Contributing to the Profession: Why Nursing Education Matters

Contributing to the Profession: Why Nursing Education Matters

In today’s climate, nursing is everywhere. It’s in the news and social media, but the coverage is rarely positive. Nursing has been America’s most trusted profession for years, but COVID-19 changed the perception of nursing.contributing-to-the-profession-why-nursing-education-matters

No longer are nurses viewed as the safe harbor for patients who were battered by the winds and wrath of an industrial health care complex. Instead, nurses are publicly placed on trial for system errors and named in lawsuits for medical malpractice. What does the future of nursing look like in America? No one knows for certain, but I do know

who can reframe the perception of nursing, and that is the nurse educator.

Soul of Nursing

The nurse educator is truly the master of the soul of nursing. Still, they are rarely esteemed for the critical work accomplished. The nurse educator takes the raw material of an eager student and pours endless knowledge and skills to form the building blocks of a nurse. There is not a single nurse in existence who has not passed through the skilled hands of a nurse educator. The educator can genuinely alter the perception of a new nurse before the nurse even realizes they have been altered. The nurse educator can transfer tolerance and understanding through their formative teachings, prejudice, and judgment. The responsibility to develop the future of the entire profession rests on a select few, rarely acknowledged, who guard our profession with love and passion.


It is passion that drives the nurse educator. It surely is not the ability to earn a high income. According to the Bureau of Labor Statistics, the average nurse educator earns an annual income of $78,000. For a job that requires an advanced degree, any nurse educator could be better served with more lucrative uses of their degree, such as a nurse practitioner or joining an organization’s nursing leadership. It’s not the hours that drive the nurse educator. Is getting Christmas off a perk? Absolutely! Is waking up to 13 texts from a student who could not upload an assignment a benefit! Absolutely not. As a nurse educator, the breaks from classes are spent reworking material, developing new experiences, and continuing to grow professionally. It is truly a passion and a calling that drives the nurse educator.

Need for Nursing Faculty

Why should every nurse be aware of the need for nursing faculty? According to the American Association of Colleges of Nursing, a faculty vacancy rate of 8.8% nationwide has remained. This has resulted in a horrendous outcome of over 91,000 qualified applicants being turned away from nursing programs. Turning away applicants continues to exacerbate the nursing shortage. With the current projection from NCSBN of close to one-fifth of the nursing workforce looking to exit in the next five years, every applicant to a nursing school is a building block to the solution.

Know Your Influence

So why consider nursing education? The nurse educator is an artist. They take a piece of unformed clay and place pressure to mold and change the clay into a beautiful vase. With every student, educators leave a tiny part of themselves to transform a corner of the world. As a bedside nurse, I touch a few lives every shift. But if, as an educator, I have taught the floor of nurses, my reach is far greater than I will ever know. Knowing that your influence can affect the health care of a region, state, or nation is a pride and privilege few know. Nursing education is a beautiful profession that is far too often overlooked but should be dutifully considered. 

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Careers for Nurses Who Like Working in the Community

Careers for Nurses Who Like Working in the Community

Hospitals remain the top employers for nurses, but they are certainly not the only places where nurses can find a fulfilling career. Some may find that their true passion is in helping others outside the confines of an inpatient setting. And luckily, that is possible. There is a great need nowadays for compassionate and skilled nurses who can serve people in the community setting. Listed here are just a few examples of specialty areas in community health that nurses may want to consider.

Hospice and Palliative Care Nursing

Hospice nurses provide comfort-focused care to patients who have a life expectancy of six months or less. Palliative care, though sometimes used interchangeably with hospice, is slightly different in that patients do not necessarily have to be in the terminal phase of their disease process. Palliative care nurses care for seriously ill individuals who are dealing with discomfort as a result of chronic diseases or treatments used to manage these diseases. Regardless of the technical differences between them, both hospice and palliative care nurses specialize in symptom management. Rather than focusing on curing patients, hospice and palliative care nurses promoting comfort, which may involve managing chronic pain, respiratory distress, or nausea, among other things. While some hospice and palliative patients are cared for in hospitals, many also receive care in their homes.

Infusion Nursing

If you are skilled with IVs, then you might consider working as an infusion nurse. Infusion nurses start and maintain various kinds of intravenous lines. Not only do they administer medications, but they also provide monitoring for their patients to make sure that treatments are effective and are not causing any adverse effects. Those who have had a lot of experience with IVs in the hospital setting might find this type of nursing appealing. Many companies, including home health agencies and pharmacies, are hiring skilled nurses who can provide infusions to patients in the community.

Wound Care Nursing

Wound care nursing is a specialty area for nurses who have a passion for helping patients afflicted with wounds, some of whom have chronic and debilitating injuries that put them at high risk for infections. Among the people who require the services of wound care nurses include bedbound patients, diabetics, patients with chronic circulation problems, and patients who have had accidents or surgeries. If you are interested in this kind of nursing, you may also want to consider getting some type of certification in wound care nursing. Your expertise will be valued by many organizations and you may see patients in their homes as a traveling consultant for durable medical equipment companies and healthcare agencies that specialize in wound treatment.

