The critical role of diversity, equity and inclusion in nursing
With an increasingly diverse population in the US, the nursing workforce needs more diversity among its staff to be more culturally aware and for patients to feel comfortable in the healthcare environment. Diversity is the inclusion of many people with differences; equity is about fairness and providing resources according to needs; and inclusion is belonging to a group and feeling supported and valued. These concepts are essential to nursing care and ensure that nursing reflects the communities it serves and delivers high-quality care to all. Nurses are crucial in raising awareness and ensuring that everyone receives non-judgmental healthcare.
There are opportunities to qualify as a nurse by taking an online nursing program in Virginia. Marymount University’s accelerated nursing degree is for aspiring nurses with a bachelor’s degree in a different subject who want to change careers. There is a high demand for nurses in Virginia, and it is one of the top-paying places for registered nurses. In the below sections, we look at diversity, equity, and inclusion in more detail.
Diversity
Diversity involves including and involving people from all identities and backgrounds to participate in a group or organization. Diversity can consist of groups of people with different abilities, ages, races, ethnicity, sexual orientation, religion and gender. It is also about the way that differences can benefit a community. A diverse organization acknowledges that people with different attitudes, beliefs, experiences and backgrounds can bring new perceptions and ideas to the group. Many studies have shown that diversity improves organizations’ work and benefits individuals and society. When healthcare organizations consider different backgrounds when recruiting, nurses’ healthcare teams benefit and patients feel more comfortable.
People enter clinics and hospitals every day, including people of every race, gender and age. Studies have shown that patients who see themselves within the healthcare workforce are more likely to trust the staff looking after them. They find it easier to communicate about their condition, better understand their treatment, and feel more satisfied with their healthcare.
Equity
Equity is a different concept from equality. In healthcare, equality is about giving everyone the same opportunities and resources to reach optimum health outcomes. Equity is about realizing that everyone has different circumstances and allocating opportunities and resources so that they get equal outcomes. Achieving health equity requires addressing historical and contemporary injustices; overcoming social, economic and other barriers to health and healthcare; and removing preventable health disparities. Giving an opportunity to someone is not sufficient if they do not have the means to use it. Equity is achieved when no disadvantage exists due to differences such as race or age.
Healthcare policy can promote equity, but there can also be changes in how nurses educate and treat patients.
Inclusion
Inclusion is about creating a safe and respectful environment for staff and patients. Inclusion for nurses means that they are a part of all patient care within their scope of practice. Nurses should have equal treatment and not be excluded based on any differences. Patients can come from many different backgrounds and identities, and healthcare organizations with diverse nursing staff can provide care appropriate for a wide range of patient preferences and needs. The working environment can be run with respect and acceptance to make inclusion an intrinsic part of healthcare settings.
Nurses and DEI
Diversity, equity and inclusion (DEI) is a growing area of focus in nursing. It relates to education, patient care, care teams and leadership. DEI is essential in nursing and can improve patient care and colleague relationships. Nursing statistics indicate the presence of minority nurses within the profession. The US Census Bureau 2020 data states that 40% of the US population identifies as people of color. According to the National Council of State Boards of Nursing 2020 survey, nurses from minority backgrounds represent 19.4% of the registered nurse (RN) workforce. The RN population is composed of 80.6% white. 9.4% of the nursing workforce is male. However, there is a need for more diversity among faculty staff. According to the American Association of Colleges of Nursing’s annual report, in 2021, 19.2% of faculty staff come from minority backgrounds.
DEI for nurses begins with education. There must be diversity among students and educators so that nurses learn to work with diverse groups. DEI is also essential when practicing as a nurse. The nursing workforce is mainly white women with low numbers of men and African Americans. Diversity in nursing affects patient care. Patients feel more comfortable if nurses look like them and have the same cultural practices. Nurses look to leadership to find diversity. DEI in nursing leadership can create a culture where different backgrounds and perspectives are appreciated.
When people do not have a common background, seeing them through our own experience can be easy. Nurses can regard patients as capable of following the steps recommended for improving their health. It can be assumed that they have the understanding and tools to reach the preferred health outcomes. There needs to be an understanding of the patient’s reality to avoid inequity. A diverse workforce creates awareness and a more comfortable environment for staff and patients.
