1. “Focusing on the Need for Diversity in Nursing” Presentation for PCAHCR Pilar De La Cruz-Reyes, MSN, RN Director of Diversity cinhc California Institute for Nursing & Health Care Optimizing the Health of Californians through Nursing Excellence

2. Goal 2: Increasing Diversity of the California Nursing Work Force Intent of the project:  Set diversity targets for 5, 10 and 15 years, consistent with the population projections and the shifting demographics of the aging RN workforce  Develop a strategically focused plan that describes interventions to meet the targets

3. Increasing Interest in Diversity  National interest in the need for a diverse health care workforce is growing  Institute of Medicine, Sullivan Commission  Health outcomes are improved when the health care workforce reflects the ethnic and cultural community that is being served.

4. Building a More Diverse Workforce  The California Wellness Foundation stated in 2005 “A healthcare workforce that mirrors our state’s ethnic and racial diversity is an important strategy for improving the health of California”  A nursing workforce that more closely mirrors California’s racial and ethnic makeup will bring greater access to and improve the quality of health care.

5. Why More Ethnic Nurses?  Nurses from underrepresented groups are more likely to understand cultural values that impact health behaviors and therefore will improve the health care system use and treatment compliance  Diminishing the fear in a patient’s face  Fear turns into a smile

6. Why is there a need for more Ethnic nurses in California  Minority populations are growing in the state  Minorities soon to become the majority  Nursing workforce needs to be more representative of the people served  Data tells the story of the need

7. Hispanic Population of the United States, July 1, 2008  46.9 million; the estimated Hispanic population in the US as of 7/1/08;  3.2% increase in the Hispanic population between 7/1/07 and 7/1/08;  132.8 million the projected Hispanic population of the US by 7/1/2050;  2 nd ranking of the size of the US; only Mexico (110 million) had a larger Hispanic population than the US.  Source: U.S. Census Bureau

8. Data  Ethnic, Racial & Gender Composition of RNs in California 07/08 2004  White, not Hispanic 58.6% 63.9  Black/African-American 4.1% 3.8  Hispanic 7.5% 6.3  Filipino 18.0% 16  Asian Indian 1.4%  Asian (not Filipino or Indian) 7.1% 4.9  Native Hawaiian/Pacific Islander 0.1%  Native American Indian 0.4% 2008 BRN report

9. California Minority Population 3 Different Regions RegionHispanicBlackFilipinoAsian CV47.7%6.0%3.0%5.8% LA47.7%9.4%14%13.2% SD26.7%7.9%6.1%2.8%

10. Percent of Minority RNs per Region Reg # of RNs W H B F A CV25,93961.8%9.6%1.9%14.1%7.9% LA94,27746.7%9.6%5.4%23.4%11.8% SD26,20165.5%6.6%2.5%18.5%2.8%

11. Setting 5 year Targets for Minorities in Central Valley  15% increase in number of Hispanic RNs which translates into 75/year  25% increase in Black/African-American nurses which translates into 25/year  No projected increase in Filipino or Asian nurses as their numbers exceed the population

12. Setting 5 Year Targets for minority RNs in LA Region  15% increase in Hispanic RNs which translates to 272 /year  9% increase in the number of Black/African-American RNs which translates to 92 /year  No projected increase in Filipino RNs as they exceed population & no projected increase in Asian RNs as they are close to the population

13. Setting 5 Year Targets for the San Diego Region  15% increase in Hispanic RNs which translates into 52 / year  20% increase in Black/African-American RNs which translates into 26 /year  No projected increase in Asian or Filipino nurses

14. How Is This Accomplished  Good news from the California Board of Registered Nurses, 2007/2008 school report.  The number of minorities enrolling in nursing program has increased and continues to do so.

