The ENA Foundation’s new Emergency Nursing Diverse Voices Research Fellowship aims to increase diversity in nursing research.
In partnership with the Emergency Nursing Research Advisory Council and the Emergency Nurses Association Diversity, Equality and Inclusivity Committee, the ENA Foundation is accepting applications for the ENDVR Fellowship through March 3. The fellowship will better support and mentor emerging researchers who are members of underrepresented groups.
“The ENDVR Fellowship embodies two important foci for ENA including the important work of the DEI committee that began in 2019 and is in line with the Foundation’s efforts to increase the visibility of research grants,” said ENA Foundation Chairperson Jeff Solheim, MSN, RN, CEN, TCRN, CFRN, FAEN, FAAN. “It’s hoped that the ENDVR Fellowship will encourage nurses from underrepresented communities to undertake research projects that will reflect and address important issues in their communities.”
Selected applicants will attend and participate in research activities at Emergency Nursing 2022 in Denver; partner with a member of the Emergency Nursing Research Advisory Council who will serve as a mentor; develop a research project to be conducted locally; attend advisory council meetings; and present their results and findings at either Emergency Nursing 2023 or 2024. The fellowship may extend to two years as required.
“The Emergency Nursing Diverse Voices Research Fellowship is important because underrepresented nurses have been systematically excluded from research opportunities in nursing. This exclusion often means that critical perspectives are missing from the research that guides our practice,” said ENA DEI Committee Chairperson Anna Valdez, Ph.D., RN, FAEN, FAADN. “We are excited about this opportunity to work with and support diverse nurses who have an interest in emergency nursing research. I am looking forward to meeting and working with new fellows.
“I encourage diverse nurses to apply for the fellowship and want them to know that their voices and contributions to the profession are welcomes and valued at ENA,” Valdez added.
Click here to learn more about or apply for the Emergency Nursing Diverse Voices Research Fellowship.
About the ENA Foundation
The ENA Foundation, a 501(c)(3) tax-exempt organization, is the philanthropic arm of the Emergency Nurses Association. The Foundation fuels the future of emergency nursing with a mission focused on providing academic scholarships and research grants to emergency nurses. Since 1991, the ENA Foundation has awarded approximately $5.3 million to more than 2,300 emergency nurses to help them earn degrees, expand their skills through continuing education and conduct research projects directly related to emergency nursing and led by nurse researchers.
To address health inequities in the United States, the American Association of Colleges of Nursing, Robert Wood Johnson Foundation, and the Institute of Medicine recommend increased representation of Black and other underserved populations in the health professions. Black nurses are more likely to work in underserved communities, but due to multiple barriers in our current admissions processes, Black students’ have limited access to RN education.
The majority of U.S. Registered Nurse (RN) graduates train in associate and bachelor’s degree programs. They apply first to the academic institution, complete prerequisite courses, and apply to the nursing program one or more years later. However, in a study of almost 2,500 pre-nursing students, only 44 of 252 Black students submitted a nursing application, with the majority withdrawing after freshman-level anatomy and physiology.
I have 28 years of experience as a professional nurse and 17 years in academia, yet my 3.3 high school grade point average (GPA) and 1,100 SAT score would have precluded my admission to most nursing programs. I was able to enter the field through an alternate pathway, the accelerated Master’s entry program in nursing at UC San Francisco, a program for students with bachelor’s degrees in other fields. Without this pathway and the use of holistic admissions review (HAR), I would not be a RN today.
HAR is one strategy to increase admission of Black students because it features the balanced use of academic metrics (e.g, GPA and standardized test scores), personal characteristics, and experiences in admissions selection. This is critical because academic metrics are significantly influenced by racial bias and economic privilege. According to a 2014 survey, a majority of dental (93%), medical (91%), and pharmacy (78%) programs embraced HAR in their admissions policies. However, only 47% of nursing programs used HAR. In 2021, 50% of nursing programs still relied exclusively on academic criteria for admissions. Several misconceptions sustain the admissions status quo in nursing education.
Misconception 1: “Black students are not interested in nursing.”
Misconception 2: “GPA and test score ranking is the most fair and efficient way to make admissions decisions.”
Reality: Academic metric-driven admissions are the fastest method, but not the most equitable. Compared to White and higher-income applicants, Black students’ perceived and actual performance is negatively affected by grading bias (elementary and higher education), disproportionate school suspension rates, arrests, and limited tutoring and test preparation access. In addition, they typically work more than their counterparts leaving less time for studying and test preparation.
Misconception 3: “Academic support services must be established before admitting Black students.”
Reality: The admission of Black students is not equivalent to admitting unqualified students. Programs that implemented HAR reported unchanged or increased GPAs, graduation, and licensure pass rates. However, Black students could benefit from university services such as summer bridge, academic advising, counseling, and financial aid programs to address non-academic stressors (because income is a predictor of nursing program success). Nursing programs can also work to promote a sense of belonging and engagement to boost performance without increasing resource demands.
