Written Testimony
of the
American Nurses Association
Before the
Committee on Institutional and Policy-Level Strategies for
Increasing the Diversity of the U.S. Health Care Workforce of the
Institute of Medicine
February 5, 2003
Barbara A. Blakeney, MS, RN, APRN,BC, ANP

Good morning Mr./Madam Chair and members of this distinguished Committee. Thank you for the opportunity to testify today. I am Barbara Blakeney, President of the American Nurses Association (ANA). ANA is the only full-service professional organization representing the nation's 2.7 million registered nurses (RNs). As the voice for professional nursing, ANA is concerned about the paucity of diversity in the nursing profession.

Racial and ethnic minorities will comprise nearly 40 percent of the population by the year 2020. Unfortunately, findings from the 2000 National Sample Survey of RNs document that racial and ethnic minority nurses represent only 12 percent of the total nurse population. Therefore, without significant interventions, the nursing workforce will continue to be out of balance with the health care demands of our nation's changing demographics.

Nursing programs currently graduate only about one-half of the number of minority students needed to reflect the diversity of the general population. Compounding the lack of student diversity, and further impacting diversity recruitment efforts, is the fact that nursing school deans and faculty also comprise a racially homogenous group. According to the American Association of Colleges of Nursing, racial and ethnic minorities represent 8.7 percent of faculty and 6.8 percent of deans. ANA believes that programs such as ANA's Ethnic Minority Fellowship Program (EMFP), are a strategy to address these disparities.

The program's broad mission is to: increase the number of rigorously educated nurses from under-represented groups, to conduct research about psychiatric/mental health issues and problems with minority populations; take leadership roles in the initiation of scientific investigations about minority populations; expand psychiatric/mental health literature about minority populations and function as members of integrated research teams. For more than two decades (1974-2002) the EMFP program has been engaged in the challenge of reshaping the community of nurse researchers and academicians by addressing the racial and ethnic gap in doctoral attainment. We are pleased to report that over 200 EMFP Fellows have earned their doctorates and more than half of these fellows are in academia. Their contributions have enriched the attitudes and perspectives of non-minority nurse researchers and academicians. ANA recommends that the EMFP model be expanded to support faculty and research development beyond the psych and mental health arena.

Another strategy to increase diversity of the nursing workforce is to create and maintain an empowering environment for nurses. ANA recommends health care providers heed the example of Magnet Hospitals which excel in patient care and in the recruitment and retention of racial and ethnic minorities. Magnet hospitals provide a unique environment which fosters career growth. They also meet the industry's gold standard for culturally diverse staffing and culturally competent patient care. They aim to hire health care professionals which match, in a large degree, the demographics of the communities they serve. For example, at St. Luke's Episcopal Hospital in Houston, Texas, (the first magnet facility in the Southwest) the facility boasts that the nursing staff speaks approximately 37 different languages. Magnet facilities go the extra mile to retain the multi cultural talent they've hired by providing mentoring, preceptorships, recognition awards, career advancement programs, and other kinds of support. For many racial and ethnic minority nurses, continuing their education and earning advanced degrees are key factors for career advancement and magnet facilities are willing and able to provide this valuable support.

Training in culturally competent patient care and workplace diversity are also a staple at many magnet facilities. For example, Mayo-Rochester Hospitals in Minnesota offer ongoing workshops on topics like "Diversity Respect and Skill Building," "Preventing Bias and Promoting Respect" and "Valuing Diversity in our Communities." These strategies help to foster an environment of inclusiveness which makes racial and ethnic minority nurses feel valued and increases retention.

ANA recognizes that nurse recruitment must begin at the middle and high school level. Magnet institutions such as St. Luke's in Houston have established a nursing career awareness program with a Houston-area high school. This provides students an opportunity to become interested in nursing as a career and interface with positive role models. There are other examples from across the country. Some extend similar opportunities to minority college students. Some offer seminars with an opportunity to participate in direct and indirect patient care under the direction of a registered nurse. These programs are demonstrating positive outcomes. Perhaps the establishment of links or partnerships between schools of nursing and inner-city schools could provide mentorship opportunities as well as an exposure to nursing. This might be a strategy to explore. Finally ANA recommends the creation of a seamless career development system for individuals in the healthcare workforce. This could provide an opportunity for continued academic development through flexible workplace programs, classrooms and faculty access.

ANA acknowledges that increasing the diversity of the nurse workforce requires a strong commitment from many stakeholders in both the education and health care arenas. We assure you that we remain committed to address this issue. Thank you and I would be pleased to respond to your questions.

2003 press releases

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