Transforming Nursing Education: The Culturally Inclusive Environment

By Susan Dandridge Bosher, PhD, MA, and Margaret Dexheimer Pharris, PhD, RN, MPH, FAAN (Editors)
Springer Publishing Company, 2009
$50 (paperback)

For years, the nursing profession has been grappling with the issue of how to recruit, educate and graduate more racially, ethnically and culturally diverse nursing students. Everyone seems to agree that there’s a critical need for nursing schools to create more culturally inclusive learning environments and curricula, develop more culturally sensitive teaching methods and eliminate cultural barriers that can create unfair disadvantages for minority students. But how exactly do you do that? How can schools of nursing move beyond theoretical discussions to start developing actual programs for accomplishing these goals?

Transforming Nursing Education: The Culturally Inclusive Environment provides some long overdue answers to these questions. But be warned: This book is only for those institutions and educators who are seriously committed to change. The word “transform” means to markedly alter the form or nature of something, and Bosher and Pharris argue in their introduction that creating a more culturally inclusive environment will require making dramatic changes to the traditional culture and structure of nursing education as we know it. And that means coming to grips with thorny, uncomfortable issues like institutionalized racism, discrimination and whitecenteredness in the educational system.

For those who are up to the challenge, Bosher and Pharris have put together an anthology of essays from more than 20 culturally diverse leaders in education and nursing to help nursing schools redesign their curricular, pedagogical and structural systems to better meet the needs of multicultural students. Through case studies, practical examples and in-depth analysis of successful programs, the book provides a roadmap for creating a more welcoming environment for minority students and faculty, revamping traditional teaching methods to accommodate diverse learning styles, developing and teaching a culturally competent nursing curriculum, and removing cultural and linguistic barriers to student success.

Transforming Nursing Education profiles many innovative programs that “model structural change,” including the Latino Nursing Career Opportunity Program at the Catholic University of America, the Recruitment/Retention of American Indians Into Nursing (RAIN) program at the University of North Dakota, the Students’ Test Anxiety Management Program (STAMP) at the College of St. Catherine and more. Each chapter concludes with specific recommendations for nursing educators and administrators.

Bosher and Pharris emphasize that Transforming Nursing Education is “not meant to be a cookbook approach to structural change but rather a stimulus for thought-provoking dialogue that will lead to concrete actions.” Because both that dialogue and those actions are so crucial to the future of the nursing in the 21st century, this landmark book is an invaluable resource and absolutely essential reading.

To order the book: Transforming Nursing Education: The Culturally Inclusive Environment can be ordered from Springer Publishing Company, 11 West 42nd Street, New York, NY 10036-8002, or online at

Real Nurses and Others: Racism in Nursing

By Tania Das Gupta, PhD
Fernwood Publishing, 2009
$15.95 (paperback)

The quote from author Tania Das Gupta that adorns the back cover of Real Nurses and Others: Racism in Nursing pulls no punches about what readers will find inside. “Most nurses of color experience everyday forms of racism, including being infantilized and marginalized,” she writes. “Most [nurses interviewed for the book] reported being ‘put down,’ insulted or degraded because of [their] race/ethnicity/color. A significant proportion of nurses, non-white and white, report having witnessed an incident where a nurse was treated differently because of his/her race/ethnicity/color.”

Das Gupta is a Canadian sociologist and activist whose previous book, Racism and Paid Work, included a chapter on racial discrimination in Canada’s nursing workforce. Real Nurses and Others, which began as a study commissioned by the Ontario Nurses’ Association (ONA)’s Racially Diverse Caucus, expands on this earlier research to present a full-length examination of systemic racism in nursing, based in part on surveys and interviews with nearly 600 ONA members, both minority and majority.

