“Focusing on the Need for Diversity in Nursing” Presentation for PCAHCR

Pilar De La Cruz-Reyes, MSN, RNDirector of Diversity

cinhc California Institute for Nursing & Health CareOptimizing the Health of Californians through Nursing

Excellence

Goal 2: Increasing Diversity of the California Nursing Work Force

Intent of the project:

Set diversity targets for 5, 10 and 15 years, consistent with the population projections and the shifting demographics of the aging RN workforce

Develop a strategically focused plan that describes interventions to meet the targets

Increasing Interest in Diversity

National interest in the need for a diverse health care workforce is growing

Institute of Medicine, Sullivan Commission

Health outcomes are improved when the health care workforce reflects the ethnic and cultural community that is being served.

Building a More Diverse Workforce

The California Wellness Foundation stated in 2005 “A healthcare workforce that mirrors our state’s ethnic and racial diversity is an important strategy for improving the health of California”

A nursing workforce that more closely mirrors California’s racial and ethnic makeup will bring greater access to and improve the quality of health care.

Why More Ethnic Nurses?

Nurses from underrepresented groups are more likely to understand cultural values that impact health behaviors and therefore will improve the health care system use and treatment compliance

Diminishing the fear in a patient’s face Fear turns into a smile

Why is there a need for more Ethnic nurses in California

Minority populations are growing in the state

Minorities soon to become the majority Nursing workforce needs to be more

representative of the people served Data tells the story of the need

Hispanic Population of the United States, July 1, 2008 46.9 million; the estimated Hispanic population

in the US as of 7/1/08; 3.2% increase in the Hispanic population

between 7/1/07 and 7/1/08; 132.8 million the projected Hispanic population

of the US by 7/1/2050; 2nd ranking of the size of the US; only Mexico

(110 million) had a larger Hispanic population than the US.

Source: U.S. Census Bureau

Data

Ethnic, Racial & Gender Composition of RNs in California 07/08 2004

White, not Hispanic 58.6% 63.9 Black/African-American 4.1% 3.8 Hispanic 7.5% 6.3 Filipino 18.0% 16 Asian Indian 1.4% Asian (not Filipino or Indian) 7.1% 4.9 Native Hawaiian/Pacific Islander 0.1% Native American Indian 0.4% 2008 BRN report

California Minority Population3 Different Regions

Region Hispanic Black Filipino Asian

CV 47.7% 6.0% 3.0% 5.8%

LA 47.7% 9.4% 14% 13.2%

SD 26.7% 7.9% 6.1% 2.8%

Percent of Minority RNs per Region

Reg # of RNs

W

H

B

F

A

CV 25,939 61.8% 9.6% 1.9% 14.1% 7.9%

LA 94,277 46.7% 9.6% 5.4% 23.4% 11.8%

SD 26,201 65.5% 6.6% 2.5% 18.5% 2.8%

Setting 5 year Targets for Minorities in Central Valley

15% increase in number of Hispanic RNs which translates into 75/year

25% increase in Black/African-American nurses which translates into 25/year

No projected increase in Filipino or Asian nurses as their numbers exceed the population

Setting 5 Year Targets for minority RNs in LA Region

15% increase in Hispanic RNs which translates to 272 /year

9% increase in the number of Black/African-American RNs which translates to 92 /year

No projected increase in Filipino RNs as they exceed population & no projected increase in Asian RNs as they are close to the population

Setting 5 Year Targets for the San Diego Region

15% increase in Hispanic RNs which translates into 52 / year

20% increase in Black/African-American RNs which translates into 26 /year

No projected increase in Asian or Filipino nurses

How Is This Accomplished

Good news from the California Board of Registered Nurses, 2007/2008 school report.

The number of minorities enrolling in nursing program has increased and continues to do so.

Data cont.from 2007/2008 BRN report

59.1% of students who enrolled in a pre-licensure nursing program for the first time are ethnic minorities; (up from 50% in 2004)

18.1% of the students were male 58.1% of students who completed a pre-

licensure nursing program are ethnic minorities 17.8% of students who completed a pre-

licensure nursing program are male. LVN to ADN programs had the greatest share

of ethnic minorities among students who completed a nursing program

Keys to Success

Decrease attrition of minority students Help them graduate Provide support Educate families Celebrate accomplishments Provide Mentors

Factors Impacting Student Attrition

Academic failure and personal reasons were reported as the factors with the greatest impact on student attrition

Almost 57% of nursing schools reported academic failure as the factor with the greatest impact on student attrition

23% of schools reported personal reasons as the factor with the greatest impact on student attrition

Student Retention

Methods to increase student retention Mentoring, remediation, tutoring Personal counseling New admission policies instituted Increased financial aid Curriculum revisions ATI testing Increased child care

How Can Nurses Help?

