Trust between a nurse and their patient is one of the strongest assets a healthcare provider can carry in their repertoire. Unfortunately, social and health discrimination against minority groups around the world makes offering trust more difficult.
Lansing, Mich.-based nurse practitioner Kristal Richardson-Aubrey and her team aim to approach this reality with empathy and understanding.
“When we don’t have an awareness of it, then we tend to play into the issue,” says Aubrey-Richardson, who runs an outpatient clinic and is an alumna of the Michigan State University College of Nursing. “It’s not seen every day, so we think it’s gone. But we still have to understand that they exist, and we should work to eliminate or, at least, decrease some of these disparities.”
Increasingly, nurses and advanced practice registered nurses are receiving the experience and education they need in their nursing programs to address disparities in healthcare and to, thereby, provide this type of holistic care. But there is still a long way to go.
MSU nurse practitioner student Trevor Gabel-Baird, who identifies as a queer man, has experienced a lack of empathy in healthcare and wants to create positive change for all.
“I’ve felt judged for who I am as a person, I wanted to eliminate those barriers that prevent people from being seen, and that stops them from going to their physicians or nurse practitioners,” explains Gabel-Baird.
MSU nurse practitioner student Trevor Gabel-Baird has experienced a lack of empathy in healthcare and wants to create positive change for all
One instance Gabel-Baird could recall was with a charge nurse in a prior role, who misgendered a transgender patient who had ended up in the intensive care unit after they made an attempt on their life.
“It was very off-putting to me to witness my peer and someone I’m supposed to look up to, especially as a brand-new nurse, putting the patient at risk, and that’s what drove me to apply for the nurse practitioner program,” Gabel-Baird says. “I felt healthcare needs more people that can speak to the lived experiences of the LGBTQIA community.”
In the LGBTQIA+ community, more than one in six adults have reported they avoid seeking healthcare due to anticipated discrimination. More than 20 percent of transgender adults reported discrimination in healthcare according to the National Library of Medicine.
Nurses Gaining Access to Varied experiences, Curriculum
“To be a nurse practitioner requires a stronger compassionate trait,” says Dr. Kara Schrader, MSU’s Primary Care Nurse Practitioner Program Director. “Nurse practitioners tend to work with marginalized populations, many of which have difficulty with healthcare access. Nurses need to be empathic when it comes to the care we provide.”
Schrader said it is important to identify these disparities early in a nurse’s career. One way to do that is by ensuring students have access to varied experiences and a comprehensive curriculum.
The end game, she said, is that nursing colleges produce students who are prepared for and representative of the communities they serve, whether as a nurse, nurse practitioners, clinical nurse specialists, nurse anesthetists, or nurse scientists.
Students like Gabel-Baird and Richardson-Aubrey, are putting that type of education to work.
“We’re able to identify the contributing factors of the medical condition to help the patient be well entirely,” Richardson-Aubrey says. “We’re not just treating them with medicine but treating the other aspects that play into the medical condition.”
Learn more about graduate programs at the MSU College of Nursing.
“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:
Going to school while working full-time as a nurse and raising a four-year-old with her husband isn’t easy, so Ashley Willie knew she wanted an online nursing program with supportive instructors and a flexible schedule.
DNP student Ashley Willie, MSN.
Willie, who is pursuing a doctorate in nursing online through Penn State World Campus, where she also received a master’s in nursing, said she wanted professors who were inclusive and available to meet with students.
“I wanted instructors who were interested in their students’ personal and career goals as well as their educational goals,” she said.
In addition, she said, “I was looking for a program that didn’t require me to be online at a certain time. I wanted more freedom and autonomy.”
Willie said prospective nursing students should look at what kind of financial support and resources are available for minority students, as well as what past and current students and instructors have to say about the program. And of course, they should check the matriculation rate and accreditation of a school, she said.
Financial support: putting your money where your mouth is
Sheldon Fields, the inaugural associate dean for equity and inclusion at the Penn State Ross and Carol Nese College of Nursing, agreed that prospective students should look at what kind of financial resources an institution commits to multicultural students.
