Despite roots stretching far back into history, nursing has only been a recognized profession for a little more than a century. While the nursing industry has made great strides since that time, it primarily remains the realm of white females. Just over 9% of registered nurses (RNs) are male, and minorities only make up about 20% of the nation’s total number of RNs.
Nursing’s lack of diversity is problematic on its own, and minority nurses may find that the diversity issue is compounded when the time comes for a career change. So what happens when seasoned nurses are ready to expand their employment horizons? Some LPNs and RNs may choose to tread the path of primary care, re-enrolling in medical school and working towards a doctorate. For others, the realm of human resources may be an attractive option.
Individuals from historically underrepresented groups are a great choice for roles within health care-related human resources management and administration. That’s because minorities are more likely to bring the topics of diversity and inclusion to center stage. And when the importance of diversity is emphasized at the managerial level, everyone benefits, from patients to providers and educators.
Discrimination in the Health Care Industry
As most people of color are well aware, discrimination is still a major social issue in 2020. And this discrimination can happen everywhere, from social settings to the workplace and beyond. Although federal law prohibits workplace discrimination on the basis of age, gender, race, religion, and disability, more diversity is needed within the health care industry, especially in the field of nursing.
That’s because nurses are essentially the foundation of quality care and healing. Further, they act as liaisons to primary care physicians and specialists, often serving as the voices of their patients. Patients from all walks of life deserve to feel as though they’re represented within the field of nursing.
By fostering a more inclusive environment, human resource managers in hospitals and clinics may be able to bridge the gaps, at least where health care for minority groups is concerned. And make no mistake, there is a glaring disparity among minority populations. According to a 2014 study published in Public Health Reports, “diabetes care, maternal and child health care, adverse events, cancer screening, and access to care are just a few examples in which persistent disparities exist for minority and low-income populations.”
Human Resources, Inclusion, and Diversity
So how does human resources fit into the equation? At their core, nursing and human resource management have a lot in common. After all, providing compassionate interactions with a diverse group of individuals is a major component of both career paths. Yet where nurses typically only deal with patients and their immediate colleagues on a daily basis, HR managers must also deal with the business side of health care as well.
For example, health care HR managers must address industry trends and set the standards for ethical practices within their facility. They may oversee digital recruitment and hiring, while also keeping patient needs at the forefront of their mind and even addressing legal situations that may arise. It’s a multifaceted job that requires knowledge, patience, and discipline as well as compassion.
A nurse who is interested in becoming an HR manager in health care should prepare to be challenged. You’ll need plenty of experience under your belt, as well as strong communication, organization, and computer skills. To get an edge over the competition, you may also want to consider pursuing an advanced degree in health administration.
Prospective HR professionals should also take note that speed and accuracy are paramount to the job, as they are in the field of nursing. Computer skills are a vital component of the job, and HR managers should have a strong grasp of technology and tools such as open-source software that allows you to quickly sign forms online, from invoices to payroll and hiring documents. Even in our digital age, most health care facilities leave a significant paper trail.
Unfortunately, sometimes that paperwork can stem from an unpleasant situation, such as legal action against your health care facility. Even when great care is taken to ensure that the most vigilant professionals are employed at a facility, that fact doesn’t always guarantee a safe and inclusive work environment. Thus, even the best HR managers may end up on the receiving end of a workers’ compensation claim.
While most workers’ compensation claims involve physical injuries, a hostile work environment could indeed be grounds for a lawsuit, especially if management was aware of the problem. And although workplace stress isn’t grounds for a workers’ comp claim, work-related trauma injuries may be. If the discrimination was serious enough to be deemed traumatic, the injured worker may indeed be entitled to compensation. As an HR manager, it’s your duty to help foster a more inclusive work environment where discrimination has no place.
This becomes even more important when you yourself are one of the very minorities who is often overlooked for leadership positions such as HR management. Nursing leadership means making connections with your staff, one of the best ways to prevent discriminatory practices is by modeling inclusion and diversity in your workplace. Do this in your hiring practices, in your relationships with your employees, in your interactions with clients; it will trickle down.
Advocating for diversity is extremely important when it comes to social justice, but it can be a fine line to tread in the workplace. Within the health care industry, minorities should try to take on leadership roles, such as in management and HR, in order to help build a more inclusive environment where patients and providers alike can feel safe, respected, and represented.
