“We’ve come a long way,” remarks Dr. Yvonne Commodore Mensah, Ph.D, MHS, RN. Now an assistant professor at the Johns Hopkins School of Nursing—where she started her PhD study in 2010—she is guiding the next generation of emerging scientists.
With a special interest in mentees of color.
That’s because sheer numbers are not the whole story of diversity, equity, and inclusion. In 2018-2019, about 15,000 Black Americans earned PhDs, about 14,000 Hispanic or Latino Americans, and just 720 American Indians — compared to over 100,000 white Americans.
Mentors guide junior researchers through opportunities with world-renowned nursing faculty, cutting-edge facilities, and opportunities for interdisciplinary collaboration throughout Johns Hopkins University and health care system. Among researchers of color and women, mentors are also critical for sponsorship and in building the fortitude to navigate underrepresented and unfamiliar spaces.
Meet Dr. Commodore-Mensah and her mentees: Dr. Ruth-Alma Turkson-Ocran and Dr. Oluwabunmi (Bunmi) Ogungbe
“Yvonne was always asking me ‘when are you going to come to Hopkins and get your PhD?’” laughs Dr. Ruth-Alma Turkson-Ocran, Ph.D., MPH, FNP-BC, RN.
They’re the same age – they are also both from Ghana, went to the same high school, and came (unknowingly) to the U.S. in the same year to become nurses. Dr. Commodore-Mensah traveled a more direct research path however, while Dr. Turkson-Ocran became a nurse practitioner first. She earned her PhD at the Johns Hopkins School of Nursing in 2019 and was a post-doc at Johns Hopkins School of Medicine until summer 2021, when she became an instructor of medicine at the Beth Israel Deaconess Medical Center and Harvard Medical School.
On the other hand… “I found and reached out to Yvonne when I began to explore doctoral programs,” Bunmi Ogungbe, MPH, RN/BSN says. Bunmi is from Nigeria. “She was one of the first people investigating cardiovascular disease among African immigrant populations.”
The COVID-19 curveball
Heart disease and African immigrant health are interests all three women share. In fact, Bunmi began the PhD program at Johns Hopkins in 2019 intending to investigate cardiovascular disease medication adherence in Ghana, working through an existing study by Dr. Commodore-Mensah. But then COVID-19 threw her work a curveball.
Grounded, with travel unsafe, Bunmi conferred with Dr. Commodore-Mensah and additional mentors, including former dean Patricia Davidson and other faculty internationally recognized for their cardiovascular and chronic care research, to take her research in a new direction: examining biomarkers that indicate an injury to the heart, to determine the long-term cardiovascular effects of COVID-19 among Baltimore City residents.
“Dean Davidson advised me that part of the journey is knowing when to pivot and take advantage of emerging opportunities,” Bunmi says. “Yvonne helped me work through such a big change. She has connected me with so many mentors and sponsors, and brought me into the spaces that matter.”
“It’s really interesting when the mentee takes a slightly different path. There is mutual learning that enhances our skills and knowledge,” says Dr. Commodore-Mensah. “After working with Bunmi I was asked to give a presentation on cardiovascular disease and COVID. And Ruth-Alma is my tech person.”
As faculty at the Beth Israel Deaconess Medical Center and Harvard Medical School, Dr. Turkson-Ocran gets to explore her interest in technology with projects investigating blood pressure at home, ambulatory blood pressure (meaning tracking blood pressure over a 24-hour period), and exploring how to use machine learning to examine blood pressure. Incredibly, information on blood pressure from wearable devices could be actionable in as little as five years.
With the interview process for her faculty position fresh in mind, Dr. Turkson-Ocran reflects on Dr. Commodore-Mensah’s generosity.
“It’s empowering to work on a multicultural team, yet, as underrepresented women in health and academia, there is something to be said for having someone who looks like me there to help raise me up.”
– Ruth-Alma Turkson-Ocran, PhD, MSN, MPH, RN
“Yvonne has constantly sponsored me, encouraged me to take on responsibilities I didn’t realize I was ready for.” She continues, “It’s empowering to work on a multicultural team, yet, as underrepresented women in health and academia, there is something to be said for having someone who looks like me there to help raise me up. It tamps down imposter syndrome and reinforces that this path is truly meant for me.”
“There is this façade of scarcity in academia,” Bunmi says. “People feel the need to hoard resources, opportunities, networks. Yvonne doesn’t do that.”
