Diversity in Nursing Professions, Research Paper Example

Abstract

Diversity in nursing staff is especially important because it enables the nurses to provide culturally competent care and makes them more effective in establishing rapport with patients so that they can accurately assess, develop, and implement nursing interventions designed to meet patients’ needs (Lowe & Archibald, 2009). Approximately one third of the total U.S. population is of minority descent and it is important for nurses to understand that the perception of the causes for illness and disease varies by culture and these differences affect individual approaches to health care. The disparities in the healthcare services afforded to those of lower economical statuses is apparent in the higher infant mortality rate of African Americans, which is more than twice that of Caucasians, the much higher death rates among African Americans from breast, lung, and colorectal cancer than Caucasians, Hispanics, or Asians, and the higher obesity rates among Hispanics (Barton & Swider, 2009). It is imperative that nurses and health care providers are trained to ask questions sensitively and to show respect for different cultural beliefs. Most important, nurses need to listen to their patients carefully so that they can create a care plan that respects the desires of the patient. Knowing the beliefs and practices of each culture is vital because nurses must be able to develop a plan of care to assist each individual patient according to their wishes. In order to effectively and actively demonstrate an ability to work in a diverse environment, the first step is to develop knowledge.

Diversity in Nursing Professions

Introduction

There is a distinct disparity in the quality of the health care services minorities receive due to culturally incongruent nursing care and in their health related outcomes as a result of such diminished care (Jeffreys, 2008). Diversity in nursing practices is the exemplification of the cultural variety and cultural differences that exist in society and the world as a whole represented by the inclusion of diverse people within an institution. This is accomplished through the removal of any barriers, perceived or real, preventing the increase of racial and ethnic minorities and an end to the heterogeneous nature of the age range, educational attainment, and ethnicity and race distributions of the nurses within the field (Barton & Swider, 2009; Wolff et al., 2010). Diversity in nursing staff is especially important because it enables the nurses to provide culturally competent care and makes them more effective in establishing rapport with patients so that they can accurately assess, develop, and implement nursing interventions designed to meet patients’ needs (Lowe & Archibald, 2009). This paper will discuss the importance of diversity in nursing practices in the context of how ethnicity, race, religion, foreign graduates, and gender impact patient health outcomes.

Discussion

Diversity has significant implications within the nursing profession due to the rapidly changing demographics of society and the patients and the lack of responsive changes within the nursing profession, as most members of the nursing profession continue to be of Caucasian descent (Sanner et al., 2010). Approximately one third of the total U.S. population is of minority descent and “the U.S. Department of Health and Human Services (U.S. DHHS) Healthy People 2010 is firmly dedicated to the principle that every person in every community across the nation regardless of age, gender, race or ethnicity, income, education, geographical location, disability, or sexual orientation deserves equal access to comprehensive, culturally competent, community-based health care” (Lowe & Archibald, 2009, p.12). It is important for nurses to understand that the perception of the causes for illness and disease varies by culture and these differences affect individual approaches to health care. Culture and religion also influences how and whether people seek health care and the nurse’s ability to utilize cultural sensitivity during the consultation determines how patients behave towards health care providers. The beliefs that guide our patient’s lives also dictate if and how nurses are able to care for their patients and how patients respond to this care, which is why health care providers must possess the ability and knowledge to communicate and to understand health behaviors influenced by culture (Flowers, 2004).

Although historically men dominated the medical field as a whole, shortages of personnel during war times spurned the saturation of female nurses to the point that there are so few male nurses today that it is considered a feminine profession and not many people are aware of the significant contributions men provided to the field of nursing (Flowers, 2004; Roth & Coleman, 2008). Gender stereotypes also play a significant role in the diversification of the nursing profession, as nurses are depicted female 99% of the time, white 97% of the time, and childless 92% of the time and the U.S. Bureau of Labor Statistics for 2008 indicate that 68 percent of physicians are male and 90 percent of registered nurses (RNs) are female (Roth & Coleman, 2008; Ulrich, 2010). Minority high school students are not hearing a consistent message from teachers, parents, guidance counselors, and peers that nursing may be a good career choice for them and many guidance counselors usually only encourage students to consider a nursing career who are average-performing, middle class, white females (Barton & Swider, 2009). Additionally, males have reported that it was more difficult to engage in work that is considered as traditionally feminine and that men are usually older when they begin their careers in nursing in comparison to women and they (Roth & Coleman, 2008). Guidance counselors are unlikely to suggest students who are high-performing, wealthy or poor, minority or male pursue careers in nursing (Barton & Swider, 2009). Although nursing was perceived as embodying the characteristics of dedication, caring, and friendliness, males had fears of being perceived as gay or feminine should they pursue careers in this field (Roth & Coleman, 2008).