Sheldon Fields, PhD, RN, CRNP, FNP-BC, AACRN, FNAP, FAANP, FAAN. Associate Dean for Equity and Inclusion, Ross and Carol Nese College of Nursing.
“To put their money where their mouths are, schools need to be committing resources — sponsoring lecture series, offering scholarships, resources specifically focused on supporting multicultural students,” he said.
Fields, who has been a nurse for 30 years, said schools should have a clear stance on diversity, equity and inclusion that is reflected in their mission statement and their strategic plan, which should be available online, and should also teach diversity, equity and inclusion issues as part of their undergraduate and graduate curricula.
If there are no multicultural nursing student groups and the topic appears to be ignored, “It’s a big red flag,” Fields said. “A multicultural student is not going to find support for who they are, for the unique perspectives and talents that they bring, and the needs they have.”
Fields urged prospective students to look carefully at a school’s nursing faculty.
“It’s one thing to say you want a diverse faculty; it’s another to actually make it happen,” he said.
Denita Wright Watson, associate director of equity, inclusion, and advocacy for the Penn State World Campus Student Affairs office, urged students to seek out institutions that focus on addressing health care disparities, inequities, and bias in health care and that are focused not only on attracting diverse talent, but also retaining it. Schools should go beyond lip service to invest in students’ academic and professional success, she said, by providing professional development opportunities and other career services, as well as supporting students’ personal well-being through mental health support, student identity groups and DEI–related programs.
Ask questions
Denita Wright Watson, MLD, Assoc. Director of Equity, Inclusion, & Advocacy for Student Affairs. Penn State World Campus.
Students should ask, “What support is out there for me, beyond academic support?” Wright Watson said. “What support is there to aid in my growth as a person?”
Prospective students should “scour and scour” a school’s website not only for their mission and values statements, but also to see what service projects the institution is involved in and what kind of speakers and events are offered, Wright Watson said.
“Google should be their best friends,” she said. “Just ask questions: Why should I pick this university? Why should I pick this program? What are they doing to meet the needs of underserved students and communities?”
Fields added: “Ask them, ‘What did you learn in a program about diversity, equity and inclusion?’ If they tell you nothing — run the other way.”
Feeling valued
Willie agreed that it’s important to look for an institution that recognizes health care inequities and equips students with tools to help reduce health care disparities, seeking to improve health care outcomes at both the individual and the population levels. An example of that is teaching students methods of recognizing vulnerable populations and using evidence-based tactics to improve health care literacy and health and wellness, she said.
All her professors at Penn State have valued both her cultural and professional background and make time to meet with individual students to discuss their goals and aspirations, Willie said.
“For me this is very important because not only do I feel valued individually, I feel like the instructors are invested in my success as a woman of color.”
Family nurse practitioners (FNPs) are needed now more than ever, especially in our fast-growing-but-underserved Latinx communities.
Latinx patients disproportionately report not having a usual source of healthcare and face challenges when trying to find a provider. They are also more likely to live in a community that is experiencing a provider shortage, so they often seek out care in community health centers.
FNPs are more likely to work in these health centers and can ensure Latinx families have access to the care they need.
Dedicated to Diversity and Inclusion
In Arlington County, home of Marymount University’s physical campus, Latinx residents comprise 20-25 percent of the population, the largest concentration in the state. Marymount University’s student population reflects the local demographic, with 25 percent of its undergraduate students identifying as Latinx or Hispanic.
Marymount is dedicated to the idea that diversity is a shared value lived by students, faculty, and staff. Those efforts were recognized when they were named the first Hispanic-Serving Institution (HSI) in Virginia.
Marymount also supports its Latinx students through a recent initiative called ¡Avanzamos! (“Moving Forward Together”), which ensures campus-wide programs and student-success efforts include issues that impact their Latinx student population. ¡Avanzamos! is part of a larger effort to promote diversity and inclusion entitled, “You Belong Here,” which brings together students, faculty, and staff who understand the challenges and needs associated with discrimination and inclusion.
