|
Lesson Regarding Cultural Diversity Is Not Lost
by ANNA President Sandra Bodin
Lately,
I have been wondering about my nursing advisor’s first impression of me
when we met during my sophomore year in college. She was a brilliant
woman and the Dean of the school of nursing. She listened to me while I
told her about my interests and the subjects I liked best in school.
She took note of what I was saying, and then suggested that I consider
a career in nursing research. I was confused because I had never heard
of a nurse doing that kind of work. Finally, I asked her what she
meant. As she described nursing research to me, I remember thinking;
“This woman must be crazy. Why would any nurse want to do that?” My
advisor must have recognized my skepticism, because she moved on to
another subject. She shared her belief that American Indian students
deserved additional funding and support to help them succeed in the
nursing program at the college. Again, I did not understand her
reasoning. I can still remember the look on her face when I blurted out
“But why are they so special?” A Cultural Diversity Theme
I
have frequently thought of that long ago conversation. I have been
investigating professional association - related goals and values to
help me prepare for several strategic planning meetings. A reoccurring
theme has been one of cultural diversity. The definition of diversity
in the health care workforce encompasses several characteristics:
Acute care settings. The nursing-sensitive quality indicators for acute care settings have been identified as:
- representation of all racial and ethnic groups from the community served;
- system-wide incorporation of diverse skills, talents and ideas from those racial and ethnic groups; and
- sharing
of professional-development opportunities and resources as well as
responsibilities and power among all racial and ethnic groups (The
Sullivan Commission, 2004).
A
study by the Institute of Medicine (IOM) (2003) found a link between
racial and ethnic disparities in care delivery and significant
disparities in health outcomes, including higher levels of sickness,
disability, and premature death. The report describes a large body of
research that underscores the existence of these disparities. For
example, racial and ethnic minorities are less likely to receive
dialysis or kidney transplants than non-minorities. I am so alarmed by
that statement, especially when I think of all the good nephrology
nurses I know that work very hard to give excellent patient care. One
of the recommendations to come out of this study is to increase the
number of minority health professionals as a key strategy to eliminate
health disparities.
Bringing About Change
The
Sullivan Commission was established in 2003 to make policy
recommendations to bring about change to address the scarcity of
minorities in our health professions (The Sullivan Commission, 2004).
While African Americans, Hispanic Americans, and American Indians
combined constitute just over 25% of the U.S. population (U.S. Census
Bureau, 2005), these three groups account for less than 7% of nurses
(USDHHS HRSA, 2006). The rationale for increasing diversity in the
health workforce is that increased diversity will improve the overall
health of the nation. All patients will benefit from a health workforce
that is culturally sensitive and focused on patient care. The Sullivan
Commission recommends that diversity should be a core value in the
health professions and that professional nursing associations should
promote the development and adoption of measurable standards for
cultural competency for nurses (The Sullivan Commission, 2004).
Cultural competence describes individual clinicians who are flexible
and capable enough to properly assess and treat all patients.
Culturally appropriate care is not simply the memorization of a list of
ethnic facts: It must include the ability to modify care plans to
incorporate patient and family perspectives (Chrisman, 2007). Cultural
competence can be learned; however, the best way to ensure culturally
competent care is to have a nursing workforce that resembles the
diverse populations we serve. The number of minority nurses in America
may be increasing. The most recent American Association of Colleges of
Nursing survey on students in baccalaureate nursing programs showed
that approximately 22% of students entering the programs, and just over
20% of the graduating class, are from racial and ethnic minorities
(AACN, 2006).
Lesson Is Not Lost!
The Health Resources and Services Administration (HRSA) Nursing
Workforce Diversity Grants program awards grants and contract
opportunities to schools of nursing looking to increase access to
nursing education for disadvantaged students, including racial and
ethnic minorities under-represented in nursing. One of ANNA’s
legislative agendas for 2007-2008 includes increased funding for this
program. The Nursing Workforce agenda item is the one I like to feature
the most when I contact members of Congress for their support. I figure
it is the least I can do to prove to my nursing advisor that her lesson
was not entirely lost on me.
Sandra Bodin, MA, RN, CNN
ANNA President
Member, Gitchee Gumee Chapter
References
American
Association of Colleges of Nursing. (2006). Enrollments in generic
(entry-level) baccalaureate programs by state and race/ethnicity, Fall
2006. Washington, DC: Author. Retrieved August 21, 2007 from
http://www. aacn.nche.edu/IDS/pdf/GEN
BACENROLL06.pdf.
American Association of Colleges of Nursing. (2006). Graduations
from entry-level baccalaureate programs by state and race /ethnicity,
Fall 2006. Washington, DC: Author. Retrieved August 21, 2007 from
http://www. aacn.nche.edu/IDS/pdf/GEN
BACGRADS06.pdf.
Chrisman, N. (2007).
Extending cultural competence through systems change: Academic,
hospital and community partnerships. Journal of Transcultural Nursing,
18(1), Supplement 68s-76s.
Institute of Medicine (IOM). (2003). Unequal treatment: Confronting
racial and ethnic disparities in healthcare. Washington, DC: National
Academy Press. Retrieved August 21, 2007 from
http://www.iom.edu/Object.File/
Master/4/175/Disparitieshcproviders8pgFINAL.pdf.蜼
The Sullivan Commission (2004). Missing persons: Minorities in the
health professions. Washington, DC: Author. Retrieved August 21, 2007
from http://www.aacn.nche.edu/Media/pdf/ SullivanReport/pdf
U.S. Census Bureau. (2005). 2005 American community survey data profile
highlights. Washington, DC: Author. Retrieved August 21, 2007 from
http://factfinder.census.gov.
U.S. Department of Health and Human Services Health Resources and
Services Administration (USDHHS HRSA). (2006). The registered nurse
population: Findings from the March 2004 national sample survey of
registered nurses. Washington, DC: Author.
|