Worker’s Compensation Nursing

Getting injured at work can affect one’s life in many ways. Depending on its severity, workplace-related injuries may affect more than just one’s physical health. Losing the ability to work can also cause mental and financial strain. As a worker’s compensation nurse, you will have the opportunity to help these individuals get their life back on track. You will have the role of a case manager who will ensure that your patients get the high-quality treatment necessary to restore them to their highest level of function.

Nurse Educators

When you think of an educator, you may picture someone who is in a classroom, lecturing and scribbling notes on a chalkboard. While nurses do teach in academic settings, there are also nurse educators who work in the community. These are nurses who may work for pharmaceutical or medical equipment companies that are selling highly technical products. The job of nurse educators, in these cases, is to assist other health care providers in understanding how these products work so that they can be safely utilized in clinical settings.

Public Health Nursing

Public health nurses wear many hats. They may go out and educate communities about preventing the spread of certain types of diseases. They may go into clinics to provide vaccinations. Other times, public health nurses may visit people in their homes to ensure that they are living under humane and sanitary conditions. In some cases, they may also function as medical case managers for underserved individuals in the community. Whatever they do, the main role of public health nurses is to safeguard and promote the health and well-being of the communities they serve.

One of the beauties of the nursing profession is the sheer diversity of available opportunities. Inpatient settings, like hospitals, are just one of the many places where nurses can share their talents and make a difference. Nurses have a lot of freedom in shaping the course of their careers and if you are looking for a change of pace, now could be your chance to do so. Who knows, you just might find your calling as a community health nurse.

Nursing Pharmaceutics: Educating Toward Safer Pharmaceutical Care

Nursing Pharmaceutics: Educating Toward Safer Pharmaceutical Care

When Felicia Menefee, RN, NP, ACNS, recruited patients for the landmark African-American Heart Failure Trial (A-HeFT), little did she know that the study would yield such positive results for them—or future patients.

Since African Americans with advanced left ventricular heart failure do worse than Caucasians in all phases of this condition, scientists wanted to see if adding a potent nitrate-vasodilator-duo to their standard therapy would make a positive difference in their symptoms, hospitalizations, and daily activities. What was the target of this National Institutes of Health study? A fixed-dose combination of isosorbide dinitrate (ISDN) plus hydralazine (HYD).

When researchers discovered that patients on the drugs indeed functioned better clinically than previously (some even energized enough to exercise), they halted the blind study prematurely. In doing so, they also handed the US Food and Drug Administration (FDA) enough data to demonstrate that survival and quality of life indeed increased, while hospitalizations decreased, on the medications. The FDA approved ISDN/HYD in June 2005 for heart failure therapy in blacks.

A-HeFT is just one of a myriad of NIH- and industry-sponsored drug and device trials Menefee has participated in during her 17 years as a nurse practitioner with Kansas City-based St. Luke’s Cardiovascular Consultants. Staffed by 48 cardiologists, many of whom are tied to academia, the practice provides ample opportunity for her to participate in clinical studies.

“Research is extremely important in advancing medicine,” she says. “Without it, health care stagnates. But with drug and other studies we can improve care. Sometimes a trial’s results are negative; sometimes they’re positive. But we won’t know unless we do it.”


Primed for Drug Studies

Perhaps you have the same curiosity as Menefee in advancing new pharmaceuticals or expanding indications for existing ones. What role can you play to help develop the next cutting-edge prescription or the newest use for an over-the-counter standard?

Truth is that unless you’ve piggy backed your nursing experience onto another degree—perhaps pharmacy, biochemistry, or medicine—your contribution likely won’t be in a drug company (or academic center) laboratory. Pharmaceutical scientists involved in the discovery or refinement of new medications typically bring masters and PhDs in the hard sciences to a company’s research and development function.

But that doesn’t mean your experience isn’t valuable. Clinical knowledge, critical thinking skills, and caregiver intuition can be a perfect match for other positions directly impacting medications. In fact, by parlaying and building on your background, you can ensure that what scientists produce in the laboratory is both safe and efficacious in real people. Whether you’re coordinating clinical drug trials in a patient setting, fielding adverse events for a pharmaceutical company, or playing another role, you can find a rewarding frontline niche.

As Sherry Banez-Muth, RN, manager of coordinating services, Center for Clinical Studies, Washington University School of Medicine, St. Louis, observes: “It’s definitely satisfying when you see people taking a new treatment that may be life-changing. It’s a good feeling to say, ‘Wow, I contributed to this.’”


Coordinating for Results

            The good news for nurses and nurse practitioners is that you don’t have to stray far from a patient setting to be part of the drug development process. Once scientists have tested their hypothesis to determine that a preparation developed in the lab may indeed help with a specific indication, the scene shifts to the FDA for a human study protocol approval. When the regulatory agency is on board, sponsors can enlist multiple clinical trial sites—health systems and large medical practices—for the Phase I to IV (and post-marketing) human studies.