“You don’t lose anything by being kind.’ Former Dean Davidson used to say that, and I’ve been so fortunate with all my mentors that I can’t help but pass it on,” says Dr. Commodore Mensah.
Read more about graduate and post graduate degrees at the Johns Hopkins School of Nursing:
Diversity, equity, and inclusion (DEI) are hot topics in the healthcare world, but including a DEI module in our yearly education isn’t enough to address these issues. Policy is a valuable tool, but actual change needs to come from a more personal level, from each and every staff member.
Before we can have a meaningful conversation about DEI that might lead us toward significant change, we need to understand the meaning of diversity, equity, and inclusion and why it is important in healthcare.
First, the issues often relate to our biases, especially those so deeply ingrained in our life circumstances that we aren’t aware of them. We can’t advocate for what we don’t understand, and if we don’t advocate for change, we will stay in our “safe” silos, which only strengthens the idea that we are separate and different.
Understanding that we are separate and different and what that means is the first step in making diversity, equity, and inclusion a part of our workspace and nurse recruitment.
Diversity is simply including people with different backgrounds. For example, when healthcare systems conduct nurse staffing while considering different cultural, gender, religious, sexual orientation, and socioeconomic backgrounds, the staff benefits from exposure to differences among coworkers, and patients feel more comfortable knowing they aren’t alone.
Our healthcare system has been lacking in diversity from the beginning, and although we’ve seen a lot of progress since the days when only white males could practice medicine, we are far from diverse.
In one study, over 56% of physicians identified as White and 64% as male, according to the Association of American Medical Colleges (AAMC). According to Minority Nurse, about 75% of RNs identify as White, and 91% are female. So if most doctors and nurses are white, most doctors are male, and most nurses are female, who are we really serving?
When we don’t have a common background, it’s easy to make the mistake of seeing the patient through our own lens instead of their reality. Our lenses place them where we want them to be—fully able and capable of taking the steps we want them to take for their health. The outcomes we desire assume the tools, processes, and understanding are within their reach and that they have the same goals we do.
Textbook knowledge can never make up for the lack of diversity in our own lives. And our lack of understanding of our patients’ reality can lead to misunderstanding or errors in care, creating inequity. Hiring a diverse workforce promotes understanding and creates a more comfortable environment for patients and coworkers alike.
Equity is a concept that often gets confused with equality. In healthcare, equality means giving everybody the same resource or opportunity to achieve their health goals. Equity is recognizing that each person has different circumstances and honoring that by allocating opportunities and resources to allow them to reach an equal outcome.
Simply giving someone an opportunity isn’t enough if they don’t have the means to use it. Equity can only be achieved when nobody is allowed to be disadvantaged due to age, race, ethnicity, nationality, gender identity, sexual orientation, geographical background, or socioeconomic status.
Access to life-saving medication is an example of inequity we see every day. A medication that costs hundreds of dollars every month may not be out of reach for someone with superb insurance coverage and a large bank account. For someone whose job doesn’t offer prescription coverage or who doesn’t make a living wage, that life-saving medication is technically available but far out of their reach. Far too many patients fail to fill the prescriptions they need for this reason.
Healthcare policy can promote equity, but we can also change how we treat and educate patients. In our medication example, we could address a patient’s ability to obtain a prescription before they leave the office or hospital. No patient should walk out the door with a prescription they can’t fill.
Inclusion is about deliberately creating a respectful and safe environment for all staff and patients. Inclusion means giving patients and staff a voice in giving and receiving care and encouraging diversity. Healthcare isn’t the place for a one-size-fits-all approach. We must all strive to embrace diversity and promote equity.
Nurses Are Uniquely Positioned to Champion DEI
Nurses may have little say in enacting policy within their healthcare systems but are very likely the first and last staff member a patient sees and the role they interact with most frequently. That close relationship with our patients makes nurses the most important role to champion diversity, equity, and inclusion with our patients, in nursing education, and within our own workspaces.
One of the most essential directives we learned in nursing school may have been to meet patients where they’re at. Let’s add and coworkers to that and, together, we can create a more effective healthcare system that serves all people.
The HHS Office of Minority Health (OMH) is hosting a virtual symposium on Thursday, September 17, 2020 to highlight state, tribal, territorial and community-based efforts to address COVID-19 among racial and ethnic minority populations. The Advancing the Response to COVID-19: Sharing Promising Programs and Practices for Racial and Ethnic Minority Communities virtual symposium will feature national, state, tribal and local experts leading these efforts and is developed for public health leaders at all levels and community organizations confronting the pandemic.
