Improving Minority Patient Outcomes Through the Diversification of the Nursing Profession

Purpose: The purpose of this integrative literature review was to examine the barriers that minority nursing students face, and ways in which institutions are challenged to increase recruitment and retention of minority students. With an increased number successfully completing RN programs, it is believed that ethnically and racially diverse patients will experience improved health outcomes as they will have nurses who are culturally competent and linguistically capable of influencing them to adhere to and implement individualized plans of care.

Background: Census reports predict that 50% of the U.S. population will consist of ethnic minorities. Nurses are the largest group in the U.S. healthcare workforce; however, the racial and ethnic background of the nursing workforce does not accurately reflect the diversity of the population on a whole. According to a 2008 sample survey of registered nurses by the U.S. Department of Health and Human Services, the minority population consisted of 37% of the U.S. population, while minority nurses made up only 16.8% of the total nurse population. Due to this discrepancy, there is a need for nursing schools to implement academic success and retention models to improve the experience for minority students.

In order to do this, institutions must determine what barriers minority students are faced with that result in poor performance. Not only should barriers to graduation be analyzed, but also predictors of passing NCLEX as this is the ultimate hurdle to obtaining the RN license.

Methods: An integrative literature review was performed using Google Scholar, PubMed and CINAHL to find quantitative and qualitative studies regarding the obstacles that minority students encounter in nursing school, and its correlation with the lack of diversity in the RN workforce. Key words included in the search: nursing, diversity, minorities, outcomes, and success. Articles published within the last 10 years were included. Using varying combinations of the keywords mentioned, Google Scholar yielded up to 18,900 articles, Pub Med yielded 13 articles, and CINAHL yielded 5 articles. To narrow further, articles discussing anything other than minorities or specific minority groups and their nursing school experiences, as well as the lack of diversity within the nursing workforce compared to the increasingly diverse population, were not considered.

Results: After rigorous review, 7 studies were included. Themes found were: 1) commonalities among ethnically diverse students in regard to nursing school experiences 2) the power of poverty, science GPA, and ESL status as predictor of student outcomes (both in terms of graduation and the ability to pass the NCLEX) 3) Belief that health care outcomes for minorities will see an improvement with a reduction in health disparities as the RN workforce diversifies. This is due to a correlation that patients will have a better experience as nurses will be culturally competent, linguistically capable, and empathetic.

Conclusion: The integrative literature review revealed that there can be multiple barriers in respect to the ability of minorities to successfully complete a nursing program, pass the NCLEX, and obtain their RN license. Further research should delve into the correlation between the increased diversity of nurses in the U.S. and improved patient outcomes among minorities. What are the factors involved? Common experiences? Mutual respect? Language and cultural similarities? Nurses must be patient advocates, and warriors who are willing to go to battle for their patients by all costs. It is crucial that minority patients who face an abundance of health disparities can feel nurtured and cared for by nurses who can empathize and understand who they are and the struggles they have faced in life. With this comes increased compliance to treatment.