Much of the work at those locales rests with nursing professionals, point people in the day-to-day operations of a drug trial. As clinical research or study coordinators, they juggle multiple tasks in making the protocol work. They not only train supporting cast members to find, screen, enroll, monitor, and collect data on participants, but they’re often on board from the onset, helping principal investigators prove that a health provider has what it takes—in experienced staff, adequate space, and access to the right patient demographics—to move a protocol forward.

As a director of clinical research for the Dallas-based Baylor Health Care System, Jennifer Thomas, RN, BSN, MS, CCRC, works side-by-side with investigators, first reviewing potential drug or device trials to ensure that they’re a good fit both financially and clinically for the institution. Thomas had her nursing skills tucked neatly under her belt when she earned a clinical research administration masters to even the negotiating playing field with sponsors over start-up costs and other numbers. “It helped me look at the bigger picture,” she says. “I’m better able to account for everything we need to do to go into a trial.”

Although Thomas no longer conducts individual studies, her imprint is widespread since she provides education and other resources to 40 professionals who manage from 70 to 100 investigational drug, device, and prevention studies, covering a multitude of conditions from diabetes to transplant research. She makes sure others are knowledgeable about a particular study and ready to conduct it according to regulations and good clinical practice.

That means becoming familiar with all aspects of the protocol, a regulatory document that can range from a mere 20 pages to a 500-page tome. It covers every possible nuance, from the hypothesis and research behind the drug to the goals, criteria, and requirements for participation. Whether the information is gleaned from principal investigator meetings, in-service tutorials, or other sources, mastering the fundamentals and logistics of a protocol is critical in running it correctly and consistently with other centers so results are valid.

“If there are too many variations, the sponsor can’t tell what’s causing a problem,” says Lynn Fukushima, RN, MSN, FNP, MBA, CCRC, nurse coordinator for the Keck Medical Center of the University of Southern California. “Is it the proposed medication itself or something else? We have to be very meticulous in our record-keeping so there’s no doubt.”

Fukushima wears many research hats in navigating drug studies related to cystic fibrosis and other pulmonary or lung diseases. For starters, she also helps her physician-colleagues determine if a clinical drug trial is appropriate by submitting information to the institutional review board for an up-or-down decision. Because her job includes budgetary tasks, she earned a health care administration MBA to better grasp the financial implications of a study.

In terms of each protocol, Fukushima sometimes works alone, organizing all aspects of a study, while other times, she’s coordinating with staffers. Whatever the case, her patient involvement changes with each trial stage. Phases I and II, for instance, can be intense since researchers are looking closely at efficacy and safety. She may see subjects weekly, daily, or even several times a day for blood draws and other procedures. During phases III, IV, and post-marketing, the individual interaction diminishes since sponsors are no longer tracking efficacy, but safety in an expanded universe of patients.

Whatever the stage, the paper chase with a clinical drug trial demands the kind of attention to detail and familiarity with medical jargon and charts that usually fit nursing professionals to a T. The skills you’ve likely established in training and honed in practice can provide an important cornerstone for managing the administrative and patient-contact components of any given study. But it’s also the ability to stay up-to-speed, think outside the box, and respond with on-the-spot analysis or critical thinking that’s important. Each protocol is replete with guidelines, but you still need to accommodate new information and unexpected turns-of-events.

In managing a support service unit for principal investigators throughout Washington University School of Medicine, St. Louis, Banez-Muth is used to the structured training and continuing education necessary to get a trial up, running, and producing valid results.

Of the 35 to 40 active NIH- and industry-sponsored studies she and her seven coordinators target at any given time, the phase II to IV drug trials represent a spectrum of urological and gastrointestinal targets. Whether Banez-Muth is personally managing a trial for a principal investigator or overseeing the work of others, she not only has to be organized but nimble on her feet. “As black-and-white as you would like things to run, it’s never that way. There’s always one patient who falls outside the box,” she says. “When that happens you want to make sure that you’re doing what you can to keep this person safe during the protocol.”


From Tuskegee to Transparency

Indeed, beyond data integrity, the primary task of nursing professionals involved in a clinical drug trial is to protect the subjects they seek, find, vet, enroll, and follow. From the moment coordinators scan medical records, tap health care providers, or reach into the community to find subjects, their focus has to be on complete honesty and concern about someone’s health and well-being.

That wasn’t always the case, given this country’s sometimes chilling research history, especially in regards to minorities. The infamous Tuskegee syphilis experiment, for instance, may have started in 1932 to chart the progression of an untreated sexually transmitted disease in black sharecroppers. Yet, by the time it ended in 1972, it had put hundreds of them at medical risk because US public health scientists and their local physician-partners withheld what had become standard-of-care treatment: penicillin. Even decades after whistleblowers shut it down, Tuskegee has left an indelible mark, particularly among African Americans.

