In 1952, during the American Nurses Association and National League for Nursing joint convention in Atlantic City, a group of over 1,000 student nurses from 43 states voted to establish a national membership organization that would provide America’s nursing students with their own independent, unified voice. The rest, as they say, is history.

Half a century later, a racially, culturally and gender-diverse crowd of more than 3,250 nursing students, faculty, nursing leaders and dignitaries gathered to celebrate that history at the National Student Nurses’ Association (NSNA)’s 50th Anniversary Convention Celebration and Alumni Reunion, “Embracing the Past, Envisioning the Future,” held April 3-7 in Philadelphia–appropriately, one of the nation’s most historic cities.

The convention featured a variety of special commemorative events, including the premier showing of the association’s 50th Anniversary video, that made it clear that the NSNA has been a leader in embracing equal opportunity and cultural diversity in nursing virtually throughout its history–from the creation of its Breakthrough to Nursing (BTN) minority recruitment program in 1964 to the election of its first African-American president, the late Cleo Doster, in 1976 and its first Hispanic president, Aurora Hernandez, in 2000.

During a panel discussion with past NSNA presidents representing the 1950s to the present, moderator Mary Ann Tuft, the association’s former executive director, recalled that during the turbulent decade of the 1960s, members of the still-fledgling NSNA had already become very activist in the areas of civil rights and other social concerns. “The issues [nursing] students discussed were hunger, welfare, the poor and the disadvantaged,” she said.

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One of the most significant projects to emerge from this era of activism was the Breakthrough to Nursing program–which in 2004 will celebrate its own 40th anniversary of recruiting racial and ethnic minorities, men and other underrepresented groups into nursing education programs and eventual nursing careers.

Two driving forces that spurred the growth of BTN in the Sixties were the passage of the Civil Rights Act in 1964 and the severe nursing shortage of 1968, explained 1968-69 President Florence Huey, RN, MA. “Even though the civil rights legislation mandated racial desegregation, in the South especially there was still a great deal of segregation. What NSNA did with its BTN project was address both that problem and the shortage of nurses, by focusing on recruiting minorities into nursing. We established the goal that at least 15% of professional nurses should be members of [racial and ethnic] minority groups.”

The past presidents’ dialogue also revealed that even before the “We Shall Overcome” decade, NSNA was actively supporting multicultural outreach and creating global partnerships to advance nursing education and health care in disadvantaged countries. Phyllis Halverson Johnson, the NSNA’s third president (1954-1955), noted that in 1954 the association presented Emperor Haile Selassie of Ethiopia with a gift of funding to provide books for a nursing hospital in the African nation. Also during the 1950s, NSNA members collaborated with the American Bureau for Medical Aid to China on a major project to raise funds for the construction of a dormitory for nursing students in Taiwan.

A Call for Cultural Understanding

Flashing forward to the present and future, the NSNA’s continued commitment to cultural diversity in the 21st century was evident at the convention in such education sessions as “Culturally Sensitive Caregiving and Childbearing Families,” “The Experience of September 11: Middle Eastern Nursing Students in an American School of Nursing” and the plenary session “A Passion for Globalization of Health Care–Commitments and Challenges,” by Afaf I. Meleis, RN, PhD, FAAN, president of the International Council of Women’s Health Issues, and Margaret Bond Simon Dean of Nursing at the University of Pennsylvania in Philadelphia.


Introduced as “a renowned international scholar with a passion for globalization,” Dr. Meleis, a native of Egypt who was raised in a Muslim household, commented that student nurses in the U.S. are growing up in more culturally diversified communities than ever before, and that it is imperative for nursing education in America to address global issues and culturally competent care. She challenged students to fully prepare themselves for a global future by developing an international perspective, a global consciousness of health care issues and a greater sensitivity to cultural differences–not only those of their patients but also those of their nursing colleagues.

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“We develop an international perspective,” Meleis declared, “when we embrace diversity to the fullest, when we engage in experiences that protect diversity and when we, individually and collectively, address questions in our daily clinical work such as: ‘How different is the [experience of] pain for this Vietnamese patient from this Yemeni patient? How different is it [from your own experience] for a Filipino colleague in Philadelphia to be far away from his or her family in California?’”

Meleis also urged nursing students to avoid falling into the destructive traps of cultural stereotyping and marginalization. “It is not culture, not color of skin, not sexual preference, not religion, not cultural heritage that marginalizes people,” she stressed. “It is ourselves and how we react to those differences [that marginalizes others].

“There is a myth, for example, that foreign nurses [working in the U.S.] are ‘different,’ that they don’t share our values or patient-care practices, and we marginalize them through this myth,” she continued. “We make them different from us by undermining their values.” In reality, Meleis pointed out, a recently published study clearly reveals that “practice values of international nurses are very congruent with those of U.S. nurses”–and also dispels the equally harmful myth that “foreign-educated nurses don’t burn out” like their U.S. counterparts do.

The Egyptian-American nursing leader encouraged students to enhance their global and cultural awareness by learning about health care models in other countries, participating in international conferences and getting involved in global human rights issues and health care policy-making. “Ask yourself at the end of every single day,” she concluded, “‘what I have done today to demonstrate tolerance of diversity, and passionate intolerance of stereotyping and marginalizing?’”

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