Chasing diversity in nursing
We’ve come a long way, but we have a ways to go
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By Robert G. Hess Jr.
PhD, RN, FAAN Executive vice president and chief clinical executive
The American nurse workforce has been chasing its own diversity since Victorian women took to nursing. In the U.S., the Civil War opened the door for women in nursing; before that, men were the main healthcare providers.
The percentage of men and women in nursing has never adequately reflected our patient population, and this disparity exists even now. For example, the percentage of men in nursing,
compared to 49.2% in the general American population, shows a dramatic incongruence. And the quest for a makeup of nurses that matches our diverse groups remains hard to reach. So, we at decided that a resource guide focused on diversity is both necessary and intriguing.
n healthcare providers is generally accepted as a precursor for understanding our patient population and providing optimal care and services for the diverse composition of Americans. It’s not just ethnic and racial groups we’re addressing. Lesbian, gay, bisexual and transgender and queer individuals have their own specific healthcare needs and values that add a dimension not encountered — or even imagined — before. If matching diversity in nursing is a challenging grail, we can try to educate the nurses we have about the cultural differences in segments of our population. At, we have taken diversity seriously for years, as evidenced by our continuing education offerings. We have more than 20 modules that address groups as diverse as the Amish, the Roma, Chinese Americans, Haitians and Muslims. We also address cultural nuances reflecting diversity that permeate simple gestures, such as a
, and complex life experiences, such as

one systematic review of the literature
found no evidence that cultural competence training for the healthcare workforce affects better patient outcomes, there is research connecting training with increased patient satisfaction. Is there evidence that diversity builds a better nursing team?
Diversity in healthcare providers is generally accepted as a precursor for understanding our patient population and providing optimal care and services for the diverse composition of Americans."
— Robert G. Hess, Jr., RN
In this guide, we look at whether a culturally diverse workforce actually provides better care than one that is not. Is there evidence? If so, does the evidence consider factors unrelated to diversity? Do some people disagree? And in examining a culturally diverse workforce, we take a broad, but generally accepted approach to diversity that includes gender, age, sex, ethnicity, sexual orientation and social status, because those are listed in most definitions of cultural diversity. In a separate article, we examine the health needs of LGBTQ people and how the cultural diversity and cultural competence of nurses can help this community. We go to a few professional organizations to get an accounting of how diversity plays out in the groups they represent. For example, we ask leaders from the American Association for Men in Nursing for their perspective on how diversity has an impact on the men who are nurses. We also speak to representatives from the National Black Nurses Association, the National Association of Hispanic Nurses and CGFNS International Inc. as well. One thing is for sure: Establishing diversity in nursing has been a long haul, and there’s still a long journey ahead. But there are many great nurses who are putting in the effort to make it happen.
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Robert G. Hess Jr., PhD, RN, FAAN, is the founder and CEO of the Forum for Shared Governance and a former editor for Hess has penned several editorials on career topics. As a presenter at professional conferences, Hess often addresses participants on
how to find the right job and steps for building a successful career