Thankfully, clinical trials today are light years from Tuskegee, not just in terms of bioethical standards but also in practical safeguards. Study coordinators can point to a drug process so rigorous and regulated by the sponsor, the FDA, institutional review boards, and other agencies that safety rules at every turn. Patients are monitored so closely with high-tech imaging and other services that care often exceeds what they receive nominally from their personal physicians. “The wonderful thing about research is that you get excellent follow-up care,” says Menefee. “It can be a very special opportunity for participants.”

But nurses must be both transparent and on their toes in engaging candidates with a medical history that matches a given protocol. Informed consent is the primary tool they hold in their quiver to ensure that every enrollee understands every relevant specific—possible risks, benefits, and commitments—of a given study. But in outlining the parameters, they also target their rights. Distilling the caveats is important for every clinical trial, especially those that demand much of a participant, perhaps even an invasive procedure, with no guarantee of positive results.

In fact, making promises that someone will receive an active ingredient or that it will work with no side effects, is a trial taboo. The only guarantees nursing professionals should be sharing with their enrollees are that they’ll be good patient advocates, pursuing everything possible to ensure a safe experience. That includes collecting vital signs and good data with each office visit, addressing any side effects or adverse events, and keeping everyone, including a patient’s personal physician, apprised of important changes. As one coordinator notes: “You’re asking people to participate in a clinical trial from which they may or may not derive any benefit. So establishing trust and rapport is important.”

Whatever the specifics, vetting presents a great opportunity for minority nursing professionals to convince fellow patients of color that their participation in a study is critical. Given your own sensitivity to the cultural mores and concerns of a community, you can be a key link in dispelling any myths about drug research while bringing volunteers into the fold.

In engaging her enrollees, Thomas, for instance, makes sure they know that they’ll never be asked to sign on to a Baylor study without someone reviewing every paragraph of the consent form with them. More importantly, if it’s not a good fit, they can leave at any time. “I understand the sensitivity among African Americans enrolling in research studies,” she says. “Hopefully I can educate them so they have a good understanding and they’re willing to say, ‘OK, I will participate in this.’”

Similarly, when Judith A. Rivera, MSN, recruits subjects for both NIH- and pharma-sponsored memory trials, her goal is to find an ethnically diverse pool of people when the study merits it. As a Latino nurse practitioner and principal study coordinator for the University of California-San Diego’s Comprehensive Alzheimer’s Program, Rivera is well aware that dementia is a serious health issue among minority, as well as majority, Americans. Unfortunately, in some ethnic communities memory loss is often dismissed as simple aging rather than a potentially serious disease.

But by targeting culturally and racially diverse subjects for a slew of drug and other studies related to memory, researchers at her institution are giving vital information to pharmaceutical companies about all of the people, not just Caucasians, who might need their products. More importantly, they’re also raising awareness among enrollees about the potential pharmaceuticals—albeit under study—that might help them remain active and functioning. “We want them to be as independent as possible for as long as possible.”


Monitoring for Safe Outcomes

Making sure that a participant isn’t compromised during a drug trial is an important part of realizing any positive results. From phase I to post-marketing, nursing professionals are not only helping patients navigate the terrain of a protocol, but they’re also gathering information about a drug’s safety and effectiveness.

Detecting and forwarding potential problems to a sponsor is a natural for nursing coordinators since their training and frequent interactions often give them a pulse on what people are experiencing. “Some nurses have a sixth sense about how a patient is doing,” Fukushima says. “If they see a frown on a face or hear unusually short answers, they may be a little more aggressive in investigating the cause.”

But overseeing a clinical trial isn’t the only way to determine if a drug is working well or not so well in a patient. In fact, many nurses are finding satisfying ways to use their critical thinking and detail skills in other research-related venues. From pharmaceutical companies to clinical research organizations (CROs) and other patient service firms, prospects abound for managing and monitoring trials as well as educating and tracking subjects. Besides sales and marketing functions to promote approved products further down the line, the activity usually centers on making sure medications aren’t hurting users.

As a clinical safety specialist for GlaxoSmithKline’s (GSK) Global Clinical Safety and Pharmacovigilance Division, Shannon Hart Anderson, BSN, RN, JD, also manages adverse event reports—unexpected and potentially harmful reactions—for a bevy of pharmaceuticals bearing the GSK imprimatur. From over-the-counter remedies to prescriptive medications, her potential targets include therapies for a wide spectrum of benign and serious diseases. “We’re like the safety police,” she says, “We have to make sure that our products aren’t harming the public.”

From her berth in GSK’s US headquarters located in Research Triangle Park, North Carolina, Anderson processes initial complaints from consumers, health professionals, sales reps, and even the FDA. She then collects follow-up information, which is entered into a safety database that serves as grist for further investigation as well as the regulatory agency reports she also must prepare. To capture the most accurate information possible, Anderson routinely relies on the logical reasoning, problem-solving, and even communication and advocacy skills she’s honed as both a nurse and an attorney.

