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The Changing Face of Nursing: Diversity Increasing Slowly


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By Debra Wood, RN, contributor 

March 8, 2013 - As America becomes increasingly diverse, the health care field is seeing more men and minorities in nursing, albeit at a slower pace than the country as a whole.

Michael Evans says diversity in nursing should match population.
Michael L. Evans, PhD, RN, said the face of nurses should match the population they are serving.

“We are making huge progress,” said Michael L. Evans, PhD, RN, dean of the Texas Tech University Health Sciences Center School of Nursing in Lubbock, who set as one of his main goals to increase diversity in nursing students and faculty at the institution. 

Christine T. Kovner, PhD, RN, FAAN, a professor at New York University College of Nursing and a lead investigator on the RN Work Project, a Robert Wood Johnson Foundation-funded longitudinal study of newly licensed nurses, agreed that the profession is making progress, particularly with increasing the number of men in nursing. But she added that changes occur gradually, because even when schools graduate high numbers of male or minority nurses, the overall percentage for the entire profession rises slowly due to its size, about 3 million.

“We’re going in the right direction, but have we made even remotely measurable strides? Absolutely not,” added Patrick Robinson, PhD, RN, ACRN, dean of undergraduate curriculum and instruction at Chamberlain College of Nursing, headquartered in Downers Grove, Ill. “Any gain is a positive, but we are nowhere near where we need to be. There has to be a concerted effort to recruit and retain highly qualified men and minorities in the nursing profession at all levels.”

Robinson indicated that the lack of diversity in nursing drives a wider wedge in health disparities as minority populations and language barriers grow.

Patrick Coonan recruits minorities in nursing program at Adelphia
Patrick R. Coonan, EdD, RN, NEA-BC, FACHE, has actively recruited under-represented populations to Adelphia University as students and faculty.

“We, as a profession, need to keep up with what is happening in the population,” agreed Patrick R. Coonan, EdD, RN, NEA-BC, FACHE, dean of the Adelphi University School of Nursing in Garden City, N.Y. “We have to actively work at it.” 

More men in nursing 

The U.S. Census Bureau released the findings from its Men in Nursing Occupations study in February 2012, which showed the number of male registered nurses has tripled since 1970, increasing from 2.7 percent to 9.6 percent.

Making the profession more attractive to men increases the pool of potential candidates, Kovner said. In addition, she added, “There is some evidence male and female brains work differently. In terms of what research we do, how we teach students, and how we deliver care in health care settings, it’s critical we have that view.”

Christine Kovner's data shows more minorities and men in nursing.
Christine T. Kovner, PhD, RN, FAAN, reported data from the RN Work Project shows increases in male and minority graduates.

Kovner’s data from the 2010-2011 study of newly licensed RNs found about 11 percent of the sample is male, a higher percentage of new graduates are male than 10 years ago. 

The American Association of Colleges of Nursing (AACN) 2012 State of the Schools report, based on responses from 87.5 percent of schools with nursing baccalaureate and graduate programs, found that 11.4 percent of students in BSN programs are men, as are 9.9 percent of students in master’s nursing programs, 6.8 percent of students in research-focused doctoral programs and 9.4 percent in practice-focused doctoral programs.

Evans said that second-degree accelerated programs are bringing in more men.

Dina Faucher reports more men in nursing due to economy
Dina A. Faucher, PhD, MSN, RN, OCN, reported that men represent the greatest increase in enrollment and attributed that to the economy.

Dina A. Faucher, PhD, MSN, RN, OCN, western regional nursing and health professions director for Corinthian Colleges in Las Vegas, also reported an increase in males in the schools’ accelerated programs. At one of the campuses, males represent nearly half of the students.

“Everyone’s going in it for job security,” Faucher said.

Coonan reported that 12.5 percent of students in Adelphi’s program are male. He attributes much of that increase to less gender stigma about the men in the profession, changes to the male role and to the economy.

The U.S. Census Bureau reported that because of the high demand for skilled nursing care, the profession enjoys low unemployment rates, 1.8 percent for RNs and 0.8 percent of nurse practitioners and nurse anesthetists. It also found men’s representation highest among nurse anesthetists at 41 percent. Male nurse anesthetists earned more than twice as much as the male average for all nursing occupations: $162,900 annually vs. $60,700.

Nick Angelis, CRNA, MSN, author of How to Succeed in Anesthesia School (And RN, PA, or Med School), said male nurses, like himself, are initially attracted by the growing role of advanced practice nurses, but he added that those advanced roles are lacking minority role models.

Robinson agreed the lack of men and minority nurses in advanced and leadership roles is a problem.

“People need to see people like themselves in those positions, so they know what they can be,” Robinson said.

Representation of minorities in nursing 

Evans indicated that patients find it reassuring to receive care from someone who comes from the same ethnic or racial background. Yet recruiting more ethnically and racially diverse students requires a concerted effort to reach out to them, at schools or community organizations, and educate them about the opportunities available in nursing.

Kathleen Potempa sees nursing diversity critical to the profession
Kathleen Potempa, PhD, RN, FAAN, called diversity critical to the profession.

“Diversity is critical to the profession from many perspectives,” said Kathleen Potempa, PhD, RN, FAAN, dean of the University of Michigan School of Nursing in Ann Arbor. That includes to “better match the changing face of U.S. demographics; to provide diversity of thought, life experience and culture in health policy and decision making; and to provide opportunity to all Americans to participate in the health professions, an enduring job sector in the U.S.”

The 2010 U.S. Census found 72 percent of Americans self-identified as white, 16.3 percent Hispanic or Latino, 12.6 percent black or African American, and 4.8 percent Asian.

The 2012 Bureau of Labor Statistic’s Current Population Survey (CPS) reported of the 2.875 million nurses in the United Sates, 6.1 percent were Hispanic, 11.5 percent black and 7.3 percent Asian. That compares to more than 2.4 million nurses in the 2003 CPS, of which 3.9 percent were Hispanic, 9.9 percent black and 7 percent Asian. 

Kovner’s data from 2010-2011 showed 79 percent of newly licensed nurses were white, less than historical percentages. But racial categories, she cautions, are difficult to define with many people stating they fall into more than one demographic group. However, her data shows that nonwhites are going back to nursing school at higher than historical rates.

The AACN study found an increase in minority BSN students, with 72 percent identifying as white, 7 percent Hispanic, 10.3 percent black and 8.8 percent Asian.

Calling health care cultural, Coonan emphasized that nurses from similar backgrounds as patients can more completely understand the culture and could lead to better outcomes.

Coonan has significantly increased minority students at Adelphi during the past nine years, boosting it from 10 percent to 57 percent from under-represented groups by reaching out into communities with higher minority populations without lowering the school’s standards. About a third of its graduate students come from minority groups.

“Then my challenge was to hire faculty from under-represented groups, and that was a lot harder,” Coonan said. But now 40 percent of Adelphi’s faculty fit that description. 

The AACN survey found only 5.1 percent of full-time faculty members are male and 11.8 percent are from racial or ethnic minority groups.

“The pool of individuals who represent ethnic and racial minorities and are prepared to teach is low,” said Evans, who called the minority faculty shortage a tremendous problem. Texas Tech actively recruits minorities into its master’s education program in an effort to grow its own more-diverse faculty.

 



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