An astounding lack of diversity in nursing

ExCorporateRN · Jan 28, 2007

The last hospital area (Med-Surg/Ortho floor) that I rotated in had high diversity. Most of the nurses were African American or African. One woman was from the Philipines. Two nurses were white. So it depends somewhat on the area - commuting, etc...

What do you think the solution is?

nj1grlcrus · Jan 28, 2007

The large majority of white female nurses is the result of the additudes 30-40 years ago, when nurses were all white females. The nurses training now are a very diverse group. I think that retirement of that huge wave of nurses reaching retirement age will drastically change the statistics. As far as not respecting the non-white male, move to the NY area, they WILL think you are a doctor, and probably value your opinion more than the traditional white female.

scrubsnhugsRN · Jan 28, 2007

Wow those are some interesting statistics, however I think since times are quickly changing and many people are coming to the age of maturity that are of mixed races (thirty years ago it was almost unheard of) you will see the statistics change. I personally think the census needs to reflect the fact that many people are are mixed and they don't, you have to choose one or the other when claiming race.

I can only hope more male minorities will leap into nursing!

ND76 · Jan 28, 2007

While I agree that those are interesting statistics...your mileage may vary considering where you actually ARE.

I live in a town that is predominantly (76%) African-American. It also has some of the best teaching hospitals in the south that recruit MD's from all over. There are several nursing schools within the city as well. At my facility, white female nurses are NOT the norm, except in the ED and L&D, (I haven't figured that one out yet?) We also have a large contingency of Filipino, Indian, and South African nurses, both male and female. The medical staff is wonderfully diverse as well.

You would find several African-American male contemporaries in my hospital, although my experience so far is that almost every single one them I work with are using the ED and ICU as a stepping-stone to get their year of critical care experience before going to CRNA school, or PA school, or NP school.

Now, I admit that most of the ancillary and support staff is African-American, but I simply think that reflects the makeup of the available job force in the city.

I don't think that the numbers you report about the makeup of nurses have anything to do with 'recruitment' being broken, at least on the hospital end OR the nursing school end. With the nursing shortage today, hospitals are desperate to retain any student that the nursing schools put out, regardless of race. They are offering COMPLETE student loan repayment, plus sign-on bonuses at my facility to new grads who complete 2 years of employment. And nursing schools are actively recruiting anyone who has the GPA and the ambition to be a nurse. Unfortunately, in my city, the high school graduation rate is now at 42%. It has become even more dismal among African-American and Latino students. You can't hold nursing schools and hospitals responsible for the ethnic diversity (or lack thereof) of their students/nurses when the reality is they are simply taking what is available to them. The "broken system" goes a lot deeper and a lot further back than that.

TrudyRN · Jan 28, 2007

So you think it's the fault of the profession for not recruiting a more diverse population? No one recruited me (white). I just figured out that I would go to Nursing school. So I guess I am wondering why minorities need to be recruited. Can't people of whatever race, religion, etc. figure out what they want to do and do it? It used to be that there were all-Negro colleges and nurse training schools because Negroes weren't welcome in white schools. That is certainly not the case today. Any race can apply to any school and gain admittance if grades, etc. are within the school's guidelines.

As for how various color males in white coats are treated, yes, you probably do see some behavior based on presumption there. The answer is that the patient will eventually get it. The physican, of whatever color, shape, gender, must simply behave in a physicanly (LOL) manner and people will get the message eventually. Try being a female doctor accompanied by male nurses or aides and see the assumptions at play there. It might be disturbing but the docs can cry all the way to the bank. And eventually the people will know that they are the docs, be they male, female, majority, minority, etc. I'm not saying this is necessarily pleasant or easy but what solution is there? Do you have one?

I'm a little weary of being blamed, openly or not so openly, for ill treatment of minorities. I have never ill-treated any minority ever. I have, however, been ill-treated by them, in that they assume, based on my race, that I view life a certain way and that that way is different from their own view.

I know the history of oppression of blacks, Chinese, native Americans, probably others in this great land of ours. But I didn't do it. I wasn't here, it's not my fault. It happened to your ancestors, not to you. And not by the hand of my ancestors, as they came to this country only 1 generation ago. (early 1900's) And another thing - I was brought up to believe in the worth and goodness and importance of all people, no matter their race, religion, politics, whatever. So I really have a problem with people assuming that I am the enemy because of my race or some other characteristic. I have worked with people from all walks of life (wealthy, poor, in between; both genders, all ages, diverent religions, all political views) and have cared for a very diverse patient population in my long career. I live in an integrated neighborhood, see doctors of various races, shop at several minority-owned businesses, and have visited every kind of church there is. Next week, I am going to Mosque with a neighbor.

