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By Dianne Anderson
In just 22 years, people of color are projected to become the majority of Americans, even though the medical field nowhere near reflects that level of diversity in nursing, especially for Black nurses.
At last count, the Registered Nurse workforce was made up of 80.6% White, 6.7% African American; 7.2% Asian and 5.6% Hispanic, according to the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers.
That gap concerns assistant professors, Dr. Shelley Burke and Dawn Bounds, Ph.D., both African-American nursing professors hoping to move the numbers. Recently, their campus proposal was approved for funding to host interns from HBCUs for three summers to conduct research and be ready for graduate school at UCI Sue & Bill Gross School of Nursing.
The UC HBCU Initiative partnership could pry the doors of opportunity open a little wider for Black student nurses to advance to a Ph.D. or doctorate.
Dr. Burke said the competition is stiff, but mainly due to the lack of nursing teachers that bottlenecks academic systems.
HBCUs usually offer bachelor’s and some have master’s degrees in nursing, but very few students move on to higher doctorate degrees in the field.
“It’s hard to get in just because of the numbers, not because [Black nurses] can’t compete, but every school has a limited amount of professors who can teach,” said Dr. Burke, Assistant Clinical Professor, DNP, MSN, RN, and a pediatrics specialist.
In her class, Black nursing students have increased, and she sees more Hispanics and Asians, but overall, it is difficult to get into higher degrees of nursing because there are not enough higher-degreed nurses available to teach.
As a result, programs must weed through about 1,000 nursing applicants to get only 50 students accepted into available seats.
“It’s a lot of going through and deciding based on what they’ve achieved. Who’s the best 50 you’re going to take? It’s not always easy, many are doing extremely well but they can’t make the cut,” she said.
Most nurses who graduate from nursing school go on to work at hospitals, but few pursue higher degrees. Fewer professors are available to teach, and classes can’t be bigger than they can handle.
Usually, a Ph.D. in nursing leans on the research side, while a doctorate, which Burke has, is more on the clinical side and on the frontlines of advancing nursing professions. She wants students to get their degrees to pass what they’ve learned to others.
She and Dr. Bounds are teachers with higher degrees in a field with broad prospects, such as teaching at the university or heading up organizations and the money is good. Pay scales vary, but those in nursing willing to work long hours in a hospital setting can get close to what doctorate instructors earn at universities.
“You can make a lot of money being a director in the hospital, [which] is a different responsibility from teaching, but both aspects make very good money. Most of the time you can enter early six figures for a professor at the university,” she said.
Salary is attractive, but she said the need for Black nurses to teach is critical. Nursing school isn’t easy for anybody, but she feels that seeing role models and proper representation can give students the confidence to know a career is possible.
“Sometimes you need to see people like your own to be motivated to know you can get to that level too. When you don’t see your own many times you think am I capable of getting up there? But you are,” she said.
Still in the early stages, the program starts its first set of six interns in 2023, having made their initial contacts at HBCUs in North and South Carolina.
“Many of these students have never been to California so it’s going to be a new experience for them. We have to see how it works for the first incoming cohort, and advance, widen outreach to more HBCUs,” she said.
Probably the best reason for getting more Black nurses in the door is that they may be more sensitive to health disparities, she said.
Across the board, higher death rates are linked to race-based health disparities.
Unfair medical treatment explains why so many Black patients do not trust the system, or get regular checkups to stay healthy. Too often, they wait too long to go for help because they say nurses and doctors do not believe them, or feel they are exaggerating their pain and looking for drugs.
“Many of our colleagues who are not like us can not relate to some of the illnesses that affect us,” she said. “It’s because people don’t how to assess, or see us as complainers and don’t take our complaint seriously.”
She hopes to draw students from beyond their comfort zone to recognize the field as a worthy profession. She also feels outreach needs to start much earlier at the high school level.
“They’re not going to pursue what they don’t know. Somebody has to [reach students about] importance of this job, how they can enhance each other, and enhance their own health, then we can expose many more minorities to the healthcare profession,” she said.
The program is a good start, but there is a long road ahead to reach parity in the field. She commended Prof. Alison Holman, who is white, and the entire team for taking the lead to go after the grant for the HBCU student advancement for a Ph.D. in nursing.
Earlier this year, findings from the National Commission to Address Racism in Nursing survey of over 5,600 nurses revealed the extent of racism in the field, with 92% of Black nurses reporting that they have personally experienced racism in the workplace.
“The acts of exclusion, incivility, disrespect and denial of professional opportunities that our nurses have reported through this survey, especially our Black, Hispanic and Asian nurses, is unacceptable,” said Commission Co-lead and National Association of Hispanic Nurses (NAHN) President Adrianna Nava, PhD, MPA, MSN, RN. “Racism is a trauma that leaves a lasting impact on a person’s mental, spiritual, and physical health as well as their overall quality of life. As the largest health care workforce in the country, we must come together to address racism in nursing as the health of our nation depends on the health and well-being of our nurses.”
To see the study, https://www.nursingworld.org/practice-policy/workforce/racism-in-nursing/national-commission-to-address-racism-in-nursing/
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