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.
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.
Workplace Discrimination
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.
Final Thoughts
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.
The University of Florida (UF) College of Nursing has named Dr. Jeanne-Marie Stacciarini, PhD, RN, FAAN, its first director of diversity and inclusion. Created to enhance awareness and dialogue about important issues in diversity, the newly established position was created based on recommendations from UF’s diversity and inclusion task force.
Stacciarini is an associate professor in the college and has been with UF since 2006. Her research focuses on mental health promotion among minorities and community-based participatory research for minority, rural, and international populations. Stacciarini has been recognized for her work with underserved populations with the 2012 Southern Nursing Research Society (SNRS) Award for Research in Minority Health and the 2014 APNA Award for Excellence in Research. Outside the College of Nursing, Stacciarini is a leader on campus as chair of the UF President’s Council on Diversity and she sits on President Fuchs’ leadership cabinet.
In her new position she aims to create better dialogue and educate others about the need for diversity. She will work on student and faculty recruitment to create a better working and learning environment. Leading a new initiative with undergraduate students in the College of Nursing, Stacciarini will be launching a program called Engaging Multiple-communities of BSN students in Research and Academic Curricular Experiences (EMBRACE).
UF College of Nursing Dean, Anna M. McDaniel, says she believes that Dr. Stacciarini’s diversity work will have a positive impact on the entire college and serve as a campus-wide model. Dr. Stacciarini is a tireless advocate for faculty, staff, students, and patients from diverse and underrepresented backgrounds, and as director of diversity and inclusion she will play a lead role in carrying out the College of Nursing’s commitment to diversity and inclusion for all members of the community.
Casey Dillon, a nursing graduate student in the college and former student of Stacciarini says she thinks more diversity in the college will prepare students for nursing careers. Nurses work with a wide variety of people every day, so diversity education is a necessary thing.
As nurses, Stacciarini says we need to be prepared to care for a more diverse patient body. She is honored to fill this important position and work to help more people understand diversity and inclusion to sustain that culture across the College. She hopes to bring ideas from the President’s Council on Diversity to new initiatives in the College of Nursing.
As the United States becomes more of a melting pot, encouraging and nurturing a workplace that welcomes the different cultures, ethnicities, and lifestyles of staff are paramount to optimal collaboration, productivity, and success. In health care, where diversity increasingly is exemplified among patients as well as employees, such an embrace is critical to achieving best outcomes.
Health care institutions across the country are heeding the call for inclusion. Many have implemented initiatives to not only attract diverse staff, but also to keep and engage them.
The Mayo Clinic in Rochester, Minnesota, for instance, launched the Multicultural Nurses Mayo Employee Resource Group (MNMERG) in July 2014 to recruit and retain nurses from diverse cultures and offer them professional support and networking opportunities. The MNMERG also mentors and educates Mayo’s diverse nurses and involves them in community programs.
With some 25 members, the MNMERG welcomes all Mayo staff. It meets monthly at the hospital, but this year will add quarterly dinners off site and is evaluating online technologies such as Skype and Sharepoint to “engage a 24/7 workforce,” says MNMERG cochair Deborah A. Delgado, MS, RN-BC, a nursing education specialist in psychiatry.
Mayo Employee Resource Groups (MERGs) have been an important component of Mayo’s overall diversity initiative; the goal is to have the following five core MERGs—African American, LGBTI, Hispanic, Disability, and Veterans—at Mayo’s three major clinical sites. Each MERG has an executive sponsor who is a leader at Mayo, but not a member of the group. For example, the MNMERG’s sponsor is a male cardiologist with experience in developing family/patient advisory groups. All of Mayo’s MERGs have formally chartered to align with at least one of the organization’s strategic diversity goals.
“These range from culturally competent care to inclusion and addressing health disparities,” says Sharonne N. Hayes, MD, FACC, FAHA, director of diversity and inclusion and professor of medicine at the Women’s Heart Clinic at Mayo. She notes that the groups share innovations and hold cross activities. “By that collaboration,” she says, “you get more hands to do the work obviously, but you also get a wonderful side product of some cross-cultural mentoring and some cross-cultural experience.”
While the MNMERG is in its infancy, feedback has been positive. “By being visible, by engaging, and by contributing, it just leads to retainment,” Delgado offers. “People want to stay because they’re able to use all of their gifts and talents to affect the organization’s purpose and goals.”
The Clinical Leadership Collaborative for Diversity in Nursing (CLCDN) at Massachusetts General Hospital in Boston has realized recruitment and retention success with diverse students of nursing. A scholarship and mentoring program established in 2007 by Partners HealthCare (PHC), an integrated system of which Mass General is a member, the CLCDN draws applicants from the nursing program at University of Massachusetts Boston.
Students must demonstrate leadership qualities, have cumulative general and nursing GPAs of 3.0 or higher, and must be entering their junior year of study since the CLCDN will carry them through their senior year. They link with racially and ethnically diverse nurse mentors, attend unit meetings and social and educational events, and observe nurses and nursing leaders in action. Additionally, they receive a stipend and financial support for tuition and fees with the expectation they will pursue employment at a PHC institution after graduating.
