From presenting education sessions on culturally competent patient care to winning prestigious achievement awards and capturing top honors for the best research poster session, minority nurses were a constant and powerful presence at the 2002 American Nurses Association (ANA) Biennial Convention, held June 29-July 2 in Philadelphia.
Presentations such as “Caring for the Hispanic Client: Tools to Use” by Jessica Escobar, RN, MSN, FNP-C (APBC), “Cross-Cultural Competency: Understanding Similarities and Differences” by Gihan El Gindy, RN, MSN, and “The Role of Cultural Competence in Clinical Competence” by Valda Boyd Ford, RN, MPH, MS, helped attendees improve their skills in understanding the needs of patients from diverse racial and ethnic backgrounds--a perspective too often ignored in nursing school curricula.
In addition, three African-American ANA members were honored for their exceptional contributions to the nursing profession. Jean Rochelle Marshall, RN, MSN, FAAN, received the 2002 Mary Mahoney Award--named in honor of America’s first black professional nurse--for her achievements in increasing educational and leadership opportunities for nurses of color. Nurses’ rights advocate Gwendylon E. Johnson, RNC, MA, was presented with the Shirley Titus Award for her leadership on behalf of nursing unions. The Honorary Nursing Practice Award went to Ernest J. Grant, RN, MSN, in recognition of the outstanding care he has provided to hundreds of burn patients throughout his nearly 20-year career.
On the research front, American Indian nurse Barbara Dahlen, FNP, MS, from the University of North Dakota College of Nursing--along with two non-Indian co-researchers, Bette Ide, RN, PhD, and Marcia Gragert, RN, PhD--won first place in the ANA Grand Rounds Poster Session’s Research for Practice Awards. Their project, Problems and Resources of American Indian Elders, was a detailed assessment of the health care needs of elders living on the Standing Rock Reservation. And at a special “Celebrating Diversity in Nursing” reception, conference attendees gathered to applaud the 14 outstanding nurse scholars who were this year’s recipients of ANA Ethnic Minority Fellowships.
But nurses of color made their greatest impact at the education session “Tapping Ethnic Minority Nurses to End the Nursing Shortage,” led by four representatives of the National Coalition of Ethnic Minority Nurse Associations. Formed in 1999 to provide a unified voice for advancing the interests of minority nurses, the coalition is made up of key leaders from the National Black Nurses Association (NBNA), the National Association of Hispanic Nurses (NAHN), the Asian American/Pacific Islander Nurses Association (AAPINA), the Philippine Nurses Association of America (PNAA) and the National Alaska Native American Indian Nurses Association (NANAINA).
Pete Reuben Calixto, RN, BSN, CNN, immediate past president of PNAA, led off by noting that minority nurses--who collectively represent only 13.4% of the current RN workforce--are an important but untapped resource. “During the 1990s, the number of minority nurses rose by 19%,” he said. “That is tremendous growth. The minority nurse population is increasing much faster than the population of Caucasian nurses. But our growth has not kept pace with [the growth of minority groups] in the general population.”
This theme was echoed by Antonia Villarruel, RN, PhD, CS, FAAN, a past president of NAHN. “By the year 2020, children of color will be the largest majority of children in the U.S.,” she commented. “In terms of nursing’s future potential, we need to be recruiting more nurses from those populations. And we have not been successful in doing that.”
A major cause of this missed opportunity, Villarruel continued, is the persistent presence of barriers that block minority students’ access to nursing education, such as inadequate preparation at the high school level, the prohibitive cost and inflexible structure of nursing programs, perceived discrimination and lack of faculty role models.
Citing the results of recent surveys of minority nursing students, the NAHN leader added, “Many of these students reported that minority faculty were not necessarily helpful--because there are so few of them. One student was quoted as saying, ‘I know Dr. So-and-So is there and she always says she’s here for me. But she’s so busy that she’s not able to help me in the way that I need.’ When a school only has one minority faculty member, they can’t expect that to be a fix-all for all the minority issues they have.”
Even though the coalition was allotted only one hour for its presentation, the speakers managed to pack in a lengthy list of solid, specific recommendations for recruiting more nurses of color into a profession starving for new talent. AAPINA president Kem Louie, RN, PhD, CS, FAAN, stressed the importance of forming collaborative partnerships to maximize the effectiveness of minority recruitment efforts. But before taking that step, she cautioned, nursing schools and health care facilities should take a long, hard look at what they hope to accomplish--and why.
“The organization must first make a commitment to minority recruitment,” Louie explained, “and do some soul-searching about why they want to have minority students or minority RN staff. It has to be more than just wanting to increase the numbers. It’s a major commitment where you need to identify goals and concrete action plans for how you are going to put this recruitment effort together--your short-term goals, long-term goals and the overall outcome you want to achieve.”
Collaborating with external partners, such as minority nursing associations, high schools, minority community leaders and faith-based organizations, as well as with the organization’s own internal resources (staff, administration, students, faculty, etc.) is “very, very key,” Louie continued.
“Unlike general nursing recruitment efforts, minority recruiting requires a ‘thinking outside the box’ approach,” she pointed out. “You can’t do minority recruitment plans the same way you do other recruiting plans. You have to be creative and you have to know your community. This means hiring nurse recruiters who are not only members of minority groups but are also familiar with the community. If you hire someone who is a person of color but is not from that community, it’s not going to work.”
Louie also urged college and university nursing programs to push for more financial support for their departments. “Given the severity of the nursing shortage, academic institutions need to have separate budgets for nursing recruitment,” she said. “I don’t find that at some of the smaller schools. They’re sort of on their own, or they have just one recruiter for the whole college, who is supposed to cover every department.”
The final speaker, coalition president Betty Smith Williams, RN, PhD, FAAN, focused on the unique and vital contributions minority RNs can make in the nursing workplace--contributions that go far beyond merely increasing the number of warm bodies available to end the staffing shortfall.
One of the key strengths nurses of color bring to the table, she emphasized, is their first-hand knowledge of minority cultures and communities. “We bring with us the ability to seek and understand the viewpoints of patients from those cultures,” she said. “We also are able to collaborate with culturally diverse community leaders--and I mean collaborate, as opposed to specifying what you want to happen and imposing your definitions on the community.”
Williams, a founding member and immediate past president of NBNA, presented compelling evidence that having more minority RNs in the workforce would not only help fight the nursing shortage but create better patient outcomes as well. “It can increase a health care facility’s language capabilities--not only literally, in terms of nurses who are bilingual or trilingual, but also in terms of cultural language, the ability to see the patient’s perception because you know their culture and are able to use that in your work,” she argued. “That’s a real asset, and it will enhance the opportunities for nursing services to be increasingly effective.
“Non-minority colleagues can really learn [from minority nurses] and increase their ability to deliver culturally competent care,” Williams added. “When you have a mixture of races, ethnicities and cultures in the workplace, you begin to learn. Diversity is enriching. It’s strengthening. And I want to say that the National Coalition of Ethnic Minority Nurse Associations, and the minority nurse associations who are its members, really have something to contribute in determining what strategies are needed to solve the nursing shortage.”