Issues of Diversity, Equity, and Inclusion in the 21st Century: Transition for New Nurses in the Workforce

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?

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 Workplace Is Much More than Skin Deephttp://269mag.com/the-beauty-of-diversity-in-the-workplace/

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. http://269mag.com/the-beauty-of-diversity-in-the-workplace/

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? http://269mag.com/the-beauty-of-diversity-in-the-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. https://www.bronsonhealth.com/diversity-and-inclusion-at-bronson/

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). https://www.ncbi.nlm.nih.gov/pubmed/28670955

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

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

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”

20. Transition Period for New Nurses

22. University of San Francisco Program Findings: Revised Casey-Fink Graduate Nurse Experience Survey 2010-2016 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

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

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

29. Mentoring Tips • Sharing stories • Reflection on past experiences • Recalling prior role models • Adopting attitude of continuous learning • Mentoring others

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. https://www.ncbi.nlm.nih.gov/pubmed/28670955

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

32. References • http://269mag.com/the-beauty-of-diversity-in-the-workplace/ • https://uctangerine.com/2017/12/08/diversity-topic-course-offered-foster-conversation/ • https://journals.sagepub.com/doi/pdf/10.1177/0969733017712079 • file:///Users/ferrel22/Downloads/Transition_to_PracticePart_3_I.PDF • https://www.aacnnursing.org/News-Information/Fact-Sheets/AACN-Fact-Sheet • https://www.ncsbn.org/2018SciSymp_Smiley-Bienemy.pdf • https://www.minurse.org/survey/2018/2018-demographics.html • 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): • http://www.siumed.edu/hr/process/new-employee-onboarding-manual.html.

33. Thank You! ferrel22@msu.edu