Similar to U.S. trends, there are a disproportionate number of “diploma-prepared registered nurses relative to baccalaureate-prepared nurses” in Canada, which lends additional credence to the educational attribute (Wolf et al., 2010). Approximately 8% of RNs in Canada were educated in other countries and 39% of the registered nurse workforce in Canada are 50 years of age and older (Roth & Coleman, 2008; Wolf et al., 2010). Several studies have addressed the challenges associated with generational differences in the workplace and the work attitudes of younger nurses (Wolf et al., 2010). Amid increasing mobility, the recruitment of internationally educated nurses has contributed to greater ethnic or racial heterogeneity of the Canadian nursing workforce; (Roth & Coleman, 2008). Integrating international students would institute tolerance and cultural awareness into daily routines as they learn to interact with one another.

Other barriers that exist include language barriers since many nurses are not bilingual and this creates a language barrier and, although there is often a translator for Spanish-speaking patients, this creates a challenge when nurses encounter other languages. However, the culture of a community and their principles tend to dictate an individual’s ability to employ culturally sensitive practices. Language barriers intensify the disparities in healthcare that currently exist to the extent that even well-educated, well-insured middle-class minorities are more likely to have difficult births, higher rates of certain cancers, more deaths from diabetes, and far less adequate health care than their White counterparts due to culturally ignorant care providers (Lowe & Archibald, 2009). Language barriers also prevent minorities from being aware of the services available to them because the notifications are not available in their native language. Programs integrated by the U.S. DHHS has made the majority of their paperwork available in a myriad of languages and employ a diverse network of employees to meet the needs of their clientele, which has set a standard in this area (Lowe & Archibald, 2009).

The disparities in the healthcare services afforded to those of lower economical statuses is apparent in the higher infant mortality rate of African Americans, which is more than twice that of Caucasians, the much higher death rates among African Americans from breast, lung, and colorectal cancer than Caucasians, Hispanics, or Asians, and the higher obesity rates among Hispanics (Barton & Swider, 2009). Lack of access to baccalaureate nursing education is largely separate and unequal for our nation’s racial and ethnic minorities even though ethnic and racial minority nurses can offer unique leadership in the development of models of care for minority populations (Barton & Swider, 2009). The American Association of Colleges of Nursing (AACN) (2011) emphasizes the need to attract students from under-represented groups in nursing, specifically men and individuals from African American, Hispanic, Asian, American Indian, and Alaskan native backgrounds, as nursing’s leaders have recognized a strong correlation between a culturally diverse nursing workforce and the ability to provide quality, culturally competent patient care. The National League for Nursing (NLN) has determined that the advances in technology increase the need for diversification and preparing an ethnically and racially diverse workforce of faculty, researchers, and scholars to mentor future nurses and nurse educators (NLN, 2011).

It is imperative that nurses and health care providers are trained to ask questions sensitively and to show respect for different cultural beliefs. Most important, nurses need to listen to their patients carefully so that they can create a care plan that respects the desires of the patient. An example of a cultural belief that all nurses should be aware of is that of Jehovah Witnesses since they do not believe in blood transfusions an, when deriving a care plan for such a patient, this is something that the nurse must be aware of so they can respect the wishes of the patient without passing judgment upon them. The main source of problems in caring for patients from diverse cultural backgrounds is the lack of understanding and tolerance. Very often, neither the nurse nor the patient understands the other’s perspective.