Although the book focuses exclusively on Canada, American readers—including nursing staff, managers, administrators and hospital diversity directors—can also learn much from Das Gupta’s analysis of the many subtle and not-so-subtle ways racial/ethnic discrimination manifests itself in today’s nursing workplace. For example, the title Real Nurses and Others refers to a black interviewee’s comment that white patients and family members routinely treated her as if she was a nursing assistant or aide rather than a “real” (i.e., white) nurse—a situation that all too many American nurses of color can relate to.

Das Gupta presents what she calls an “intersectional analytical framework” for understanding how and why workplace racism can occur in health care institutions. But Real Nurses and Others really comes alive when it focuses on the case studies and personal testimonials of the many nurses who reported experiencing discrimination from colleagues, managers, patients, doctors and others because of their race/ ethnicity. The book documents many examples of “everyday racism”—e.g., targeting, scapegoating, excessive monitoring and blaming the victim—as well as “how fear, lack of support, management collaboration, coworker harassment and ineffective institutional responses make it difficult for victims of racism to fight back.”

The slim (128-page) book does have a few shortcomings. There is no research data on Aboriginal (First Nations) nurses, an admittedly small but still important part of Canada’s minority nursing workforce. And while Real Nurses and Others does an excellent job of discussing the problems of racism in nursing, I would have liked to see Das Gupta go one step further by proposing some recommendations and solutions. But all in all, this brave and provocative book makes fascinating reading—especially for those in the nursing profession who are not afraid to engage in honest dialogue about a serious issue that is all too often swept under the rug.

To order the book: Real Nurses and Others: Racism in Nursing can be ordered in the U.S. from Independent Publishers Group, 814 N. Franklin Street, Chicago, IL 60610, [email protected]. Canadian readers can order it directly from the publisher at

Paperwork: The Path We Tread

The Path We Tread

In this updated and expanded third edition of the now-classic text The Path We Tread: Blacks in Nursing Worldwide, 1854-1994, by pioneering African-American nursing educator and leader Dr. M. Elizabeth Carnegie, the author’s intentions are to introduce to some, and reaffirm to others, the positive image of black nurses and their many contributions to the profession of nursing over the last 140-plus years.

If you have not read the first or second editions of this award-winning book, this latest version will provide an informative history of the challenges and accomplishments of black nurses. For those who are followers of the series, the third edition updates all applicable chapters and adds two all-new chapters that broaden the book’s international scope.

The book’s content facilitates readability with an extremely well-organized format. The chapters are appropriately titled to create the impression that the reader is tracing the steps of a trail these nurses blazed. The book begins with the earliest documented accounts of black nurses who treated the wounded on various 19th century battlefields and culminates with the present-day accomplishments of black nursing leaders who have risen to highly esteemed positions in the military and other areas of government.

Chapter 1, “Answering the Call,” describes some of the first black nurses’ roles during three early wars extending from 1853 to 1898. The author gives a concise historic account of each of those wars, followed by a brief biography of some of the most renowned nurses who served in them. Among those highlighted are Mary Seacole (the Crimean War), Harriet Tubman, Sojourner Truth and Susie King Taylor (the Civil War) and Namahyoke Curtis (the Spanish-American War).

The second chapter, suitably titled “The Foundation Is Laid,” chronicles the establishment of nursing programs at historically black institutions as early as 1866 and describes how these learning institutions were designed to formally educate black nurses. These early programs were categorized as either “basic” (diploma, associate and baccalaureate programs) or “post-basic” (master’s degree programs and non-degree programs in nurse-midwifery and public health nursing). Dr. Carnegie details the challenges these programs faced as well as their successes and growth.

“From Dreams to Achievements,” Chapter 3, examines several key national initiatives that were devised to recruit more blacks and other people of color into the nursing profession in the 20th century. Dr. Carnegie describes how some of these recruitment projects were born out of necessity, such as the urgent need for nurses created by World War II. Others were created as a result of the Civil Rights Act of 1964.

