The Importance of Creating A Diverse Nursing Workforce For Culturally Competent Care

The Importance of Creating A Diverse Nursing Workforce For Culturally Competent Care

The Importance of Creating A Diverse Nursing Workforce For Culturally Competent Care
The Importance of Creating A Diverse Nursing Workforce For Culturally Competent Care

The incredibly diverse demographics of the American population needs a nursing workforce that better represents the people it serves. Nursing census statistics report that more than 83% of nurses are Caucasian and 90% are female. There is a decided need to create a more diverse nursing workforce to reflect this demographic and provide culturally competent care.

What is Culturally Competent Care?

Culturally competent care is designed to meet the needs of people with different behaviors, values or beliefs. It ensures that the delivery of care is tailored to meet the social, economic, and cultural needs of a population, including language requirements.

Excellent culturally competent care encompasses the patient's personal ideas about wellness and illness. Many factors can influence an individual’s values and beliefs about health, including:

  • Nationality

  • Language Barriers

  • Gender

  • Socioeconomic Status

  • Physical Ability

  • Mental Ability

  • Sexual Orientation

  • Occupation

  • Religion

Creating a more culturally competent workforce improves healthcare outcomes, and the single most important factor in cultural competence is the creation of a more diverse nursing workforce.

The Future of Nursing is Creating and Fostering a More Diverse Workforce

The Institute of Medicine published their landmark report on the future of nursing in 2010. This collaborative initiative between the Robert Wood Johnson Foundation (RWJF) and the American Association of Retired People (AARP) identified the key goal of developing a more diverse workforce. The Campaign for Action was born from this landmark report and is designed to implement the primary goals outlined in the report through committees such as the Diversity Steering Committee.

Diversity Steering Committee

The Diversity Steering Committee is made up of organizations that represent groups that are underserved in healthcare.

Specific groups represented by the Diversity Steering Committee include the following.

  • Male nurses

  • Latino nurses

  • African-American Nurses

  • Native American Nurses

  • Asian Nurses

The Diversity Steering Committee is comprised of committee members from the following organizations.

  • American Assembly for Men in Nursing

  • Asian-American/Pacific Islander Nurse’s Association, Inc.

  • National Alaska Native American Indian Nurse’s Association, Inc.

  • National Association of Hispanic Nurses

  • National Black Nurse’s Association

  • National Coalition of Ethnic Minority Nurses Association

  • Philippine Nurses Association of America, Inc.

Studies have shown the gaps in care exist despite access to health insurance, income, or where people live, and the keys goals are as follows:

  • Diverse workforce to reflect America’s demographics

  • Provide culturally competent care

  • Reduce gaps in care that exist among demographic workers

  • Reduce healthcare disparities between racial, ethnic and socioeconomic groups

An important intervention is to increase the number of healthcare workers who represent their served population. Every nurse plays a role in fostering and creating a more diverse nursing workforce.

Nurses! The Person Up!

It is very important to increase the diversity of the nursing workforce for many reasons. First, nurses comprise the largest part of the healthcare workforce. In 2014, the Bureau of Labor Statistics recorded that 2.7 million of the 11.8 million reported healthcare workers, which made nurses the largest population of workers.

Second, nurses have consistently been rated the most trusted profession by the Gallup poll for 15 years in a row. Nurses are front-line, direct-care providers who can help foster and create a diverse culture of health. Studies have shown that overall patient outcomes are improved when nurses speak the same language or demonstrate culturally competent care. Steps to creating a more diverse nursing workforce are at the individual, organizational, and legislative level.

Organizational Steps to Creating a Culturally Competent and Diverse Nursing Workforce

Organizations should be committed to maximizing diversity. The key to cultural competence is a diverse healthcare workforce. To achieve this goal, healthcare organizations should take the following steps:

  • Hire minority health care workers

  • Promote minority health care workers

  • Establish or strengthen minority leadership programs and initiatives

  • Develop patient and community feedback systems to improve care quality.

  • Provide interpreter services based on assessment of patient’s language needs

  • Make educational materials available in different languages

  • Institute quality improvement strategies when indicated

  • Monitor racial and ethnic disparity data

  • Implement a quality improvement monitoring program for medical errors as a result of a communication breakdown

Choosing to work for a progressive healthcare system which strives for cultural competence and excellence of care is optimal, but not always possible. Thankfully, every nurse has the power to advocate for cultural competence and strive for the individual as well as organizational excellence.

What Can the Individual Nurse Do?

Every nurse has the opportunity to impact patient outcomes positively and is challenged to become knowledgeable in culturally competent care. Nurses must take it upon themselves to:

  • Understand the six pillars of care, and make self-assessments a part of every interaction.

  • Provide care that is safe, effective, patient-centered, timely, efficient and equitable for all patient populations.

  • Learn about implicit bias and understand how it plays a role in adverse outcomes.

  • Seek to understand and gain knowledge regarding multi-cultural patient populations by asking questions, and taking courses on cultural competence.

Making Gains But Still, A Long Way to Go

Diversity in the nursing workforce is improving, but much work still needs to be done at the individual, organizational and legislative level. For the six pillars of health care to be consistently achieved for all patients, the basis must be sensitivity, compassion, and tolerance. Organizations must provide in-house training and tools to achieve a diverse, educated and tolerant workforce to serve a multicultural community.

The Health Resources and Services Administration (HRSA) which is a part of the US Department of Health and Human Services (HHS) acts as the national leader for the development and retention of a diverse and culturally competent workforce.

The National Sample Survey of Registered Nurses (NSSRN) was initiated in 1977 and data was collected every four years, up until 2008.The following data is a compilation of information obtained from the 2008 NSSRN Survey and the HRSA’s 2013 report on trends in the nursing workforce.

As of 2008, there were 2,824,641 RN’s in the U.S. There were 690, 038 LPN’s.


  • 9.1% male RN’s

  • 7.6% male LPN’s

Minority Nurses

  • 9.9% Black or African American (Non-Hispanic)

  • 8.3% Asian

  • 4.8 % Latino or Hispanic

  • 1.3% Identify with multiple races

  • 0.4% Native American

Minority Nurses by Region

Pacific Region- Highest number of overall minority nurses at 30.5 %

Areas with Highest Percentage of Asian Nurses

  • Pacific Region - 16% of those nurses have an Asian background

  • Atlantic – 7.3% Asian nurses

  • West South Central – 5.6 % Asian Nurses

Areas with Highest Number of Black or African American Nurses (Non-Hispanic)

  • South Atlantic- Black or African American 9.5 %

  • West South Central – 8.8% Black or African American

  • East South Central-7.7 % Black or African American

Areas in Highest Number of Hispanic or Latino Nurses

  • West South Central -7.8 %

  • Pacific- 6.7%

  • Mountain- 6.1%

Nurses who understand their patient’s culture and language can better advocate for their care. Communication is improved and understanding enhanced. Patients feel valued and more comfortable. Every healthcare interaction is an opportunity to make a positive impact on patient outcomes.

The changing demographic of patients demand our healthcare providers to be culturally competent, and the best intervention is to hire a more diverse workforce. Experienced RNs, consider combining your experience with education that focuses on the best nursing practices to date with the RN-BSN program at Fran U.