But the most important roadmap may be the positions she’s held previously with CROs, outside firms hired by a pharmaceutical company to provide a wide range of support services. That may include managing the day-to-day operations of a drug study or even serving as an outside monitor, making sure that each site follows a protocol correctly and meets FDA standards. In honing the pharmacovigilance skills she now uses at GSK, Anderson mastered the nuances of adverse event reporting and the importance of being detail-oriented as a drug safety scientist. “We need to know the ins and outs of what happens,” she says, “so that we can look for trends that may prompt us to change our label or even our product.”

Likewise, as a diabetes-musculoskeletal medical professional for Indianapolis-based Eli Lilly and Company, Marla Neal, RN, BSN, MHCA, educates health professionals about drugs and devices that may help their patients. When physicians and other practitioners pose questions of the sales force, she’s tapped to provide the definitive answer. Neal accesses every possible database and medical professional to respond to each request. She also updates sales members about current clinical trials while helping them understand how each Lilly product impacts a disease process.

But it’s her other priorities—capturing accurate information about unexpected side effects and product complaints—that really tap her nursing skills. “Oftentimes patients don’t even realize that they’re having an adverse event,” she says. “So I’m very diligent about asking the direct questions and picking through the subtle conversation for clues. It’s critical for making sure that our drugs are really improving the lives of our customers.”

Adds Shannon Bradley, RN, a telehealth nurse educator and team lead for The Lash Group, a Charlotte, North Carolina-based patient services support company: “When you’re speaking to someone on the phone, you need to ask the right questions because people don’t always come forth with information on their own. You have to help them identify what’s important.”

Bradley is the nursing voice on the other end of the line when patients, pharmacists, and other health care professionals make contact with her company’s Dallas office, usually by dialing the “800” reporting number on a medication’s packaging. Using her clinical intuition, honed as a hospital neonatal intensive care unit and trauma nurse, she collects and reports adverse events linked to medications manufactured by one of her firm’s pharmaceutical company clients. It’s a varied list, from digestive and fertility drugs to oncology and neurology medications.

But her primary role is often to educate and support patients in staying the course with their medication. For no matter how many drugs move from clinical trial to market, they aren’t effective if they’re not taken according to directions. “We want them to understand,” she says, “the significant impact medication compliance has on their therapy outcome.”


Reaping Rewards: Better Health and Other Benefits

Besides bedside nursing, there may not be a better way to use your skills and intuition than in drug development. You might not be the academic researcher or laboratory scientist behind a preparation, but you can help bring a drug the final distance via other roles. Truth is, by participating in the process once it involves ordinary people, you’re witnessing cutting-edge medications making dramatic differences in the quality of real lives. A grandmother who couldn’t comb her hair or walk without a cane before an arthritis drug trial, for instance, performs both tasks eight months into it. A grandfather who couldn’t play with his grandchildren now travels across country to romp with them.

As to Menefee, the landmark A-HeFT trial left her with many good feelings about being a co-investigator in the drug improvement process. Even though she didn’t place many African Americans in the trial, the protocol has worked so well since that now whenever a black heart failure patient in her practice meets the medical criteria, she prescribes ISDN/HYD to optimize their other meds. She hasn’t been disappointed yet.

The medication duo not only gives her more options in extending quality of life, but also serves as proof that research works. Every trial success, as well as every study failure, just reinforces her belief in the benefits of being part of the process. “Before a drug is even approved, I already know something about it,” she says. “So when it’s brought to market, I don’t need a sales rep to tell me how great it is. I know because I’ve already been involved with it. I’ve seen it work!” MN


Running the Gauntlet

The lengthy and complicated process of moving a drug to market is broken down into various phases. After a pre-clinical development stage during which animal and other laboratory tests have proven that a product is initially safe, the emphasis shifts to human or clinical trials. Although most drugs never reach that stage, the ones that do undergo a rigorous process in winning FDA-approval.

           Phase I: A drug is tested on 20 to 80 healthy volunteers not only to see if it’s initially safe but also to determine the most frequent side effects.

•           Phase II: If the drug hasn’t produced unacceptable levels of toxicity during the first phase, it’s tested in a few dozen to 300 subjects with the condition or disease to obtain preliminary data on how well it’s working.

•           Phase III: If a drug demonstrates a good level of effectiveness, it’s tested in an expanded pool of subjects, from several hundred to about 3,000, to see how it works with different dosages, populations, and in combination with other drugs.

•           Phase IV and other post-marketing studies: Conducted after the FDA has approved a given drug, these trials are used to gather additional information about safety, efficacy, and even other uses.


Parental support for first-generation college students

For incoming freshmen, attending college can feel like entering a maze. But for first-generation students, that maze can have added twists and turns, as they may not have a role model or rule book to follow when starting out as a first-year student.

In turn, while parents are proud of their college-bound daughter or son, they too are unfamiliar with the road they are about to travel. Yet, parents can still offer ample support for students just by showing up at family orientation events, asking questions from the program staff, and seeking out other parents to share information, guidance, and direction.