As nurses, you know that health care is always changing. Nursing is not the same profession today as it was when you started five, ten, or twenty years ago. Part of these changes steep in a better or evolved understanding of what it means to care for patients, but others are out of nurses’ control and reflect changes both in the health care industry generally and in-patient populations.
The introduction and expansion of new tech in the health care setting combined with the rapid rate of change in patient populations mean that nursing is more dynamic than ever before. And you need to keep up.
What are the most pressing changes nurses are facing right now? These are a few of the things that will change the way you practice your profession over the next few years.
Nurses Will Need to Balance the Hands-on/Hands-off Approach
Nursing is, by definition, a very hands-on practice. Care requires a nurse to be wholly present with a patient. But some of that is already changing, and the rate of change could grow substantially over the next few years. Why? Because the Internet of Things (IoT) and all its sensors are gaining ground in hospitals and clinics.
Wearable tech and smart sensors have the ability to record and remotely transmit health data from patients directly to care providers. Everything from vitals to movement is now trackable with current tech, and nurses are increasingly responsible for patients who use it.
The implications are huge for nurses. On one hand, nurses can spend less time on rote tasks, which will make a difference in daily activities and relieve a small amount of pressure as nurses deal with a continued labor shortage. At the same time, it will also change the way nurses care for patients: how will nurses provide bedside care if they no longer need to attend to patients at their bedside?
Nurses Will Find New Colleagues to Work With
Nurses work as a team with physicians, specialists, and administrative staff to keep their organization functioning. However, the continued introduction of new technology in the health care industry will demand nurses to work more closely with two emerging groups: IT professionals and medical coders.
New technology in hospitals means organizations will require an influx of IT professionals to keep all the tech up and running. For nurses, it means working with this group when they find issues with the tech used on the ground.
At the same time, the growth of IT professionals in clinical settings offers an opportunity for nurses. They will help nursing staff stay at the forefront of tech and learn how to balance patient care with technology in a way that’s effective and safe. Working closely with IT teams can also help nurses better protect vital health data and avoid HIPAA violations by avoiding simple mistakes and identifying vulnerabilities.
Patient Self-Advocacy Will Continue to Grow
The role of the nurse as an advocate will also be challenged over the next few years. Already, patients have benefited from advancements like AI and wearable tech. However, as more and more companies insert themselves into the American health care system, the role of the patient as a self-advocate will also begin to grow because they have new resources outside the hospital and clinic system.
Improved self-advocacy is good news for patients and nurses alike. Nurses do their best to encourage patients to ask questions, seek answers, and share their health goals. A more educated and self-empowered patient population benefits everyone, and self-advocacy is a key indicator of patient satisfaction.
However, you can expect to also see it challenge the role of the nurses. Self-advocacy is also empowering non-health care businesses to get involved in certain items. For example, Amazon now allows customers to use their Health Savings Account (HSA) funds to pay for certain items. Nurses will need to adjust to the potential of patients taking on more of their care outside the purview of a clinic. And Amazon isn’t just interested in selling diabetes supplies: you could see giants like these trying to insert themselves into catastrophic disease management and treatment.
Patients Will Be More Diverse in Almost Every Way
Already, nurses need to have a strong understanding of caring for diverse patient populations. However, the changes in demographics, social systems, and epidemiological patterns will only continue, and nurses need to prepare themselves to care for increasingly diverse patients and learn to navigate the ethical challenges that can come with adapting to new patient populations.
Nursing in a diverse context means doing more than providing interpreters and using intake forms in multiple languages: though, these things are vital first steps. It also means learning about the most prominent patient groups and to gain a better understanding of their social, cultural, and religious contexts.
For example, if caring for an elderly Hindu woman, a nurse may find that they need to be specific when they require the woman to fast. In Hindu culture, fasting is part of a religious practice but it can allow them to eat fruit and drink water. Nurses need to be specific about what ‘nothing by mouth’ means. The difference is important and could dramatically impact a patient’s outcomes.
How Will Nursing Challenge You?
These upcoming changes in the health care industry will change the way you practice nursing once again. The addition of new tech, changes in the shape of self-advocacy, and shifts in patient populations all present both opportunities and challenges for both nursing and health care as a whole.
Most importantly, these changes can help you and your colleagues be better, more dynamic nurses and contribute to improved health for your communities. So, don’t fear these changes. Embrace them. If anyone can meet the challenges facing health care over the next few years, it’s nurses.
