Diversity in Nursing: How It Improves Care

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Nearly 75% of registered nurses and more than 85% of nurse practitioners are white, according to the U.S. Bureau of Labor Statistics (BLS). As a result, the nursing profession falls short of representing the public it serves. Explore why diversity in nursing is key to better health outcomes for all and what more can be done.

To learn more, check out the infographic below, created by Regis College’s online BSN to Doctor of Nursing Practice program.

An overview of the state of diversity in the nursing workforce and how greater diversity among nursing staff improves patient care.

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Chapter 1: The History of Diversity in Nursing

By 2045, minorities are expected to make up the majority of the U.S. population. Therefore, there’s an increasing need for greater diversity among nursing staff if the health care industry is to ensure that everyone feels included and well cared for.

The Current State of Nursing Diversity

However, staffing data shows that only about 20% of registered nurses come from minority backgrounds. Asians make up 7.2% of the nursing workforce, Black nurses represent 6.7%, and Hispanic nurses represent 5.6%. American Indian/Alaska Native and Native Hawaiian/Pacific Islander individuals represent 0.5% and 0.4% of the nursing workforce, respectively.

This distribution does improve somewhat for nursing students. The data shows that students from minority backgrounds represent 40.8% of those enrolled in bachelor’s degree programs, 38.9% of those enrolled in master’s degree programs, 38.9% of those enrolled in doctoral programs focused on practice, and 35.5% of those enrolled in doctoral programs focused on research.

Programs Designed to Encourage Diversity

In 2022, the American Nurses Association (ANA) began its “Journey of Racial Reconciliation” campaign. The organization acknowledged how it had harmed nurses of color and how racism continues to hinder diversity efforts in the industry.

ANA also said it needed to reconcile its own history, citing specific events as examples. From 1916 to 1964, it kept Black nurses from joining the organization. In 1965, it made recommendations undermining the educational institutions that nurses of color had the most access to. It also acknowledged that organizations for nurses of color sprang up in 1974 due to ANA’s ongoing actions.

One of the ways ANA is addressing this reconciliation is through its National Commission to Address Racism in Nursing, which it established to address the ways racism has an impact on nurses, patients, communities, and health care in general. The commission surveyed more than 5,600 nurses and found that 63% experienced racism from a peer or supervisor. The survey also discovered that 81% witnessed racism experienced by a colleague. Furthermore, 57% stated that they challenged racist treatment in the workplace; of these, 64% said nothing changed.

The survey also concluded that several issues continue to impede diversity efforts. One of these is racism and racist attitudes, specifically attitudes that assume that racial groups have distinct characteristics that make some of them supposedly inferior to others. Another issue is bias, which is defined as a prejudice in favor of or against something. A third issue involves stereotypes, defined as exaggerated and often negative perceptions of members of a group.

Chapter 2: Why Is Diversity in Nursing Important?

Better health for everyone requires a nursing workforce that’s culturally and ethnically similar to the general population that it serves. This matters because health disparities are common across the U.S., leading to misdiagnosis, delayed diagnosis, and inadequate care and treatment. Because patients tend to interact most frequently with nurses, diversifying the nursing profession can be a gateway to more equitable care.

How Does Diversity Help?

Diversity in nursing can help deliver better health care in several ways. Diversity can boost creativity and innovation, and it can help improve problem-solving, collegiality, and cooperation. It also helps boost a facility’s ability to connect with patients. Additionally, it improves a facility’s ability to attract more employees and allows them more organizational flexibility.

Diversity and Culturally Competent Care

Diversity allows a facility to provide culturally competent care, which in turn can improve health outcomes. This is critical for numerous reasons. For instance, a lack of awareness of the issues facing a particular group can result in fear, failure to access the health care system, negative health outcomes, and a lack of trust. However, having awareness of those issues and making an effort to increase awareness can improve trust and result in patients more easily accessing health care providers.

