Cultural diversity refers to the co-existence of different ways of life in a society (UNESCO, 2001): the state of appreciating, understanding and embracing differences among people irrespective of their ethnic, racial, traditional or societal ethos (Green, Lopez, Wysocki, Kepner, Farnsworth & Clark, 2015). The UNESCO Declaration on Cultural Diversity recognized cultural diversity as a shared heritage of all humanity (Article 1). Being an integral part of humanity, cultural diversity, thus, permeates all facets of human endeavor including the nursing practice.
Movement of people across borders coupled by changes in population demographics has been attributed to adjusting societal composition along such parameters as ethnicity, race, age, and gender. This has led to re-evaluation of cultural competences needed by medical professionals. According to Hansen (2014), cultural competence entails avoiding branding individuals and over-generalizing. It also demands that the caregiver to structure medical details and guidance to each patient. This could involve a native caregiver, who understands the language of the patient. For instance, a nurse who has skills in sign language would be the best option to attend to a patient with hearing challenges. To cope with changes, healthcare sector ought to enhance the cultural competences of its workforce in order to improve the quality of services. Beard (2014) argued that an increasingly diverse population requires a diverse workforce, more suited to provide patient-centered care.
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There is need to infuse cultural diversity competences for nursing practitioners. Thus, the current essay roots for diversity in the nursing practice by exploring the literature around the need for a culturally diverse nursing workforce in the US and the proposed benefits this may have on health-care provision. It also delves into the implications cultural diversity awareness will have on my practice as a nursing professional.
The case for a more culturally diverse workforce in the nursing profession has not been amplified in more certain terms than it has been in the recent past. The need has been argued primarily based on the changing diversity profile of the service recipients, patients, while the service providers continues to be dominated by Caucasians and females (Vilarruel, Washington, Lecher & Carve, 2015, Beard, 2014). There are may forms of diversity that are identified other than gender and ethnicity. Socioeconomic, geographical, religion, creed, and sexual orientation are other forms of diversity that are of interest to medical caregivers.
In 2010, the Institute of Medicine (IOM) issued a report in which it advocated for more ethnic, racial, and gender diversity within the nursing profession to advance the quality of care and minimize health-care differentials. Two reports followed in the subsequent year, the Department of Health and Human Services’ Action Plan to Reduce Racial and Ethnic Health Disparities and the National Stakeholder Strategy for Achieving Health Equity (NSS) (Hansen, 2014). The common theme proposed for enhanced federal involvement in creating a more diverse workforce. IOM released another report in 2004 that stressed on the need for much more diversity among healthcare providers. From a foregoing, it is evident that professional bodies were aware of the impeding disparity. They were also keen in initiating actionable plans that would see diversity entrenched in the nursing workforce.
Perhaps, the data on projections that was delivered by the US Census Bureau in 2014 gave more impetus to the push for diversity in nursing profession. It was a wake-up call: statistics revealed that there shall be changes in the ethnicity composition of the population in the future. It was forecasted that the changes would occur predominantly within the ethnic minority population, apparently poised to attain majority-minority status by 2044 (Colby & Ortman, 2014). The US Census Bureau established that by 2060, owing to various factors such as differential mortality and fertility levels, the total population of ethnic and racial minority groups will stand at 57% of the total US population (Ayoola, 2013). Despite the changes in population diversity, the nursing workforce has remained largely averse to diversity. As reported by Beard (2014), a survey published in 2013 by the National Council of State Boards of Nursing showed that American of African descent, Hispanic, Native Indians, and Native Pacific Islander nursing workforce makeup eleven percent of the caregivers’ population. Notable though, the total us population is made up of a third of the ethnic minority groups. Inclusion is about embracing all parties their numbers in the general population notwithstanding. Low figures and lack of representation can generate a feeling of alienation and a sense of second-class citizenship.
While advocating for a culturally diverse nursing workforce, various writers have presented numerous benefits that have been seen to accrue as a result of the practice (Green et al, 2015, Hansen, 2014, Beard 2014, Seely, 2019, Saxena, 2014). They tend to agree that a diverse nursing workforce is good for the patient welfare and interpersonal relationships among the medical health workers. Moreover, understanding how to accommodate patients’ cultural beliefs together with conventional medical procedures, has a way of hastening treatment. Acknowledging these types of patient differences can decrease the stress of the patient.
Saxena (2014) asserts that workforce diversity promotes productivity. As people learn to work together, they appreciate and accommodate each other’s views and beliefs without being prejudicial, discriminative or biased. It is essential that leadership is appreciated as a vehicle necessary for managing the vices and thus promote productivity. Recently, Seely (2019) while affirming cultural competences, asserted that leadership success can be achieved by building relationships and appreciating diversity in a nursing workforce.
There are four reasons for states to engage in workforce diversity. This was established by Dr. Jordan J. Cohen, professor of medicine and public health at George Washington University and president emeritus of the Association of American Medical Colleges (AAMC). Dr Cohen and his associates indicated that workforce diversity in medical circles; is a suitable method of promoting cultural competences; enhance uptake of high-leve health-care services; strengthen the healthcare research undertaking; develop leaders who can oversee a healthcare system that embraces diversity through its ranks (Hansen 2014).
It has been argued that increasing diversity in the health care workforce could help to eliminate health care disparities and strengthen overall cultural competence (Beard, 2014). This notion is further stressed by Hansen (2014) revealing that expenditures for African Americans, Asians and Hispanics are because of health disparities reached 30 percent of direct medical care. Healthcare providers must have the capacity to provide care in a diverse context in order to alleviate the disparities As a result of the increasing diversity of the U.S. population,. This paper argues that enhancing nursing workforce diversity could promote a deeper understanding of health issues by taking knowledge closer to the communities through their representative in the health sector. On the overall, the government could benefit through reduced cost of healthcare as well as reduce employee downtime thus delivering a healthy economy.