I said all that to say this - everyone is biased, it seems. Those we call minority individuals are biased against other minorities and against majorities. Sure, there are plenty of majorities who still don't understand that we are all God's children. But there are just as many minorities who pre-judge majorities and assume the worst about them.

This will probably never really change but definitely can stop only when everyone, including minorities, lays aside presumptions, pre-judgements, and stereotypical ways of thinking and believing. We can't have equality that is really more equal for minorities than for majorities. There has to come a point when minorities say, "OK, time to set aside the past and deal with today" and take a fresh look at the actual individuals they work with and get to know them as people, not as members of a particular race, religion, gender, etc.

Personally, I seriously believe that this will not happen in my lifetime. Right now, we are still at the point where, for instance, for Black History Month, posters go up all over the building about various black heroes and heroines. What do you think would happen if we had a White History Month? Asian you could get by with, or Hindu History Month, or Buddhist History Month, certainly Muslim History Month. But white? This would not be welcomed. It would be like having a White Nurses' Club. There is a Black Nurses' Club where I work. (They have sort of a journal club but also help various staff financially, like when someone does. They solicit donations from everyone for this but I have never seen a non-black helped.) But if the few white nurses openly formed a club, we'd be labeled as racists. I'm sorry but you can't have it both ways. Right is right and fair is fair. Either all can do it or none can do it. Which is it? I have to put up with Christmas stuff for weeks and weeks, too. As a Jew, this is an affront to me but can you imagine what I'd get if I tried to make Christmas disappear from the work place? So I just enjoy the lights on dreary winter days and go on living my life as best I can.

Ironic but where I work, we have top management all black. (CEO, COO, DON, ADON, Clinical Specialist, plus all of their secretaries are black)

Middle management: 8 black and 4 white

male nurses: 6 We desperately wish we had more.

LPN's: 19 black and 1 white.

RN's: 56 black, 3 white, 2 Asian.

aides: 90 black, 3 white.

unit secretaries: all black

Housekeeping: black manager, staff 1 Asian, 3 white, 5 black

Dietary: white manager, staff all black

Maintenance: black manager, staff 4 white, 1 black

Security: white manager, staff 70/30 b/w

Receptionists: 5 black, 0 white

Doctors: Chief of staff Asian, 3 white attendings, 1 black, 10 Asian

There are other departments but you get the idea.

Patients: about 50/50 black and white, very rarely someone who is Asian, Hispanic, or other.

Jews on staff: exactly 3 that I know of

Muslims: about 15%

Protestant: about 65%

Catholic: about 19%

Peace to all. This is our world. Let's make it work for all of us.

kimber1985 · Jan 28, 2007

Wow! I live in South Florida and I don't find these stats relevant at all.

I am sure I will offend someone here.

I have a class of about 26 and 6 or 7 are black and I use that word because they are not African Americans. They are multicultural. 2 are Asian at least 5 are Hispanic. That is half the class. I would say that at least that percentage are working in the hospital. I almost view nursing as a minority career choice. My current instructor is I believe African American, previous one from the Islands, and previous an Indian as in India and a male. I currently have no male students in male class, I find that the only minority. I don't know why, and I don't see any disadvantage to being male, except that you will be mistaken for a doctor or a respiratory therapist.

ZASHAGALKA, RN · Jan 28, 2007

Let me throw out 3 potential causes:

1. historical cultural bias. By that, I mean Jim Crow.

2. The lack of role models as a result of #1. Many nurses are 'legacy' nurses, having become nurses because they have family members that 'sparked' their interests. Guilty, here. Those 'legacies' serve to entrench historical patterns. Besides, such a high percentage of whites might itself send a cautionary tale to potential minority candidates: a potent warning about their perceived acceptance.

3. Competitive GPAs mean that only top-tier students feel like they can compete. I wish I could say that all our secondary schools were of equal calibre; they are not. The result is that 'elite' college students generally tend to be well-represented by students from 'elite' secondary schools. That's not nursing's fault.

I haven't 'blamed' anybody; I'm simply pointing out that the nationwide statistics, absent any anecdotal job site, are glaring. I think it does mean that the system is either broken, or incapable of adapting to representative reality. I'm not saying it's a 'people' problem, but a 'process' problem.

Or, Here's a loaded question: Can a black nurse be just as good a nurse as a white nurse? If you believe that the answer goes without saying, then shouldn’t it also go without saying that nursing should make a much better effort to recruit those nurses in representative numbers?

Even IF that under-representation is a result of historical and cultural trends not of our direct making, does that excuse ignoring the results?

~faith,

Timothy.

