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

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; • 2nd 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 Population3 Different Regions

10. Percent of Minority RNs per Region

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!!!