Chapter 12: Cultural Diversity in the Health Care Workforce

1. Chapter 12: Cultural Diversity in the Health Care Workforce

2. Diversity in the Nursing Workforce #1 • Workplace diversity is the collective, all-inclusive mixture of human differences and similarities that provides an organization with a large pool of people with knowledge, skills, and abilities required for the accomplishment of organizational goals and objectives. • Creating a more diverse health care workforce has value for the people being served and the health care organization from the perspective of its employees and leaders.

3. Diversity in the Nursing Workforce #2 • Nursing has become increasingly diverse in age, gender, race, ethnicity, national origin, and educational preparation. • Nurses from minority backgrounds account for 19% of the RN workforce. • Men represent 9.6% of the nursing workforce. • Men in nursing attain higher wages and faster promotions than do women. • Currently employed RNs are nearing or have exceeded retirement age, fewer RNs between 36 and 45 years old.

4. Diversity in the Nursing Workforce #3 • Nursing is in the midst of a period of substantive transformation that is influenced by the following three trends: 1. An aging population of Baby Boomers who are now experiencing manifestations of the aging process and retirement from the health care and other workforces 2. Passage of the Affordable Care Act (ACA) of 2010 that provides health insurance to millions of people in the United States who previously were uninsured 3. Increased educational preparation for nurses

5. Diversity in the Nursing Workforce #4 • Barriers to diversity include: • Inadequate K-12 education systems for students from minority and economically disadvantaged populations • Insufficient financial aid • Faculty shortages • Societal stereotypes • Negative attitudes and behaviors in the workplace

6. Diversity in the Nursing Workforce #5 • Strategies to increase diversity: • Increase the number of underrepresented minorities in the health professions pipeline. • Corporate culture: Shared values, beliefs, meaning, and understanding are components of the corporate culture. • Organizational climate usually measures perceptions or feelings about the organization or work environment.

7. Diversity in the Nursing Workforce #6 • Strategies to increase diversity (cont.): • Diversity management: systematic and planned commitment by organizations to recruit, retain, reward, and promote a heterogeneous mix of employees • Organizational inclusion: degree to which individuals feel they are part of critical organizational processes by work group involvement, ability to express ideas and opinions, access to information and resources, ability to influence decision making, and a sense of psychological safety and job security

8. The Challenges and Opportunities of a Multicultural Health Care Workforce #1 Cultural Perspectives on the Meaning of Work • Individualist: Importance is placed on individual inputs, rights, and rewards; emphasizes values such as autonomy, competitiveness, achievement, and self-sufficiency. • Collectivist: Maintains group harmony above the partisan interests of subgroups and individuals. Values such as interpersonal harmony and group solidarity prevail. • Results in differences in the meaning of work.

9. Question #1 • Is the following statement true or false? • The meaning of work as a way to earn a living is considered an individualist perspective.

10. Answer to Question #1 • True • Rationale: Individualists work to earn a living. People are expected to work; they need not enjoy it. Leisure or recreational activities frequently are pursued to alleviate the monotony of work. People from individualist cultures tend to dichotomize work and leisure. Individualist concepts of work reflect an orientation toward the future. • Most English-speaking and European countries have individualist cultures.

11. The Challenges and Opportunities of a Multicultural Health Care Workforce #2 • Cultural values exert an influence on workplace factors. • Values exert a powerful influence on how each person behaves, reacts, and feels. • Cultural perceptions of the situation may also precipitate conflict. • Conflict refers to actions that range from intellectual disagreement to physical violence.

12. The Challenges and Opportunities of a Multicultural Health Care Workforce #3

13. The Challenges and Opportunities of a Multicultural Health Care Workforce #4 • Cultural values that may cause conflict: • Family obligations • Personal hygiene • Communication • Touch • Etiquette • Clothing and accessories

14. The Challenges and Opportunities of a Multicultural Health Care Workforce #5 • Cultural values that may cause conflict (cont.): • Intergenerational and interpersonal relationships • National and ethnic rivalries • Gender and sexual orientation • Moral and religious beliefs • National origin

15. Question #2 • Which of the following is not considered a cultural value that influences workplace factors? • Paid time off • Time orientation • Space/distance • Touch

16. Answer to Question #2 • A. Paid time off • Rationale: Cultural values exert an influence on workplace factors which in turn influence each other, such as: time orientation, family obligations, etiquette, communication patterns, space/distance, touch, meaning of work, and work ethic. When cultural values of individual staff members conflict with the organizational values or those held by coworkers, challenges, misunderstandings, and difficulties in the workplace become inevitable.

17. Cultural Self-Assessment of Health Care Organizations, Institutions, and Agencies #1 • Organizational cultural self-assessment should be part of the strategic planning process for a variety of practice settings. • The organization should consider the following areas: • Demographics and descriptive data • Assessment of strengths • Assessment of community resources • Assessment of weakness/areas for continued growth

18. Cultural Self-Assessment of Health Care Organizations, Institutions, and Agencies #2 • The organization should consider the following areas (cont.): • Assessment from the perspective of clients and families • Assessment from an institutional perspective • Assessment of need and readiness for change

19. Cultural Self-Assessment of Health Care Organizations, Institutions, and Agencies #3 • The process of cultural self-assessment includes: • Collecting and analyzing demographic and descriptive data • Assessing strengths and weaknesses or limitations • Assessing the need and readiness for change • Implementing change • Evaluating the effectiveness of changes • Implementing any necessary revisions

20. Question #3 • Is the following statement true or false? • The competent transcultural nurse administrator is influential in the establishment and implementation of policies that promote cultural understanding, knowledge, and skill in the workplace.

21. Answer to Question #3 • True • Rationale: The successful transcultural nurse administrator will behave respectfully toward others from diverse backgrounds and will implement policies that promote cultural understanding, knowledge, and skill in the workplace. Nurses in leadership and management positions will apply the principles of transcultural nursing to the multicultural workplace, just as they have done in the past to provide culturally competent and congruent care for patients.

22. Cultural Self-Assessment of Health Care Organizations, Institutions, and Agencies #4 • After conducting a cultural assessment of the health care organization, institution, or agency, facilitators, and barriers can be identified. • Understanding cultural differences in the workplace and developing skill in conflict resolution will continue to be needed in transcultural nursing administration in the new millennium. • Promoting harmony in the multicultural workplace is the ultimate goal.