier Saunders.
National Association of Hispanic Nurses (2012). NAHN welcomes Walden University as corporate member. Retrieved from http://www.nahnnet.org/2012WaldenCorporate
Member.html
Schim, S., Doorenbos, A., & Borse, N. (2006). Cultural competence among hospice nurses.
Journal of Hospice & Palliative Nursing, 8(5), 302-307.
U.S. Department of Commerce. United States Census Bureau. USA Quick Facts from the US
Census. Retrieved from http://quickfacts.census.gov/qfd/states/00000.html