Diversifying Our Nursing Faculty
The history of the nursing profession is steeped in exclusion that dates as far back as the late 19th century with the establishment of professional nursing in the United States. From the exclusion of minorities attending nursing schools to unequal pay for minorities when employed in the same institution as white counterparts, the profession has certainly been a contributor and executor of the institutional racism woven into the fabric of this country. Many argue that this exclusion continues today, with minority nursing colleagues feeling stunted in their professional growth, marginalized in their workplaces and silenced. Until we recognize and address our issues of exclusion of racial and ethnic minorities in nursing, we will continue to limit our power as a profession and the true impact that we can have on health in the United States.
While overt barriers to nursing school admission are diminished, the shortage of minority nursing faculty has a profound impact on successfully recruiting and admitting a culturally diverse student body. White women comprise the majority of nursing faculty at 80%. In a policy brief issued by the American Association of Colleges of Nursing in March 2017, it was noted that the percent of diverse nursing students increased from 27.3% to 31.7% between 2011 and 2015. In stark contrast, the percentage of diverse nursing faculty only increased from 11.8% to 14.9% over the same time period. In the state of Maryland (MD), the number of diverse nursing faculty is 24.7% while the number of diverse nursing students is 39.4%. It should be noted that MD has one of the highest rates of faculty diversity in the nation (behind only California, Florida and Hawaii). Nevertheless, more effort needs to be given to attracting and retaining ethnic, cultural and gender diverse faculty.
On my first day of an undergraduate English class, Dr. Hawkins surveyed the room and determined that literature readings that semester would reflect the demographics of the room. We were majority women so we would read a majority female authors. She noted the percentage of each minority group and assured us that we would read an adequate number of authors who reflected each of our ethnicities. While Dr. Hawkins’ process was not steeped in research or grounded in empirical evidence, it did reflect a simple social construct. It is socially logical and reasonable for people to want to be represented in their work and learning environments.
This is true of nursing students, who are in need of role models that represent their lived experiences and backgrounds. To be clear, the suggestion here is not that the only faculty that students should encounter are those that match their ethnic and cultural background. This is the current state for our majority white students who encounter majority white faculty. Instead, I am suggesting that all students need a variety of faculty experiences and that there is tremendous value in having role models whose physical and cultural image mirrors your own. Development of a professional nursing identity is best achieved when nurses can see themselves advancing professionally through representation and mentorship.
Furthermore, as we begin to thread the social determinants of health throughout curricula, discussions about race, poverty, power and access must be facilitated with students. Clinical experiences should be designed such that students are exposed to communities in greatest need of social, political and healthcare interventions. Nursing students must be taught to advocate for patients beyond the bedside. Ethnic and culturally diverse faculty will be able to support schools of nursing in effectively facilitating instruction that helps students to inform a nursing identity grounded in justice for all persons.
Intentional recruitment activities aimed at increasing the numbers of ethnic and culturally diverse nursing faculty need to be implemented. These activities begin with analysis of interviewing techniques and strategies, followed by education of search committee members on evidence based culturally sensitive interviewing. Search committee members, and all faculty need to assess their implicit biases and acknowledge the impact of these on candidate selection and interview feedback.
Retention strategies for current ethnic and culturally diverse nursing faculty should also be implemented. Current minority faculty need to be supported and their experiences as faculty should be assessed. Specific assessments should include: integration into faculty culture, sharing of institutional knowledge, socialization within the faculty, and availability and utilization of support structures throughout the nursing program and college/university. Through these assessments, campus climate can be qualified and intervened upon where necessary. Administrative leaders should intentionally develop training and support programs for all faculty that assist with understanding current workforce climates and making meaningful and impactful changes to address challenges.
Nurses are foundational to improving the health of patients, communities, and populations. Of the variety of healthcare professionals encountered by patients, nurses are the most directly involved. As we begin to recognize the complexities that affect people and their health, who but nurses are positioned to address the whole person and have lasting positive impact on health? Though our healthcare goals for the communities we serve are achievable, we have missed the mark on providing an ethnic and culturally diverse workforce that mirrors the diversity found in the general population. Appropriately addressing this by first increasing our recruitment and retention of ethnic and culturally diverse faculty will allow us to leverage our power and have more success achieving intended outcomes.
References:
American Association of Colleges of Nursing (2017). Nursing faculty: A Spotlight on diversity. https://www.aacnnursing.org/portals/42/policy/pdf/diversity-spotlight.pdf
Bennett, C., Hamilton, E.K., Rochani, H. (2019). Exploring race in nursing: Teaching nursing students about racial inequality using the historical lens. The online journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJN.Vol24No02PPT20
National League for Nursing (2017). Disposition of full-time nurse educators by race-ethnicity 2017. http://www.nln.org/docs/default-source/default-document-library/disposition-of-full-time-nurse-educators-by-race-ethnicity-2017.pdf?sfvrsn=0
