In 2011, the Institute of Medicine, now National Academies of Sciences, Engineering and Medicine, published the landmark Future of Nursing: Leading Change, Advancing Health report, which contained a recommendation to increase the diversity of the nursing workforce at every level of the health care system. The report was updated in 2016 and prioritized the lack of diversity in the profession as a persistent challenge, as evidenced later by a 2017 survey conducted by the National Council of State Boards of Nursing (NCSBN) and the National Forum of State Nursing Workforce Centers. The survey reported the demographics of the profession as: 80.8% White/Caucasian; 6.2% African American; 7.5% Asian; 0.4% American Indian/Alaskan Native; 0.5% Native Hawaiian/Pacific Islander; 1.7% two or more races and 2.9% other. We can and must do better.
One of the areas of focus of the current Future of Nursing 2020–2030 committee is to identify the systemic facilitators and barriers to achieving a workforce that is diverse including gender, race, and ethnicity, across all levels of nursing education. The timing could not be better.
The AONL board has focused on the area by reviewing our bylaws, developing educational content and appointing board members to increase the diversity necessary for our organization. This past fall the AONL Diversity and Belonging Committee began its work. The committee’s leaders, President-elect Erik Martin and appointed board member Joy Parchment, have convened members several times to draft a mission, vision and conceptual framework. With the vision “to unleash the potential of a diverse and collective nursing community,” this committee’s work will drive the future direction of AONL.
We are confronting racism head-on because we recognize it as a public health crisis and a roadblock on our path to zero harm.
As your AONL president, I am participating in the newly convened National Commission to Address Racism in Nursing. The co-leads for the Commission are Ernest Grant, president, American Nurses Association; Alana Cueto, president, National Hispanic Nurses Association; Martha Dawson, president, National Black Nurses Associations; and Debra Toney, president, National Coalition of Ethnic Minority Nurse Associations. The work is currently focused on establishing a vision and mission. This will guide the creation of work groups in the areas of education, practice, policy and research to facilitate a deeper discussion into aspects of the profession.
In the wake of social and political changes, health care leaders have committed to improve and increase the diversity, equity and inclusivity of their workplaces. However, progress has been slow as organizations grapple with implementing efforts that encompass not just race and ethnicity but also gender, sexual orientation, culture and religion. There is no one approach for all organizations given the richness of diversity across communities. Here at Duke Health, we established a framework that we call Moments to Movement. This is Duke Health’s collective stand against systemic racism and injustice. The name signifies going beyond passive moments of reflection and becoming more active as we build a movement to make lasting change for our patients, their loved ones and each other. It is a process of honest discussion and self-examination across all roles and disciplines to make our organization and our community stronger, healthier and more just.
We are confronting racism head-on because we recognize it as a public health crisis and a roadblock on our path to zero harm. We recognize that a healthier organization can only happen if all of us feel a strong sense of inclusion and belonging, so the first step in achieving our health system goals is to acknowledge those parts of our culture that need to change. That is the work of Moments to Movement.
As nurse leaders, we know that understanding and respecting one another is critical to delivering care that best meets patients’ needs. In the spirit of focusing on solutions, this issue contains articles that provide context and ideas so you can start making positive changes in your own organization right now.
The article by Ena Williams and Martha Dawson focuses on the literature that can help us understand the background and challenges minority nurses face, as well as recommendations organizational leaders can adopt to support a diverse nursing leadership workforce. Their article highlights the importance of sponsorship as a method to create opportunities for diverse nurse leaders, particularly those in mid-career.
Jane Fitzsimmons and Angelleen Peters-Lewis focus on diversity in the C-suite. According to a 2020 report for McKinsey and Company and Leanin.org, women comprise 66% of health care entry-level positions, but only 30% of C-suite roles. Only 5% of those are held by women of color. The authors describe results of a survey designed to reveal barriers to career advancement and seven broad recommendations for promoting equity and inclusion.
Attracting more men into the nursing workforce has been a persistent challenge. Demetrius Porche and David Beasley’s article provides much needed context on the state of men in nursing, including the data on males enrolled in nursing programs, their roles in academia and strategies for recruiting more males into the profession.
The remaining article comes from Rush Health System in Chicago, providing incredible accounts of efforts to reduce food insecurity, improve health literacy and a collaboration to address homelessness, all during the pandemic.
Finally, I would like to recognize the Honor Roll of Donors who support the AONL Foundation. Because of their generous support, we are achieving our mission of bridging science and education to shape the future of health care.
Thank you for all that you and your teams are doing to continue to care for all aspects of your communities.
ABOUT THE AUTHORS
Mary Ann Fuchs, DNP, RN, NEA-BC, FAAN, Vice President of Patient Care & System Chief Nurse Executive Duke University Health System, Associate Dean of Clinical Affairs Duke University School of Nursing, Durham, N.C