Altra, BSN, RN · Jan 28, 2007

Let me throw out 3 potential causes:
1. historical cultural bias. By that, I mean Jim Crow.
2. The lack of role models as a result of #1. Many nurses are 'legacy' nurses, having become nurses because they have family members that 'sparked' their interests. Guilty, here. Those 'legacies' serve to entrench historical patterns. Besides, such a high percentage of whites might itself send a cautionary tale to potential minority candidates: a potent warning about their perceived acceptance.
3. Competitive GPAs mean that only top-tier students feel like they can compete. I wish I could say that all our secondary schools were of equal calibre; they are not. The result is that 'elite' college students generally tend to be well-represented by students from 'elite' secondary schools. That's not nursing's fault.
I haven't 'blamed' anybody; I'm simply pointing out that the nationwide statistics, absent any anecdotal job site, are glaring. I think it does mean that the system is either broken, or incapable of adapting to representative reality. I'm not saying it's a 'people' problem, but a 'process' problem.
Or, Here's a loaded question: Can a black nurse be just as good a nurse as a white nurse? If you believe that the answer goes without saying, then shouldn’t it also go without saying that nursing should make a much better effort to recruit those nurses in representative numbers?
Even IF that under-representation is a result of historical and cultural trends not of our direct making, does that excuse ignoring the results?
~faith,
Timothy.

My few random thoughts:

The demographic statistics of practicing nurses in my particular area do closely resemble those you have quoted. However, in my area, this is probably not the result of ultra-competitive admission to nursing programs or (current) blatant discrimination. Within a 50-mile radius there are 8+ diploma programs, 5-6 ADN programs and roughly a dozen BSN programs running the gamut from private universities to state schools. Yes, admission is competitive, but not to the degree seen elsewhere. Those statistics, with the obvious exception of gender, do pretty closely reflect the general make-up of the populatio here.

On an entirely different note, I have heard more than once from African-Americal parents that they would not encourage their children to pursue nursing. As we have frequently discussed here, nursing sometimes has an image problem among lay people: they focus on the perception of nurses as simply the assistants of doctors, and on the physical, "dirty" aspects of the job. Some minorities may well wish to put a great deal of distance between themselves and any career choice that could even remotely resemble the limited choice of dirty, menial jobs of the past.

Maybe I'm being narrow-minded, but I would rather recruitment efforts focus on painting a realistic picture of nursing so as to attract those who are truly well-suited for this profession, instead of overt attempts at racial/ethnic/gender diversity.

PurrRN · Jan 28, 2007

. That's not nursing's fault.
Or, Here's a loaded question: Can a black nurse be just as good a nurse as a white nurse? If you believe that the answer goes without saying, then shouldn't it also go without saying that nursing should make a much better effort to recruit those nurses in representative numbers?
Timothy, just wanted to say that I often enjoy reading your thought provoking posts. I do believe that a black nurse not only can be but IS just as good as a white nurse, but I guess I just don't understand why a recruitment program should be implimented based on race. Based on a personal interest in health care, sciences and employability, yes, but race? I guess what I'm missing here is that when I chose to go to nursing school, I didn't choose it because of the % of races in the field, but because it interested me personally. Actually, until this post, I'd never ever thought about it, so I'm looking forward to hearing your thoughts. What barrier to health care career's are being percieved by non white individuals?

hope3456, ASN, RN · Jan 28, 2007

Awesome post Timothy! I have felt the same way about nursing....alot of the problem comes from nursing education, IMHO. I personally thought the nsg program I was in was very discriminating in the name of 'high standards.'

The way nsg school works, d/t the demanding schedules and academically intense courseload, caters to the more 'upper class' - a student who is more financially secure and has above average academic ability has a much better chance of making it. I had to work while attending nsg school, and that was definately a strike against me. I was only able to finish b/c of some 'lucky breaks.' Most of my fellow students were married and were supported financially by their DH's...they didnt work while in school. But yeah, I am a caucasian woman.

A BSN program in the neighboring community admits competitively, by the point system. You get points if you are minority or male, if you grew up in a rural area, or in any other geographic region that is 'socioeconomically disadvantaged.'

I live in a predominately white, upper class suburban community (nicknamed vanilla valley, b/c of the low percentage of minorities), and my CC nsg class was very representative of that. I would love to live/work somewhere where there is more diversity...

Altra, BSN, RN · Jan 28, 2007

I'm simply pointing out that the nationwide statistics, absent any anecdotal job site, are glaring. I think it does mean that the system is either broken, or incapable of adapting to representative reality. I'm not saying it's a 'people' problem, but a 'process' problem.
Or, Here's a loaded question: Can a black nurse be just as good a nurse as a white nurse? If you believe that the answer goes without saying, then shouldn't it also go without saying that nursing should make a much better effort to recruit those nurses in representative numbers?
Even IF that under-representation is a result of historical and cultural trends not of our direct making, does that excuse ignoring the results?
~faith,
Timothy.

This is where I disagree. Is there statistical evidence that minority candidates are being disproportionately turned away from nursing programs? Is there any anecdotal information on why more minority students do not choose to pursue nursing as a career?