15. Data cont. from 2007/2008 BRN report  59.1% of students who enrolled in a pre- licensure nursing program for the first time are ethnic minorities; (up from 50% in 2004)  18.1% of the students were male  58.1% of students who completed a pre- licensure nursing program are ethnic minorities  17.8% of students who completed a pre- licensure nursing program are male.  LVN to ADN programs had the greatest share of ethnic minorities among students who completed a nursing program

16. Keys to Success  Decrease attrition of minority students  Help them graduate  Provide support  Educate families  Celebrate accomplishments  Provide Mentors

17. Factors Impacting Student Attrition  Academic failure and personal reasons were reported as the factors with the greatest impact on student attrition  Almost 57% of nursing schools reported academic failure as the factor with the greatest impact on student attrition  23% of schools reported personal reasons as the factor with the greatest impact on student attrition

18. Student Retention Methods to increase student retention  Mentoring, remediation, tutoring  Personal counseling  New admission policies instituted  Increased financial aid  Curriculum revisions  ATI testing  Increased child care

19. How Can Nurses Help?  Encourage Ethnic Nursing Organizations to “adopt” a nursing school  Serve a mentors to minority nursing students at “adopted” school (s)  Become RN Ambassadors of the Coalition for Nursing Careers in California  Become familiar with cncc.org and choosenursing.com

20. HRSA Grant Proposal  “Adopt a Nursing School” Project  Statewide mentorship network  Identify a school  Nursing School Director gets names of minority mentors and provides information to the minority nursing students  Mentors and students link up as needed

21. Coalation for Nursing Careers in California (CNCC)  Works to encourage students, particularly underrepresented minority students to seek a career in nursing;  Attend school career days and offer information about nursing  Share their own stories of how they became a nurse with interested students  cncc.org and choosenursing.com

22. What About Faculty  Need more minority faculty  Minority students need to see more role models  Needed at all nursing programs  Minority faculty can stress the importance of cultural sensitivity in patient care

23. Faculty Numbers  3,437 faculty; 91.4% female; 8.6% male Ethnicity Black/African American 9.0% Asian 5.5% Filipino 5.5% Hispanic/Latino 6.8% Native American 0.6% White 70.4% Other 2.2% BRN data, 2007/2008

24. Barriers to Recruiting Faculty  Non-competitive salaries  Insufficient number of faculty applicants with required credentials  Overall shortage of RNs  Private, state university of community college laws, rules or policies  BRN rules and regulations  7% of schools reported no barriers to recruiting faculty

25. How Can Nurse Recruiters Help?  Encourage minority nurses to serve as part-time faculty;  Encourage minority nurses to get their Masters or doctorate  Push for joint appointments  Encourage minority nurses who are looking for something different or planning to retire to think about becoming faculty.

26. Future Goals  HRSA grant proposal “Hands Touching Hands”  Letter of support will be needed from the various organizations  Identify potential sources of funding to support diversity efforts  Encourage the inclusion of more Cultural Sensitivity programs in healthcare

27. So Now What???  What do we need to do?  What ideas can be generated?  Who do we need to get on board?  How do we make a difference?

28. Statewide Mentorship Network  Need to link all the ethnic nursing organizations in the state  Black Nurses Association, National Hispanic Nurses Association, Philippine Nurses Association, Asian Nurses Association, American-Indian Nurses  NCEMNA; National Coalition of Ethnic Minority Nurse Association

29. Ethnic Nursing Organization Website  How do we link all of the ethnic nursing organizations into one website?  What is the mechanism to do this?  What resources will we need?  Is NCEIMA the avenue?  How can we make it happen?  How do we “advertise it” once completed?

30. Involvement of Families  Important role that family plays in minority households;  Helping family understand the rigorous nursing program;  Orientation programs for family members at the start of a nursing program  Providing family members with information, literature, websites, etc.

31. Recruitment of More Men into Nursing  How do we encourage more young men to seek a career in nursing?  How do we deal with the “stereotyping” of nursing being a female occupation?  How do we educate minority parents of the value of nursing as a career for men?  Men in Nursing video

32. Men in Nursing Video  Focuses on male RNs and why they chose to go into nursing  Video includes minorities  Provides a personal perspective  Good for middle and high school students  Represents male nurses from various areas of California

33. DVD Development  Having minority RNS tell their “story” of how they overcame obstacles to become a nurse  Tips on how to make it through the nursing program  Support needed  Family involvement  Use of mentors and tutors

34. DVD on “Beating the Odds”  Promoting this idea to RNs;  Involving minority nurses of each ethnic group (including men);  Identify funding opportunities for DVD;  Arrange for videotaping;  Promote the DVD to schools;  Inclusion of family members in video

35. Reaching Success  If we want more underrepresented minorities in the workforce, we are going to have to recruit more URM students into nursing and help mentor/tutor them so they complete the nursing program and graduate  We will need everyone’s help in order to accomplish this.  We need YOUR help!!

36. Summary  Questions/Ideas THANK YOU!!!