NR 391 Workforce Diversity Discussion

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NR 391 Workforce Diversity Discussion

NR 391 Workforce Diversity Discussion


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As nurses, we often work with physicians or other healthcare team members whose native language is not English. In fact, some of you may have interviewed a non-native English speaker for your Course Project.

  1. Share an example of miscommunication that has occurred as a result of this disparity.
  2. Reflect on your new-found knowledge of transcultural nursing, and describe how this miscommunication could have been prevented.’

    What is Diversity in Healthcare?

    Diversity in any workplace means having a workforce comprised of multiple races, ages, genders, ethnicities, and orientations. In other words, it refers to when the medical and administrative staff of a healthcare facility represents a wide range of experiences and background.

    In modern society, healthcare diversity can refer to a number of qualities, including but not limited to the following characteristics:

    • Race
    • Ethnicity
    • Gender
    • Age
    • Sexual orientation
    • Religion
    • Political beliefs
    • Education
    • Physical abilities and disabilities
    • Socioeconomic background
    • Language
    • Culture

    Even military service is considered a unique background and experience that should be included in diversity.

    Espousing diversity in healthcare can lead to cultural competency, the ability of healthcare providers to offer services that meet the unique social, cultural, and linguistic needs of their patients.

    In short, the better a patient is represented and understood, the better they can be treated

    Why is Healthcare Diversity So Important?

    Diversity in the workplace carries a host of benefits for healthcare employers, their staff, and their patients. Those benefits include:

    Higher Employee Morale

    Diversity creates a stronger feeling of inclusion and community for healthcare workers, which makes the workplace feel safer and more enjoyable.

    Better Care for Diverse Populations

    A healthcare staff should be as diverse, if not more diverse, than the patient base they are treating. This helps ensure that no matter who walks through the door, there is someone on staff who can identify with them, communicate with them, and better serve their individual needs.

    Higher Employee Retention

    This goes hand-in-hand with improved morale. The happier and safer healthcare workers feel in the workplace, the longer they will stay.

    Better Recruitment

    A commitment to diversity helps when recruiting new healthcare workers and administrative staff. It allows you to cast a wider net to attracted new talent and it offers a stronger hiring proposition for candidates who may consider working at your hospital or clinic.

    Stronger Individual Motivation

    When there is a lack of diversity, minority healthcare workers may feel stifled or unable to express their unique talents and personality traits. This is a natural inclination for people when they are more concerned with fitting in as opposed to “being themselves.” That added pressure can lead to increased stress, reduced morale, and it may event inhibit them from speaking up when their perspective is needed most. A diverse work environment sends the message that a worker’s cultural and ethnic background is an advantage that should be respected, if not celebrated.

    Better Problem Solving

    A wide range of perspectives can lead to more creative solutions when solving problems during an emergency or even during routine patient-care. Allowing for new ideas and diverse perspectives can also lead to greater innovation and operational excellence.

    Better Results

    As illustrated by our section on healthcare diversity statistics (below), diverse healthcare teams get better results, period. The data show us that medical teams who embrace diversity provide better healthcare.

    Final note on the benefits of healthcare diversity—

    It’s worth mentioning that while diversity is important, diversity without inclusion is ineffective. Not only do healthcare teams need to represent a variety of backgrounds, but each member needs to be given a voice.

    What are the Risks of Lacking Healthcare Diversity?

    Just as healthcare diversity has its advantages, there are major risks that can be attributed to the lack of diversity.

    Communication Breakdown

    Be it the result of a language barrier, differences in philosophy, differences in cultural norms (& expectations), or even cultural bias, lack of diversity can lead to communication breakdown with patients. And when patients cannot fully communicate or express their needs, dangerous mistakes can occur.

    Limited Perspectives

    Lack of healthcare diversity can lead to limited perspective when providing patients with medical care, psychological treatment, and social support. It can stunt innovation and creative thinking, but more importantly, it could impede critical observations surrounding a patient’s diagnosis, medical history, or other socio-economic factors that may affect their health and well-being.