In the Rutgers College of Nursing Educational Opportunity Fund (EOF) Program, parents are strongly encouraged to be a support base to their students. The EOF program has a Family Orientation Day where not only parents, but the entire family is invited to attend. Family Orientation Day provides an overview of what students are expected to do in the intensive six-week Summer Readiness Program. The College of Nursing has the only EOF program exclusively for nursing students in the state of New Jersey.

In 2011, parents were given a firsthand account from a parent whose daughter completed the summer program the previous year. She and her daughter spoke to the audience and answered questions. Additionally, the mother stayed through the entire day to privately speak to parents, many of whom indicated this was especially appreciated. Having a parent whose child went through the program offered them a sense of relief and comfort, making it easier to leave their daughter or son on campus.

At the end of the Summer Readiness Program, the students “graduate” to become members of the College of Nursing (Class of 2015). The students participate in a celebration entitled “Culture Kitchen,” where students and/or parents prepare a dish from their culture. It is truly a feast! Students represent many countries, and sampling the cultural cuisine is a cherished memory of the Summer Readiness Program. This past year’s program was especially gratifying because one parent insisted on being a part of the team in setting up the buffet table and working with the students and staff! It was important for her to become actively involved and not sit on the sidelines.

Perhaps the most moving part of the Culture Kitchen program is watching the students reflecting on their summer experience and seeing the proud faces of their parents. Students benefit from their parents’ support and involvement, and parents are encouraged to be a part of the students’ college experience. The EOF Program wants parents to feel welcomed; we understand the daunting process of wanting their child to be educated along with the difficulty of “letting go” so their daughter or son can progress into adulthood and become a distinguished nurse.

Building Capacity: A Blueprint for Faculty Diversity

Most colleges and universities have strategic plans that articulate goals to strengthen faculty search procedures to increase the diversity of their staff. While such goals are important, they have come under attack in the past, even needing legal support. For example, Justice Sandra Day O’Conner in her Supreme Court majority opinion clearly communicated that the skills needed in today’s global market can only be developed by exposing students to “widely diverse people, cultures, ideas, and viewpoints.”1 The Association of American Universities has long communicated that diversity experiences not only enhance the education quality and outcomes of students from underrepresented populations, but of all students.2

The Sullivan Commission on Diversity in the Healthcare Workforce articulated that the health professions of the United States have not kept pace with changing demographics and may be more directly related to disparities in health access, status, and outcomes than the overall lack of health insurance. With minority populations projected to become the majority by 2050, health disparities may continue to worsen if health care professionals do not become more reflective of the populations they serve.3 The diversity challenge is even greater in the academic settings that educate undergraduate and graduate nurses. The American Association of Colleges of Nursing reported that less than 10% of faculty in baccalaureate and graduate nursing programs are from underrepresented groups, with 5.6% African Americans, 1.5% Hispanics, 1.9% Asian, and less than 1% American Indian/Alaskan Native documented.4

The lack of minority nurse educators communicates to students and communities of color that the profession does not value diversity. Lacking mentors and role models to support and enhance their education, students from underrepresented populations may not recognize the professional opportunities that exist for faculty in higher education, and the academic leadership that is needed from a diverse nursing workforce to eliminate health disparities in the 21st century.

The growing multicultural world that all student nurses enter requires exposure to a diverse faculty who bring varying research perspectives, pedagogy, and life experiences to the classroom, the laboratory, health systems, and the surrounding community. A critical need exists to create, implement, and evaluate blueprints for action that will attract, retain, support, and promote the leadership and success of faculty from underrepresented populations in schools of nursing. Action steps to be considered in blueprints should strive to:

    • Increase the applicant/pipeline pool of diverse faculty candidates from underrepresented populations
    • Promote a climate of diversity
    • Market for diversity
    • Prepare search committees to review diverse candidates
    • Retain diverse faculty

Increase the applicant pool

U.S. colleges and universities are educating a larger and more diverse group of students than ever before. According to the Educational Testing Service, student diversity will increasingly evolve over the next decade, with 80% of the anticipated 2.6 million new college students from underrepresented populations, including African Americans, Hispanics, Asian/Pacific Islanders, or American Indians. Undergraduate minority students enrolled in colleges and universities will increase from 29.4%–37.2%.5,6 Most recently, the report on the future of nursing acknowledged the need to respond to the under-representation of racial and ethnic minority groups, including men, in the nursing workforce.7

While a steady increase in the minority university student population has occurred, similar diversification among university faculty has not happened.8 Faculty diversification not only attracts diverse students, thus increasing the applicant pool and supporting academic program growth, but it also contributes directly to the quality of student education. Diverse faculty expose students to a wider range of scholarly perspectives and ideas that build on a variety of life experiences, create intellectual stimulation with new research questions, and foster fresh perspectives in the academic enterprise. Diversification is also the right action, not only from a social justice perspective, but based on business.9 The corporate world has long accepted a mandate that they must expand markets to serve diverse communities to survive in a competitive environment.

