Snapshot: This article begins with an overview of minority nursing demographics, and presents some of the challenges, strategies and opportunities that nurses from minority backgrounds may face. The article also includes a brief history of minorities in nursing from an American perspective, and a library of resources and links.
Diversity in Nursing: An Overview
- Nursing is changing, but remains predominantly white and female. While the nursing workforce has gradually become more diverse, the profession remains relatively homogeneous. More than 80% of nurses are Caucasian, and over 90% of all nurses are female.
- Minorities comprise a relatively small but growing percentage of Registered Nurses. Recent surveys indicate that approximately 15% of RN’s are racial or ethnic minorities, and up to 30% of current nursing students are minorities. By comparison, about one third of the general U.S. population are members of minority groups. While the growing percentage of minority RN’s is promising, research and past experience show that the attrition rate for nurses from minority backgrounds is also higher, which makes it harder to predict the long-term percentage of nurses from minority backgrounds.
- Nurse educators and leaders are even less diverse than the nursing workforce. Recent surveys suggest that only about 10% of nursing faculty are members of minority groups. Minorities are also more likely to be under-represented in senior nursing leadership positions, in professional nursing associations, and among nurse researchers.
- Minority groups vary in their representation among nurses. While African America, Latino, and American Indian and Alaska Native groups are under-represented (only about 10% of all nurses are members of one of these groups), Asian American nurses are slightly over-represented relative to the general population. When speaking of minorities in nursing, it is often helpful to be specific about the group in question.
Minority Nurse Barriers & Implications
- The barriers minority nurses face include social, psychological and economic factors. The barriers minority nurses face are numerous and diverse. Barriers include role stereotypes (i.e. the public’s perception of what a nurse is “supposed to look like”), a lack of mentors, a lack of academic preparation and advising in the pre-college years, and economic hurdles (i.e. the cost of nursing education), to name a few. While one factor may be more or less important on an individual level, most educators and other experts agree that the path to increasing diversity in nursing must operate on many levels, and address a broad range of barriers. Many minority nurses report having internalized these barriers as a significant challenge, and conversely, that a strong desire to be a nurse – and to succeed despite these numerous challenges – is critical to success.
- Minority nurses encounter unique stressors and challenges. Minority nurses face not only broad hurdles, but also daily challenges that can be a source of stress and frustration. Honestly acknowledging and working to overcome with these challenges is often important to success. Such stressors include overcoming the feeling of being a “token” minority, working harder than Caucasian nurses to prove motivation, competence or credibility, differential promotion or salary experiences, and in some cases explicit discrimination and/or racism from peers, patients and educators. While Caucasian nurses may not even be consciously aware of some or all of these stressors, many minority nurses report them on a regular basis. Minority nurses who have successfully overcome these barriers often report increased self worth, determination and confidence. Both research and experience show that open discussion of such stressors, and a supportive educational or professional environment in which minority nurses can seek support from one another and from sympathetic non-minority peers, are important factors in success.
- A diverse nursing workforce is important to providing high quality healthcare. Helping nurses from minority backgrounds succeed is not only helpful to individuals; a growing body of research and experience suggests it is also beneficial to the nursing profession and to society as a whole. The evidence suggests that nurses from minority backgrounds are more likely to work in healthcare settings that serve under-served populations, where there is often a shortage of clinicians. In this sense, helping minority nurses succeed may be an important step in expanding access to healthcare for such populations. Due to their own backgrounds and experiences, minority nurses are often well positioned to understand and meet the needs of an increasingly diverse U.S. patient population; this is important because minority groups in the general population often have unique health concerns and challenges that can affect patterns of healthcare usage, and healthcare outcomes.
- Despite challenges, the opportunities for minority nurses are many, and may be growing. While the barriers and stressors that nurses from minority backgrounds face are real, the nursing profession is growing steadily more diverse, and the contributions that minority nurses have made and are making to the profession are increasingly recognized. Many schools and workplaces now offer both formal and informal networks and societies for nurses from minority backgrounds, which can be valuable resources for nurses at any stage of their career. While discrimination still exists, barriers in the form of formal discrimination and racism are far less socially acceptable and less prevalent than in past generations. Despite numerous challenges, nurses from minority backgrounds today are arguably better positioned than any past generation to transform and improve the nursing profession, and to increase quality and health outcomes for an increasingly diverse patient population.
Strategies for Change
- Be an advocate and ally for positive change. While many barriers that nurses from minority backgrounds face are structural, others can be addressed on a more personal level. Whether you’re a member of a minority group or not, find ways to be supportive and respectful of nurses from diverse backgrounds. Make judgments based on merit, not some pre-conceived idea of what a nurse “normally” looks like. If you see unfair or discriminatory behavior, don’t keep silent; politely but firmly stand up for fair and equal treatment.
- If you’re a successful minority nurse yourself, be an example and consider serving as a mentor. Minority nurses who have “made it” are in a uniquely qualified position to offer knowledge and support to others. While the challenges that nurses from minority backgrounds face today may be somewhat different from your own, consider giving back by volunteering your time to educate or inform younger nurses via teaching or volunteering in professional or educational settings. See the “Resource” section below for more ideas.
- Offer support earlier. Beyond the behavior of individuals, research shows that individuals often make career and educational decisions at the high school level, or earlier. One of the most effective ways to encourage broad, structural change in nursing is to ensure that minorities are encouraged and supported to consider nursing as an attractive and viable career option during the middle school and high school years, when many students begin to contemplate longer-term career and educational decisions.
- If you’re an instructor or employer, treat minority nurses fairly and watch out for hidden biases. This should go without saying, and most employers and educators will try to do this. That said, it can be surprisingly easy to fall prey to biases and unfair assumptions. Before speaking or acting, do your best to honestly consider whether you would apply the same standard to a nurse from a non-minority background. Would the communication (in terms of both style and substance) be the same? Would you make the same assessment, form the same judgment, or offer the same opportunity? Asking these sometimes difficulty questions of ourselves, no matter our background, is an important driver of positive change.
- If you’re a patient, treat minority nurses with the same courtesy and expectations as anyone else. Whatever an individual’s ethnic or cultural background, he or she has to undergo the same licensing and master the same skills as anyone else to be a successful nurse. As is true for educators and employers, patients should treat their nurse, whatever their ethnic or cultural background, with the manners and respect that every individual is due.
- NCEMNA: http://www.ncemna.org
- This organization is the National Coalition of Ethnic Minority Nurse Associations (NCEMNA) that is comprised of five national ethnic nurse associations. It aims to support and advocate for ethnic minority nurses in the U.S. and for the provision of affordable, culturally competent healthcare by offering training programs, sponsoring research, and encouraging networking among ethnic minority nurses and their allies at both the local and national level. An easy way to get started is to sign up for the group’s free newsletter on the home page of the site.
- Minority Nurse: http://www.minoritynurse.com
- This is both a website and an organization that is a tremendous online resource for minority nurses of all backgrounds. The site features informative articles and advice, has a job forum, an education section with featured programs, a scholarship-finder, a directory of events, its own blog, and links to current and past issues of Minority Nurse Magazine.
- AACN Diversity in Nursing: http://www.aacn.nche.edu/diversity-in-nursing
- This is a sub-section of the much larger website for the American Association of Colleges in Nursing (AACN). It offers both useful aggregated data and curated links on a variety of important topics, including trends and statistics, funding opportunities, initiatives for diversifying the nursing workforce, and a directory of more specialized groups and professional associations that serve minority nursing populations.