For more than a century, nursing has been thought of as the domain of women. But that has fluctuated over the last few centuries. Men actually dominated nursing through the mid-19th century. During the Industrial Revolution, men began leaving nursing for factory jobs. Florence Nightingale led the advancement of women in nursing, targeting upper and middle class women for nurse training. In fact, men were not allowed to serve in the Army Nurse Corps during World Wars I and II. Today, as workplaces evolve, more men are entering the profession again amidst a nursing shortage.
About 13% of nurses in the U.S. today are men, compared with 2% in 1960, according to the Washington Center for Equitable Growth. However, in the high-paying specialty of nurse anesthetist, there is an equal number of men and women.
The United States is leading the way in the increase in the number of male nurses. While the U.S. rate of men in nursing was not much higher than in Switzerland and Brazil in 1970, it rose rapidly over the next several decades and far surpassed these countries in addition to Portugal and Puerto Rico.
The rise of men in nursing is due in part to a shift in available jobs, especially as traditionally male-dominated jobs in manufacturing jobs like automakers have been taken over by automation or moved overseas for cheaper labor. A recent study published in the journal Social Science Research reviewed eight years of Census data. The study found that of men who had worked in male-dominated industries and then became unemployed, 14% decided to enter industries dominated by women, such as nursing. Eighty-four percent of men who didn’t lose jobs moved onto traditionally female jobs. Unemployed men who got jobs in female industries received a pay increase of 3.80% when making the move.
Where the Jobs Are
Another reason propelling more men into nursing is a shortage of nurses. According to the Bureau of Labor Statistics (BLS), employment for registered nurses will grow 12% between 2018 and 2028, much quicker than the average of other professions. There will be a need for 3.19 million nurses by 2024.
California is expected to have the highest shortage of nurses, and Alaska will have the most job vacancies. Other states that will face shortages of nurses in the next few years include Texas, New Jersey, South Carolina, Georgia, and South Dakota.
One driver of the need for more nurses is the growth of the aging population, who will require more medical care. Job growth is expected in long-term care facilities, especially for the care of stroke and Alzheimer’s patients. The need for nurses treating patients at home or in retirement communities will continue to grow. The rise in chronic conditions such as diabetes and obesity also means more nurses will be needed.
Pay and Training
The median annual wage for registered nurses was $71,730 in 2018, according to the BLS. The lowest 10% earned less than $50,800, and the highest 10% earned more than $106,530. Those working for the government and hospitals earned the most.
But like many other professions, men are outpacing women in pay. Male RNs make an average of $5,000 more per year than their female counterparts, according to a study published in the Journal of the American Medical Association. This salary gap hasn’t improved since the first year the salary survey was done in 1988. The difference in pay ranges from $7,678 per year for ambulatory care to $3,873 for work in hospitals. The largest gap, $17,290 for nurse anesthetists, may explain why so many men enter that specialty.
The researchers note that increasing transparency in how much employees are paid could help narrow the gap. In addition, part of the pay gap may be due to women taking more time out of the workforce for raising their children. FiscalTiger.com suggests that offering adequate leave to both mothers and fathers after the birth of a child could have a role in making pay more equitable.
The Washington Center for Equitable Growth’s report suggests that the amount of formal training required to become a registered nurse may bring men into nursing from other occupations later in their careers. The minimum training for registered nurses is an Associate Degree in Nursing. Increasingly, employers are demanding more education, however. That includes earning a Bachelor of Science in Nursing (BSN) degree. RNs in the U.S. military must have a BSN, and the Veteran’s Administration, which employs the most RNs in the country, requires a BSN for promotion.
While men are still a minority in nursing, various programs offer support and networking. The American Association for Men in Nursing was founded in 1971 but shuttered in a few years. In 1980 it was reformed and now has thousands of members. It encourages men of all ages to become nurses and supports their professional growth.
Some nursing schools also have groups to support male nursing students. New York University, for example, has Men Entering Nursing (MEN), open to all nursing students at the Rory Meyers College of Nursing to discuss the concerns and perceptions that affect men and what it means to be a male in the field of nursing.
Nurses need to be prepared for every eventuality in patient care: they welcome life into the world, and hold patients’ hands as their lives come to an end. The core job duties are physically, emotionally, and spiritually taxing — and sometimes dangerous — so it’s no surprise that nurses experience burnout at an alarming rate.
