The current nursing workforce does not reflect the growing diversity of the U.S. population. In 2016, the U.S. reflects an increased Hispanic and racial diversity, with 61.3% of the population defined as white, non-Hispanic; four states (CA, HI, NM, TX) are now majority-minority (U.S. Census, n.d.). However, the registered nurse (RN) workforce remains overwhelmingly Caucasian at 78.5% (Data USA, n.d.); ethnic and racial minorities represent 19.5% of RN’s with 9% identifying as African American or Black (National Council of State Boards of Nursing, 2016). A number of professional nursing organizations have called for an increase in the number of diverse registered nurses (Campaign for Action, n.d.; National League for Nursing, 2016). Research has demonstrated a diverse workforce can improve the quality of care, enhance patient communication and reduce healthcare disparities (Phillips & Malone, 2014; Williams et al., 2014). There is a need for well-educated nurses who are clinically competent, skilled in evidence-based practice, outcome-oriented and focused on delivering quality patient- and family-centered care. The development of partnerships between healthcare institutions and schools of nursing can facilitate the transition of minority registered nurses into practice and fulfill the demand for a diverse workforce. The purpose of this research was to understand the ongoing experiences of African American registered nurses who participated in a collaborative clinical leadership program, the CLCDN, developed and supported by a hospital system and a university school of nursing.
Methods: A qualitative descriptive design using responsive interviewing and Black feminist theory framework was employed to explore the impact of the program and the nurses transition into practice. Nineteen African American registered nurses who were graduates of the program agreed to participate in the 7 focus groups. A semi-structured interview guide was used to elicit information and guide the discussion. Each focus group was audiotaped and field notes were kept by the research team. Thematic qualitative content analysis method was used to understand the phenomena from the participants’ perspectives. Demographic data was collected and analyzed.
Results: Nineteen African American nurses, ages 25-51 years old, participated in the research study. Three themes emerged from the data that spoke to the importance of a diverse nursing workforce and the challenges of African American nurses in particular. The themes were “this was a light coming through”, challenges of being a person of African descent and “it makes a difference when patients can find that diversity”. The collaborative clinical leadership program provided financial, social and professional support for the students as they transitioned into nursing practice; in turn they believed that their presence and experiences has improved patient care through the provision of culturally competent care to diverse patients and increased awareness among their nursing colleagues.
Conclusion:
Implications for Practice/Research. Although the focus group number is small and results may not be generalizable to all diverse populations, this is the first attempt at exploring the longitudinal effect of a collaborative academic leadership program on the nursing careers of student participants. Did this program build the leadership capacity in the hospital system, specifically creating diverse nurse leaders or an environment which would support the development of diverse nurses into leaders? Additional research on collaborative academic programs that foster nursing leadership among diverse nurses.
Conclusion. As research has demonstrated, building a diverse workforce and delivering culturally competent care is imperative and fundamental to reducing health disparities and poor patient outcomes. This research provides an opportunity to understand the successes and challenges encountered by African American nurses in educational programs and healthcare institutions. Using this knowledge, nursing and healthcare educators and leaders can develop programs that will implement strategies that will facilitate the transition and retention of diverse nurses in the workforce and improve the capacity of the employer to deliver culturally competent care.