Found in every corner of communities, from hospitals and schools to homeless shelters and outpatient clinics, nurses outnumber doctors 3 to 1 and spend twice as much time with patients.
But there’s one glaring problem: The current nursing workforce doesn’t reflect the people they care for.
More than 40% of Americans identify as people of color, yet less than 20% of registered nurses are BIPOC (Black, Indigenous or People of Color). This lack of diversity has the potential to hurt everyone, from BIPOC nurses who feel isolated on the job to people from historically underserved populations who tend to suffer poorer health outcomes.
Johnson & Johnson has long been committed to supporting nurses, and that includes investing in solutions to increase diversity across the nursing profession.
“As a company, we strongly believe that it’s crucial to help build and support a nursing workforce that mirrors the communities they care for,” says Lynda Benton, Senior Director of Global Community Impact Strategic Initiatives of Johnson & Johnson Nursing.
63% of nurses have experienced racism on the job. More than three-fourths of Black nurses said racism negatively impacts their professional well-being.
“When you’re a nurse with a diverse background, you are likely to bring a differentiated perspective to patient care,” explains Benton. “You may have broader and deeper insights into patient beliefs, attitudes, ethnicities and perceptions. When patients see nurses and other members of the medical team who look like them, it can remove barriers, open up conversations and ultimately improve access to quality care.”
Johnson & Johnson’s Our Race to Health Equity (ORTHE) Initiative has funded more than $1 million in scholarships to BIPOC nursing students through the Foundation of the National Student Nurses Association. Now, ORTHE is investing in two pilot programs that encourage and mentor nursing students of color.
The first program is a year-long leadership initiative developed by the National League for Nursing (NLN), an organization whose mission is to promote an inclusive nursing workforce and support nursing education. The NLN leadership program is designed to help students of color with a smooth transition from their last year of school to their first clinical job.
The second initiative is led by the American Association of Colleges of Nursing (AACN), which represents more than 865 nursing schools nationwide. The AACN has developed a detailed online survey for student nurses to measure their sense of belonging in classrooms. The goal is to use the survey results to foster a more inclusive and encouraging culture on campuses.
Both programs zero in on the transition period when student nurses enter the professional world—a crucial make-or-break time when some new graduates lose their footing.
For Global Diversity Awareness Month, here’s a closer look at each program and how it’s poised to help change the face of nursing.
Helping student nurses transition from school to work with a leadership program
A full-time nursing job can feel overwhelming at first. Fresh out of school, nursing graduates find themselves caring for multiple patients with complex health conditions, juggling lab orders, administering medications, communicating with families and navigating the dynamics of a new workplace.
“When you’re starting out, the challenge is ‘Let me not miss anything today,’” says Allyssa L. Harris, R.N., Ph.D., WHNP-BC, Dean of the College of Nursing at Prairie View A&M University (PVAMU) in Texas. “It takes a while to get the organizational skills.” And as a nurse of color, she says, “you have to learn to own the pieces, all while living up to expectations and increased scrutiny.”
That can take a serious toll on retention. In one survey of recent nursing school graduates published in the Journal of Nursing Administration, 30% of first-year nurses left their nursing jobs after that first year, and nearly 60% resigned by the second year.
More than the workload may be to blame for such a high turnover. A Rutgers School of Nursing study found that nurses of color experienced a “dual pandemic” of COVID and racism, and 63% of nurses have experienced racism on the job. More than three-fourths of Black nurses said racism negatively impacts their professional well-being, according to the study, which was published in the journal Behavioral Medicine.
With troubling stats like these in mind, the NLN developed a program called Transitioning Senior Nursing Students in Historically Black Colleges and Universities (HBCUs) into Clinical Practice.
The program’s name sums up its goals. By taking part in webinars, hearing from panels of experts and meeting one-on-one with coaches, students learn skills like how to communicate more effectively, stay organized, resolve workplace conflicts and collaborate with co-workers. They also learn that self-care is a necessity to ward off burnout.
Those skills will come in handy on the job, as well as beyond. “We need more proactive programs that can help nurses manage stress, be more resilient and have more well-being in the workplace,” says the NLN’s Chief Program Officer Janice Brewington, Ph.D., R.N., FAAN.
So far, more than 400 students and 90 faculty across six HBCUs have participated in NLN’s year-long course. Harris has implemented the program at PVAMU and encourages her students to take part. “Anything we can do to help ease students’ transition and make their load a little lighter is worth it,” she says.
“We’re teaching students how to find their voices to speak and to be able to lead,” adds Brewington. “When you have nurses of color in leadership positions, that impacts how decisions are being made and who they’re making decisions about.”
A survey to jumpstart fostering a sense of belonging on campus
About 100,000 registered nurses in the U.S. quit their jobs in 2021, the biggest drop in four decades. In a recent survey, over 40% of RNs said that they, too, were thinking about leaving their positions.
Another troubling statistic also has nurse educators on high alert: After a 20-year increase, enrollment in nursing school programs is on the decline.
“With so many nurses leaving the profession, we can’t afford to lose anyone who is admitted into nursing school,” says Vernell DeWitty, Ph.D., R.N., AACN’s Special Consultant for Diversity, Equity and Inclusion.
When students feel like they belong in their classroom and at their school, “it enhances their ability to achieve their true potential, and most importantly, to remain in school,” says DeWitty.
The AACN is addressing that sense of belonging with an online tool, the Leading Across Multidimensional Perspectives (LAMP) Culture and Climate Survey. The LAMP survey asks students, faculty, staff and administrators questions about perceived discrimination on campus, how safe they feel at their school and how strongly they feel like they belong.
Creating more inclusive learning environments and preparing a more diverse nursing workforce to provide high-quality care is critical to addressing healthcare disparities and health inequities across our nation.
“It’s pretty comprehensive,” says DeWitty. “We want to get a well-rounded perspective from respondents about what they’re perceiving about their campus, culture and climate at that point in time.”
The survey was developed four years ago, but AACN had no way to collect the data and generate reports to provide helpful feedback to schools. Johnson & Johnson’s ORTHE funding has allowed AACN to build the technology infrastructure to do just that.
Fifty-one nursing schools across the country have participated in the pilot study, and many more schools have expressed interest. The data has been collected, and a final report with the results is expected later this summer.
Preliminary results already show significant differences in responses among students by racial and ethnic groups. That can provide a detailed roadmap for administrators to understand where and how improvements can be made.
For instance, student feedback can help schools determine if their current approach to academic and career advising is effective or if students preparing for licensing exams would benefit from more support. When it comes to clinical training, educators can get a better understanding of the respect and care that nursing students are providing to diverse patients.
By 2044, more than half of all Americans will belong to a minority group.
“Creating more inclusive learning environments and preparing a more diverse nursing workforce to provide high-quality care is critical to addressing healthcare disparities and health inequities across our nation,” says DeWitty.