    Lack of Role Models

    Mentorship plays a critical role in our medical system. Doctors, nurses, medical assistants, and administrative personnel will always need the support of a mentor to guide them in their respective professions. It’s important for healthcare workers to have role models they can look up to and emulate throughout their careers. A lack of diversity can make it difficult for minority healthcare workers to find mentors with whom they identify and learn from. In turn, this can thwart their professional growth and their ability to provide the best patient care.

    Lack of Future Diversity

    Albeit an obvious consequence, it is an important one to the future success of any healthcare organization. The less diverse your medical staff is today, the harder it will be to foster it within your team tomorrow.


    Bias does not always have to be explicitly expressed within a healthcare setting for it to become a problem. Bias can still impact decisions made for patients when it is embedded in the policies and procedures of a healthcare organization. This is referred to implicit bias within a system. Greater diversity can stymie the destructive effects of implicit bias in patient care.

    Diversity By the Numbers: Healthcare Diversity Statistics

    Disparities in healthcare outcomes by ethnicity are unfortunately a real problem. For examples, studies have shown that:

    • African-American women with breast cancer are 67 percent more likely to die from the disease than are Caucasian women.
    • The mortality rate for African-American infants is almost 2.5 times greater than it is for white children.
    • Hispanic and African American youth are substantially more likely to die from diabetes than white populations.
    • Even when controlling for access-related factors, such as patients’ insurance status and income, some racial and ethnic minority groups are still more likely to receive lower-quality health care.

    It can be inferred that one of several reasons for these disparities may be tied to a lack of diversity in healthcare. According to a report by the U.S. Department of Health and Human Services,

    • Hispanic populations are significantly underrepresented in all of the occupations in Health Diagnosing and Treating Practitioners occupations.
    • Among Non-Hispanics, Blacks are underrepresented in all occupations, except among Dieticians and Nutritionists (15.0 percent), and Respiratory Therapists (12.8 percent).
    • Asians are underrepresented Speech–Language Pathologists (2.2 percent), and Advanced Practice Registered Nurses (APRN) (4.1 percent).
    • American Indians and Alaska Natives are underrepresented in all occupations except Physician Assistants, and have the lowest representation among Physicians and Dentists (0.1 percent in each occupation).

    What our research tells us is that wherever diversity is encouraged and cultivated, businesses (hospitals included) perform significantly better.

    • A study by the firm McKinsey and Company entitled “Why Diversity Matters” found that gender-diverse companies are 15% more likely to outperform those non-gender-diverse companies, and ethnically diverse companies are 35% more likely to outperform companies with minimal diversity.
    • Diversity even has an effect before a medical worker enters the field. Studies have shown that students who study within a diverse student body and faculty make better doctors.
    • “We argue that student diversity in medical education is a key component in creating a physician workforce that can best meet the needs of an increasingly diverse population and could be a tool in helping to end disparities in health and healthcare,” said coauthor Paul Wimmers, an assistant professor at the David Geffen School of Medicine at UCLA.
    • There are also findings that support the position that racial diversity in higher education is associated with measurable, positive educational benefits.

    In short, the numbers tell us that diversity leads to better care, better employees, and better results.

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    How to Promote Diversity in Healthcare

    It may be true that a greater burden of the responsibility for establishing healthcare diversity falls on hospital administration and HR. After all, those departments control much of the hiring, advertising, and recruitment within their respective institutions.

    However, healthcare workers (doctors, nurses, medical assistants, etc.) can also play an important role. Here of some of the ways members of a healthcare staff can promote diversity in the workplace.

    1. Create a Welcome Environment

    Foster an environment of inclusiveness in every area possible. Make sure that all voices are heard, and that all coworkers feel safe to share their perspectives.

    2. Address Issues of Bias Quickly and Openly

    Often the victims of bias or discrimination are reluctant to come forward themselves for fear of repercussion or other forms of retaliation. Supporting co-workers in these times and reporting cases quickly and transparently are vital to creating a safe working environment for everyone.

    3. Encourage Diverse Applicants

    Do you know someone who would be a wonderful fit in the healthcare community? Encourage them to pursue their dreams!