Of course, after achievements comes recognition–but for black nurses, it did not come easily. Chapter 4, “Struggle for Recognition,” addresses the barriers of racial discrimination faced by these credentialed black nurses seeking acceptance in America’s majority nursing organizations. It also provides inspiring examples of management and leadership positions attained by qualified black nurses on both national and international levels.

Pathfinders and Pioneers

Chapter 5 continues this theme by celebrating the pathfinders who fought to overcome racial barriers and, by becoming “firsts” in various areas, paved the way for other black nurses to follow. Some of the pioneers featured in this chapter include Dr. Beverly Clair Robinson, the first chair of the American Nurses Credentialing Center (ANCC) Commission on Certification, and Jessie Sleet Scales, the first black public health nurse in the United States.

Chapter 6, “So Proudly We Hail,” focuses on the hardships faced by black nurses who had gained the right to serve in our country’s wars but were otherwise treated as second-class citizens because of their ethnicity. Dr. Carnegie spotlights the triumphs of black nurses in the armed forces and in important government agencies such as the U.S. Public Health Service and the Department of Veterans Affairs. This chapter also has excellent photographs of some of these nurses in uniform.

The last two chapters, exclusive to this third addition, discuss the challenges and accomplishments of black nurses in the English-speaking countries of Africa and the Caribbean. Illustrations of relevant maps and a short description of each of these countries are included. The addition of these new chapters expands and substantiates the book’s subtitle of Blacks in Nursing Worldwide.

The book also includes an extensive collection of additional informative resources, including a bibliography, a chronology and numerous illustrations that allow the reader to see portraits and group photos of many of the nursing champions discussed in the text. There are also eight appendices, listing black nursing leaders past and present, that serve as an outstanding reference source. These lists include black deans and nursing program directors, charter members of prominent black nursing organizations, recipients of the American Nurses Association’s Mary Mahoney Award, and black Fellows of the American Academy of Nursing (FAANs).

Living History

One of The Path We Tread’s greatest strengths is that Dr. Carnegie is the ideal historian. She has lived through almost nine of the 13 decades this book encompasses and has traveled many of these same pathways during her own groundbreaking nursing career, which spans 60-plus years. Therefore, the author brings a wealth of first-hand information to the table, yet her proficient writing expertise enables her to present the facts objectively without attempts at personal analysis or predictions. When she does write about her own personal experiences, this added perspective seems to make the book come to life. It helps enhance the accurate facts and impeccable research that are deeply drilled into the pages.

Another reason why this book is essential reading is the proven success of the first two editions. In fact, they were so successful that Dr. Carnegie was requested to write the third. Together these writings correct the scarcity of available historical data on black nurses.

The new edition’s one weakness is that the references cited at the end of each chapter and in the general bibliography do not contain any online resources. Because information retrieval today relies so heavily on the Internet, the book falls short in this area. Many of the institutions and organizations discussed in the text have Web sites and probably had them at the time of publication, yet this information is not included.

Like its predecessor editions, the target audience for this important book is nurses both novice and seasoned, of all races and genders. It is also an ideal classroom text for giving students a more factual and diverse perspective of nursing history with emphasis on the black nursing experience. In today’s world, where cultural diversity has finally begun to take its rightful place, the mere title of this book should spark the interest of current and future generations of nurses and inspire upcoming minority nurse leaders to embrace this profession with a true sense of pride in their professional heritage.

Author of First-Ever Book on the History of Minority Nurses Wants to Hear Your Stories

Did you know that abolitionist leaders Harriet Tubman and Sojourner Truth both worked as nurses during the Civil War? Can you name the first black nurse to join the American Red Cross Nursing Service? (Answer: Frances Reed Elliott Davis, in 1918.) Were you aware that Dr. Phoebe Dauz Williams was the first Filipino-American nurse to become a Fellow of the American Academy of Nursing (FAAN)? Or that the National Association of Hispanic Nurses (NAHN) was founded in 1975 by Ildaura Murillo-Rohde, RN, PhD, FAAN?