Misconception 4: “Students admitted using lowered admission standards will fail licensure exams.”
Reality: The admission of qualified Black students is not equivalent to lowered admission standards. More Black students might qualify for admission if programs used HAR for the selection process. Graduation and licensure pass rates are associated with science GPA and standardized nursing tests (TEAS), but not overall GPA (most common). Additionally, there is no evidence to suggest that a student with a 3.5 GPA and a 58 test score is less likely to succeed than one with a 4.0 and 85.
Misconception 5: It is illegal to consider race in admissions.
Reality: Since the 1996 ban on Affirmative Action, academic institutions successfully defended their use of race as a mission-aligned component of admissions policies in 3 Supreme Court cases. HAR is one of few evidence-based approaches to increase student diversity in health professional education programs.
What are some reasons you do not disclose your race or ethnicity? Have you ever felt better not responding to this information? Why or why not? I know I have never felt like I should go back in an application and check the box as being Black or African American. There has been a certain level of gratification of going into an interview without this information being disclosed. I remember getting rejection letters and wait list letters from universities and often thought why when explanation was not given except for the high number of applicants. As a registered nurse with experience and higher than a B average in all undergraduate studies these questions often surfaced. Was I not selected due to information disclosed about my background? One starts to wonder when meeting exceeding the minimum qualifications.
There is a great feeling of being considered for employment or chosen for a nursing program by review of my accolades from my curriculum vitae without my race and ethnicity being accounted for. The question of demographic reporting was brought up in a meeting last week. The question was asked about why some students do not check this box when applying to nursing programs. Is this information necessary to disclose? Why should they disclose?
Should students have to be asked this information or encouraged to do so? My first thought was this demographic data is great reporting to nursing program accreditation. However, currently diversity in students and faculty is reviewed but, not a criteria that will impact a nursing programs ability to obtain accreditation. What made me feel uncomfortable in this conversation was that only one other faculty could answer the question for the most likely cause along with myself as to why these questions are often left unanswered. It is hard to fathom that itself racism and structural racism barriers continue to exist in higher education.
Students of color may fear a difference in treatment or not getting acceptance into the program if they chose to disclose. We have to continue working toward breaking barriers in the area of structural racism. This is an example of a potential bias that may be occurring to students from diverse backgrounds. We must continue to have faculty from diverse backgrounds available to mentor these students and who look like them in university settings.
Another question would be do we eliminate this information from the applications. Is this discriminatory in any way? Should the results be seen only from an administrative view? There are so many questions about why this information is used. We could potentially limit who see’s this data. Admissions committees should be limited on this information so that implicit bias are not occurring.
Diversity in the nursing faculty has been an ongoing topic of discussion. Over the last year, there has been a degree of discourse in the United States. Many universities created or are in the process of creating position statements for diversity, equity, and inclusion. The question is, why did we have to wait? Why not be proactive instead of being reactive?
At my alma mater, Norfolk State University, a historically Black university, I was welcomed with open arms, not just from the nursing faculty but all faculty. It resonates with the student and self-efficacy when they can see people who look like them, who have reached the goals they are attempting to achieve.
As an African-American nursing faculty member for RN, MSN, Nurse Practitioner, and DNP students, my goal is to help my students reach their goals. It is a bonus to help inspire a person of color that may not have felt the encouragement of their counterparts.
While I am here to make a difference, there still are challenges that I face as a doctorate-prepared professor, where I am not treated equitably. Researchers Christine Salvucci and Carolyn A. Lawless reported in the Journal of Cultural Diversity in 2016 that minority faculty of color have unique experiences, which has an impact on interpersonal relationships and the professional components of their career compared with White colleagues. In some of the articles that were reviewed, there was a review of topics that included “Insincerity and Putting You in Your Place,” “Invalidation of Sense of Self,” and “Unequal Standards.” As some of my colleagues of color and I have discussed and experienced these topics, the aforementioned topics resonate with me. There is increasing diversity in the students that are presenting to advance their education. How can we begin to retrospectively attempt to address diversity, equity, and inclusion for the students, and we have not properly addressed for the faculty? We have to do better. More research is required, and change is necessary.
As the nation continues to grapple with the wide-ranging effects of racism, the nursing industry continues to take steps to address disparities, inequalities, and racism. Last summer, the Academy of Medical-Surgical Nurses (AMSN) ramped up the AMSN DEI Campaign, motivated by the killing of George Floyd.
Terri Hinkley, EdD, MBA, BSN, RN, and chief executive officer of the Academy of Medical-Surgical Nurses (AMSN) and Medical-Surgical Nursing Certification Board (MSNCB), says Floyd’s killing troubled her deeply, leading her to question if she had done everything she could to make the world as safe and inclusive as possible. Hinkley spoke with the presidents of AMSN and MSNCB and with her family and then wrote, My Reckoning, an op-ed expressing her commitment to actively working to combat racism.
