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Diverse Patients Need Diverse Nurses

Think about traveling to a different country. Maybe you have a language app to help communicate in the local language, but confusion can still happen. Now imagine the miscommunication that could happen if you are in the emergency room and nobody speaks your language. The outcomes become way more critical.

At least 350 languages are spoken in U.S. homes, according to the U.S. Census Bureau. This is just one measure of the many ways our nation is becoming more diverse. To reflect the communities it serves, the nursing profession must promote diversity in its workforce as well.

The preference for BSN-prepared registered nurses (RNs) is growing. Diploma- and ADN-prepared nurses from all backgrounds can benefit their profession and patients by earning a Bachelor of Science in Nursing (BSN). Bridge programs such as the online RN to BS in Nursing at Fitchburg State University can be an ideal path.

What Does Nursing Diversity Mean?

Florence Nightingale made history as the first female nurse to care for hospitalized soldiers in the Crimean War. Today, the nursing workforce is overwhelmingly female. The 2017 National Nursing Workforce Survey shows male nurses making gains, up from 6.6% in 2013 to 9.1% in 2017.

Increasing diversity is about much more than gender balance, however. Gallup describes diversity as “the full spectrum of human demographic differences.” In addition to gender, this includes characteristics such as age, race, religion, ethnicity, veteran status, sexual orientation, political beliefs, physical features, socio-economic status, language, education, disabilities and abilities.

The American Association of Colleges of Nursing (AACN) provides a snapshot of RN workforce diversity among race and ethnicity groups:

  • White/Caucasian: 80.8%
  • Asian: 7.5%
  • African American: 6.2%
  • Hispanic: 5.3%
  • American Indian/Alaskan Native: less than 1%
  • Native Hawaiian/Pacific Islander: less than 1%

The National League for Nursing (NLN) highlights a particular need to improve diversity in higher levels of nursing: 87% of nurse faculty and 86% of nurse executives are white.

According to the Brookings Institution, Hispanics, blacks, Asians, and multiracial groups will outnumber the white population by 2045. As Ernest Grant, Ph.D., RN, FAAN, the first male president of the American Nurses Association (ANA), said, “There should be more people of different backgrounds entering the profession so that it reflects society.”

Why Does Nursing Diversity Matter?

In any workplace, a diverse, inclusive culture fosters a sense of belonging, which can improve retention. Nurse turnover is a serious problem, so the benefits of a more diverse nursing workforce start there. Increasing retention contributes to higher-quality patient care.

The AACN recognizes the strong correlation between a diverse nursing workforce and “quality, culturally competent patient care.” On the other hand, a lack of diversity contributes to poorer health outcomes. The AACN quotes the landmark 2004 report “Missing Persons: Minorities in the Health Professions.”

“The fact that the nation’s health professions have not kept pace with changing demographics may be an even greater cause of disparities in health access and outcomes than the persistent lack of health insurance for tens of millions of Americans. Today’s physicians, nurses, and dentists have too little resemblance to the diverse populations they serve, leaving many Americans feeling excluded by a system that seems distant and uncaring.”

More than a decade later, the healthcare industry is making gains, but greater nursing diversity is still needed.

Language is one way to understand the link between nursing diversity and health equity. In the U.S., patients whose primary language is not English are at greater risk for negative health outcomes. According to the The Joint Commission, risks include:

  • Surgical delays
  • Longer hospital stays when professional interpreters are not used at admissions and/or discharge
  • Line infections, surgical infections, falls, pressure ulcers
  • Readmissions

Improving nursing diversity can also make a difference in small but powerful ways. A nurse educator writing for the Robert Wood Johnson Foundation (RWJF) shared the story of a Spanish-speaking patient who had just given birth. She was alone. When a Spanish-speaking nursing student interacted with her in a language she understood, “her face lit up.” This interaction is credited with improving the patient’s emotional and physical well-being.

The Institute of Medicine (IOM) — now the National Academy of Medicine (NAM) — has called for a more diverse nursing workforce “to better meet the current and future health needs of the public and to provide more culturally relevant care.”

This requires, of course, that nursing schools recruit and encourage students from more diverse backgrounds. As a BSN becomes the norm, diploma- and ADN-prepared nurses who go on to earn their bachelor’s degree can help build a nursing workforce that represents and welcomes diversity in all its forms.

Learn more about Fitchburg State University’s online RN to BS in Nursing program.


United States Census Bureau: Census Bureau Reports at Least 350 Languages Spoken in U.S. Homes Florence Nightingale

NCSBN: National Nursing Workforce Study

Gallup: 3 Requirements for a Diverse and Inclusive Culture

American Association of Colleges of Nursing: Enhancing Diversity in the Workforce

NLN: Achieving Diversity and Meaningful Inclusion in Nursing Education

Minority Nurse: Making History: Q&A With ANA’s First Male President Earnest Grant

Robert Wood Johnson Foundation: Culture of Health Blog – Why Diversity in the Nursing Workforce Matters

NCBI: The Need to Increase the Diversity of the Nursing Workforce

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