In fact, the National Nursing Engagement Report for 2019 found that 15.6% of all nurses were feeling burned out at the time of reporting, with 41% of nurses who reported themselves as feeling unengaged also reporting feeling burned out. But many nurses also know they can’t leave — or even take time off — because the nursing shortage is so critical that every hour counts.
We’ve written before about how to combat nurse burnout, but it’s just as important to recognize the dangerous signs of burnout when it starts.
What Are the Signs of Burnout?
Between the long hours, the demands of the job, and just being human, most nurses will experience either the signs of burnout or full Burnout Syndrome (BOS) at some point during their careers. As the National Nursing Engagement Report showed, even fully-engaged nurses report these symptoms. The first step to combating BOS is to recognize the symptoms.
Perhaps the first sign and highest predictor of burnout is emotional exhaustion. Nurses know what it’s like to be tired, but emotional exhaustion leaves you feeling completely drained as a result of the stress of your job. In addition to feeling fatigued in every way, people who are emotionally exhausted often feel like they’ve lost control of their lives — they often report feeling trapped in their situation, whether it’s at work or in an outside relationship.
Another sign of burnout is depersonalization. When you become so exhausted that you have to detach from your surroundings to survive, then you are burnt out. Your outlook may be negative or even calloused, and it can express itself in unprofessional comments directed at colleagues, feeling nothing when a patient dies, or even blaming patients for their problems.
The final major predictor of burnout is a reduced feeling of personal accomplishment. You may not feel that you’re a good nurse or that you make any difference at all in patients’ lives. Nurses working in high-intensity settings, like the ICU or emergency room, may experience this more often as they receive a greater proportion of cases where little can be done for the patient.
Why Burnout is Dangerous for Nurses and Patients
Burnout is more than having a bad day; it’s an impaired outlook on nursing and life in general. Experiencing burnout doesn’t mean you don’t love your job, nor does it mean that you aren’t good at what you do. In fact, this reality makes it even more difficult for nurses who experience burnout because leaving is just another impossible choice.
At the same time, burnout is as dangerous for nurses as it is for their patients. A nurse in the throes of BOS is both less likely to have life satisfaction and more likely to provide a poorer standard of patient care. In a study published in Research in Nursing & Health, researchers explored the correlation between the quality of care and nurse burnout among 53,846 nurses from six countries. They found a strong correlation between higher levels of burnout and nurse-rated quality of care.
In other words, burnout can become a self-fulfilling prophecy. Burnout can result in lower standards of patient care, which further informs the reduced feelings of personal accomplishment. As nurses make mistakes, they feel even lower job satisfaction and an even greater intensity of burnout, which goes around again to manifest itself once again in patient care.
How Nurses and Nursing Leaders Can Combat Burnout
Nurses are caught between a rock and a hard place — the nature of the job is stressful, but if you love what you do, you can’t quit. Although almost all nurses will go through burnout at some point, there are things that both practitioners and health care organizations can do to stave it off and help re-engage burned-out nurses.
Education is one of the critical ways that nurses can empower themselves and avoid burnout. Pursuing further education can renew your passion for what you do and help you overcome roadblocks. It also puts you in a better position to provide the latest evidence-based care to patients, which correlates to better patient outcomes and increased job satisfaction.
Nursing leaders and administrators also have a strategic role to play, as the environment in which nurses practice needs to be a supportive one. Creating a positive work environment that limits unnecessary stress and allows nurses to care for themselves and recharge can do wonders in both reducing burnout and igniting engagement.
Those same leaders and administrators can also take notes from other industries’ workplace safety practices. You can’t just say you have a safety culture, you need to commit to it by formalizing the ways in which you intend to create and maintain the culture and creating avenues to accept employee input.
There’s Always More Work to Do to Prevent Burnout
Nurses can’t get rid of the high-stress, high-stakes environments they work in. They can’t wave a magic wand and save every patient no matter how severe their condition, and they can’t stop feeling to cope.
In other words, burnout is a given part of being a nurse. While these feelings are normal, nurses also need support in preventing the bad (and downright dangerous) days from outweighing the good ones. Nurses and administrators can and must work together to prevent burnout — and while the challenge is a significant one, it is achievable if we all listen to each other.