As indicated by Flowers (2004), following a model for developing cultural competence should include cultural awareness, knowledge, skill, encounter, and desire and should nursing staff avoid stereotyping a patient based on appearances or assuming that they belong to a “particular culture or ethnic group on the basis of characteristics such as outward appearance, race, country of origin, or stated religious preference” (p.51). Nursing professionals should value diversity, have the capacity for cultural self-assessment, be conscious of the dynamics that may occur through cultural interactions, have institutionalized cultural knowledge, and have developed adaptations of service delivery reflecting an understanding of cultural diversity, all of which should permeate the entire organization, including policies, procedures, and attitudes (Cultural Diversity, 2008).

Conclusion

Diversity in nursing staff is especially important because it enables the nurses to provide culturally competent care and makes them more effective in establishing rapport with patients so that they can accurately assess, develop, and implement nursing interventions designed to meet patients’ needs (Lowe & Archibald, 2009). The United States is becoming more diverse and the way the healthcare system works must be adjusted to conform to these changes. It is important for nurses to be educated on different cultures in order to provide culturally competent care to each patient. Knowing the beliefs and practices of each culture is vital because nurses must be able to develop a plan of care to assist each individual patient according to their wishes. In order to effectively and actively demonstrate an ability to work in a diverse environment, the first step is to develop knowledge. The criteria for development of a successful diversity inclusion strategy must ensure that the plan will be effective at overcoming the barriers they were designed to overcome and that the model can be replicated (Barton & Swider, 2009). The number of minority high school and non-traditional students in the pre-nursing system must increase dramatically before there is an increase in the number of applications to nursing programs from minority groups, since minority populations are poorly informed about nursing careers (Roth & Coleman, 2008). Encouraging diversity within institutional structures and educational strategies that intentionally provide opportunities for cross-cultural encounters promote both learning outcomes and racial/cultural understanding (Sanner et al., 2010).

References

American Association of Colleges of Nursing (AACN). (2011, July15). Fact Sheet: Enhancing Diversity in the Nursing Workforce. Retrieved from http://www.aacn.nche.edu/media-relations/diversityFS.pdf

Barton, A.J. & Swider, S.M. (2009). Creating Diversity in a Baccalaureate Nursing Program: A Case Study. International Journal of Nursing Education Scholarship, 6(1) Article 14, 1-14, doi: 10.2202/1548-923X.1700. Retrieved from http://www.bepress.com/ijnes/vol6/iss1/art14

Cultural Diversity. (2008). Cultural Competency. Retrieved from: http://www.culturediversity.org/cultcomp.htm

Flowers, D.L. (2004). Culturally Competent Nursing Care A Challenge for the 21st Century. American Association of Critical-Care Nurses, Critical Care Nurse, 24, 48-52. Retrieved from http://www.cconline.org

Jeffreys, M. (2008, November/December). Dynamics of diversity: Becoming better nurses through diversity awareness. NSNA Imprint, 36-41. Retrieved from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_NovDec08_Feat_Jeffreys.pdf

Lowe, J. & Archibald, C. (January-March 2009). Cultural Diversity: The Intention of Nursing. Nursing Forum, 44(1), 11-18.

National League for Nursing. (2011). Global/Diversity Initiatives. Retrieved from http://www.nln.org/aboutnln/globaldiversity/index.htm

Roth, J. & Coleman, C.L. (2008). Perceived and real barriers for men entering nursing: Implications for gender diversity. Journal of Cultural Diversity, 15(3), 148-152,

Sanner, S. et al. (2010, Summer). The impact of cultural diversity forum on students’ openness to diversity. Journal of Cultural Diversity, 17(2), 56-61

Ulrich, B. (2010, January). Medicine and society: Gender diversity and nurse-physician relationships. Virtual Mentor: American Medical Association Journal of Ethics, 12(1), 41-45. Retrieved from http://virtualmentor.ama-assn.org/2010/01/pdf/msoc1-1001.pdf

Wolff, A.C. (2010). Beyond generational differences: a literature review of the impact of relational diversity on nurses’ attitudes and work. Journal of Nursing Management, 18, 948–969.