A mismatch exists between the African American population and the number of African American nurses. White non-Hispanics compose 69.3% of the nursing workforce with a baccalaureate as opposed to 10.7 % of African Americans (American Association of Colleges of Nursing, 2015). The National League for Nursed (2014) reported an increase in enrollment of minorities in basic nursing programs by 2% from 2012 to 2014. However, once stratified by race, African Americans’ enrollment has dropped from 12.9% to 12.2% as compared to Hispanics that have increased from 6.8% to 8.1%. Although many initiatives have been made to recruit and retain students in different nursing programs, very few have specifically conveyed the experiences of African Americans concerning their recruitment and retention in BSN programs to increase their representation in nursing workforce (Dapremont, 2014; Institute of Medicine, 2015; Murray, 2015; Sbaraini, Carter, Evans & Blinkhorn, 2011). The purpose of this qualitative study is to investigate the driven forces behind successful recruitment and retention of African Americans in BSN programs.
Method, Sample and Data Collection
A field test was conducted to evaluate the interview questions that would be presented to the participants for proper wording (Schmidt & Brown, 2012). Panel was composed of four doctorally prepared educators. Once the experts concurred that the interview questions adequately addressed the research questions and aligned well with the purpose of the study, approval was obtained from the University’s Institution Review Board (IRB). Permission was also solicited and obtained from the Nursing Director to use the premise as interview site and distribute letters requesting volunteers from recent, African American, nursing graduates who had completed their BSN. The participants were born and raised in United States, and resided in the mid-Atlantic region. Furthermore, these graduates were between 25 and 45 years old (Charmaz, 2014).
The letter indicated the researcher’s office as the site of the interviews. All efforts were made not to provide identifiable information about the graduates nor the institution. All of the aspects of involvement were explained to the participants in clear and concise language. The consent form included clauses such as: the reason the participants were invited to take part in the study, the permission to audiotape the interviews, the information about the researcher, the purpose of the study, the location and duration of the study, and the potential risks and benefits of the study. The right to withdraw at any time during the research process was also inserted (Marczyk, DeMatteo & Festinger, 2005). All documents and data were stored electronically on a password-protected jump drive (USB drive) or in a locked filing cabinet located in the researcher’s office to which only the researcher has access. Three years after the study completion, all of the information obtained from the participants will be destroyed (Schmidt & Brown, 2012).
Fourteen participants were engaged in-depth and face-to-face interviews for the data collection process. After demographic data were objectively collected through close-ended questions, the remainder of the interview was composed of open-ended questions to allow the participants to narrate their responses (Bendasolli, 2013; Maykut & Morehouse, 1994). An interview guide, composed of nine semi-structured questions, was used to ascertain the questions were answered. The interviews were conducted in English and a copy of the verbatim transcript for verification and correction was provided to each participants. Each interview lasted approximately 45 to 55 minutes. The interview started by acquiring demographic data from the participants, which included age, number of American generations, years of practice as a BSN, year of graduation from the BSN program, place of birth, zip code of residence, and current level of education (Charmaz, 2014; O’Reiley & Parker, 2013).
Data Analysis
The interview responses were transcribed line-by-line. The qualitative software NVivo 10® (2014) was used to organize the data. During open coding the collected data were assembled into building blocks (Walker, 2012). Axial coding consisted of conducting an in-depth and sophisticated analysis to find the themes around which the other concepts pivoted (O’Reilly, 2013). The researcher used an iterative and cyclical approach to data analysis to constantly compare data collected within each interview and across other interviews until data saturation signaled the need to discontinue the effort of collecting and analyzing further data (Charmaz, 2014). The final step was characterized by the emergence of four themes: (a) honoring the silent contract commitment, (b) uncovering inner strengths, (c) awaking the altruism within, (d) sacrificing on purpose.
Results
Theme 1(honoring the silent contract commitment) is a description of the graduates’ perceptions and experiences of their commitment to themselves and others who contributed to their success in the program. The participants used terminologies such as “determination to break the cycle” to describe their perceptions of the inner strengths needed to enroll, be retained, and successfully graduate from the program. The data for this theme 1 also revealed participants’ perceptions of how their commitment to honor “a silent contract” between themselves and others served as driven force for their success in the program. In Theme 2 (uncovering inner strengths), the participants provided data on the inner strengths cultivated or discovered to be successful in the program. The participants perceived their intention to be highly educated in terms of “self-actualization” and “true north discovery”. Although the indicated inner strengths help their recruitment, data also revealed the use of synonymous terminologies such as “self-confidence” and “self-esteem” to describe participants’ perceptions of other inner strengths needed to survive the rigor of the BSN program and succeed. Theme 3 (awaking the altruism within) emerged from five terms: advocacy, standing in the gap, be present, and role modeling. The participants used these terms frequently to describe their perceptions of their function in the community as the impetus for their successful recruitment and retention in the BSN program. The participants described their function they assume in communities where there is a lack of health educators, role models, and presence of health authorities to empower members to advocate for themselves or to advocate for those who cannot do so for themselves. The data for theme 4(sacrificing on purpose) supported the personal adjustments the participants had to make to be recruited and retained in the program. The participants described the ways they sought available resources and how humility helped them acknowledge and confront their academic weaknesses. The graduates also perceived the need to relinquish old habits and to adopt new ones as necessary to their success.
Discussion and Limitations
The above results describe how African American students relied on their inner skills and dispositions for their successful recruitment and retention in a BSN program. This study suggested other innovative recruitment and retention approaches that are more effective as a bundle, instead of as isolated strategies (Prins & Mooney, 2014). This study reiterated the need to include experiential learning as a teaching strategy to increase the program visibility and to use the community as the classroom to offer students opportunity to transfer their theoretical knowledge into practice. Finally, this study revealed how African American students perceive experiential learning as one of the best learning platforms. The experiential learning helped awaken the altruist within the BSN graduates to make decisions, advocate, stand in the gap, and role model in their community. The research findings captured how, during different experiential learning activities, the students learned to take advantage of their relatedness to create partnerships with the community members, provide services, and influence their health behaviors. Nurse educators can use this revelation as stimuli to update resources in their programs. Nontraditional strategies should be used. Curricula, pedagogical organizations, tests, and instructions should be redesigned (Porr, Brennan-Hunter, Crossman & Parsons, 2014). These researchers’ studies may also help the educators to identify and capitalize on students’ inner skills and dispositions.
The researcher recommends conducting studies in multiple states to verify whether geographic differences are relevant. A longitudinal study, involving students in Historically Black Colleges and Universities and predominantly Caucasian programs could verify how learning context influences the students’ perspective of their experiences with their recruitment and retention in BSN programs.
Conclusion
Students’ success was largely related to their psychological state. Those who brought to bear inner skills such as sense of commitment, self-actualization, self-confidence, and self-motivation pursued their goals and succeeded in the nursing program. The nursing education must undergo radical transformation of curricula, course offerings, and learning approaches. Finally, nursing leaders and educators must design new performance indicators to accurately measure the effectiveness of learning activities. The findings of this study are merely the point of departure of a chain of actions that are needed to accomplish social justice. Increasing the number of African Americans in the nursing workforce may lead to increase trust and participation in research studies for the discovery of effective management or a cure for health issues that specifically affect African Americans.