The code of ethics is a guide for nursing practice. It declares that every patient must receive nursing care regardless of their situation, background or resources. Nurses must be aware of any bias they have to provide comprehensive healthcare and be culturally competent. Bias is not always conscious, but it can lead to discriminatory behavior that harms relationships with patients and colleagues. Some biases are so deeply ingrained that people are not aware of them. An example could be age bias where a colleague assumes that a nurse near retirement age cannot cope with the stress of working in the emergency room. This bias could affect the healthcare team and patient care.
Nurses understanding DEI and reflecting on their personal bias can develop culturally capable relationships. Recognizing social health factors can promote equity in patient outcomes. Some patients do not have access to what they need to be healthy. For example, patients may struggle to pay for their medication, and nurses can help them access prescription assistance. Nurses can determine what patients need for their medical condition and advocate for resources.
Diverse healthcare teams can have better communication, problem-solving skills, change competency and commitment to enhanced patient care. DEI within the nursing team can inspire nurses to learn from and about others, and this improves their practice. There are strategies that nurses can use to bring DEI to their workplace. They can ensure that they receive DEI education and encourage other nurses to partake in this education. The more everyone on the team knows about DEI, the better team and patient outcomes.
Nurses can learn from colleagues and patients from other cultures by asking them about their cultural preferences. It is beneficial for nurses to know their organization’s DEI policies and whether any groups or committees are working to promote it in the workplace. Nurses can celebrate differences by getting to know colleagues and patients from other cultures and learning about their celebrations and traditions. Nurse leaders can be role models for their teams by promoting diversity and recruiting nurses from varied backgrounds and cultures.
Nurses can develop an understanding of the composition and needs of the communities they serve. Education and care planning can be adapted to meet these needs. Disparities can be addressed, and planning and resources can be adjusted to achieve the best possible health outcomes. Inequities can be related to language, staff lacking cultural awareness, lack of cultural awareness integration into care plans, and more. If there is a diverse workforce that reflects the community, this will improve the nursing practice.
Nurse leaders and DEI
Nurse leaders play a considerable role in advancing DEI and ensuring that all patients feel represented. They have the influence to encourage DEI and oversee nursing practice. They can demonstrate leadership in educating their teams to recognize bias and provide tools to create change effectively. Nurse leaders can promote inclusion by providing nurses with a safe and welcoming environment. They can give everyone the opportunity to say what they think and provide learning opportunities to all team members.
Nurse leaders can have cultural awareness when recruiting new nursing staff. They can find ways to reach minorities when placing advertisements and attending minority job fairs. They can make it clear in their advertising that all applications are welcome, which can show that inclusion matters in their environment.
Nurse leaders may encounter bias in the workplace. They must accept that bias does exist and create a culture that encourages discussion. They can be role models and promote inclusion. Leadership staff can model the desired behavior and help to create a fair workplace that accepts all patients and employees. Nursing programs typically include DEI training and nurse leaders can reinforce this at work. Nurses can better understand their biases and learn more about cultural and social factors that influence patient behavior.
Advances in healthcare technology have made it easier for nurse leaders to measure health equity. Healthcare networks collect data on the demographics and socioeconomic status of patients and staff. Nurse leaders can use data to improve patient outcomes and work allocations to staff. Data can help with DEI practice at work. Nurse leaders can create DEI environments by recognizing inequity and being good leaders.
Nursing organizations that promote DEI
Many organizations promote and implement DEI initiatives in nursing. These organizations have recently highlighted the need for DEI in nursing education and practice. There is presently a lack of nurses who represent the communities they serve, and nursing organizations are prioritizing a more balanced nursing workforce.
The American Association of Colleges of Nursing (AACN) works to bring innovation and excellence to research, education and practice. The values of DEI are central to their mission, and they work to connect with future students by preparing nurses to care for a diverse group of patients. The numbers of minority nursing students taking advanced degrees have been low but have increased over the last 10 years. The AACN believes that nursing education must develop a nursing workforce that respects and is compassionate toward diverse patient populations. The AACN advocates for DEI in nursing through public policy initiatives and regulatory advocacy.
