A nurse’s work, by definition, includes daily engagement with people from all walks of life.
As part of the healthcare sector’s work to provide meaningful, comprehensive care to all patients, it’s important for the nursing profession to reflect the rich diversity of the communities they serve. But what does that mean in practice? And why is it so crucial for both patient outcomes and the well-being of healthcare professionals?
In this article, we’ll explore how embracing Diversity, Equity, and Inclusion (DEI) in nursing not only fosters a more compassionate and culturally competent workforce, but also improves the overall quality of care. From addressing systemic inequities to creating more inclusive work environments, we’ll dive into the ways that healthcare institutions are striving to build a nursing community where everyone—regardless of race, gender, or background—feels valued and empowered. So, whether you’re a nurse, a healthcare professional, or simply interested in the future of healthcare, join us as we discuss the vital role DEI plays in shaping a more just and effective healthcare system.
What is Diversity, Equity, and Inclusion (DEI)?
Diversity, Equity, and Inclusion, often referred to as DEI, are three interconnected concepts that play a crucial role in creating a fair and welcoming environment in any setting, including the workplace.
- Diversity refers to the presence of differences within a given setting. These differences can include race, ethnicity, gender, age, sexual orientation, disability, socioeconomic status, and many other attributes. When we talk about diversity, we're recognizing the wide range of experiences, perspectives, and backgrounds that people bring to the table.
- Equity goes a step further by focusing on fairness and justice. It's about ensuring that everyone has access to the same opportunities and is not disadvantaged due to systemic barriers or biases. Unlike equality, which treats everyone the same, equity recognizes that different people may need different resources or support to achieve similar outcomes.
- Finally, Inclusion is about creating an environment where everyone feels respected, valued, and able to fully participate. It's not just about having diverse voices in the room but ensuring those voices are heard and that their contributions are recognized.
In essence, DEI is about building spaces where differences are celebrated, fairness is the standard, and everyone feels they belong.
Whether in the workplace, schools, or communities, embracing DEI helps create stronger, more innovative, and more compassionate environments for all.
Why Is Diversity in Nursing Important?
Nurses who share or understand their patients’ cultural, linguistic, and socioeconomic backgrounds are better equipped to communicate effectively, build trust, and tailor care plans that meet patients’ unique needs.
For instance, a bilingual nurse can directly communicate with patients who speak the same language, avoiding misunderstandings, helping patients feel safer and more comfortable, and ensuring accurate information exchange. Similarly, a nurse who understands the dietary restrictions of a particular group can provide more appropriate nutritional advice and care, thereby enhancing the patient’s comfort and compliance with treatment plans.
The work of cultural competence not only improves patient satisfaction but also can lead to better health outcomes, as patients are more likely to follow medical advice and engage in their own care when they feel understood and respected.
Diversity in nursing is also meaningful for employees and within the workplace, as it fosters a more inclusive, more supportive work environment. When nurses from various backgrounds come together, they bring different perspectives and experiences, which can lead to innovation and improved team dynamics.
A diverse nursing workforce is also a critical part of creating a more equitable healthcare system, helping to break down stereotypes and reduce biases. In a field where teamwork and collaboration are essential, having a variety of voices and experiences strengthens the overall care provided and helps ensure that all patients receive the compassionate, high-quality care they deserve.
What Is Cultural Competence?
Cultural competence is the ability to understand, communicate with, and effectively interact with people across different cultures. In the healthcare setting, it involves recognizing and respecting the diverse beliefs, values, and practices of patients from various backgrounds.
Cultural competence isn’t just about knowing the right terminology or having a basic awareness of different customs; it’s about being genuinely attuned to the ways culture influences a person’s experience of illness, health, and healthcare. It means being open-minded, avoiding assumptions, and asking the right questions to provide care that is truly patient-centered.
For healthcare professionals, cultural competence is crucial because it helps bridge gaps in communication and understanding that might otherwise lead to disparities in care. For example, some cultures may have specific beliefs about certain treatments or may use traditional remedies alongside or instead of Western medicine. A culturally competent nurse would be aware of these possibilities and engage in a respectful dialogue with the patient, ensuring that their care plan is not only medically sound but also culturally sensitive. This approach not only improves patient satisfaction but also fosters trust, leading to better adherence to treatment plans and, ultimately, better health outcomes.
In essence, cultural competence is about more than just awareness—it’s about action. It’s the skill set that enables healthcare providers to deliver high-quality care to every patient, regardless of their cultural background. By continually learning and adapting to the diverse needs of their patients, culturally competent healthcare professionals play a vital role in reducing health disparities and promoting a more inclusive, equitable healthcare system.
Diversity, Equity, and Inclusion in Nursing
Many hospitals in California have established dedicated Diversity, Equity, and Inclusion (DEI) departments or councils, reflecting a growing commitment to fostering inclusive environments both for healthcare workers and patients.
These DEI departments are tasked with addressing systemic inequities, promoting cultural competence, and ensuring that healthcare practices and policies are equitable and inclusive. For one example, the UCSF Benioff Children’s Hospitals have a comprehensive DEI program that includes a council focused on advancing diversity, equity, and inclusion through strategic initiatives like workforce diversification, leadership development, and addressing health disparities.