While the program helps nurses learn about DEI, it’s also a way for them to build competence, says Hinkley, especially in areas they may not be familiar with or have a deeper understanding of. “We do not understand the norms, practices, and requirements of cultures we did not grow up with or in,” she says. “By focusing on building competency, we are striving to take away the ‘blame and shame’ that often surrounds these issues and discussions. Let us start with the basic principle that everyone wants to be respectful of others and build on that to help them understand and be able to take action to make that happen.”
75% of the nurses that completed the survey reported that they wished to have a better understanding of topics related to diversity, equity, and inclusion.
92% reported that it is important for their national professional association to take action regarding diversity, equity, and inclusion and lead efforts for its members.
46% reported experiencing harassment or discrimination because of issues of race, class, gender, age, religion, culture, sexuality, or ability.
63% witnessed harassment or discrimination.
DEI work is sometimes uncomfortable, as Hinkley noted, and that’s why it’s important to give nurses the tools to have discussions around difficult topics. “We genuinely believe that we, as nurses, start from a position of caring and compassion,” she says. “We believe that every nurse wants the best possible outcome for their patient, and for their teammates to be respected and supported as an integral part of the team.”
As nurses learn more and become more intentional with their DEI work, they can more effectively advocate for those around them—whether teammates or patients. “DEI isn’t a one and done initiative,” says Hinkley. “It is a journey that will only have its beginning in the first 18 to 24 months. This is a lifelong learning initiative, one that AMSN is embracing and committing to.”
Hinkley says AMSN is committed to making this process inclusive and developed several different activities intended to help nurses be able to identify their own biases, or those within their institutions, and develop solutions to combat them.
Members can participate in a six-module educational certificate program in which the first module (the first module is offered at no cost to members) will focus on why the program is important. The remaining modules will allow deep dives into the areas of greatest discrimination, such as race, sexual orientation and gender identity, disabilities, age, and culture and religion, says Hinkley.
As nurses begin to move through the process and gain a new understanding, Hinkley says stepping back for the big picture is essential. “AMSN wants to build a culture of inquiry, where our nurses can start to question why we do things the way we do, or why I believe the things I believe,” she says. “Is there a different perspective that might shape how I approach a situation, or patient, or problem? Am I intentional in my actions, or am I just doing what I was taught and the way it has always been done? It is all about opening conversations, with yourself and others.”
Gaining competence and new perspectives will transfer into better nursing practice, higher nursing standards, and patient care in very specific ways, she says, including
as individual employees who remain competitive and effective in a changing workforce
as employees of organizations who will be DEI ambassadors to their organizations after completing the certificate program
as members of the largest segment of the healthcare workforce who will increase DEI competence across the healthcare sector
as primary providers of patient care in the nation whocan address the inequities in patient care
Hinkley noted that even with a DEI focus, real-life experiences can be uncomfortable. “I would like to share an example I experienced recently,” she says. “Someone I know came out as non-binary, changed their name (I will call them Storm), and their pronouns. Another friend (I will call Alice) was so distressed she would not be able to remember Storm’s pronouns because we have spent a lifetime of only having binary choices: he/him or she/her. ‘They’ sounds odd and feels odd, and we have a lifetime of using ‘they’ for more than one person. That results in dissonance and is incredibly challenging from a cognitive perspective. Alice is doing her best to be supportive and respectful and was so worried that she was going to forget and say the wrong pronoun. I tried to help Alice understand that if it were an honest mistake, Storm would understand, and they would not be offended. I tried to stress that Storm understands that we are all doing our best to be supportive and, in turn, have new things to learn as a result.”
As Hinkley notes, overnight change isn’t expected, but there are things nurses can do to help themselves move forward. “I think it is important to understand that no one expects perfection, they just expect the same respect and value that everyone else is given. What helped me was practicing. I practice using inclusive pronouns at every opportunity. I also challenge myself not to use binary pronouns, but rather to collectively refer to individuals I do not know as ‘they’ until I learn their preferred pronouns. I am not always successful, and just the other day I said ‘he or she’ when referring to a nurse in an example to a point I was making. I was gently corrected to ‘they’ and the conversation continued. Life-long learning is a hallmark of the nursing profession, and we embrace that in every other area of our lives, so why not this one?”
As nurses’ DEI work grows stronger, Hinkley says it will have a pervasive effect on nurses’ work, patient care, and the workplace in general. “Having the opportunity to improve health for all individuals would be the best possible outcome of this initiative and would bring me personal and professional joy,” says Hinkley. “I also feel very strongly about doing my part to contribute to the work environment for all nurses. I am keenly interested in issues regarding the work environment, and the human cost of caring to nurses and healthcare providers. There are so many wonderful aspects to nursing and being in the caring profession, but we do not all have the same experience at work, and I am excited to be able to improve the work experience for all nurses.”