This can help a facility address immediate concerns impacting a specific racial demographic. One of these is Black maternal health. This is a significant issue in the U.S., as rates of maternal morbidity and mortality are among the highest in the world.

Roughly 700 people die each year in the U.S. while pregnant or in the year after giving birth, and another 50,000 deal with serious consequences from labor. Those rates are particularly high among Black women and other women of color. Black women are three times more likely to die from pregnancy-related causes than white women. Furthermore, college-educated women who are Black are 60% more likely to die in childbirth than high school-educated women who are white or Hispanic. However, research shows that the more diverse a state’s nursing workforce is, the lower the risk of poor maternal health outcomes for women of color.

Chapter 3: How to Promote Diversity in Nursing

Various strategies can help improve diversity in nursing. For instance, employers can change their outreach efforts to better connect with diverse candidates. They can also create organizational partnerships with diverse professional nursing associations. Additionally, they can ensure diverse leadership.

Nursing Schools and Diversity

Nursing schools also have a key role in improving diversity. They can revitalize curriculums. They can also establish diversity, equity, and inclusion (DEI) committees. Additionally, they can guide conversations toward humility and away from denial and defensiveness. Another step nursing schools can take is to celebrate diversity. They can also create and support mentorship opportunities. In addition, they can address microaggressions, which are seemingly minor insults that can have a large impact because they disrespect a person’s values or identity. They can also diversify their hiring practices. Finally, they can partner with minority communities and organizations.

Challenges to Promote Diversity in Nursing

Organizations should take care to avoid certain pitfalls while promoting nursing diversity. They need to avoid “tokenism,” in which a person is included just to give the appearance of diversity. They must also resist turning diversity into a buzzword, in which it’s used to impress but doesn’t actually result in tangible change.

On an individual level, nurses can help improve diversity and circumvent these challenges through a few actions. They can initiate conversations about diversity, ask for more people’s opinions on a subject, and start or join a diversity committee.

Conclusion

Nurses are uniquely positioned to improve health equity across the U.S. While diversity efforts require comprehensive changes to education, practice, policy, and research, opportunities abound for nurses to effect positive change on an individual level — making nursing an empowering field.

Sources

American Association of Colleges of Nursing, Enhancing Diversity in the Workforce

American Nurses Association, “Leading Nursing Organizations Launch the National Commission to Address Racism in Nursing”

American Nurses Association, “New Survey Data: Racism Within the Nursing Profession is a Substantial Problem”

American Nurses Association, Our Racial Reckoning Statement

American Psychological Association, Bias

American Psychological Association, Racism

American Psychological Association, Stereotype

The Atlanta Journal-Constitution, “How Nurses Can Help Promote Diversity in the Industry”

Campaign for Action, “Campaign’s Diversity and Inclusion Advisors on How Nurses Can Improve Health Equity”

Centers for Disease Control and Prevention, “Working Together to Reduce Black Maternal Mortality”

Cleveland Clinic, “What Are Microaggressions?”

Health, “Tokenism: What It Is and Its Mental Health Effects”

The Hill, “A More Diverse Nurse Workforce Could Result in Better Maternal Health Outcomes”

The Journal for Nurse Practitioners, “The Decolonization of Nursing Education”

Oncology Nursing News, “The Future of Nursing Must Be Diverse”

Oncology Nursing Society, “Diversity in Nursing: How the Profession Is Addressing Racial and Gender Gaps”

Online Journal of Issues in Nursing, “Quality Nursing Care Celebrates Diversity”

RN Journal, “What Role Does Cultural Diversity Play in Patient Safety?”

Rural Health Information Hub, Rural Health Disparities

ScienceDaily, “Diverse Nurse Workforce Linked to Better Maternal Health Outcomes in Childbirth”

U.S. Bureau of Labor Statistics, Labor Force Statistics from the Current Population Survey

UWorld, “Diversity in Nursing Education”