1. Muirhead, Lisa DNP, ANP-BC, FAANP, FAAN
  2. Richard-Eaglin, Angela DNP, FNP-BC, CNE, CDE, FAANP
  3. Webb, Michelle DNP, RN, BC-CHPCA


An introspective look.


Article Content

Increasing diversity in the nursing workforce is essential for building organizations that support health equity among underserved communities, but diversity in nursing is not enough. It cannot amend the effects of existing practices of racism that impede the success of nurses of color. Few nurses of color reach the C-suite where decisions are made, so power imbalances remain in favor of majority groups. Although women continue to make significant strides in achieving educational milestones, women of color lag in wages and positions of leadership.


According to the American Association of Colleges of Nursing, the RN workforce is 80.8% White, and among full-time nursing school faculty, 80% are White. Morrison-Beedy and colleagues (Journal of Professional Nursing, 2018) noted that less than 10% of nurses of color hold executive leadership positions, which is strikingly low. Although schools of nursing have increased enrollment of students from underrepresented groups, institutional efforts fail to reach concordance of racial and ethnic diversity among faculty and the nursing workforce at large.


Inadequate racial and ethnic diversity in nursing has significant influence on educational experiences, workplace satisfaction, and career progression in practice, research, academia, and leadership. Despite possessing advanced education and experience, many nurses of color face glass ceilings in their careers. Success in academia and health systems is often hindered by anachronistic tenure and promotion standards with pejorative practices that stifle development and advancement. As a result, some nurses of color have left institutions feeling alienated, devalued, and demoralized.


Deep roots. Racism is the cornerstone from which superiority, discrimination, inequality, and inequity were constructed. This foundational premise continues to perpetuate marginalization and unfair disadvantages that are reflective of historical laws and statutes that granted rights and privileges to one racial group and denied them to others. While many of these laws are obsolete, racism is deeply rooted in the fabric of society and still contributes to attitudes and behaviors that sustain socially and politically unjust organizational practices.


Institutions of higher education are not exempt from racial biases that manifest as disparities in enrollment, hiring, promotion, rank, and tenure. Students and faculty of color are often affected by racial and ethnic stereotypes that propagate low expectations and disregard for expertise and scholarship, and circumscribe power and resources. Other consequences of racism in higher education that impede nurses of color from reaching their full potential include


* the facade of inclusiveness.


* internal alliances that morph into networks outside of the academy.


* inequitable distribution of resources.


* race-based power imbalance.



The facade of inclusiveness refers to normalized practices within institutions that offer underrepresented faculty a seat at the table without an authentic milieu to foster belonging-in other words, the illusion of inclusion. Historically, stakeholders have used numerical metrics to fulfill diversity goals without meaningful shifts in culture. This approach falls short of reaching ideals of equity, inclusion, and belonging.


In dialogue with other nurses of color, we concur that internal alliances within institutions represent racially exclusive networks that exist outside of the academy. These informal coalitions provide access to individuals in positions of power and influence, as well as information on resources, scholarships, and opportunities for career advancement. Exclusion results in inequitable distribution of professional development capital, such as funding opportunities and leadership-building resources.


Race-based power imbalance is another corollary of racism. This imbalance is pervasive. It causes disfranchisement, conformity pressure, and attempts to nullify the voices of nurses of color and stifle professional advancement.


Nursing has extraordinary opportunities to lead unconventional strategic initiatives that extend beyond diversity metrics and aim for inclusive excellence. It will require courage, consistency, roadmaps, and accountability to undermine current racialized structures. This transformational journey may be arduous, but it is paramount in fulfilling the humanitarian responsibilities of the nursing profession.