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Associations give tips on fostering cultural diversity
Diverse backgrounds of both RNs and patients should be considered
Janice Petrella Lynch, MSN, RN
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No matter what the setting, nurses and other healthcare professionals work with patients from diverse backgrounds who have divergent cultural and religious beliefs and also are of various ages, educational levels and sexual orientations. The nursing profession has recognized the need to increase diversity in the workforce to improve communication and patient education, adherence to treatment modalities, and ultimately improve patient satisfaction and health outcomes.
Freida Hopkins Outlaw, RN
It is no longer a question of whether the profession should foster cultural diversity in nursing, according Freida Hopkins Outlaw, PhD, RN, FAAN, executive program consultant for the
Minority Fellowship Program at the American Nurses Association

“It is a matter of our being focused on evaluating the evidence-based practices to be used to ensure that our growing racially, ethnically and culturally diverse populations receive the culturally and linguistically competent care needed to reduce and eliminate heath disparities,” she said.
The understanding of one another’s differences starts with nurses themselves, with their own uniqueness, beliefs and practices and unconscious biases, said Madelyn Yu, MSN, RN, president-elect,
Philippine Nurses Association of America
, and nurse manager, Saint Barnabas Medical Center, Livingston, N.J.

“Only then, can we say we understand our patients and one another and can communicate clearly what needs to be done when caring for our patients in a global community,” she added.
Misty Wilkie, RN
But equally important is taking the time to learn about and understand other cultures said Misty Wilkie, PhD, RN, immediate past president of the
National Alaska Native American Indian Nurses Association
, and associate professor, Bemidji (Minn.) State University. “We all have a unique story and background as to why we end up who we are. I find the most interesting stories are from those who have a different cultural background than my own,” Wilkie said. "I’m fascinated with learning about cultural beliefs, values and behaviors because I want to be respectful of others. By learning about what makes a person tick, we can provide the highest quality of care to our patients.”
“We all have a unique story and background as to why we end up who we are. I find the most interesting stories are from those who have a different cultural background than my own.”
— Misty Wilkie, RN

Tips to increase diversity in the workplace
To improve everyone’s understanding of diverse populations and to promote diversity in the workplace, it takes a committed effort on everyone’s part, Yu said. Yu, Wilkie and Outlaw offer specific recommendations to accomplish this goal:
• Raise diversity awareness by promoting diversity days such as Philippine Heritage Day, Black History Month, Cinco de Mayo, Portuguese Month, Diwali and many others.
• Assess the patient population profile within the facility, including the percent of whites, blacks, Asians, Hispanics, Pacific islanders and others. Then perform an assessment of workforce profile among staff, leaders and administrators.
• Broaden recruitment strategies to diversify the workforce, based on patient and staff profile assessments.
• Assess unconscious bias among healthcare workers to develop and implement inservice staff education.
• Perform community outreach to determine health disparities among diverse groups through health fairs, ethnic advisory boards, language lines, participation in LGBTQ education forums and walks.
• Get administrative buy-in and develop a strategic plan so everyone understands increasing diversity is a priority across the organization.
• Be proactive about having diverse nurses in all levels of the organization/workplace with a special focus on management and decision-making positions.
• Be proactive about hiring practices as diversity of nurses in the workplace does not happen without focused hiring strategies.
• Create a mentoring program for nurses who enter the workplace and are from diverse backgrounds.
• Create a sense of belonging among nurses of diverse backgrounds by listening to and honoring their input and creating opportunities for them to be recognized for their contributions.
Associations get involved in diversity
Nursing associations and their regional chapters actively support their members in promoting diversity, both within the associations as well as in facilities where their members are employed.
With its activities at the national and local levels, the PNAA has the goal of promoting better understanding of people’s unique characteristics, whether it is related to their culture, age, sexual preferences or religion, according to Yu. "We know that when we educate ourselves about the unique characteristics and cultures of others, it automatically promotes a better understanding between patients and healthcare providers, with the ultimate outcome of improved health and well-being for our patients,” she said.
For example, the PNAA chapter in Richmond, Va., has a group called “Sayaw” or dance, and they perform in churches, community health fairs, in their hospitals and at many community events. “As other examples, the PNAA collaborates with the Philippine Embassy in New York and in Washington, D.C., in projects such as ethical hiring of Filipino nurses, participation in parades to celebrate Philippine Independence, the celebration of USA-Philippine Friendship Day and the celebration of Filipino Saint Lorenzo Ruiz,” Yu said.
In recent years, NANAINA has been working to revitalize the association. Members are working with other national organizations, universities, colleges and communities to improve the health and well-being of American Indians and Alaska Natives. “Last June we had a successful conference in St. Paul (Minn.), and plan to have another one next June,” Wilkie said. “These conferences provide vital information to those working with and caring for American Indian and Alaska Native people and communities. Our goal is to continue to educate those providing services to these communities so health disparities are minimized.” NANAINA members are willing to consult with nursing programs with a large number of AI/AN students to provide best practices on retaining and graduating those students, according to Wilkie. “We are also willing to serve as mentors because we recognize the challenges they face while pursuing a nursing degree,” she added. The ANA continues to advocate for funding and opportunities that promote cultural diversity within the nursing workforce. In addition, the Code of Ethics for Nurses with Interpretive Statements provides a sound underpinning for why we need a cultural diverse workforce that understands the needs of patients, families and communities across the U.S., Outlaw said. “Provision 8.3 notes that increasing diversity in nursing fosters the mission that ‘nurses must recognize that healthcare is provided to culturally diverse populations in this country and across the globe,’” Outlaw said.
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Janice Petrella Lynch, MSN, RN, former nurse editor/nurse executive for OnCourse Learning, is a nurse consultant for She is currently the director, Help and Resource Center, for the Marfan Foundation.