Encourage Ethnic Nursing Organizations to “adopt” a nursing school

Serve a mentors to minority nursing students at “adopted” school (s)

Become RN Ambassadors of the Coalition for Nursing Careers in California

Become familiar with cncc.org and choosenursing.com

HRSA Grant Proposal

“Adopt a Nursing School” Project Statewide mentorship network Identify a school Nursing School Director gets names of

minority mentors and provides information to the minority nursing students

Mentors and students link up as needed

Coalation for Nursing Careers in California (CNCC)

Works to encourage students, particularly underrepresented minority students to seek a career in nursing;

Attend school career days and offer information about nursing

Share their own stories of how they became a nurse with interested students

cncc.org and choosenursing.com

What About Faculty

Need more minority faculty Minority students need to see more role

models Needed at all nursing programs Minority faculty can stress the

importance of cultural sensitivity in patient care

Faculty Numbers

3,437 faculty; 91.4% female; 8.6% maleEthnicityBlack/African American 9.0%Asian 5.5%Filipino 5.5%Hispanic/Latino 6.8%Native American 0.6%White 70.4%Other 2.2%

BRN data, 2007/2008

Barriers to Recruiting Faculty

Non-competitive salaries Insufficient number of faculty applicants

with required credentials Overall shortage of RNs Private, state university of community

college laws, rules or policies BRN rules and regulations 7% of schools reported no barriers to

recruiting faculty

How Can Nurse Recruiters Help? Encourage minority nurses to serve as

part-time faculty; Encourage minority nurses to get their

Masters or doctorate Push for joint appointments Encourage minority nurses who are

looking for something different or planning to retire to think about becoming faculty.

Future Goals

HRSA grant proposal

“Hands Touching Hands” Letter of support will be needed from the

various organizations Identify potential sources of funding to

support diversity efforts Encourage the inclusion of more Cultural

Sensitivity programs in healthcare

So Now What???

What do we need to do? What ideas can be generated? Who do we need to get on board? How do we make a difference?

Statewide Mentorship Network

Need to link all the ethnic nursing organizations in the state

Black Nurses Association, National Hispanic Nurses Association, Philippine Nurses Association, Asian Nurses Association, American-Indian Nurses

NCEMNA; National Coalition of Ethnic Minority Nurse Association

Ethnic Nursing Organization Website

How do we link all of the ethnic nursing organizations into one website?

What is the mechanism to do this? What resources will we need? Is NCEIMA the avenue? How can we make it happen? How do we “advertise it” once

completed?

Involvement of Families

Important role that family plays in minority households;

Helping family understand the rigorous nursing program;

Orientation programs for family members at the start of a nursing program

Providing family members with information, literature, websites, etc.

Recruitment of More Men into Nursing

How do we encourage more young men to seek a career in nursing?

How do we deal with the “stereotyping” of nursing being a female occupation?

How do we educate minority parents of the value of nursing as a career for men?

Men in Nursing video

Men in Nursing Video

Focuses on male RNs and why they chose to go into nursing

Video includes minorities Provides a personal perspective Good for middle and high school

students Represents male nurses from various

areas of California

DVD Development

Having minority RNS tell their “story” of how they overcame obstacles to become a nurse

Tips on how to make it through the nursing program

Support needed Family involvement Use of mentors and tutors

DVD on “Beating the Odds”

Promoting this idea to RNs; Involving minority nurses of each ethnic

group (including men); Identify funding opportunities for DVD; Arrange for videotaping; Promote the DVD to schools; Inclusion of family members in video

Reaching Success

If we want more underrepresented minorities in the workforce, we are going to have to recruit more URM students into nursing and help mentor/tutor them so they complete the nursing program and graduate

We will need everyone’s help in order to accomplish this.

We need YOUR help!!

Summary

Questions/Ideas

THANK YOU!!!