State of the Union

According to Webster’s New Collegiate Dictionary, the word “unite” has the following meanings:

• To bring together so as to form a whole.
• To bring together by a common interest, attitude or action
• To join and act together in a common purpose or endeavor.

Now consider that racial and ethnic minority nurses–including African American, Hispanic, Asian/Pacific Islander, American Indian/Alaska Native and Filipino nurses–collectively account for 13.4% of the nation’s total RN population, according to the most recent National Sample Survey of Registered Nurses. Imagine what could be accomplished if all of these minority RNs, regardless of their different ethnicities, joined forces and came together to form a whole–a single entity united by common concerns and committed to acting together for the common purpose of increasing diversity in the nursing profession and improving the health of minority Americans.

For seven years now, the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), based in Culver City, Calif., has been doing exactly that. Formed to unite the concerns and strengths of all nurses of color, today the coalition continues to expand its strategic efforts to act together on behalf of minority nurses and patients–and the emphasis is on action.

The idea of forming a unified coalition of ethnic nursing associations actually began more than seven years ago–back in May 1997, when the U.S. Department of Health and Human Services (HHS), Bureau of Health Professions, Division of Nursing, held a conference in Denver on minority health issues. Leaders from several prominent minority nursing associations were invited to give presentations at the conference and share their expertise. For these distinguished nursing leaders of color, being together at the same event was an ideal opportunity to network and get to know each other better.

“Some of us already knew each other; others of us were meeting for the first time,” says NCEMNA President Betty Smith Williams, DrPH, RN, FAAN, a founder and past president of the National Black Nurses Association (NBNA). “We began to talk together about our respective associations’ issues and goals. We found that we had mutual concerns, and we began to realize that joining our forces into a coalition would enable us to leverage our combined expertise to achieve mutual goals and accomplish more together than each association could accomplish alone.”

A little more than a year later, that vision had become reality. In December 1998, NCEMNA was officially incorporated as a 501(c)(3) non-profit professional organization. The four founding member associations were the NBNA, the National Association of Hispanic Nurses (NAHN), the National Alaska Native American Indian Nurses Association (NANAINA) and the Asian American/Pacific Islander Nurses Association (AAPINA). A fifth member, the Philippine Nurses Association of America (PNAA), joined the coalition soon after. The current president of each association, plus either a past president or the president-elect, serves on the NCEMNA board of directors.

From its inception, the coalition has been a collaborative national force and powerful advocate for both the concerns of minority nurses and for the health care needs of ethnic minority populations, who continue to suffer disproportionately high rates of disease and mortality compared to the Caucasian majority. NCEMNA’s goals include:

• Support for the development of a cadre of ethnic nurses reflecting the nation’s diversity.
• Advocacy for culturally competent, accessible and affordable health care.
• Promotion of the professional and educational advancement of ethnic nurses.
• Education of consumers, health care professionals and policy makers on health issues of ethnic minority populations.
• Development of ethnic minority nurse leaders in areas of health policy, practice, education and research.
• Endorsement of best practice models of nursing practice, education and research for minority populations.

“Power in Numbers”

In many ways, NCEMNA is a truly unique nursing organization. Individual nurses cannot join the coalition; rather, it could be thought of as an “association of associations.” But if you are a member of one of the five minority nurse associations that make up the coalition, NCEMNA does indeed speak for you. In fact, it serves as a single, uniform voice for the approximately 350,000 nurses of color nationwide who belong to the participating associations. And it’s a voice that has gained volume and attention over the past seven years.

“There is power in numbers–and visibility,” comments Roxanne Struthers, PhD, RN, president-elect of NANAINA and assistant professor at the University of Minnesota School of Nursing in Minneapolis. “NANAINA is a smaller association, so it’s nice to be part of a larger organization in order to address the health disparities we face.”

“One of the benefits to being part of NCEMNA is to have the opportunity to participate on national projects,” adds Rudy Valenzuela, MSN, RN, FNP-C, president of NAHN and director of clinical services and health promotion for the Regional Center for Border Health in San Luis, Arizona.

As a single voice speaking for some of the fastest-growing population segments in the country, the coalition has succeeded in getting influential players to listen–from majority nursing associations and scholarly journals to federal health policy makers and the health care corporate sector. Says Williams, “My thinking, especially among some of the majority powers, is that it’s easier for them to deal with one organization instead of five separate associations. Therefore, I think NCEMNA is viewed as a positive.”

Increasingly, health care decision makers have come to see the coalition as not just “a positive” but an invaluable source of knowledge and expertise about the minority nurse population and the crisis of racial and ethnic health disparities in America. For example, in both 2000 and 2002, NCEMNA representatives participated in national collaborative workshops on minority health issues and research needs with high-ranking officials of the National Institute of Nursing Research (NINR).