Action steps

    • A number of changes are needed to increase the applicant pool, such as developing partnerships with minority-serving institutions and establishing alumni directories of doctorally prepared minority graduates for consideration in post-doctoral or visiting scholar appointments. This action will promote scholarship and research of mutual interest to the scholar, the school, and the community.
    • Metrics should include memorandums of understanding with individual colleges or universities with results measured by the number of candidates identified from partnering institutions for recommendation to search committees. To assure the success of these partnerships with minority-serving institutions, ambassador programs could be developed by assigning faculty members to communicate and represent their respective schools of nursing at designated partner institutions.
    • Faculty who teach at these institutions could be invited to do a presentation and talk about promising students for post-doctoral consideration through a faculty exchange initiative. Schools of nursing must set aside resources to support minority scholars in residence as well. Finally, an academic faculty network should be considered so introductions can be made through the network to administrators from underrepresented populations at member institutions.

Promote a climate of diversity

While organizational climate has a range of definitions, Baird suggests common descriptors include friendliness, hostility, or acceptance.10 Organizational climate includes the current attitudes, behaviors, and standards/practices that concern the access to, inclusion of, and level of respect for individual and group needs, abilities, and potential. This definition includes all groups, not just those who have been traditionally excluded or underserved by colleges and universities.5

If a school of nursing is to succeed in terms of the retention and recruitment of faculty of color, it must embrace diversity. Turner and Myers report that faculty of color leave for many reasons, including hostile environments—a major factor discouraging potential applicants.6 In contrast, a school of nursing that provides an environment that supports the success of diverse faculty is attractive and facilitates recruitment and retention. Research has shown that endorsement from leaders provides credibility for such programs.11 It’s important that administrative support is reflected by publicly rewarding departments, divisions, and units who demonstrate measurable improvement. Support from the top and rewards for increasing diversity have been shown to be the two key factors that determine the success of diversity programs.12

Action Steps

    • Fostering assessment and accountability must begin with a faculty diversity climate survey and should include an exit survey for those that leave. Faculty surveys should include both quantitative and qualitative data that measures the diversity climate within the school of nursing. Results should be reported through school departments and discussed in faculty meetings with recommendations to the faculty at large, as well as search committees, specifically.
    • Activities that promote a supportive climate should be identified through departments and the faculty panel discussion. The PBS film Shattering the Silences: Minority Professors Break Into the Ivory Tower could be shown at department meetings, followed by faculty discussions led by a diversity expert. A panel discussion focused on faculty diversity should be a yearly faculty event. It is also recommended that faculty who have led and created activities that support a climate of diversity receive merit recognition from those administrators held accountable for achieving faculty diversity in their departments.
    • Resources should be established to conduct climate surveys and maintain an office of diversity to assure that planning, implementation, and evaluation occur. Ideally, a faculty leader who is also a member of the dean’s leadership team would coordinate these activities. This nurse faculty leader should provide a vision and structure for faculty initiatives that will not only support the inclusive climate needed for recruitment, retention, and promotion of diverse underrepresented faculty but that will involve the entire school in a program that sets achievable and measurable goals with a business plan.
    • As research is needed to investigate diversity, equity, and climate beyond race and ethnicity to include differentials in power and privilege, external research support through federal, foundational, and private grant mechanism should be explored. The diversity office should address the need to continue to support and develop academic programs that focus on issues of diversity, underserved populations, and societal disparities, which will attract diverse faculty and scholars. Pilot research on faculty climate could also be supported through these mechanisms; then a larger study could be launched with funds sought through the National Institute of General Medical Science, an NIH program.

Marketing for diversity

Communicating a school’s commitment to diversity, whether through conferences, national meetings, publications, posters, brochures, and/or official websites, ensures the transparency of the school’s diversity recruitment goals. Business research shows diversity marketing reduces turnover costs and inspires a desire to be part of a dynamic and responsive team. It also helps institutions win the competition for talent by attracting, retaining, and promoting faculty and leadership from underrepresented populations. Organizations cited as the best places for employment by diverse underrepresented groups also experience an increase in applications.13 Furthermore, research has shown endorsement from the organization’s leadership brings credibility to diversity programs and influences attitude change.11

Sullivan (2007) underlined the critical role academic leaders play in successful diversity programs. These leaders must create a culture within their academic units that supports the implementation of a strategic plan—one that establishes goals, defines success, and fosters accountability, best practices, and financial resources.14

Action steps

    • Schools of nursing can maintain a diversity website that links to the school’s departmental sites. This site must communicate that diversity in the organization is critical to the recruitment of faculty from underrepresented groups. It should also showcase the successes of faculty from underrepresented populations in research, teaching a diverse student body, collaborating with university faculty and diverse communities, and scholarly achievements.
    • An interactive school of nursing Facebook page reflecting the diversity of the school’s leadership team, faculty, and students is also needed for effective marketing. It should be updated on a regular basis and evaluated by the number of hits and links made by browsers. A member of the school’s leadership team should be designated to work with appropriate media resources to maintain and update an interactive website that showcases the school’s successful recruitment, retention, and promotion of diversity.