Nurse advocacy
Nurses interact with many health professionals at every level of practice. One of their responsibilities is to practice advocacy. The Nursing Code of Ethics states that nurses must mitigate health inequality and protect human rights. This involves advocating for people to overcome healthcare barriers. Nurses must work to ethical standards and be unbiased when working with patients. Nurses can look over treatment plans with patients and make sure that they understand their treatment. Many people find medical terminology difficult to understand, and nurses can explain clearly.
Low health literacy can considerably affect patient understanding of health information and making appropriate health decisions. Some factors that prevent understanding are undiagnosed cognitive impairment, vision and hearing issues, reading levels, and language and cultural differences. Groups at high risk for low health literacy are ethnic minorities, refugees, those living in poverty, and ethnic minorities. Nurses can educate their patients, giving them medical information that they understand. Nurses can recognize communication barriers and work to achieve cultural and spoken connections.
Nurse advocacy can relate to current patient care and health concerns. They can observe the influence of policy and politics daily in the workplace. They are the largest staff group in healthcare and are in a position to see the impact of health policy. They have experience of how policy affects patient care. They can join nursing organizations and use their voices to influence patient care in the future.
Underserved populations
Health disparities are preventable differences in health that are experienced by populations disadvantaged by geographic location, environment and economic status. Health disparities can be experienced by many populations, such as racial and ethnic groups, people with limited English, people with disabilities, and people who are LGBT+. Nurses can reduce health disparities by advocating for patients. They can do this by advocating for patient rights, interpreters and distress screening.
Underserved populations have little or no contact with healthcare or are vulnerable in other respects. These can be educationally disenfranchised people, individuals with disabilities, and prisoners. There can be barriers preventing underserved populations from accessing healthcare and having health coverage. Poverty is one reason for not having access to healthcare, and this can be true for people living in some rural areas. A cultural reason preventing access to healthcare can be not speaking English. Urban and rural communities lack enough health professionals to meet population needs. Nurses may be caring for patients with living conditions they have not experienced, but they must accept their patients and focus on their health. Building relationships with patients can help them make changes to improve their health.
Some patients are vulnerable and may not have the resources needed for healthcare. Nurses must be non-judgmental and listen well to discover the patient’s obstacles. Nurses can advocate for raised awareness and change and protect the health of underserved populations. Nurses can liaise with Medicaid and insurance companies. They can join committees that advocate for underserved populations in schools, hospitals and communities.
Underserved populations experience higher death rates, rising diabetes diagnoses, high cancer and heart disease rates, and high infant mortality rates. Nurses work with patients from diverse cultures and need cultural awareness to deliver an equitable service. The correct interventions can address poor health, disadvantages, untimely disease and death. Nurses can advocate for policies that bring health equity and address health-related social factors. They can be strong advocates because they understand healthcare.
When implemented correctly, DEI initiatives can increase access to healthcare for diverse patient populations, improve patient care and achieve higher levels of patient satisfaction. A diverse workforce of nurses can provide more effective care to a diverse population of patients. Not all nurses can relate to every cultural background, identify with every gender identity or speak every language. With more diversity among nursing staff, there may be a nurse who can make suggestions and improve patient care. Nurses who feel accepted in their diversity can provide better care for patients with diverse backgrounds. Employers who recognize the importance of diversity prioritize hiring nurses from different cultures, races and ethnicities.
Working to embed DEI in nursing
The modern world of nursing needs to embrace DEI to better reflect the communities they serve and provide improved patient outcomes. It has been recognized that a more diverse nursing workforce benefits patients, staff and society. Nurses are trained to recognize their own bias and be aware of the benefits of diversity. Nurse leaders are essential in leading by example and having a work environment that is open-minded and welcoming to everyone. Some populations lack access to healthcare, and nurses can advocate for these people and use their knowledge and experience to reduce health disparities. Health organizations and their staff are committed to increasing DEI for the betterment of healthcare, nurses, and their patients.
