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Diversity as a healthcare problem
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Introduction
In nursing, diversity is a concept that has been demonstrated and proven to have many benefits. However, when it comes to diversity in nursing, many barriers still need to be overcome. The profession itself has a significant number of obstacles in the way of promoting and supporting diversity within the sector. These include limited training, lack of financial support for underrepresented groups, poor working environment for those who are members of these groups for a period after graduation, lack of mentorship and employment opportunities, the isolation during graduate school from others from different backgrounds, lack of support from supervisors/coaches or coworkers while working with underserved communities in their gift training program.
Nursing lacks racial or ethnic diversity as a profession, an issue that needs to be rectified. Educating healthcare professionals about ethnic diversity, critical thinking, and sensitivity to cultural realities will benefit the patient and society. As a result, nurses will be better able to provide culturally competent care.
Impacts of a lack of diversity
In the nursing profession, diversity is a key factor in ensuring that all patients are treated with dignity and respect. It’s also important to recognize that diversity is a strength—it can help us find common ground with others, reducing the possibility of friction and conflict.
The impact of lack of diversity in nursing on the patient or patients and the organization it affects is profound. In some cases, it leads to poor communication between nurses and patients. This can lead to frustration and even anger on both sides, especially if no one understands how each person feels about their situation.
The lack of diversity within the profession significantly impacts patients and their care. By not including people from a wide range of backgrounds, nursing professionals miss out on valuable information about their patients’ lives. This can lead to poor assessment and treatment choices and an inability to provide culturally competent care for all clients.
Additionally, by limiting their exposure to different cultures and backgrounds, nurses may benefit from learning ways to better serve their communities.
Nurses also risk being isolated from other healthcare professionals and organizations if they need more diversity in their staff. By limiting themselves to only working within their departments, they could take advantage of opportunities to learn from experts in other fields who might help them improve patient outcomes or provide more effective care.
The patient is affected by a lack of diversity because it reduces their ability to receive optimal care. It can lead to patients receiving less information and being exposed to less diverse opinions on how to treat them. This can cause them to make poor decisions, resulting in longer hospital stays or more complications.
PICO components
P: patient, population, or problem
Patient: -Patients are not receiving the level of care they need because there need to be more nurses in the system.
Population:-The patient population is diverse, but nursing professionals need more exposure to more diverse populations.
Problem:-The problem is that patients need more professional diversity to receive the care they need.
I: intervention
Intervention: Increase awareness about the importance of diversity in nursing and encourage diversity among nursing students.
C: comparison
The problem is that not enough minorities are being educated to become nurses, and thus there are not enough practitioners to care for all patients who need them. Diversity is important because it allows for more innovative ways of practicing medicine.
O: outcome
The outcome: To increase diversity in nursing, we should implement more programs and initiatives that foster an inclusive environment for all nurses.
Lack of diversity in nursing is a problem with an outcome of increased risk of health problems.
Evidence-based practice (EBP) question
The question is:
What are the effects of lack of diversity in nursing as a profession?
Research-based article that answers your EBP question
Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: a qualitative study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9.
Background
This research aims to examine nurses’ perceptions of cultural competence training. In particular, it seeks to understand how nurses perceive the effects of such activity on their practice and how they would like to improve the training process.
This study is useful for nurses because it shows them how important cultural competence training is for their patients. It also shows that there is a need for more training in this area so that all nurses can learn how to provide better care to their patients.
Methodology
In this qualitative study, eight Finnish nurses participated. They were randomly assigned to one of two groups: Group 1 (n = 4) and Group 2 (n = 4). The first group received cultural competence training, while the second group received no training. After completing their respective tasks, participants were asked whether or not they would like to participate in further studies such as this one on cultural competence. The results showed that both groups had similar attitudes towards cultural competence training before it occurred, believing that it would be beneficial for them and their patients. The results also showed that participants felt more confident about providing culturally competent services after receiving cultural competence training.
Level of evidence for the research-based article using the Johns Hopkins Nursing
Evidence-Based Practice (JHNEBP) model.
This article presents a systematic review that includes a qualitative component to explore nurses’ perceptions of cultural competence training at an international organization. The authors identified a total of 771 citations, including 581 controlled studies and 222 non-controlled studies. Also, they defined the five research domains that are important elements for any study on nursing interventions: methodologic quality; exposure to research evidence; development of nursing expertise; teamwork and collaboration; health benefits, and patient outcomes. Six studies were qualified as high quality.
