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3 Ways Nurse Leaders Can Support Diversity in Healthcare

One phrase to come out of the last decade is “representation matters,” meaning people need to feel represented in a space or environment to feel validated. Government is improving in this area, as just this year, the United States swore in Kamala Harris — the first female, Black and Asian American to hold one of the highest posts at the federal level of vice president.

Yet, the United States needs more gender diversity across a number of industries and sectors, including healthcare.

Diversity in Nursing: Reflecting Patient Demographics

Diversity in nursing, as described by author Erica Bettencourt, encompasses gender, veteran status, race, disability, age, religion, ethnic heritage, socioeconomic status, sexual orientation, education status, national origin and physical characteristics.

One might argue that as caregivers, nurses inherently pledge to provide the same level of care to everyone in their charge. But unfortunately, that doesn’t always ring true — conscious or unconscious bias by healthcare professionals mean not every individual receives the same quality care. That’s why Bettencourt says it’s so important for the nursing workforce to “reflect” patient demographics.

“A person who has little in common with you cannot adequately advocate for your benefit,” she cautions. “Otherwise, you might as well have a history teacher in charge of advanced algebra.”

A Focus on Health Equity

Lack of diversity in the nursing workforce is not a “new” issue. The Institute of Medicine (IoM), now the National Academy of Medicine (NAM), made diversity a key point in its landmark report, “The Future of Nursing.” By promoting and supporting diversity within the nursing workforce, the healthcare industry can achieve greater health equity. Specifically, benefits of a diverse industry include:

  • Safer, more customized care for minority groups
  • Culturally sensitive models of intervention
  • More appropriate recommendations to government agencies (local, state, federal)
  • Improved nursing research, education, administration and leadership

Improved research, education and leadership are especially critical for this movement to gain traction, as nurse leaders and administrators can contribute to a positive cycle of diversity. The more nurses in these leadership positions employ diversity within their organizations, the greater impact they will have on the entire healthcare universe: patients and providers.

Advocacy & Implementation in Motion

Diversity has many facets, all of which contribute to better patient outcomes. Nursing leaders can make significant strides within their organizations by focusing on three key areas:

1) Equality

Not every nurse on staff in a hospital, clinic or any healthcare setting will be “equal” in skill level. A Master of Science in Nursing (MSN) degree can help you level up your knowledge and expertise beyond an associate degree in nursing (ADN) or bachelor of science in nursing (BSN).

But every nurse and patient in these settings are equal as people and should be treated as such. Contributor to the National Library of Medicine, Rosie Stenhouse, says equality means “nurses must treat people as individuals, avoid making assumptions about them, recognize diversity and individual choice and respect and uphold their dignity and human rights.”

2) Cultural Competency

Nurse Journal says culturally competent care consists of four components:

  1. Awareness of one’s cultural worldview
  2. Attitudes toward cultural differences
  3. Knowledge of different cultural practices and worldviews
  4. Cross-cultural skills

When all four are integrated into nursing practice, nurses can build a positive, trustworthy relationship with their patients — a crucial component of nursing care. “Nurses must be able to understand and appreciate different cultural backgrounds in order to do their job effectively and with the highest degree of care,” states Dr. Gregory Knapik, DNP and assistant professor of nursing.

3) Representation

Representation goes back to Bettencourt’s analogy of history versus advanced algebra. For example, a nursing staff of all-white, cisgender females in their 40s might find it difficult to relate to a young, Asian-American transgender woman — and vice versa. Walking into such a scenario could clearly put the patient in an uncomfortable position. This can cause that the patient may not return or even be hesitant to seek out care elsewhere, fearing the same lack of representation.

How much of a deficit is the U.S. in regarding representation? The American Nurses Association (ANA) reports that only about 20% of practicing nurses are nonwhite, and only 9% are men. However, individuals who complete nursing degrees beyond the associate level are contributing to better representation in the field.

According to the American Association of Colleges of Nursing (AACN), nurses of minority backgrounds are more likely than their white counterparts to pursue higher education in nursing. This includes African American (52.5%), Hispanic (51.5%) and Asian (75.6%) nurses. “Whether it’s in educational settings or in the workplace, that is what will get us to where we need to be,” states Brigit M. Carter, registered nurse, associate professor and associate dean for diversity, equity and inclusion at Duke University School of Nursing.

Diversity in Healthcare: Promoting “Difference”

The American Organization of Nurse Executives (AONE) compiled a guide containing principles for improving diversity in healthcare organizations. Two of the group’s essential principles perfectly reflect the continuing mission among nurses, nurse leaders and the healthcare industry:

  • Diversity is more than a compliance issue; it is an issue of stewardship of human resources
  • Difference is not a problem; it’s an opportunity to learn and grow

If nurses — especially those in leadership positions — can keep these principles top of mind, the trickle-down effect to others in the organization can (and will) result in significant progress.

Learn more about The University of Southern Maine’s Master of Science in Nursing – Nursing Administration and Leadership online program.


American Organization of Nurse Executives: Guiding Principles for Diversity in Healthcare Organizations

Cleveland Clinic: Growing and Developing a More Diverse Nursing Workforce

Diversity Nursing: Why Is Diversity in Nursing So Important?

National Library of Medicine: Understanding Equality and Diversity in Nursing Practice

Nurse Journal: Cultural Competence in Nursing

U.S. News Health: Why Representation in Nursing Matters

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