“When you’re a minority and you’re going into an environment where you might be the only diverse person on your clinical unit, as an example, it can be really challenging; it can be very lonely,“ says Gaurdia E. Banister, PhD, RN, FAAN, the PHC CLCDN liaison to UMass Boston and executive director of the hospital’s Institute for Patient Care. “We wanted to put mechanisms in place to ensure the success of our students and, certainly once they graduated, the best possible [career] alternatives,” she says.
Mass General diverse nurse leaders who have successfully navigated such waters can “provide these wonderful, wonderful pearls of wisdom and support and encouragement and listening skills,” explains Banister, and they serve as mentors, as do CLCDN graduates. Of the 54 mentors to date (32 from Mass General), some are repeats. Other statistics are just as impressive—such as PHC’s 82.6% hiring rate among the 69 graduates thus far (47.8% of whom have been employed by Mass General) and the almost 80% retention rate for these graduates.
“They love being a nurse. It’s exactly what they anticipated their career to be,” says Banister. “They are constantly promoting how positive it has been for them and that they feel like our organizations are becoming much more of a welcoming and diverse place to work.”
At the Cleveland Clinic, location-specific Diversity Councils at each of the enterprise’s community hospitals and family health centers are effectively supporting and sustaining an inclusive work environment. These employee-led councils implement action plans and sponsor activities based on strategies and goals defined by an Executive Diversity Council, all aimed to enhance employee engagement and cultural competence.
While the Executive Diversity Council works “to set the tone and the agenda,” the location-specific councils “serve as the tactical team,” explains Diana Gueits, director of diversity and inclusion. The main-campus council, for one, formed the Nursing Cultural Competence Committee and the Disability Task Force; the task force, in turn, developed the Disability Etiquette Lunch ’n Learn, a program to assist caregivers in their interaction and communication with disabled individuals that has since been taken enterprise-wide. Gueits notes the councils share and cross-pollinate ideas.
Cleveland Clinic’s chief nursing officer sits on the Executive Diversity Council, and many nurses participate in the location-specific councils with several diverse nurses serving in leadership roles (the councils overall represent a cross-section of the clinic’s workforce). Two cochairs and a cochair-elect lead each council, act as local ambassadors for diversity, engage with executive leadership, and provide feedback to the Office of Diversity and Inclusion, which facilitates the business-like, SMART-goals approach of the councils.
“This is a passion for them,” says Gueits of the cochairs, who are selected based on their experience in leading transformative teams and their commitment to diversity and inclusion. “I think that what the councils provide them is an opportunity to see, to actually be part of an initiative and be part of that process from A to Z.”
Cleveland Clinic has 21 location-specific councils, a number that is sure to increase as the enterprise expands. “That is the intention,” Gueits says, “to make sure that we embed diversity and inclusion in our commitment to all our locations and give an opportunity or platform for all our caregivers to be engaged.”
Julie Jacobs is an award-winning writer with special interest and expertise in health care, wellness, and lifestyle. Visit her at www.wynnecommunications.com.
Working at self-reflection tasks and being open to learning new approaches are the very first steps to making your work environment more inclusive. But no one can single-handedly change a workplace to make it more inclusive. Changing culture is a group effort and everyone has to be up to the challenge, says G. Rumay Alexander, EdD, RN, FAAN, clinical professor and director of the Office of Multicultural Affairs at the University of North Carolina at Chapel Hill.
Once your team has taken the necessary first steps to assess how they can make changes in their own thinking and their own approaches to work, what are the next steps?
1. Set the Standard
“Begin with a commitment to be decent with one another,” says Alexander. “Do not demean one another. Disagree without assaults on another’s self-esteem.” The rules of engagement are especially important here. “’Say, ‘We will agree to disagree.’”
2. Begin the Conversation
Understand that inclusion and respect mean something different for everyone. And differing opinions don’t always make for a comfortable discussion. One of the biggest workplace myths, says Alexander, is that workers make up a big, happy family. “If we are one big, happy family, then people have to swallow their feelings and deny their differences. That denial makes for a very unstable foundation for inclusion to occur.”
3. Value Opinions
Inclusion means just that – including everyone in the picture and respecting what they bring to the table. Your colleague may not think the way you do, but that diversity of opinion and method creates a realistic picture. As colleagues, you will not always agree, but you should cultivate an environment where everyone feels safe enough to express an opinion.
4. Accept the Strong and the Weak
We all excel at something, and we all have our weak points. An inclusive work environment means that wishing and hoping for a cure all to disagreements is replaced by an honest effort to accept others’ gifts and capacities, says Alexander. Inclusion endures weaknesses and strengths. Each person brings something different to the table and all of those things are valuable. Alexander recommends asking, “What can we use and how can we make it work for us?”
5. Realize Some Things Take Time
Quick answers make everyone happy if they work, but finding a solution rarely works out that way. Make sure your team knows it’s OK for them to admit they don’t have the answers. Part of the process includes saying you don’t know what to do and then investigating so you find a way to do what’s needed.
Changing your culture to make it more inclusive requires lots of work – both as an individual and as a team member. But taking the time to put in the extra effort means any changes you make are likely to be long lasting and beneficial.
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