Reach Out, We’ll Be There

“If this were easy, it would already be done.”

So Bette Keltner, PhD, RN, newly appointed dean of the Georgetown University School of Nursing in Washington, D.C., describes the minority recruitment challenge faced by nursing schools throughout the country. In an effort to more closely reflect the diversity of the general population and secure a voice for all communities, nursing schools are trying both old and new methods to attract more students of color to their campuses.

Keltner, immediate past president of the National Alaska Native American Indian Nurses Association, plans to attack Georgetown’s need for more minority nursing students from all fronts, beginning with careful planning. “There is no easy formula,” she says. “[Minority recruiting] is a complex set of circumstances and requires a systematic plan, similar to a business plan.”

The Georgetown dean encourages college and university nursing programs of all sizes to approach their diversity needs with a similar strategy. By drafting a written plan and highlighting short-term and long-term goals, schools will begin to formulate incremental steps to increase minority enrollment, Keltner advises.

Why are so many schools of nursing so eager to increase the diversity of their student populations? While each college or university may have its own motivation, many of these efforts seem to be driven more by a desire to better reflect the community than by a push from administration to up the minority percentages, or boost enrollments in general.

“One of nursing’s major selling points is that if you come into this profession, you will be able to serve your community,” explains Melissa Avery, MSN, RN, [TITLE TK] at the University of Minnesota’s School of Nursing in Minneapolis. The university’s Center of American Indian & Minority Health, established in 1987, recently received a major grant to further increase diversity at the school. The center provides academic, social and financial support to minority undergraduate and graduate students.

The goal of increasing diversity at the University of Minnesota is not limited to the nursing program, but exists throughout the UM system, Avery adds. In fact, receiving the grant to improve nursing diversity was a direct result of the Duluth campus’ success in attracting Native Americans into its medical school.

Entering the Mansion

Keltner believes recruiting more minorities into the nursing profession presents a threefold challenge for nurse educators.

“First, it isn’t just a nursing problem,” she asserts. “Increasing diversity has become a challenge for all professions. Historically, when minorities have been barred from participation, there is no pipeline established to lead students into the field.

“Second, the nursing profession has not adequately responded to changes in professional demographics. We still primarily recruit women. If you look at medical schools around the country, even the most traditional ones, enrollment is now approximately 50% men and 50% women. It’s hard to recruit minorities when you’re ignoring 50% of the minority population.”

Keltner’s third concern is the large number of minority nurses who stop their professional education at the vocational school certificate or associate’s degree level. “While vocational schools and junior colleges are doing a good job of attracting minorities into the field of nursing, those degrees do not lead to leadership positions,” she says. “This keeps minority nurses who do not go on to baccalaureate or advanced degree programs at the low end of the career ladder.

“It’s like opening the door to a mansion, but you can only stand on the front steps. You can’t go in where it’s warm, where the chairs are comfortable and where you can participate in the conversation.”

 

While Keltner expresses tremendous respect for minority nurses who hold nursing diplomas or two-year degrees, she also stresses the urgent need for more nurse leaders. “Minority nurses need to have a voice on administrative boards, in teaching and in the policy arena. It’s unfortunate that there are so many nurses of color who are not getting the advanced education that would prepare them to be those voices.”

Bridging the Gaps

Fortunately, college and university nursing schools are beginning to respond to this challenge. A growing number of baccalaureate programs are reaching out to students in two-year programs, helping to ease the transition for minorities who need encouragement and help in pursuing higher education.

“Sometimes, we do encourage students to attend a junior college first,” says Deb Wilson, program coordinator for the Recruitment/Retention of American Indians Into Nursing (RAIN) program at the University of North Dakota in Grand Forks. “Because a four-year institution can sometimes be overwhelming, our program helps junior college students receive one-on-one assistance. We help them succeed in the two-year program so that they will ultimately be able to succeed in a four-year program.” RAIN offers junior college students such assistance as help in course selection and a quarterly newsletter.

Another innovative way nursing schools are attracting more minority students is by making their classes more accessible to students who are trying to juggle the demands of career, college and family. Online learning programs are becoming increasingly popular. Schools are also finding that offering classes off-campus in locations convenient to minority communities is an effective tool.

With its newly received grant money, the University of Minnesota will fund a distance-learning program for graduate students. “This will make things more convenient for our minority students,” Avery explains. “They will be required to be on campus some of the time, but not nearly as much as they would in a traditional nursing program.”

Reaching Out—With Cultural Competence

To let prospective minority students know about the benefits their programs offer, many nursing schools are taking a more targeted approach to their advertising and publicity efforts. According to Avery, the University of Minnesota’s School of Nursing budget includes money to advertise in magazines and professional journals aimed at minority nurses. She is also working with historically black colleges to attract nursing students from those four-year programs into UM’s graduate school.

Other institutions have had good results by recruiting at career fairs in minority neighborhoods, manning booths at professional nursing conferences and even enlisting the help of alumni to speak to prospective nursing students.