How the researcher analyzed the data
The researchers conducted a qualitative study with 42 nurses to understand their perceptions about cultural competence training and how it can be improved for better health care delivery in the future. The data was collected through interviews and observation techniques. The data analysis revealed that most participants perceived that there should be more emphasis on creating a supportive environment for learning and practice rather than just providing training material to them. Furthermore, they suggested that the training content should be more practical rather than theoretical to make it more engaging and useful to them.
Ethical considerations
The ethical considerations of a study are numerous, and it can be difficult to determine where one begins, and another ends. The author discusses the importance of being culturally competent when conducting nursing care sensitive to the needs of patients from different cultural backgrounds. The authors recognize that many nurses have yet to receive training in cultural competency as part of their education or experience as healthcare providers. This can lead to negative outcomes for patients who receive care from nurses unaware of their own cultural biases and assumptions about appropriate and acceptable behavior in different cultures.
The article describes how nurses’ perceptions about cultural competence training were gathered through an online survey distributed via email to all registered nurses working at the University Hospital in Turku, Finland, from January 2018 through March 2018. The survey asked questions about how much they agreed with statements such as “I know how my values affect my professional behavior” and “I understand how my personal beliefs affect
The authors found that nurses perceive that there need to be more resources available to them for cultural competence training. Still, they are willing to devote time outside work to learn about different cultures. One way they suggest increasing cultural awareness would be to provide more opportunities for nurses to attend training outside work hours.
Quality rating of the article according to the JHNEBP model.
The quality rating of the research-based article is high. The report includes the terms “study,” qualitative,” qualitative,” cultural competence,” nursing,” and “theory.” This article uses multiple types of data in its analyses, such as textual information (facts), analyzed evidence (data), and hypothetical/interpretation-based evidence (opinions). The study group was consistent in their findings; there was no overlap or disagreement. The author used Qualitative data for their analysis; it was a good fit because it made a case for why changes need to be made in nursing practice and education.
Results and conclusions
Findings suggested that the training could raise knowledge of different cultures and assist nurses in providing culturally sensitive services. However, some limitations of this study are: first, there is no way to verify the accuracy of all the statements made by participants; second, there is no clear definition of “culture” here; third, there is no nurse’s checklist that can be used as a reference tool after training has been done.
How the article helps answer the EBP question.
The article discusses how nurses need to develop cultural competence and how this will assist them in providing care in culturally diverse environments. Cultural competence is a term that describes the skill an individual has to understand other cultures. It is an understanding of other people’s beliefs and values, cultural norms, historical backgrounds and traditions, spirituality, and language use (cross-cultural communication).
A non-research-based article
Iheduru‐Anderson, K., Shingles, R. R., & Akanegbu, C. (2021). The discourse of race and racism in nursing: An integrative review of the literature. Public Health Nursing, 38(1), 115-130.
2.1. Background
The introduction to this article focuses on the purpose and aims of this study. The objective is to close gaps in discourse and understanding of race and racism in nursing, especially among other health professionals. The study will use theoretical frameworks as a means to achieve this end. The purpose is to improve understanding and knowledge of racism in nursing through a review of current literature, interpretations, definitions, events, and conditions related to racial discrimination in nursing practice based on themes derived from the perspectives of black and white nurses.
Type of evidence used
This study aims to conduct an integrative review of existing research on the discourse of race and racism in nursing practice. Primary data was gathered from a search engine, PubMed, Scopus, and Google Scholar. Texts were scanned and reviewed for relevance and quality. Eight articles were chosen based on the heterogeneity of subject matter, which accounted for seven papers involving only one or two authors, four pieces involving six or more authors, and one paper with 11 authors. The goal was to identify patterns in how race is constructed in health care settings, identify gaps in research on this topic and offer suggestions for further studies.’
Level of evidence in the article using the JHNEBP model.
This article is a level 5 evidence-based practice (EBP) study. It is a systematic review of literature, using the JHNEBP methodology. The purpose of the study was to synthesize existing literature on the discourse of race and racism in nursing. The authors utilized the JHNEBP systematic review and meta-analysis model to guide their review and analysis of the literature.
Quality rating of the article according to the JHNEBP model.