These DEI efforts are not limited to a few hospitals but are part of a broader movement within the state’s healthcare system. The American Hospital Association (AHA) has noted that many California hospitals are participating in DEI benchmarking surveys, which help track progress and share best practices across the industry. This reflects a statewide effort to embed DEI principles into the core operations of hospitals, ensuring that all patients receive high-quality care regardless of their background, and that the healthcare workforce is reflective of the diverse populations they serve.
DEI initiatives in hospitals often include mandatory training programs for staff, policies to ensure equitable hiring and promotion practices, and the creation of supportive environments for underrepresented groups.
The Fight for Equity for Women in Nursing
In California, male registered nurses (RNs) earn a median salary of $90,000, which is $14,000 more than the median salary for female RNs, who earn $76,000. This disparity persists even though women make up the vast majority of the nursing workforce and is especially pronounced in specialized and higher-paying roles, such as nurse anesthetists, where the gap can exceed $17,000 annually.
This gender pay gap reflects broader systemic issues within healthcare, where women often face barriers to salary negotiations and career advancement. Studies show that men in nursing are more likely to negotiate for higher salaries, which contributes to the wage disparity. Additionally, women in leadership roles, such as Chief Nursing Officers, still earn less than their male counterparts, with men earning an average of $132,700 compared to $127,050 for women in the same positions.
Addressing these inequities requires systemic change, including greater transparency in salary practices and stronger advocacy for pay equity within the healthcare system. In California, recent legislative efforts like Senate Bill 1162 aim to increase pay scale transparency and hold employers accountable for gender pay disparities, which could be a crucial step toward achieving equity for women in nursing.
DEI in Education
DEI initiatives also exist in education, aiming to ensure that institutions are not only diverse in their student and faculty populations but also equitable in providing access to resources, opportunities, and support systems that allow every individual to thrive. This approach is increasingly critical as higher education institutions seek to address long-standing disparities and create more inclusive campuses that reflect the diverse society we live in.
Recent government efforts include encouraging colleges and universities to implement targeted recruitment and outreach programs, especially in partnership with K-12 schools and community colleges, to attract a more diverse student body. This includes advocating for policies that consider the various adversities students may have faced, such as economic hardships or racial discrimination, in the admissions process. This ensures that students who have overcome significant challenges have the opportunity to access higher education and the benefits it brings, including social and economic mobility.
DEI vs. Affirmative Action: What’s the Difference?
Diversity, Equity, and Inclusion (DEI) and Affirmative Action are both strategies aimed at creating more equitable environments, but they approach the goal from different angles and with distinct methods.
DEI is a comprehensive framework that goes beyond simply increasing diversity in numbers. It focuses on fostering an inclusive culture where all individuals feel valued and have equal opportunities to succeed, regardless of their background. DEI initiatives typically include a wide range of efforts, such as diversity training, mentorship programs, and policies aimed at reducing bias and ensuring equity across all levels of an organization or institution. The aim is to create an environment where everyone, from students to employees, can thrive.
On the other hand, Affirmative Action is a specific policy designed to address past and ongoing discrimination by providing opportunities to historically underrepresented groups, particularly in education and employment. Affirmative Action often involves setting targets or considering race, gender, or other factors as one of many criteria in admissions or hiring processes. The goal is to correct imbalances and ensure that these groups have fair access to opportunities that they may have been previously excluded from due to systemic discrimination.
While Affirmative Action is a tool that can be part of a DEI strategy, it is more focused on the initial steps of creating diversity rather than the ongoing cultivation of an inclusive environment.
In essence, while both DEI and Affirmative Action aim to promote fairness and reduce inequality, DEI is broader and more holistic, focusing on long-term cultural change, whereas Affirmative Action is more of a tactical approach to leveling the playing field by addressing immediate disparities.
Critically, these concepts are not an “either/or”: in fact, understanding the difference between DEI and Affirmative Action is key to appreciating how organizations and institutions can use them in tandem to create a more just and equitable society.
Diversity in California DNP Programs
According to a study conducted by the University of California, San Francisco (UCSF) using 2018-2019 data, the nursing workforce in the Golden State is becoming more and more diverse. Still, people who identify as minorities are less likely to pursue advanced nursing degrees: recent studies by the American Association of Colleges of Nursing (AACN) found that, while 264,835 minorities graduated from generic baccalaureate programs in nursing between 2010 and 2022, less than 34% of all graduates went on to pursue master’s degrees, and just 4.8% of all minority graduates went on to become Doctors of Nursing Practice (DNPs).
In essence, this means that, while minority enrollment in higher education for nursing is increasing, few nurses from minority backgrounds pursue graduate and doctoral degrees. Nurses with master’s and doctoral degrees tend to work in senior-level positions, commanding higher salaries and more responsibilities. As such, this means that nurses from minority backgrounds are more likely to work as Registered Nurses (RNs), while white nurses are more likely to work in more senior positions.
Because there’s significant room for growth in equity in nursing, the AACN is one example of an organization in the United States that provides a DEI program to encourage diversity and leadership in the nursing profession. The AACN frequently collaborates with foundations and universities to conduct research on topics like inclusion for nurses with disabilities, combatting racism in university settings, and trauma-informed care. The AACN also offers webinars, conferences, grants for faculty, and publications that share information about DEI in university contexts.