According to the Centers for Disease Control and Prevention (CDC), a history of systemic health and social inequities have put racial and ethnic minority groups at an elevated risk of contracting COVID-19 or experiencing severe illness, regardless of age. CDC data suggests the prevalence of diabetes, cardiovascular disease and other underlying conditions also contribute to disparities in health outcomes within communities of color.
The OMH virtual symposium aims to support the dissemination of promising practices, programs and strategies for combating COVID-19, especially in racial and ethnic minority communities.
It is an unprecedented time in the lives of nurses working in hospitals worldwide. Nurses face evolving obstacles on a daily basis. They must contend, as always, with complications that include last-minute shift cancellations, extended work hours, continuing education needs, and other established practical considerations. At the same time, COVID-19 illnesses have brought a host of historic challenges for those in the profession.
Consequentially, it is easy to lose sight of nursing’s essence: it stands as one of the most dynamic, stimulating, fulfilling, and important career-choices in 2020; nursing means taking part in a noble pursuit dedicated to healing the sick and providing a personal touch to the vulnerable. If you are considering joining the ranks of hospital nurses, you can hold on to that ethos even as you focus energy toward dealing with day-to-day working challenges. By taking the following actions you will thrive in the field.
Practice What You Preach
Projections show that nursing employment should increase at a faster rate than the combined average of other professions. If you are employed where supply does not yet meet demand, you may face long shifts with large patient loads. Combine this scenario with a job profile that includes your continually facing the unexpected, and you will see that you have to take care of yourself around the clock.
Practicing good sleep hygiene may be one of your greatest challenges, yet you need to make this a priority. Sleep deprivation is a leading cause of working errors and job burnout. Unfortunately, when you experience multiple nights of reduced slumber you build sleep debt, a condition that compounds mental and physical fatigue.
You must also pay attention to your nutritional needs. The job’s unpredictability means that finding the time to eat well can be unpredictable too. As a health professional, you are aware of what constitutes a good diet, particularly for you. While you may not be able to sit down to a relaxing lunch or dinner, you can prepare good snacks ahead of time that you grab throughout the day. Also, you may find you have gone a whole shift without drinking. Pack a water bottle, since hydration is important.
Dress the Part and Fit in the Fitness
Working in a hospital, you will find yourself on your feet far more than behind a desk, and some of your duties will involve moving and lifting patients and equipment. You must work to prevent injury and wear to your body.
While you may not be able to choose your uniform top and pants, you can wear the most comfortable shoes for your situation. They will need to fit well, of course, but they also must provide support, stability, and traction. They should be durable, too, so that they do not shed pieces in the middle of rounds, and you don’t have to waste valuable time looking for replacements several times a year.
You must be fit to handle the job’s physical demands. Developing a workout routine consisting of strength, flexibility, and aerobic conditioning will reduce your chances of spending off days in the hospital’s rehab department. Also, the better your conditioning, the better you will feel when you settle in at home at day’s end. As part of your healthy-lifestyle approach to the job, try to eliminate smoking and reduce your alcohol consumption, if either is a significant part of your day.
Be a Lifelong Learner
Your learning begins when you prepare to enroll in an accredited nursing program. It continues throughout your time taking classes, but knowledge acquisition does not end when you receive your certificate or diploma.
For example, the continual growth of advanced technologies for use in medicine is one of the bigger changes to nursing in recent years. If you are not comfortable using technology, you will become a liability. You need to be able to keep up with the revolution by continuing your education every year of your career.
Be the Part and Be in the Moment
Patients can create their own challenges. You may not be certain of a patient’s mood, mental state, or overall temperament as you enter the room. It can be difficult at those times to face upset or frustrated ones. However, it helps to be open to your patients’ points-of-view. Many are understandably anxious and uncertain, and in a bureaucratic hospital setting, they can feel particularly dehumanized.
Your own mood and behaviors go a long way toward easing a patient’s fears. To put on your optimistic game face, remind yourself of the importance of your role in the whole care of each person in every room on your floor. This is backed up by polls that show nurses rate highest in areas of honesty and ethics among professions. Your patients trust you and, they rely on you to be partners in their care.
Your ability to step back and take stock of your worth is an asset you should bolster throughout your career. By being proactive in facing and addressing the expected and unexpected challenges nurses face, you can be certain to enjoy a long, successful career.