According to the author’s description, the article is based on empirical evidence and thus should be rated as high quality. In addition, there are hundreds of citations in which the second element of validity is covered, namely. The concepts examined in this study relate to nursing practice.
Author’s recommendations in the article that help answer the EBP question
The article describes how nurses need to acknowledge that limitations in attitudes, beliefs and behavior patterns exist within nursing care delivery systems when dealing with patients of color. They discuss a lack of intercultural communication skills and a lack of staffing, leading to the under-representation of minority nurses in some settings. The authors recommend developing competencies related to training and education, focusing on cultural competence training for all levels of nursing regardless of specialty.
Practice change that addresses the EBP question
With the increasing diversity of the population, it is imperative for nursing to ensure that its practices are reflective of the changing demographics. To combat this, nursing must make a concerted effort to implement practice changes that address the effects of lack of diversity in nursing as a profession. This entails incorporating culturally sensitive care, prioritizing diversity in recruitment and hiring, providing training that promotes culturally competent patient care and advocating for improved access to healthcare for all individuals regardless of their background or identity. Ultimately, these changes will help ensure that the nursing profession is reflective of the population it serves, which will benefit both patients and nurses.
As the nursing community continues to work towards addressing the effects of lack of diversity within the profession, various practice changes have been enacted in order to encourage diversity. One of the most effective practices has been to diversify nursing education, both in terms of student demographics and curriculum. This ensures that a diverse range of individuals are exposed to the profession and are given the opportunity to pursue it. Additionally, focusing on cultural competency education in nursing school helps to ensure that nurses understand the unique needs of diverse communities and are better equipped to serve patients from all backgrounds.
Key stakeholders in supporting the practice change recommendation.
The key stakeholders will include the leader of the nursing department, which can be a medical-related entity or a non-medical entity, could address this issue by promoting problem-solving and creating an environment where it is safe to discuss topics related to diversity and inclusion. To make such an environment, we need to involve an interdisciplinary HR leader who recognizes that employees should feel comfortable talking about these kinds of problems and be able to identify when they occur. This leader needs to empower their staff to discuss these issues openly rather than being afraid of retaliation. In addition, another key stakeholder is the board. These leaders need to be aware that diversity and inclusion affect everyone within their organization with positive results as long as all involved parties report back regularly on what has been done so far to help make this happen
Barriers in implementing the practice change recommendation.
Some barriers may impede change in the way leaders interact with their staff of nurses in the nursing profession. The most common ones include lack of communication, insensitivity, and lack of appreciation for nurses’ work. This can be overcome by establishing a safe environment where diversity can be discussed openly within the organization, which will lead to positive results.
Strategy used to overcome the barrier
We are familiar with nurses’ challenges when interacting with patients or other professionals. However, this is not exclusive to nursing but rather a larger problem in healthcare. Communication is key in education and medicine; however, in both groups, we see resistance. In nursing education, there has been an increase in resumes submitted by students with limited academic backgrounds – most often lacking in communication skills (for example, ESL). In addition, some students lack interest, which makes them less willing to speak up for themselves and more willing to settle for less than what they deserve. This reluctance may manifest itself as negativity towards administrators and educators, as well as among fellow students.
Outcome (the O component in PICO) from the EBP question
Nurses with ethnic and cultural backgrounds that differ from their peers can encounter barriers in healthcare settings. Nurses of diverse racial/ethnic backgrounds are often stigmatized by colleagues, patients and families, employers, and the public. A lack of diversity in a healthcare setting can also impact patient care. Nurses will be more likely to rely on nursing knowledge rather than culturally specific practices if they are not familiar with the history, traditions, and beliefs specific to other cultures. Organizations should use data collection to measure nurses’ collaboration, practice environment, and organizational climate across these issues.
Conclusion
The lack of diversity in nursing as a profession is an ever-present issue. Such a problem is not restricted to just one culture, but the overrepresentation within older generations reflects the experience of the workforce over time. Many people who have graduated from a nursing program may have little or no knowledge about race and cultural differences. Thus, nurses who understand cultural diversity minimize the need for verbal counseling that reinforces stereotypes. In addition, it can also reduce racial bias in patient assessment and lead to more successful patient outcomes.
References
Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: a qualitative study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9.
Iheduru‐Anderson, K., Shingles, R. R., & Akanegbu, C. (2021). The discourse of race and racism in nursing: An integrative review of the literature. Public Health Nursing, 38(1), 115-130.