For the 2000 workshop, each of the coalition’s five member associations prepared a state-of-the-art white paper on the health status and needs of their particular ethnic community as well as recommendations for nursing research to improve the health of these populations. The five white papers were subsequently published in the journal Nursing Outlook in 2001 and 2002. And in 2002, a panel of four NCEMNA representatives presented an education session entitled “Tapping Ethnic Minority Nurses to End the Nursing Shortage” at the national biennial convention of the American Nurses Association (ANA), the nation’s largest nursing professional association.

“We have been sought out in many arenas,” Williams agrees. “When there is a call for nursing leaders, we’re at the table. We’ve assumed a position in nursing where our input and the quality of who we are have gained substantial recognition. That’s an accomplishment in terms of recognition of the value of minority nurses.”

“One of NCEMNA’s main achievements is advancing the recognition that minorities are present in the nursing workforce and that we are an important aspect of health care because we are the providers who are educated on the cultural [aspects] of treatment,” adds Valenzuela.

One health care industry corporate player that has also recognized the value of NCEMNA’s efforts is Aetna, the Fortune 500 insurance giant. “We presented a grant proposal to Aetna and they were responsive because they share our interests and goals,” says Williams. “We shared our vision with company officers and their support enabled us to work on writing a grant.”

In the initial stage of NCEMNA’s partnership with Aetna, the firm’s Aetna Foundation provided funding to help the coalition develop the infrastructure it needed to move forward as an organization, such as hiring a small administrative staff. Today the main focus of the NCEMNA/Aetna collaboration is an innovative program that offers financial and mentoring assistance to outstanding nursing students of color who are interested in research careers. The annual Aetna/NCEMNA Scholars Program, initiated in 2003 and supported by a grant from the Aetna Foundation, provides financial support to 10 minority nursing students–two from each NCEMNA member association. The scholars, who are nominated for the program by their associations, also receive mentoring in such areas as personal/professional development, leadership development and cultural competency.

Researching Solutions

The Aetna/NCEMNA Scholars Program is just one example of what has become a primary focus for NCEMNA in the 21st century: creating programs to increase the number of ethnic minority nurse scientists and researchers who can investigate the causes of minority health disparities and find solutions for eliminating them. As in many other nursing specialties, nurses of color are severely underrepresented in the research field, Williams notes. “I certainly believe the massive nature of the shortage of ethnic minority nurse scientists [compared to] the number of ethnic people in the country presents a huge imbalance,” she states.

Furthermore, much like the current nursing faculty shortage, aging researchers are beginning to retire, creating a critical need for a new generation of nurse scientists who can fill the vacancies and continue the work.

For many years, minority nursing leaders have recognized the urgent need to develop a network of researchers of color who can discover new knowledge about diseases that disproportionately affect minority Americans. This knowledge, in turn, can lead to new treatment strategies and preventive interventions that will help close the gap of unequal health outcomes.

“The more minority nurses there are in research, the more that information will get translated into practice, which is really what we need–innovations, investigations and translation,” asserts Struthers, a member of the Ojibwe tribe.

The need for training and professional development programs that will help stimulate the growth of a cadre of minority nurse researchers was a major focus of NCEMNA’s collaborative workshops with NINR, one of the National Institutes of Health (NIH). The consensus of the discussions was that a multi-pronged method of identifying, mentoring and promoting minority nursing students with the potential to become researchers would be the most effective approach.

To obtain federal funding for the development of such a program, NCEMNA turned to the National Institute of General Medical Sciences (NIGMS), another NIH institute. “NIGMS is the NIH division that has been working since the 1980s to increase the number of ethnic minority scientists in the health professions,” Williams explains. “Over the years NIGMS has provided grant funding to organizations such as the Society for Advancement of Chicanos and Native Americans in Science (SACNAS).”

Because many of NCEMNA’s board members are seasoned grant writers, it didn’t take long to pull the grant proposal together. “We [had a board meeting] in November, then wrote and submitted the grant in February,” Williams recalls.

The result: In 2004, NIGMS awarded the coalition a $2.4 million grant to fund a five-year initiative called “NCEMNA: Nurse Stimulation Program.” The grant leadership team is comprised of distinguished nurse educators and researchers from each of the five NCEMNA member associations.

“That was quite an accomplishment, because most of the NIGMS funds go to universities,” says Williams, who is the grant’s principal investigator. “Our position, however, was that as a nonprofit minority nursing professional organization, all of our member associations have direct contact with a large pool of ethnic minority nurses who could be encouraged and developed to pursue careers in research.”

Building a Network

What exactly is the NCEMNA: Nurse Stimulation Program? It’s a unique, landmark project designed to engage and cultivate the next generation of nurse scientists from racial and ethnic minority populations. Its mission is threefold:

• To create a network of ethnic minority nurse researchers.
• To develop mechanisms to support ethnic minority researchers at all career levels.
• To engage ethnic minority students to consider nursing research as a career trajectory.
NCEMNA will use several strategies to accomplish these goals. They include:
• Creating a database of minority nurse researchers and students that will be used to promote communication, the exchange of ideas and support for programs of research between current and potential nurse scientists.
• Providing opportunities for aspiring minority nurse researchers to take part in mentoring development sessions, attend scientific symposia and interact with leading nurse scientists from across the United States.