Minority nurses in the United States have a rich and proud history dating back to at least the mid 1800s, yet most people have little knowledge of these courageous nurses’ exceptional accomplishments and the barriers they overcame to achieve their rightful place in the nursing profession. But Marie O. Pitts Mosley, RN, EdD, PNP, is planning to change all that. The noted nursing scholar and historian is currently at work on a landmark book that will celebrate the history and leadership of nurses of color in America.

Tentatively titled Despite All Odds, the book will feature personal stories, biographies and photographs of minority nurses that will document, in Mosley’s words, “our oral histories of courage, hope, perseverance, faith and fortitude.” She envisions a wide international audience for this long-overdue book, including elementary and high schools, nursing schools, other university programs, historians, nurses and the general public.

Mosley, an associate professor at Hunter-Bellevue School of Nursing in New York, says this first-of-its-kind history is intended to “recognize all [minority nurses] who overcame great obstacles. . .who have a song to sing, a story to tell or a vision for all people of the Earth. This book is a celebration of your strength,” she adds. “It pays tribute to you and is dedicated to all nurses of color.”

Would you like to be part of this exciting project? If you are a minority nurse with “a song to sing, a story to tell,” or a photograph to share, Dr. Mosley would like to hear from you so that your experience can be included in Despite All Odds. For more information about how to submit material for the book, contact her at 2541 Seventh Avenue, Apt. 8K, New York, NY 10039, (212) 926-1647, email [email protected].

Maya Angelou Collaborates With Medical School to Launch Minority Health Research Center

When you hear the name of acclaimed African-American writer Maya Angelou, what’s the first thing that comes to mind? Her best-selling autobiography I Know Why the Caged Bird Sings? Her poem “On the Pulse of Morning,” which she read at Bill Clinton’s presidential inauguration ceremony in 1993? Now that Wake Forest University School of Medicine in Winston-Salem, N.C., has established the Maya Angelou Research Center on Minority Health, her name will soon be associated with the national initiative to eliminate racial and ethnic health disparities as well.

Angelou, who is the Reynolds Professor of American Studies at Wake Forest University, serves on the steering committee for the new research center, which is intended as a model that can be replicated in other communities across the nation. Other internationally known minority leaders who serve on the center’s national advisory board include Coretta Scott King, the Honorable Andrew Young and former Housing and Urban Development Secretary Henry Cisneros.

Established through a $500,000 grant from The Duke Endowment and an $80,000 grant from The Winston-Salem Foundation, the Maya Angelou Center’s mission is to enhance wellness, improve quality of life and reduce the burden of disease in underrepresented minorities through education and research that can be translated into effective health care approaches. One of the center’s key goals is to increase the representation of people of color in the biomedical research community–as study participants, researchers and practitioners–so that doctors can learn more about the prevention and treatment of diseases that disproportionately affect minority groups.

The Angelou Center will also form partnerships with the local community and with Winston-Salem State University, a historically black school, to develop a nationally recognized model for addressing minority health disparities. Other critical items on the center’s agenda include the creation of programs in underrepresented minority health education, and the career enhancement of underrepresented minority researchers, educators, clinicians and leaders.

Book Reviews: 2001

The Mentor Connection in Nursing

By Connie Vance, EdD, RN, FAAN, and Roberta K. Olson, PhD, RN [eds.]
Springer Publishing Company, Inc., 1998

Reviewed by Kem Louie, PhD, RN, FAAN. Dr. Louie is president of the Asian American/Pacific Islander Nurses Association and associate professor at William Paterson University, Department of Nursing, in Wayne, N.J.

What exactly does the concept of mentorship mean in the specific context of the nursing profession? Does mentoring really make a measurable difference in minority nursing students’ professional development? The Mentor Connection in Nursing, a recently published anthology edited by Connie Vance, dean and professor at the College of New Rochelle (N.Y.) School of Nursing, and Roberta K. Olson, dean and professor at South Dakota State University College of Nursing, presents some thought-provoking answers to these questions.