But to be truly successful in recruiting minority nursing students, schools must be sensitive to students’ cultural needs, Keltner emphasizes. “Recruiting minorities is very different [than recruiting non-minorities]. The approach must be more personal and family-oriented. That doesn’t mean you can’t recruit minority students with promotional CDs and Web sites, but those efforts should be followed up with a face-to-face visit or a telephone call.”

Most minority parents are eager for their children to go to college, she adds. But it’s often difficult for them to send their children away to school because of cultural traditions, fear for the child’s safety and fear of the family’s growing apart. In Keltner’s culture, for example, a child’s umbillical cord is buried near the house so that the child will never move far from home. Without that knowledge, a non-Indian recruiter would automatically assume that the parents are eager for their child to attend a good school, regardless of its location.

The Price of Success

In addition to providing specialized academic and cultural support systems, nursing schools that hope to attract more students of color must not overlook the financial pressures many minority students face. Most schools have found that a successful minority recruitment program must address this need with more than the usual financial aid package.

Keltner readily admits that tuition is expensive—a bachelor’s degree from Georgetown carries a $150,000 price tag. But she also points out that students have many other expenses that can be draining to their pocketbooks. “Trips home during breaks are important and can be very expensive, depending on how far away the student is from home. Even phone calls home need to be supported,” she asserts.

Delaware State University, a historically black college in Dover, Del., offers stipends to its neediest students, many of whom are single parents, says Dr. Mary Watkins, chair of the Nursing Department. When granting stipends, the school expects students to cut down on the hours worked at outside jobs to give them more time to study.

Wilson, who has been recruiting minority students to the University of North Dakota for 20 years, believes that students’ inability to pay for their education is becoming more common and harder to address, because of changing financial aid rules and the rising cost of tuition.

One funding source that has helped many RAIN students is the Indian Health Service. The agency provides scholarships and post-graduate placement services. Wilson maintains close contact with officials there.

Teaching Diversity With Diversity

To make their nursing programs more attractive to students from a diverse range of backgrounds, many schools are examining their faculty as well. An all-white, all-female teaching and advising staff isn’t likely to boost minority recruitment. Students want teachers they can relate to—they need positive role models who share their ethnic backgrounds. An academic staff with a lack of ethnic and racial diversity can be detrimental to minority student recruitment efforts.

“Student and faculty diversity often go hand in hand,” explains Avery. “We’re trying to recruit faculty of color as well as students of color. Currently, we have three American Indian faculty members. We hope to continue that and further increase our faculty diversity.”

But because minorities are still severely underrepresented in the ranks of academe, recruiting minority faculty can be difficult. “There are so few nursing educators of color, and they are being recruited so heavily right now. It’s hard to get them,” Avery explains.

Delaware State’s Watkins takes the importance of a diverse faculty one step further. She feels the faculty must also be able to relate to the perils and pains experienced by many of today’s minority youth.

“About half of our faculty are minorities, and we want them to understand our students’ struggles,” she says. “Some of our students have had family members murdered and other serious problems. We want our faculty to be caring and understanding of those issues.”

Holding On to What You’ve Got

While nursing schools may be working hard to recruit more minority students, they may soon be facing a more serious challenge: retaining those students.

“Three years ago, we hired a nurse recruiter to go out and recruit students. She was bringing them in, but we weren’t keeping them,” Watkins explains.

This inspired Watkins to develop the Nursing Retention and Academic Success Project (N-RASP) at Delaware State. She hired a retention expert who helps students with everything from classroom problems to parenting advice. The school also revamped its programs to give borderline students the support and encouragement they need to succeed.

“Many of our minority students have a lower level of confidence and self esteem; they have to be really determined to make it,” Watkins states.

To help give minority students a better chance to succeed, some schools have implemented pre-nursing programs. “Many of our students have been poorly prepared in high school,” says Watkins. “If students have a C average, we will admit them into our pre-nursing program. They must maintain a 2.5 grade point average, complete all nursing subjects with a C or better and score 60% on our nursing entrance exam. We currently have 65 students in the pre-nursing program and we expect 20 of them to eventually become full-fledged nursing students.”

The N-RASP program offers students such assistance as motivational seminars and special courses that teach critical thinking and writing skills. N-RASP is also a prime example of how a successful mentoring program can keep students from dropping out. Each faculty member mentors one or two students for the duration of their nursing college experience. In addition, female undergraduates are assigned a more experienced student to be a “Big Sister,” while “Big Brothers” assist freshman and sophomore males. “Sometimes younger students are more open to their peers’ advice than their professors,’” Watkins comments.

Ultimately, one key ingredient seems to be common to all successful minority student recruitment programs: a committed staff that believes not only in the need for more potential minority nurses, but also in the college’s ability to attract them.

“We work 24 hours a day, seven days a week,” says Wilson. “When a student needs us, we have to be there. It takes that kind of commitment to make it work.”