In-spite of the many benefits which can arise from nursing workforce diversity, it is worth recognizing that it comes with its fair share of challenges. It requires dedicated leadership to manage diversity. As Green and colleagues (2015) aptly put it, managing workforce diversity implies much more than simply appreciating that people are different and are bound to exhibit different characteristics. It demands leadership that recognizes the utility in the differences, fights segregation, and elevates inclusivity through proactive and purposed actions.
Arising from workforce diversity are issues of negative attitudes and behaviors which may spread at the workplace. They include prejudice, stereotyping, and discrimination (Green et al, 2015). Nursing management need to be aware that these issues could lead to costly litigation. Moreover, they can do harm to working relationships, damage morale and work output and quality. As a matter of policy, management should be familiar with the law and practice it. There ought to be great consideration of such vices when preparing nursing personnel who are to serve in a culturally diverse setup.
Minorities are not only under-represented within the mainstream nursing service providers, but also in leadership and management positions in the health sector (Hansen, 2014). The role of the nurse leader is paramount in promoting a positive work environment to increase staff engagement will become increasingly important for organizational success. While advocating for a more diverse faculty in schools of nursing, Beard and Volcy (2013) expose the biases and racism that has infiltrated nursing education. A culturally diverse faculty would otherwise mentor upcoming nursing professionals and propagate the ethos of a culturally diverse nursing workforce. In addition, the educator is equipped with knowledge and experiences that may be similar to those of the student. This faculty member is at a vantage position to share experiences and provide guidance to students of the same divide as the students negotiate the American nursing education system (Ayoola, 2013.
It is apparent that the US population is undergoing profound change in terms of cultural diversity. Stakeholders in the health sector have been identified to play a pivotal role in advocacy. The change has elicited reaction from authorities on ways of bridging the gaps identified such as enlisting more nursing personnel from diverse background and having more faculty from the minority groups represented. Also notable is commitment of resources towards establishing the trends in population dynamics. There are a number of benefits that may accrue to the nursing profession by way of embracing diversity at the workplace. Despite the many benefits, challenges emanating from within the diverse workforce are identified. A sustainable diverse workforce demands for well-trained personnel coupled with the right attitude. There is need for trainee nurses, therefore, to develop cultural awareness. Towards that end, training programs could also aim at imparting cultural competences in order to develop an all-round professional who is able to function well into the future.
As a professional caregiver in the nursing practice, I need to develop cultural awareness. I will purpose to be consciously aware of and appreciate the diversity of my patients and their communities to the extent that my aim will always seeking the best option for each patient. Different patients have diverse aspirations with regard to their treatment. As a caregiver, the knowledge gained pertaining to cultural diversity would enhance my understanding of their stand point with regard to treatment. Culture has a significant influence in health-related beliefs and practices. I am aware that I will be operating in an environment where cultural pluralism will be rife. I will need to approach cultural pluralism as an unalienable to every human being. The code of ethics under which I will be operating specifies that I must provide the best service to all my patients and communities irrespective of their background. It is thus imperative that to enhance my service, I will need to acquire cultural diversity competences. The reality of the times I will operate in during my nursing career is also food for thought and a source of motivation towards attaining the requisite diversity competences: that is, a time when cultural diversity will have blossomed as minority numbers surpass the current majority Caucasian population.
Cultural awareness is bound to not only enhancing my service to the patients but also my interpersonal relationships with colleagues and at the workplace community. Advocacy for inclusion into the nursing career for ethnic and racial minority groups set to be enhanced in readiness I foresee the composition of the nurse professionals changing. As I harness my cultural competences and grow in nursing leadership, I will be able to resonate with Beard’s (2014) sentiments on learning how to create safe environments where opinions on race and ethnicity are encouraged and valued. Cultural awareness and collegiality are a recipe for innovative nursing care where cultural diversity is used to advance the nursing profession as a service to the patients and at interpersonal relationship level.?
Ayooka, A. (2013). Why diversity in the nursing workforce matters. Retrieved from https://www.rwjf.org/en/blog/2013/05/why_diversity_inthe.html.
Beard, K. V. & Volcy, K. (2013). Increasing minority representation in nursing: A more diverse nursing faculty is crucial. American Journal of Nursing, 113(2).
Beard, K. V. (2014). How much diversity in nursing is enough? If we’re afraid to even talk about such questions, we’re not yet there. American Journal of Nursing, 114(9).
Colby, S. L. & Ortman, J. M. (2014). Projections of the size and composition of the U.S. population: 2014 to 2060, current population reports, P25-1143, U.S. Census Bureau, Washington, DC.
Hansen, M. K. (August, 2014). Racial and ethnic health disparities; Workforce diversity. National Conference of State Legislatures.
Saxena, A. (2014). Workforce diversity: A key to improve diversity. Procedia Economics and Finance, 11, 76-85.
Seely, K. (2019). Communication and the diverse workforce. Nursing Management. DOI-10.1097/01.NUMA.0000550452.09752.e8.
UNESCO (2001). UNESCO Universal declaration on cultural diversity. Retrieved from http://www.unesco.org/new/en/social-and-human-sciences/themes/international-migration/glossary/cultural-diversity/.
Vilarruel, A., Washington, D., Lecher, W. T. & Carver N. A. (2015). A more diverse nursing workforce: Reater diversity is good for the country’s health. American journal of Nursing, 115(5).
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