    4. Diversity for More Than Diversity’s Sake

    Always remember, the point of encouraging diversity in your hospital or clinic isn’t to have a diverse hospital or clinic… it’s to have a better hospital or clinic. As explained above, a diverse workforce can provide a rich array of experiences and understanding that can only enhance the patient-care experience and draw more success to your hospital or clinic.

    5. Listen

    Sometimes the best action you can take to promote diversity and creating an open work environment is by simply listening. Listening (without interjecting or suggesting fixes) helps each of us understand new perspectives, opens our minds to unseen needs, and shows co-workers or patients that their opinion matters.

    Diversity Training

    Another way to nurture greater diversity in a healthcare staff is through diversity and cultural competence training.

    Diversity training helps by:

    • Increasing cultural understanding and skills
    • Teaching how to respond to cultural differences
    • Increasing awareness of personal and subconscious biases
    • Identifying potential barriers to care
    • Improve intercultural communication skills

    While some hospitals may offer diversity training as part of their employee onboarding process or continuing education, this isn’t always a requirement, which is why it’s important for all healthcare professionals to take the initiative to better themselves—whether or not it’s required.

    Workplace diversity training courses are common and can easily be found online but finding diversity training geared specifically for healthcare may take a little more digging (particularly during the COVID-19 pandemic).

    Check with your hospital’s human resource department for their recommendations. Or if you’d like to get started right away, try an online program such as Diversity Science’s Inclusion Training for Healthcare.

    Diversity in Healthcare: Examples from the Field

    Building a diverse medical staff sounds great in theory, but what about the real world? Does a diverse staff actually produce better results for patients?

    The answer is a resounding yes.

    A great place to start is the American Health Association’s 2018 case study report, Diversity in Healthcare: Examples From The Field, which you can read here.

    These cases include:

    • A children’s hospital in Palo Alto, California, built for the specific purpose of aiding a diverse patient base—many of whom were previously forced to travel several hours for healthcare.
    • A chain of 350+ hospitals and clinics that created a diversity in leadership program, one which has already increased management diversity by more than 10%.
    • A Pennsylvania hospital that launched an independent study into patient care disparities to identify areas of bias negatively impacting treatment.
    • A Brooklyn medical center that created a thorough in-house cultural training program for its employees, one that ranges from language to cultural philosophy to religious observances.

    Another example comes from the website, which tells the story of a doctor who was able to use techniques learned during cultural and diversity training to reach across language barriers to help a patient heal.

    A 62-year-old Dominican patient presented with hypertension. In the past two years, she had been seen by several physicians, had multiple tests to rule out any underlying etiology, and tried a variety of medications to control her blood pressure. Despite these efforts, her blood pressure remained poorly controlled. The patient, whose primary language was Spanish, had limited English skills but refused an interpreter at all clinic appointments. It appeared that the patient was nonadherent with taking the antihypertension medicine, taking it only periodically when she felt tense or stressed. Further inquiry by the physician revealed that the patient was illiterate and did not understand the complex medication regimen she had been given.

    The physician was able to explore the patient’s explanatory model for hypertension using the [diversity training] approach. The patient strongly believed that her hypertension was episodic and related to stress. She didn’t take her daily antihypertension medication because it didn’t fit her explanatory model. The physician was able to reach a compromise by explaining that, although her blood pressure goes up during stressful times, her arteries are under stress all the time, even though she didn’t feel it. Taking medications daily would relieve the arterial stress but would not help with her emotionally stressful episodes. The physician was able to negotiate with the patient to add relaxation techniques to her daily routine.

    Because of their diversity training, a doctor was able to provide care in a way that had before been impossible, and because of this, a life was quite possibly saved.

    Diversity is Vital to Patient Care

    Creating diversity in healthcare isn’t just important, it’s vital. Language, culture, and ethnicity can easily create barriers, and in an industry where lives hang in the balance and every second could mean the difference between life and death, delays and obstacles can quickly become deadly.

    But diversity isn’t something that can be created overnight. It requires a leadership dedicated to increasing cultural awareness and inclusion. It requires co-workers who are willing to take the time to learn about each other. It means being willing to identify and address personal biases. And it means boldly opening ourselves up to discomfort for the greater good of our patients.

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