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Workforce diversity may help reduce health disparities
Boosting the number of diverse caregivers has become a high priority
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By Heather Stringer
EDITOR'S NOTE: Heather Stringer is a freelance writer.
By 2044 more than half of all Americans are expected to belong to a minority group, yet only about 20% of nurses who responded to the 2015 National Workforce Survey of RNs identified themselves as from a racial or ethnic minority. Men also are a minority in the nursing workforce, representing only 11% of RNs, according to recent studies.
Although the number of RNs identified as members of racial or ethnic minorities and the number of men in the workforce has slightly increased over the years, boosting the percentages of diverse caregivers has become a high priority for organizations both nationally and regionally as momentum builds to reduce health disparities in the U.S.

Certain racial and ethnic minorities, for example, have a higher risk of obesity and complications from diabetes. The belief is that a more diverse nursing workforce representing variations in gender, age, ethnicity, sexual orientation and social status will improve outcomes for patients from diverse backgrounds.
Although more research is needed to prove a correlation between workforce diversity and better outcomes, one prominent review of 55 studies in 2006 showed that minority patients received better care from practitioners of their own race or ethnicity.

The review, conducted by the U.S. Department of Health and Human Services/Health Resources Service Administration, also showed that non-English speaking patients experience better interpersonal care, greater medical comprehension and greater likelihood of keeping follow-up appointments when they see a practitioner who speaks their language. Minority practitioners also are more likely to seek out ways to serve minority and other medically underserved populations, according to the review. Nursing organizations throughout the country have worked to increase diversity in the workforce, and now the fruits of their efforts are materializing. In 2014, for example, the National Association of Hispanic Nurses received a five-year grant totaling $1.25 million from the National Institutes of Health to launch a campaign to promote the nursing profession among Hispanic communities. The campaign includes broadcasts on popular Hispanic radio shows that featured bilingual nurses who aim to spark interest in the profession.
“The broadcasts cover the value of being a Hispanic nurse, common barriers, nursing school resources and career path opportunities,” said Anabell Castro Thompson, MSN, APRN, ANP-C, FAAN and president of NAHN. The campaign also provides a toolkit for nurses who are interested in spreading this message in schools, community fairs and other public events.
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Supporting minority students
While it has been critical to draw more minorities to the nursing profession, finding ways to support these students during nursing school is equally important, said Amanda Quintana, DNP, RN, FNP, and project director for the Colorado Center for Nursing Excellence.

The organization received funding in 2013 and 2015 to begin training nurses from diverse backgrounds to become mentors to minority student nurses. The nurses learned how to help mentees with issues like juggling nursing school with other jobs, how to prioritize school in the midst of family expectations and how to study for an exam.
Male nurses are role models
Amanda Quintana, RN
The prohibitive cost of nursing school is a burden that organizations also are addressing to increase under-represented student enrollment. The University of Rochester School of Nursing in New York State saw diversity in admissions increase after the program began offering $10,000 scholarships to minority students who enrolled in the accelerated one-year BSN program, said Kathy Rideout, EdD, PPCNP-BC, FNAP, dean of the school of nursing and professor of clinical nursing and pediatrics.

The scholarships were funded by RWJF and the American Association of Colleges of Nursing, and then the school decided to match the $10,000. These student scholars also received mentoring in areas such as writing, test taking, stress management and career transition.
Kathy Rideout, RN
To encourage the scholars to pursue further education, the school offered to provide full financial support for six students who went on to pursue doctoral education at the institution, and now twelve of them have been hired in the clinical and lab setting at the nursing school. Even though the funding from RWJF ended in 2016, the school continues to draw a high percentage of students under-represented in nursing, and who comprise 25% to 30% of the nursing school class. “The scholarship program created a wonderful pipeline into our graduate programs and even into our faculty,” said Rideout.
To date, 86 mentors have been trained and supported more than 90 mentees in Colorado, and another 40 mentees began the program in September 2017. All the students who received mentoring and graduated went on to pass the NCLEX. The program recently received an additional $2 million from the HRSA to continue for the next four years, and will expand to include resources such as tutoring and cultural diversity training. The program has been so successful that the Colorado Center for Nursing Excellence is collaborating with the AARP and the Center to Champion Nursing in America to train nurse leaders in the Rocky Mountain states to replicate the program.
Increasing the number of men in nursing has proven to be difficult, with the percentage creeping up only 7% in the last 40 years, according to the U.S. Census Bureau, but members of the American Association for Men in Nursing hope that demographics may be on their side.

Although caring for aging loved ones is usually considered a female role, a new report from AARP found that 40% of nonprofessional family caregivers in the U.S. are men, which is about 16 million men. They not only provide care in different ways than their female counterparts, but they also want male nurses to teach them how to care for their loved ones, said Jason Mott, PhD, RN, CNE, national secretary for AAMN and an assistant professor in the college of nursing at the University of Wisconsin, Oshkosh. “The majority of these men are untrained, and they are asking for hands-on education from male nurses,” Mott said. AAMN will be partnering with AARP and Vistas Healthcare, a national provider of hospice care, to launch a campaign promoting the importance of drawing more men into nursing to support the nation’s male family caregivers, he said. Mott also is partnering with AARP to study how men provide care differently from women. He has found that men are less likely to seek out social support, and they feel less comfortable performing intimate caregiving, such as bathing. “We need more men in nursing who understand these struggles and can help male caregivers navigate these issues,” Mott said. Although leaders who are advocating for diversity in the workforce acknowledge that change takes time, and there is still much progress to be made, they agree that each success story seems like a victory worth celebrating.

Quintana, for example, remembers one of the nursing students in the Colorado mentoring program who had come from a low-income background. The woman shared that completing nursing school was the first time she had accomplished anything significant in her life. Now she wants to become a mentor for others and is pursuing a master’s degree in nursing. “It’s one thing to collect quantitative data, but another thing to hear stories from the lives of students,” Quintana said.
Hispanic nurses help families learn about and prevent obesity
Nurse leaders at the National Association of Hispanic Nurses were aware that the obesity epidemic was preventable, but communities needed education about how to live healthier lives. The organization received funding from the Coca-Cola Foundation to launch Muevete USA, a program that would send nurses into schools and other community settings to teach students “the importance of exercise, how to read food labels, choosing healthy snack options and the lifestyle changes needed to improve self-esteem and body image,” according to NAHN.
“Hispanic nurses lived in the communities and were knowledgeable about the foods and culture in those areas, so they were able to educate people about how to solve some of the common problems they face,” said Angie Millan, DNP, RN, FAAN, past president of NAHN and director of the program.
Muevete USA started in five communities in 2012, and after the first year the organizers realized parents also needed training to maximize the chances of long-term lifestyle changes in families. Nurses began inviting parents and relatives to the program, which continued to receive funding for five years and was eventually implemented in 15 communities throughout the country. Now NAHN chapters are seeking funding from their communities to continue the program.
“What was most rewarding was making a difference in our own communities,” Millan said. “We know that children who are obese usually become obese adults, and nurses are showing kids and adults how to make choices that can impact their health for the rest of their lives.”
Editor’s note: Content courtesy of Seattle Children's.
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