1. Issues of Diversity, Equity, and Inclusion in the 21st Century; Transition for New Nurses in the Workforce
Bronson Nursing Research Conference
March 21, 2019
Denise K. Ferrell, DNP, RN
Associate Dean for Community Engagement and Public Service
Director for Diversity and Inclusion

2. Overview 21st Century Issues Definitions
Health, Nursing and Educational Organization Statements
Workforce Demographics (Age, Gender, Race/Ethnic)
Transition Period
Practice and Policy Implications

3. 21st Century Issues
What are the issues our new nurses face in the workforce?
These issues may be different from when some of us started out. What’s so different now?

4. What’s so different now?
Affordable Care Act
Patient Readmissions/Reimbursement
Patient Acuity
Organizational Leadership/Structure
Generational Differences
Staffing
Long Work Hours
Workplace Hazards
Workplace Violence
Bullying and Harassment

5. The Beauty of Diversity in the
The Beauty of Diversity in the Workplace  Is Much More than Skin Deep

7. Workplace diversity no longer merely denotes the color of one’s skin in the workplace, but rather implies the range of differences belonging to the people of an organization.
Differences in race, gender, ethnicity, age, education, place of birth, tenure, position within the organization, religion, family background, sexual orientation, cognitive style, and more affect how individuals perceive themselves and others.

8. When individuals come together on a team, these perceptions influence interactions and propose a challenge to organizational communications, performance, and ability to adapt to change.
What is the quality of the atmosphere that dominates your nursing workplace?

9. Defining Diversity and Inclusion
We define diversity as what makes each of us unique. Inclusion means to embrace, respect and value diversity without judgment, bias or stereotype.

10. Defining Equity
Equity in providing care is also a major value in the nursing profession. Equitable care aims to provide the entire population with safe, efficient, reliable, and quality nursing services at all levels of health.
The quest for the establishment of equity is a priority of health systems across the world and the World Health Organization (WHO).
Equity in nursing care: A grounded theory study
by Rooddehghan, Z., ParsaYekta, Z., Nasrabadi, AN
Equity is a basic human need1 that is vital to life and makes human development possible; like any other basic human need, efforts are needed for equity to be realized.2 The quest for the establishment of equity is a priority of health systems across the world and the World Health Organization (WHO).3 In general, the experience of inequity in healthcare leads to social resistance and conflict, and creates phenomena such as shock, trauma, anxiety, depression, and frustration

11. Robert Wood Johnson
Build the Diversity & Inclusion strategy on a strong foundation
Execute an integrated and targeted outreach program
Provide relevant benefits and programs of support
Build a purposeful culture of inclusion

12. American Association of Colleges of Nursing (AACN)
Works to establish quality standards for nursing education
Assists schools in implementing those standards
Influences the nursing profession to improve health care
Promotes public support for professional nursing education, research, and practice
The national voice for baccalaureate and graduate nursing education

13. Institute of Medicine (IOM)
The Future of Nursing: Leading Change, Advancing Health Recommendations
Aging
Gender
Racial and Ethnic
The Future of Nursing: Leading Change, Advancing Health Recommendations Related to Diversity

14. IOM Health Recommendations
“The combination of age, gender, race/ethnicity, and life experiences provides individuals with unique perspectives that can contribute to advancing the nursing profession and providing better care to patients.”

15. Aging
“To fill gaps created by retirement and the increasing demand for nursing services, resulting in part from an aging population and increased rates of insurance coverage, the nursing workforce will need to expand by attracting younger individuals into the profession— a challenge that has been more difficult for the nursing profession than it has been for medicine.”

18. Racial and Ethnic
“Although nurses need to develop the ability to communicate and interact with people from differing backgrounds, the demographic characteristics of the nursing workforce should be closer to those of the population at large to foster better interaction and communication”
MISSING PERSONS: MINORITIES IN THE HEALTH PROFESSIONS A REPORT OF THE SULLIVAN COMMISSION ON DIVERSITY IN THE HEALTHCARE WORKFORCE.

20. Transition Period for New Nurses

22. Beginning of Program TTP NGRN Response
University of San Francisco Program Findings: Revised Casey-Fink Graduate Nurse Experience Survey
“What difficulties, if any, are you currently experiencing with the transition from student to RN role in the questions below.”
Beginning of Program TTP NGRN Response
End of Program TTP NGRN Response
Role expectations (e.g., autonomy, more responsibility)
45%
34%
Lack of confidence (e.g., communication skills, delegation, knowledge deficit, critical thinking)
78%
74%
Workload (e.g., organizing, prioritizing, feeling overwhelmed, patient acuity)
27%
22%
Fears (e.g., patient safety)
Orientation issues (e.g., work area familiarization, technology, relationship with preceptors, information overload)
43%
19%
Table 2. University of San Francisco Program Findings: Revised Casey-Fink Graduate Nurse Experience Survey
SOURCE: Fink et al., 2008 NGRN = new graduate registered nurse, TTP = transition to practice

23. Graduated Nurses’ Orientation Experiences
Systematic review of qualitative studies
Findings establish that the orientation and the preceptor have a great impact on how newly graduated nurses experience the start of their career.
Attention needs to be paid to the variation and imbalance in the quality of orientation programmes and preceptors. A more formal form of mentorship need to be developed further.
Pasila K., Elo, S., Kaariainen, M.,

24. Novice to Expert
Unrealistic expectations to rapidly function as a competent nurse
Determining realistic expectations for the new graduate nurse remains a challenge
Knowledge development in clinical practice
Dr. Patricia Benner

25. Novice to Expert (cont’)
Preceptor Training Programs
Feedback; bi-weekly meetings
Adult Learning Theory
Evaluation

26. Let us acknowledge our encouragers…..
Mentoring
Let us acknowledge our encouragers…..
The Mentor’s Spirit, Sinetar, M, (1998)

27. From our readers: How mentorship affects retention rates of new nurses
April 2013 Vol. 8 No. 4Author(s):

29. Mentoring Tips Sharing stories Reflection on past experiences
Recalling prior role models
Adopting attitude of continuous learning
Mentoring others
Baxley, S. M., Ibitayo, K., Bond, M.L. Mentoring Today’s Nursing; A Global Perspective for Success, (2014)

30. Practice Implications
…..providing optimal and equitable healthcare depends on the quality of the atmosphere dominating the nursing workplace and the nurses’ ability to provide a high standard of care.

31. Organizational Policy Implications
Nursing Residency and Mentoring Programs
Integrated teamwork in workforce development
Diversity & Inclusion embedded within the mission, vision and values
Embed diversity and inclusion in administration and culture of the institution
Nursing Residency and Mentoring Programs across practice areas
Integrated teamwork through workforce development
Ground Diversity & Inclusion within the mission, vision and values
Embedding diversity and inclusion in the administration and culture of the institution ensures that they become part of everything the institution does.

32. References http://269mag.com/the-beauty-of-diversity-in-the-workplace/
file:///Users/ferrel22/Downloads/Transition_to_PracticePart_3_I.PDF
file:///Users/ferrel22/Downloads/From%20novice%20to%20expert_Transitioning%20graduate%20nurses.pdf
Sinetar, M. The Mentor’s Spirit, (1998)
Baxley, S. M., Ibitayo, K., Bond, M.L. Mentoring Today’s Nursing; A Global Perspective for Success, (2014)
How mentorship affects retention rates of new nurses, April 2013 Vol. 8 No. 4Author(s):

33. Thank You!