According to Cary and colleagues, the majority population will become a minority, with the minority increasing from 37% to 57% by 2060. The nursing shortage amid retirement age nurses and the exodus during the COVID pandemic has been widely reported. The shortage of nurses of color is even more drastic. According to Shead, Robert Wood Johnson and the Institute of Medicine have called for addressing health inequities and complexities of diverse populations by increasing the nursing workforce diversity.

Neal’s study explores how racial underrepresentation among nursing program graduates contributes to healthcare disparities. It examines the perspectives of graduates from racial minority groups to identify factors that lead to their academic success.

The news and literature (including from Benson and colleagues, Cary and colleagues, Goode and colleagues, and Sumpter and colleagues) report that addressing health disparities can be achieved through practitioners who resemble the population experiencing them. The current political climate will impact health disparities; for example, according to the NLN and Tinetti and colleagues, the recent Congress voted to reduce spending on diversity in the nursing workforce. Tinetti and colleagues discussed the need for practitioners who care for endangered populations to have similar backgrounds. Underrepresentation is directly correlated with health disparities (Benson et al., 2022)

To eradicate health disparities, we need to understand what them. Health care disparities can occur when the outcomes for healthcare issues are notably worse for one population over another, and the only difference may be race, sex, or economic disparities (Sumpter et al., 2022). Health disparities, as defined by the Centers for Disease Control and Prevention, are preventable differences in the burden of disease, injury, violence, or the opportunity to achieve optimal health. Minority patients frequently feel satisfied and motivated to achieve outcomes when cared for by minority providers (Eden, et al.,2021, Horwedel et al.,2021).

As the researcher, a descriptive study was conducted and by analyzing responses from interviews with graduated nursing students of color, invaluable information was derived. All students attended a specific nursing program at a university and earned a bachelor of science in nursing (BSN). These students passed their NCLEX and are working as nurses. 

Improving Diversity in Nursing

Since it is believed that disparities will be reduced more effectively with more nurses of color, the question becomes: what will improve the likelihood that more nursing students of color succeed?  In this research study, a small sample size was interviewed and asked all the same questions, including what made them successful in their nursing program. The students all attended the same program, and they were asked what helped them succeed.

All interviews were conducted on Zoom and transcribed using Otter.ai. Once the interviews were available in written form, the words were analyzed for commonality. The participants reviewed the written interview for accuracy and agreed upon the written script. Themes emerged about the tangible ideas that led to their success. The themes were listed in NVivo to facilitate analysis of common occurrences. Despite believing that technology would be the primary reason students were successful, the research showed otherwise. Quite a few used unconventional methods, such as YouTube and Google, to understand concepts; however, the overwhelming conclusion, reached by all students except one, was that faculty support and encouragement were the leading reasons for their success.  A couple of students had experiences attending other universities before graduating from the university used in the research. One student explained that you can tell when a faculty member truly cares about their well-being and success in the program because, in other programs, you can feel like you are just a number. Cary et al. (2020) explored participants who expressed that faculty support was needed and that faculty encouragement helped them be successful, and that support was more easily accepted when the faculty looked like them.  Cary et al. (2020) found similar results, reporting that students sought advice from faculty who appear to share the same lived experiences. Students are more likely to seek out faculty with similar racial/ethnic backgrounds to mentor them if they believe they can understand their issues, as they may share the same lived experiences. Cary et al. (2020) explored how keeping minority teachers on staff will help minority students succeed by providing mentorship and support from professors who share their ethnicity.

This leads to another problem: a shortage in nursing, which is even greater when discussing faculty shortage (Benson et al., 2022). The shortage of nursing faculty cannot hinder quality nursing experiences in clinical and lab settings. The resources used to foster the learning of nursing concepts can be equally important to the student’s success. Nardi et al. (2020) agreed that resources were important for academic success, but they stressed that stress management and anxiety should be addressed. Since there is a shortage of nursing faculty, just as it is a shortage of nurses, we can also conclude that there is a shortage of faculty of color, as mentioned by Cary et al. (2020), Green (2020), and Matthews (2022) all mentioned in their studies on how implicit bias impacted the nursing profession’s lack of diversity.

Today’s Climate

The political climate recently has made it more difficult to address health disparities, whether because of dismantling diversity, equity, and inclusion, or mentioning that nursing is not a profession. Nursing is an integral part of the medical profession, meaning doctors need nurses to care for patients. The nurses also need to notify physicians of any changes in the patient’s condition to avoid complications and/or death. We need to continue promoting the need for nurses, especially nurses of color, if we hope to address disparities among people of color. Students need a clear, methodical curriculum, rich clinical experiences, simulation opportunities to improve and enrich nursing concepts, and faculty and peer support to enhance their self-determination. It would be optimal to have a diverse faculty, but until that can be achieved, nursing programs should consider implementing an assessment tool to select faculty who not only educate but also provide care and support to their students.

The evidence for the lack of racial diversity among nursing program graduates and its impact on health disparities is noted by various researchers (Benson et al., 2022; Goode et al., 2018). Despite our challenges in politics, faculty, curriculum, finances, and all the rest on the list, we must increase the nursing population to support, care for, and protect the public. This is good for everyone, not just people of color.

References

Armstrong, R., & Tyson, C. (2022). Say their name: Early critical race theory scholars and their place in the debate. Diverse: Issues in Higher Education, 38(21), 40. https://search.ebscohost.com/login.aspx

Benson, R. T., & Koroshetz, W. J. (2022). Health disparities: Research that matters. Stroke, 53(3), 663–669. https://doi.org/10.1161/STROKEAHA.121.035087

Cary, M. P. Jr, Randolph, S. D., Broome, M. E., & Carter, B. M. (2020). Creating a culture that values diversity and inclusion: An action-oriented framework for schools of nursing. Nursing Forum, 55(4), 687–694. https://doi.org/10.1111/nuf.12485

Eden, A. R., Taylor, M. K., Morgan, Z. J., & Barreto, T. (2021). Racial and Ethnic Diversity of Family Physicians Delivering Maternity Care. Journal of Racial and Ethnic Health Disparities, , 1-7. 10.1007/s40615-021-01055-y

Goode, C. A., & Landefeld, T. (2018). The Lack of Diversity in Healthcare: Causes, Consequences, and Solutions. Journal of Best Practices in Health Professions Diversity: Education, Research & Policy, 11(2), 73-95. https://search.ebscohost.com/login.aspx

Green, C. (2020). Equity and diversity in nursing education. Teaching and Learning in Nursing, 15(4), 280-283.

Horwedel, D. (2021). Culturally Congruent Care. Tribal College Journal, 32(4), 34-39. https://search.ebscohost.com/login.aspx

Matthews, A. K., Abboud, S., Smith, A. U., Smith, C., Jeremiah, R., Hart, A., & Weaver, T. (2022). Strategies to address structural and institutional barriers to success among students of color in nursing programs. Journal of Professional Nursing, 40, 96-104. https://doi.org/10.1016/j.profnurs.2022.03.005

Neal, M. (2024). Perceptions on the Success of the Students of Color in a Nursing Program: A Qualitative Descriptive Study, Pro Quest Dissertation,

Nardi, D., Waite, R., Nowak, M., Hatcher, B., Hines-Martin, V., & Stacciarini, J. R. (2020). Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing Leadership. Journal of Nursing Scholarship, 52(6), 696-704. 10.1111/jnu.12602

Sumpter, D., Blodgett, N., Beard, K., & Howard, V. (2022). Transforming nursing education in response to the Future of Nursing 2020–2030 report. Nursing Outlook, 70(6), S20-S31. 10.1016/j.outlook.2022.02.007