Preparing Leaders to Advance Nursing: Project Plan

Despite the increasing diversity in nursing, there is a disparity in the proportion of nurse leaders from underrepresented minority groups(URM). The lack of URM nurses in leadership positions is of increasing concern in today’s complex healthcare climate. Nursing workforce predictions indicate that there could be a shortage of up to 67,000 nurses in mid-level and executive positions (Dyess, Sherman, Pratt, & Chiang, 2016). Nurses from URM groups are in a unique position to fill this shortage as they are equally or more likely than non-minority nurses to pursue advanced degrees in nursing. Current research suggests that the healthcare community in the U.S. views diverse leadership as a valuable business resource, and links diversity with achievement of strategic goals including patient satisfaction and improved staff and patient outcomes (Jackson & Garcia, 2014). However, the American Hospital Association’s benchmark study shows that minority representation in leadership positions within healthcare organizations has been reported as only 14% of hospital board members, 12% of executive leadership positions, 10% of Chief Nursing Officers, and 17% of first- and mid-level management positions (American Hospital Association, 2012).

Nurse leaders will be integral in developing innovative strategies in healthcare delivery to meet the evolving needs of our society. Health inequity and disparity continue to be priorities on both the National and State level. In order to address this urgent problem, nurse leaders with insight and a specific skill set for addressing these issues through research, practice, education, and policy are needed. While a diverse nursing workforce continues to be a priority, emphasis should also be placed on the development of nurse leaders from URM groups. Underrepresented minority nurses must move into leadership positions in order to influence hiring decisions, policy implementation, and the promotion of diversity within healthcare settings. Leadership positions afford nurses an increased ability to influence resource allocation, recruitment of a diverse workforce, and shape organizational and national policy that could influence the health status of URM populations (Phillips & Malone, 2015).

Multiple factors influence whether underrepresented minority nurses advance into leadership positions. In addition to exclusion from leadership development opportunities because of ethnicity, lack of mentorship, visibility, and management training are also noted to be barriers to advancement into leadership for these nurses. (Carter, 2015; Khosrovani & Ward 2011). Often nurses, particularly those from URM groups, find it difficult to envision themselves as potential leaders early-on in their careers. Hence, they may miss opportunities to develop a repertoire of leadership skills and knowledge necessary to advance their careers and gain leadership positions. Leadership development should be viewed as a part of becoming an expert nurse and formal preparation of future nurse leaders is critical. In order to address the increasing need for underrepresented minority nurse leaders, the Preparing Leaders to Advance Nursing (PLAN) project was developed.

PLAN addresses a key recommendation of the IOM report calling for nurses to be involved in decision-making bodies to help lead change to transform health care, and for “public, private, and governmental health care decision makers at every level” to “include representation from nursing on boards, on executive management teams, and in other key leadership positions” (IOM, 2010).

By identifying and emphasizing leadership strengths early in a nurses’ career and enhancing those leadership skills as they progress, there will be an increase the number of underrepresented minority nurses who are academically and experientially prepared to lead organizations across the care continuum. These leaders will also be poised to transform health care with a specific sensitivity to health issues of those from underrepresented groups.

PLAN was designed to address the known barriers faced by URM nurses as they attempt to move into leadership roles. The overall aim of Preparing Leaders to Advance Nursing is to develop underrepresented minority nurse leaders who are poised to lead changes in an emerging and complex healthcare system through practice, education, innovation, and policy. This 3 - year project includes multiple strategies for both undergraduate and graduate nursing students. At the baccalaureate level nurses participate in activities that foster a leadership identity, and develop and expand their capacity for leadership roles. As graduate students, nurses gain deepened insights and skills needed to advance nursing. Graduate students participate in numerous activities the foster engagement in the community and profession. These include service learning, mosaic mentoring, and active participation in professional organizations such as Sigma Theta Tau. All students are eligible for academic support services and financial support to attend professional conferences and join professional organizations. Additionally, insights on the challenges faced during the program planning and implementation phases and how those challenges were addressed will be discussed. Participants are asked to complete a narrative reflection on their experiences and the impacted they have had on their leadership journey. Preliminary results from the narratives will be shared during presentation