Factors Affecting Success in Nursing School: Experiences of African American BSN Students

Purpose: While the US population is increasingly diverse, the nursing workforce is not keeping pace with the racial demographics of the population as a whole. Results of a 2017 national nursing workforce study revealed that 19% of RN respondents represented a minority group, a statistic unchanged from the 2015 and 2013 surveys (Smiley et al., 2017). Nurses make up the largest segment of health care providers, and most nurses are White females. Recent data indicated that 6.2% of nurses identified as African American (Smiley et al., 2017), while 13% of the US population is represented by African Americans (Colby & Ortman, 2015). Lack of diversity in health care professionals, and subsequent limited knowledge about values and health care needs of certain populations may negatively impact health outcomes (AACN, 2019; National Academy of Medicine, 2013). Ethnic minorities represented only 22% of recent RN graduates. In addition, while African American nursing students accounted for 10.8% of nursing students (NLN, 2016), available data (HRSA, 2010) revealed that African Americans accounted for only 7% of RN graduates.
The purpose of this presentation is to discuss African American students’ perspectives of factors that affect successful completion of nursing school.

Methods: The setting for this study was a private, predominately White, Christian university with a nationally accredited nursing program. During the study period, African Americans represented 10% of the 236 member BSN student body. Of the students who participated in the study, 47% reported that they had earned less than a passing grade in one or more nursing courses. Despite the fact that 43% of respondents had previously earned a college degree, success in nursing courses remained problematic. After receiving approval from the university’s institutional review board, junior and senior nursing students who self-identified as African American on their admission applications were invited via email to participate in the study. Fifteen of the 24 eligible students agreed to participate. Data collection began with a face-to-face focus group to introduce the study and to answer any preliminary procedural questions. A series of three e-questionnaires was then emailed to participants over a 2 week period. Each e-questionnaire included three open-ended questions and space to provide any additional information.

Results: Currently, data analysis is incomplete. Preliminary findings have revealed the emergence of five themes from the data: (a) being invisible, (b) sense of isolation, (c) proving myself, (d) focus on school as protective, and (e) being misunderstood.

Conclusion: Attention to retention factors for African Americans in schools of nursing will lead to strategies for graduation success. A diverse nursing workforce is critical to bolster efforts to reduce the health disparities gap and to ensure high quality, culturally sensitive health care (AACN, 2017; National Academy of Medicine, 2013; Sullivan, 2004). A diverse nursing workforce enhances communication and lessens the chance for bias and misunderstandings. In addition, care recipients are more likely to adhere to health care education and recommendations from care providers who are perceived to be cognizant of the patients’ values and cultural practices.