The time has never been better for nurses who want to complete a Family Nurse Practitioner program. Marymount’s online nursing programs prepare nurses for a career as an FNP, allowing them to help underserved populations across the country, including Latinx communities.
Marymount offers several FNP programs for nurses with various levels of education.
For BSN-prepared nurses, Marymount’s online DNP-FNP program teaches skills needed to be a nurse leader who not only offers compassionate care but improves patient outcomes by providing the best patient care across multiple populations in a complex, ever-changing environment.
Marymount’s CCNE-accredited online MSN-FNP program, also designed for nurses with a BSN, utilizes a curriculum strongly focused on ethics and evidence-informed care. Learn from practicing FNPs who are experts in their field and translate theoretical knowledge from the sciences and humanities into the delivery of advanced nursing care to diverse populations.
Marymount’s FNP post-master’s online certification prepares nurses who already have an MSN degree to build on existing knowledge to optimize patient care and be at the forefront of the ever-changing healthcare landscape.
Marymount’s online FNP programs offer a unique opportunity to balance work and school, achieve career goals, and obtain the knowledge and skills needed to sit for the AANP or ANCC family nurse practitioner certification exam after graduation.
To ensure all students can concentrate fully on working and studying, Marymount’s Clinical Placement Team coordinates all aspects of the clinical placement process to ensure the successful completion of clinicals at a placement site within a reasonable distance to the student’s home.
Nursing strives to exceed the boundaries when it comes to providing patient care in the United States, and nursing leaders have long understood the importance of diversity in the workplace to obtain quality outcomes for their patients.
Over the last decade, the American Association of Colleges of Nursing (AACN) has dedicated efforts to diversify the workforce. The aim is to have adequate representation from all groups—including men and individuals from the African American, Alaskan Native, Asian, Hispanic, Native American, Native Hawaiian, and those of other backgrounds.
Improving nurse workforce diversity will help decrease health disparities and increase health equity so all people of all groups can be as healthy as possible. Because different populations often present symptoms dissimilarly or are predisposed to distinct conditions, it’s important for nursing schools and staff to gain a wider perspective on the patients they serve. In parallel, when nursing staff mirrors the population they serve, it’s common for patients to feel more trusting and comfortable discussing their personal concerns and symptoms.
The National Council of State Boards of Nursing (NCSBN) and The Forum of State Nursing Workforce Centers were surveyed in 2017 to look at the cultural makeup of the nursing pool. Registered Nurses (RN) from minority backgrounds represented 19.2% of the workforce.
The survey identified the RN ethnic backgrounds comprised of 80.8% white/Caucasian; 7.5% Asian; 6.2% African American; 5.3% Hispanic; 0.4% Native American/Alaskan Native; 0.5% Native Hawaiian/Pacific Islander; 1.7% Two or more races; and 2.9% other nurses. Of the total nursing workforce, men accounted for 9.9% of the workforce, up from 1.1% from 2015.
Elmhurst University, located just outside of Chicago, is committed to successfully recruiting and retaining their nursing students to meet the growing need in their communities. Elmhurst’s mission is to prepare nurses for professional practice and exceed leadership roles to meet the needs of a diverse society.
If you are looking for a new career path in high demand, a degree in nursing can launch you into a highly respected, satisfying, and financially stable profession. Elmhurst University understands the importance of providing high-quality nursing degrees in a timeframe that matches the workforce demand.
Find the Right Program for You
Elmhurst University offers a distance accelerated BSN nursing program for those who are ready to begin their nursing career today. Students complete all course requirements in less than 2 years. An online distance learning structure allows those living in remote areas to gain access to a high-quality nursing education. Furthermore, there are just two on-campus visits during the program, limiting the number of travel disruptions to students.
Elmhurst University nursing students.
The 16-month fast-track program prepares students to sit for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam. Elmhurst University is consistently above the national and state scoring averages on the NCLEX exam. In 2020, 90% of their BSN students passed the exam.
Elmhurst University’s application process is easy to access online. Apply today and take the first step to a rewarding career.
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.