Borrowing from the ancient tradition of story telling, the book features short essays and personal stories by nearly 100 nurses exploring the concept of mentorship, its practical applications and what mentoring means to the nursing profession.

What makes the book particularly valuable to nurses of color is that, to my knowledge, at least 13 of the contributing authors are minority nurses. They include such leaders of the profession as Beverly Malone, PhD, RN, FAAN, former president of the American Nurses Association; Clara L. Adams-Ender, PhD (HON), RN, FAAN, brigadier general, U.S. Army (retired); Hattie Bessent, EdD, RN, FAAN, former deputy executive director of the ANA’s Minority Fellowship Program; Eula Aiken, PhD, executive director, Southern Council on Collegiate Education for Nursing; Patricia Castiglia, PhD, RNC, PNP, FAAN, dean of the College of Nursing and Health Sciences at the University of Texas at El Paso; and Marie Santiago, EdD, RNC, founder of the Philippine Nurses’ Network. The book also includes a chapter on global and cross-cultural mentoring.

The anthology is organized into five parts: The Mentor Connection, Perspectives on Mentorship, The Process of Mentorship, Contexts for Mentoring and Expanding the Mentor Connection. Taken as a whole, this examination of mentoring from a variety of angles confirms the editors’ contention that the mentor connection in nursing is making an important contribution to the leadership and career development of students and practitioners. Although not all of the nursing leaders who share their stories say they had mentors, those who did have mentors tell of advancing in the profession faster and having more career satisfaction than other nurses.

Though it is difficult to measure the effects of mentoring, the opening essay by Vance and Olson identifies five benefits of mentorship in the nursing profession:

• Career success and advancement

• Personal and professional satisfaction

• Enhanced self-esteem and confidence

• Preparation for leadership roles and succession

• Strengthening of the profession.

Songs of Empowerment

The personal experiences of mentoring shared by the minority nurse contributors make particularly powerful reading. Beverly Malone notes that mentoring is a type of nurturance, “a song of power” that can help African-American nurses overcome the triple challenge of being a woman, a nurse and black. She eloquently states, “In your darkest night, it is the song that comes to your memory in phrases and smells and sensations speaking of strategies, tactics and visions of change.”

In her essay “The Privilege and Responsibility of Mentoring,” Hattie Bessent argues that mentoring is a critical concern for the future of America’s nurses. Mentoring can occur at many levels, she notes, and must be continuous, goal-oriented and have the protégé’s best interests in mind. “I have discovered that a mentor for nurses, especially minority nurses, must be relentless and possess a clear vision about futuristic possibilities for the protégé,” she concludes.

Felicitas A. dela Cruz, DNSc, RN, and her coauthors make a strong case for mentoring by sharing the results of a program at Azusa Pacific University School of Nursing designed to improve the retention and academic success of minority graduate students. The program developed mentoring partnerships between students and minority nurse leaders, such as advanced practice nurses. After one year, the grade point average of the mentored students was higher than that of minority students who did not participate in the mentoring program.

Marie Santiago discusses the origins of the Philippine Nurses’ Network, an organization aimed at mentoring, inspiring, supporting and empowering immigrant Filipino nurses. “Teaching students in the clinical setting enabled me to see the frustrations experienced by newly arrived nurses from the Philippines and other countries,” she writes. “They were working in a strange and new workplace and carrying heavy patient assignments, while at the same time going through the acculturation process and dealing with homesickness.”

The Mentor Connection in Nursing can be a useful resource for anyone interested in the process of mentoring, including new student nurses, novice nurses and experienced nurses in a variety of settings. My one criticism is that the book does not offer strategies or models for mentoring minority nurses—information that is urgently needed, because the nursing profession continues to operate with a lack of minority nurses in leadership positions. Perhaps Vance and Olson will consider this critical issue as a topic for a future book.