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Narrowing racial disparities in nursing


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Alexandra Wilson Pecci, for HealthLeaders Media, October 30, 2012

Despite ongoing efforts to improve nursing diversity, minorities continue to be underrepresented in the nursing profession. But over the past few weeks, I've read about several scholarships and grants that aim to increase the ranks of minority nurses.

In other news, I also learned about a study which shows that high nurse workloads disproportionately affect older black patients. On the surface, these two pieces of information seem unrelated, or at least seem only superficially related because they both involve race in some way.

Taken together, however, they are striking because they not only illustrate how racial disparities play out in the nursing world, but they show the need for increasing the number of nurses out there.

The nursing workload study calls for more nurses on the floor, and opening up access to nursing education to more candidates will help.

Let's first look at the nursing workload study, which comes out of the University of Pennsylvania School of Nursing. Researchers studied more than 548,000 patients ages 65 and older who underwent general, orthopedic, or vascular surgery in 599 hospitals in California, Florida, New Jersey, and Pennsylvania. Of the patients, 94% were white and 6% were black.

The data, gleaned from  nearly 30,000 hospital staff nurses working directly in patient care, showed that older black patients are three times more likely than older white patients to suffer poorer outcomes after surgery, including death, when cared for by nurses with higher workloads.

In fact, when the patient-to-nurse ratio increased above 5:1, the odds of patient death increased by 10% per additional patient among blacks, compared to just 3% per additional patient among whites.

"These results suggest that improving the quality of postsurgical outcomes of older patients, particularly older black patients, means putting more nurses on the floor," wrote lead author J. Margo Brooks Carthon, PhD, RN. "Better staffed hospitals are better prepared to meet the more complex needs of older patients, particularly minorities with higher rates of co-existing conditions."

And where to find those additional nurses? Perhaps from groups which, according to the latest National Sample Survey of Registered Nurses, remain underrepresented in the RN population when compared to the general population. For example, the data shows that nurses from minority racial and ethnic groups represent only 16.8% of all nurses. Although only about 65% of the U.S. population is white, non-Hispanic, 83.2% of RNs are white, non-Hispanic.

But there is work going on to bridge this gap.

The University of North Alabama College of Nursing and Allied Health recently received a grant of $2.1 million from the U.S. Department of Health Resources and Services Administration. The $2.1 million grant will support about 67 scholarships for pre-nursing and nursing majors in its first year, and about 80 scholarships by year four.

The grant will help disadvantaged students, particularly underrepresented minorities, enter the school's UNA's new OPEN (Opportunities for Entry Into Nursing) program, which aims to address local and national healthcare needs among disadvantaged and minority populations, as well as an underrepresentation of minorities in the nursing workforce.

As part of their training, OPEN students will work with local clinics serving minority, economically disadvantaged, and vulnerable populations.

Up north, the School of Nursing at the University of Massachusetts Amherst received an $892,559 grant from HHS for a three-year program to draw future nurses from minority and disadvantaged communities.

The school says the grant will help to fully fund a program called Achieving Diversity: A Comprehensive Approach to Nursing Workforce Diversity, which aims to increase the number of ethnic minority and disadvantaged high school students who choose and successfully prepare for careers in nursing.

It also aims increase the percentage of ethnic minority and disadvantaged students who successfully complete baccalaureate degree nursing programs and pass the National Council Licensure Examination.

Another HHS grant will allow the University of Michigan-Flint Nursing Department to offer 15 Health Resources and Services Administration Scholarships for Disadvantaged Students.

Once again, it seems that increasing access to education for nurses has the potential to alleviate a number of ills. Helping to educate minority nurses will not only improve minority representation in nursing, but it will also add to the nursing workforce in general, and maybe even improve patient outcomes, which will help everyone.

Source: HealthLeaders Media