Recommended Cultural and Clinical Considerations for Leaders and Educators Working With Muslim Nurses and Students

• Abstract Summary:  This presentation will identify workplace and academic practices that may produce feelings of exclusion in Muslim nurses and students. Specific recommendations and strategies promoting inclusion are discussed. 

In 2012, 37% of the United States (U.S.) populations were individuals from racial or ethnic minorities while only 19% of nurses were from minority backgrounds. Nurse leaders believe it is imperative to increase diversity, both to reflect the cultural diversity in the U.S. and to combat the nursing shortage (American Association of Colleges of Nursing, 2015). Muslim nurses/students constitute a growing and diverse population in the U.S., who are underrepresented in nursing (McDermott-Levy, 2011). While race and ethnicity of nurses are commonly recorded, there are not readily accessible reports of the number of Muslim nurses in the U.S.

The purpose of this presentation is to examine existing evidence in literature, to identify gaps in the literature, and to examine recommended cultural and clinical considerations for leaders and educators working with diverse employees, specifically Muslim nurses, so they can collaborate to develop strategies for an inclusive work/academic environment.

As an underrepresented population, Muslim nurses/students may face additional pressures in already stressful work or educational settings. Following September 11, 2001, the U.S. culture directed greater negativity towards Muslims (Ingraham, 2013). Negativity manifests itself in a variety of ways from subtle intolerance to severe discrimination. One example of subtle discrimination may be refusal to allow appropriate religious practices, such as wearing a hijab (a headscarf some Muslim women choose to wear). Laws prohibit organizations from refusing accommodations for religious beliefs; however, laws are ambiguous and leave room for interpretation that may allow employers/educators to ignore the employee/student requests.  The responsibility to fairly accommodate the request of the employee falls on the organization. For example, there continue to be concerns about patient safety when addressing wearing the hijab in the operating room, even though recommendations are clear that head coverings can be accommodated (Wood, 2015). Muslim nurses at greater risk for undue hardships, such as struggling on a daily basis to incorporate religious practices into the work environment, especially when reasonable accommodations are not made. These hardships can lead to burnout and feelings of exclusion (Findley, Hinote, Hunter, & Ingram, 2014).

A review of the literature was conducted using combinations of the keywords: head covering, hijab, Muslim nurses or nursing students, and religious accommodations. Research evidence is sparse with most information being provided through editorials, expert opinion, and commentary pieces. Research studies reviewed are on lower tiers of evidence, such as qualitative and survey studies. In these studies, populations are small. No studies were located in which randomization, large samples, or control groups were included. While the level of evidence is not high, exclusionary practices in healthcare are identified and information on the creation of a culture of inclusivity is available.

In order for the nursing profession to embrace diversity, nursing leaders, educators, and nurses must be aware of the discrimination towards Muslim nurses/students in the U.S. and methods of accommodation for cultural and religious beliefs. Leaders, educators, and nurses need to attend to specific considerations when working with Muslim nurses/students. Future research needed includes: more clearly estimating the number of Muslim nurses in practice and in schools of nursing; examination of non-Muslim leaders', educators', and nurse's/students' knowledge/attitudes/beliefs regarding Muslim populations; comparison of Muslim nurses/students experiences to groups who are not Muslim, and assessment of interventions to promote feelings of inclusion.