Healthcare recruiters and nursing leaders are facing unique challenges in the post-pandemic environment of 2022. However, one persistent issue that has remained a constant variable is the lack of diverse representation in healthcare workers. To best serve, accommodate, and care for the diversity of a community, healthcare organizations are pressed to improve diversity, equity, inclusion (DEI), and belonging, in nursing immediately.
This issue was heightened during the most intense periods of the pandemic and highlighted the dire need and additional challenges faced by both patients and healthcare workers. With most healthcare organizations managing a patient-centered care framework and relying on strong patient satisfaction scores to keep their door open, this problem cannot be simply overlooked. Illness does not discriminate and the limitations of diversity in the healthcare workforce finds diverse patients that are often underrepresented in the realm of their caregivers.
DEI has been a recent focus for businesses and organizations of every stripe, but these efforts for the healthcare industry can make a significant impact, as they directly affect patient health outcomes and quality of life in a profound way.
Why Healthcare Is in a Unique Position To Impact DEI Efforts
While many healthcare organizations support DEI efforts, many have yet to implement the strategies necessary to achieve this social change. It is imperative to understand the difference between being supportive and taking action to implement change. In our 2022 Nurse Salary Research Report: Trends and Insights for Leaders and Recruiters, we found that persons who identify as Hispanic or Latinx are underrepresented across all nursing license types compared to their proportion in the U.S. population as a whole. This data aligns with the National Association of Hispanic Nurses’ (NAHN) findings that although Hispanics make up 17% of the total population, only 3.5% out of the more than three million registered nurses (RNs) in the U.S. are Hispanic.
The 2022 Nurse Salary Research Report contains insights from over 2,500 RNs, APRNs, and LPNs/LVNs from regions across the U.S. with data related to nurses’ views of their jobs and satisfaction in their roles, as well as their demographics.
The report also provides a snapshot of nurse representation across the U.S. Only 2% of our survey’s respondents were Black or African American men, whereas Black or African American women made up 8% of female nurses. By contrast, Asian men made up 10% of male nurses, and Asian women made up only 5% of female nurses.
The Impact on Patients and Nurses
The lack of DEI contributes to negative outcomes including patients and their families that find the following examples the most detrimental to their overall experience and care: lack of female leadership, health equity, provider diversity, cultural competence, intellectual and developmental disabilities care, and LGBTQIA-focused care.
Patients that identify in these marginalized groups fail to see themselves accurately represented in the organizations providing their healthcare services. It is the civic responsibility of healthcare leaders to implement strategies to combat these ongoing issues for the wellbeing of not only their patients and their community, but also for the healthcare industry at large.
Caregivers, explicitly nurses, are experiencing the same misrepresentation among their leaders. Nurses will be more successful in their careers when they have managers and leaders they can identify with. Healthcare providers should have the same DEI concerns for their staff as they have for their patients. Staff members must feel included, supported by leadership, and comfortable in their workplace environment in order to provide high quality and inclusive care to their patients.
Improving DEI in Nursing: Where Do You Start?
Step 1: Bring everyone in.
Understanding the organization-wide reach of a DEI initiative cannot be overstated. While the Human Resources department plays an obvious role in recruitment and hiring practices, don’t forget about the less obvious roles/departments that indirectly affect DEI.
Example: Consider the visuals used in marketing or the accessibility of information and services for various populations, such as having patient education materials available in multiple languages.
Step 2: Establish leadership commitment.
To truly impact DEI in nursing improvement efforts in a meaningful and lasting way, executive leaders must agree to fully commit and set the tone for the rest of the organization to follow. Channels for feedback will help to keep authenticity and accountability at the forefront of these efforts.
Example: Kicking off a DEI project with an intentional presentation to the organization’s leaders to understand the “why” and the value of improved patient and employee satisfaction by implementing a DEI strategy within the organization. Having leaders sign a commitment letter and displaying it for employees and patients alike sends a strong message that the organization takes DEI improvement seriously.
Step 3: Educate effectively.
Providing education such as cultural competency training as a requirement for employees is a great place to start. Vetted training with qualified DEI instructors is key to minimizing implicit bias.
Example: Include required education as part of new hire onboarding and orientation. Additional courses can also be included and scheduled for follow-up training as needed based on the key performance indicators and success of the DEI interventions.
Step 4: Know your baseline.
Identify a reliable resource or method to evaluate your organization’s current work culture in relationship to DEI indicators such as leadership analysis, inclusion competency, and current policies and programs specifically for DEI in nursing. This initial evaluation will help determine how well you are currently performing and provide the data needed to indicate the areas of opportunity that need to be addressed in your organization.
Example: Using patient and employee surveys or focus groups can help organizations learn more about the current perception of DEI and how to prioritize their areas of opportunity.
Step 5: Identify key performance indicators of success.
Select two to three key performance indicators to focus on over a fixed time period (e.g., year over year analysis). This action can help your organization implement targeted programs and focused interventions that lead to best practices that will drive the success of a DEI initiative.
Example: Creating a goal of increasing the number of staff members in departments that provide care to bilingual patients by 5% in one year to provide improved quality of care.
Step 6: Measure success.
Intermittently tracking progress is the key to success. Whether goals are creative around hiring, brand, or experience, routine progress checks should be well defined to focus on specific metrics. They should also be scheduled on an ongoing basis to help quickly shift efforts if necessary and be sure objectives are being met — shared first with the leadership team, then within the organization. This will ensure that everyone can remain committed to the success of the DEI initiative.
Example: Monitoring patient satisfaction scores, gauging the number of training sessions for DEI education, or improving the retention rate of candidates with diverse backgrounds.
DEI in Nursing Impacts Recruitment and Retention
The systemic misrepresentation of marginalized populations is just as dangerous to society as a physical illness. Presently, the healthcare industry has the platform to make a monumental change in DEI throughout the world. This crucial change starts with recruiters and leaders implementing strategic DEI initiatives and positively impacting the lives of both patients and staff.
Recent data also suggests that DEI efforts may affect nurse recruitment and retention. In one survey, 86% of candidates said DEI was important to them. Understanding what matters most to nurses is key, as nurses are in a position to actively seek out organizations that meet their needs, such as prioritizing a diverse workforce. Additionally, nurses that feel understood and empowered will be more likely to stay with an organization throughout their career.
As our nation’s diversity will undoubtedly continue to grow, so must the nursing workforce to better serve patients needs and advance health equity. To better understand the current level of diversity in nursing in greater detail, you can review the findings within the 2022 Nurse Salary Research Report.