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Cultural diversity goes deeper than DNA
Nurses do not mirror the population, but they can learn all they can about them
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Morrisville, NC 27560
By Jennifer Mensik
PhD, MBA, RN, NEA-BC, FAAN
The U.S. has changed a lot over the last several hundred years. Being a nurse during the 1800s was very different then it is now, not just in terms of technology, but in diversity of cultures.
My maternal grandmother’s descendants came over on the Mayflower. My maternal grandfather’s side arrived a little later and moved across the country into the Oregon territory by the early 1800s. My paternal side arrived in the early 1900s; my paternal grandfather was the first to be born as a citizen here on that side of the family. Many of us have similar stories of our ancestors’ arrival to the U.S. And now there is the rise in genetic testing and the personal stories of people finding ancestral connections they didn’t know they had in distant regions of the world.
This summer I decided to try one of the DNA ancestry kits. Like many, I have seen the commercials and how many people are surprised with some of their results. When I got it back, I posted it on Facebook to share with others. Someone asked me if I was surprised with any of the data. The more I think about it, I am surprised at one thing — that my background is not more diverse. I am 99% European and 1% Native American and East Asian (0.8% Native American and 0.2% Yakut). From my knowledge of genealogy, I knew most of it.

Going back multiple generations on my maternal grandfather’s side, my fifth great grandmother is from the Colville Indian Tribe. I had never heard of Yakut (I had a fifth to seventh great grandparent who was 100% Yakut). So that has promoted us all to investigate that area of the world more. My descendants are Eastern European, British, Irish, French, German, Scandinavian, Balkan, Native American, Finnish and Yakut. My dad’s genealogy tree is a work in progress, but he too did the DNA test. He is 100% European.
In nursing school, we learn about culturally appropriate care.
Madeleine Leininger’s theory of cultural care
was the basis of that education. As a nurse theorist, she pointed out certain assumptions, such as that cultural care values, beliefs and practices are influenced and embedded in the context of any culture. Leininger further states people who experience nursing care that fails to be congruent with their beliefs and values may show signs of cultural conflict, noncompliance, stress and ethical/moral concerns.
We may not be able to learn all that we need to always be effective at change within a certain culture, but that doesn’t mean that we cannot make a difference within a culture that isn’t ours. Nor does it mean that we shouldn’t try to learn as much as we can about other cultures and even our own.” — Jennifer Mensik, RN
Diversity in nursing is about each of us understanding our own biases, limitations and perspectives of not only our own, but other cultures that may be underrepresented in the RN workforce. According to a
2013 report from the Health Resources and Services Administration
, greater shares of RNs are white or Asian than in the overall work-age population, while Hispanic/Latino and African-American populations make up a smaller share of RNs than their representation in the overall work-age population.
Diversity is about promoting diversity within our own profession. We may not be able to learn all that we need to always be effective at change within a certain culture, but that doesn’t mean that we cannot make a difference within a culture that isn’t ours. Nor does it mean that we shouldn’t try to learn as much as we can about other cultures and even our own.

That said, until we mirror the cultures we serve, we may not be able to fully connect. Increasing the diversity of our nursing profession and improving our cultural competence, is key to improving the health of our nation.
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EDITOR'S NOTE:
Jennifer S. Mensik, PhD, MBA, RN, NEA-BC, FAAN, is division director of care management at Oregon Health and Science University and instructor for Arizona State University College of Nursing and Health Innovation DNP program. She also is treasurer for the American Nurses Association. Formerly, Mensik was vice president of CE programming for Nurse.com published by OnCourse Learning. A second-edition book she authored, "The Nurse Manager's Guide to Innovative Staffing," won third place in the leadership category for the American Journal of Nursing Book of the Year Awards 2017.