Earlier this year, NCEMNA marked another milestone–and it’s no coincidence that this latest accomplishment is directly related to the launch of the Nurse Stimulation Program. On March 10-13, the coalition held its first-ever National Conference in Washington, D.C. With a theme of “Creating Research Careers: The Beginning,” the inaugural conference was an ideal first step for setting the program’s mentoring, networking and professional development vehicles in motion.

To identify potential candidates for the Nurse Stimulation Program who would be invited to the conference to gain an introduction to the research field, the coalition initially gathered data from the five members associations. NCEMNA then issued a call for candidates who would be interested in participating in a mentoring program that would direct individuals into research careers.

After receiving at least 100 applications, the coalition selected a total of 50 mentees–10 from each of the five member organizations. Additionally, NCEMNA selected five doctorally prepared nurse educators–again, one from each minority nursing association–to serve as mentors.

“We felt it was important to have the mentee pool include nurses and students from all educational levels,” Williams emphasizes. “We have mentees who are students in BSN, MSN and PhD programs, as well as new nursing faculty members who have not had a lot of research experience. It’s especially critical to start cultivating future minority nurse scientists early, while they are still in baccalaureate programs.”

While the concept of minority nurse mentoring programs is not new, it’s important to remember that many of the current generation of minority nursing faculty and scientists had to achieve their professional accomplishments without the guidance of like-minded minority mentors–because there were none available. These nursing pioneers were the trailblazers and barrier-breakers, and their successes came from their tenacity and vision. “When [our generation] came along, there was no one to take us by the hand and help develop us in academia. You achieved independently in those environments or you didn’t survive,” explains Williams.

That’s one reason why so many of today’s minority nursing leaders believes it’s crucial to reach out to the next generation of minority nurses through mentoring. “Providing financial assistance to students is important, but equally important is creating mentors,” says Valenzuela. “NCEMNA is already starting to do that. We’re creating an infrastructure to allow the numbers of minority nurses going into research and academic fields to increase.”

Adds Struthers, “Having role models is so important, because you can look at how others do things and how they have accomplished things that you’d like to achieve.”

Staying Connected

For the 50 Nurse Stimulation Program mentees, attending the1st Annual NCEMNA National Conference was an exciting opportunity to immerse themselves in the world of research. The event’s first day, which was open to the public, was devoted to scientific sessions and poster presentations by leading minority nurse researchers from around the country. The rest of the conference was a closed session set aside exclusively for mentoring. Two different mentoring tracks were offered, based on the mentees’ educational and career levels: one for undergraduate and graduate students, the other for mentees with more advanced educational preparation, such as new PhDs and faculty.

The mentoring sessions were inspirational and empowering for all who were there, says Struthers. “The standout moment was hearing the mentees, one after the next, talk about their plans for research careers. I enjoyed that so much because it was so powerful and is so needed,” she explains.

Over the year following the conference, the mentees and their mentors will continue to communicate regularly with each other, through informal emails and phone calls as well more formal communications, such as one-on-one meetings. “They will also stay connected through the use of Internet vehicles, such as Web networks and chat groups or forums,” adds Williams.

As this year’s mentees begin to take their first steps toward research careers under the guidance of their mentors, NCEMNA is carefully monitoring and evaluating the program “so that we know what is working and what isn’t,” Williams says. “We’re quite pleased with the early evaluations of the conference. It’s a growing process and we expect to be increasingly effective.” She also anticipates an equally strong response when NCEMNA issues the call for its next group of mentees, who will attend the coalition’s 2006 annual conference next March in Chicago.

Sharing the Wealth

While some notable coalitions, such as the European Union, are still experiencing growing pains, the National Coalition of Ethnic Minority Nurse Associations has shown a remarkable steadiness in pursuing its mission and increasing the power of its collective voice over the past seven years. Williams attributes this success to hard work, careful strategic planning and, above all, the high level of leadership, education and accomplishment that unites its member associations.

“Some of these ethnic nursing associations have been in existence for more than 30 years,” she notes. “Between us, we have an immense wealth of pioneering leaders in academia, research and clinical practice.”
Through initiatives such as NCEMNA: Nurse Stimulation Program and the Aetna/NCEMNA Scholars Program, the coalition is not only ensuring that this legacy will continue but also advancing an agenda that will make a significant impact on increasing the diversity of the nation’s nursing profession. “With education and knowledge generated by an increase in research, there is power to recruit minority nurses because we will have something to offer them,” says Williams.

For more information about NCEMNA and its five member associations, visit www.ncemna.org.

Editor’s Note: Minority Nurse Senior Editor Pam Chwedyk also contributed to this article.