Strengthen the search committee’s success

Nationally, hundreds of campuses are engaged in competitive efforts to diversify their faculties in response to external and internal pressures. Yet, according to Caroline Sotello Viernes Turner, in her book Diversifying the Faculty: A Guidebook for Search Committees, five prevalent myths have hindered the hiring process of ethnically, racially, and gender underrepresented diverse faculty.15

  1. Good minority faculty only go to the best universities.
  2. To hire minorities, standards must be lowered.
  3. Minorities prefer the private sector.
  4. Espousing equal opportunity doctrine is sufficient.
  5. Minorities will not go to predominantly white institutions. 

Research published in the Journal of Higher Education in 2004 showed that among institutions with predominantly white populations, the hiring of faculty from underrepresented groups occurs when at least one of the following three conditions are met. First, the job description explicitly engages diversity at the department level. Second, an institutional “special hire” strategy is used, such as waiver of a search, target of opportunity hire, or spousal hire. Third, the search is conducted by an ethnically/racially diverse search committee.16 Search committees often approach their charge in a passive, routine way (i.e., advertise the position in publications, evaluate résumés, invite three to five candidates for campus interviews, and then make an offer).

To address the need to recruit faculty from underrepresented racial/ethnic or gender diverse populations in a school of nursing, the search committee must take a more proactive approach to finding candidates from such populations. All steps taken during the search process can contribute to a solid foundation for the successful retention of diverse faculty hired as well as ongoing successful recruitment into the future.

Viernes Turner writes that schools of nursing should focus on eight action steps to form successful hiring committees:15

  1. Diversify the search committee itself.
  2. Educate the search committee on personnel issues and prepare the members through an annual retreat.
  3. Debunk the myths listed above.
  4. Create tailored position descriptions.
  5. Attract diverse candidate pools.
  6. Examine hiring biases.
  7. Host campus visits
  8. Make the offer.

The campus visit is also a critical moment of opportunity that allows the candidate to make a well-informed decision on whether the position and the school of nursing is a right fit. Evaluation forms should be provided to all campus parties involved in the visit and discussed by the committee. Asking the candidate to comment on the process will also provide the school’s search committee with information to improve the process for subsequent campus visits. It is important to not only evaluate the candidate, but also the search committee process, in order to improve the chances of reaching the desired outcome.

Action Steps

    • First, assuring that the composition of the search committee has different points of view is critical to its success. Members who represent diverse populations must be appointed.
    • Next, preparing the committee through a yearly retreat that addresses unconscious hiring bias and debunking of myths must be used in conjunction with current university guidelines to prepare new members and refresh returning members for the year’s goals. An annual search committee evaluation plan should be implemented to review the effectiveness of the diversity recruitment process. Metrics should include a percentage increase of the diversity applications and a percentage increase in hires.
    • Departments then need to conduct their own hiring patterns audit, examining the tenure track and associated clinical and research faculty patterns. At the annual evaluation discussion of department recruitment needs, a diversity recruitment plan must be developed and sent to the search committee prior at the beginning of the academic year.
    • Finally, a departmental diversity awards program will need to be established to acknowledge excellence in diversity recruitment and support of a climate of diversity that recruits and retains racially/ethnically and gender diverse faculty.

Retain a diverse faculty

The most successful universities have both a strong commitment and action plans that support faculty diversity.17 An important and overlooked strategy to retain professors from underrepresented populations is to create a critical mass to prevent feelings of isolation and alienation that result in leaving.15

Action steps

    • Mentorship programs should be established that help guide diverse faculty through promotions and tenure tracks. These programs should be advertised on school of nursing websites and shared with potential candidates. Diverse faculty should also be mentored in their achievement of awards that recognize excellence in research and teaching. Finally, ongoing mentorship will be needed to develop the leadership potential of diverse faculty, with recognition given for such leadership.
    • Resources must be designated to support family policies as needed by candidates; these should be marketed through the search committee process and the website. Funds will be needed for startup packages that will support pilot work and presentations of scientific findings at national or international meetings. Support may be needed for the development of untenured new faculty hires as well. Finally, exit interviews should be considered for tenured and untenured diverse faculty at departure to explore reasons for leaving the university.

Using a blueprint to transform an institution to reflect a pluralistic society requires the collective evaluation of attitudes, the behaviors they generate, and the unconscious bias that shape faculty actions.18 Critical to this process is a vigilant and widespread diversity campaign that promotes individual ownership of the blueprint for change and is advocated and supported by both the faculty and school leadership.

A need exists for schools of nursing to showcase a vision and strategy for recruitment, retention, and promotion of a faculty that reflects the diversity of the United States and the world whose health they plan to promote. And as Benjamin Franklin once said, “By failing to prepare, you are preparing to fail.”


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  3. Sullivan, Louis W. (2004). Missing Persons: Minorities in the Health Professions, A Report of the Sullivan Commission on Diversity in the Health Care Workforce. Sullivan Commission, p. 66
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