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Diversity, equality, and inclusivity in nursing

by sophiajames

Historically, nursing has not been a diverse occupation. The stereotypical image of a nurse as a young, white female has, for much of our history, been reasonably accurate. And because of the long-term impact of that stereotype, other groups in the population have all too often faced discrimination or been discouraged from even trying to become nurses. Fortunately, this is a problem that has been recognized, and medical employers are determined to address the balance. We are a diverse population, and employers are determined that this should be reflected in the staffing of hospitals and other medical establishments. No matter what your background, there has never been a better time to consider a nursing career.

What is meant by diversity?

When considering diversity, the first examples that spring to mind are sex and race. However, diversity goes far beyond that. It can include sexual orientation, gender identity, religion, ethnicity, age, disability, and veteran status. Additionally, it can also reflect differences in background, education, experience, and beliefs.

In terms of education, it might be thought that this will not apply to nursing since all nurses must achieve particular standards in their training. However, although the educational qualifications to get into nursing might be the same, the education prior to that can be very different. One nursing student might, for example, be someone who has excelled academically at school and is entering nursing soon afterward. Another might be in their 30s, have left school with few qualifications, and have worked in a number of low-skilled jobs before returning to education. Despite their different educational backgrounds, both can become excellent nurses.

Is diversity important?

Some may think that an emphasis on diversity is unimportant – that as long as the nurses in their local hospital know what they are doing, it does not matter if many are white or female. However, this is a very simplistic way of looking at the situation, and while we certainly should value the dedicated stereotypical nurses, there is evidence to demonstrate that diversity in nursing improves healthcare standards and benefits society as a whole.


Nursing is a rewarding position where you get to make a difference every day through helping others, often at some of the most vulnerable points in their lives. It offers good long-term job security and many opportunities for promotion, making it a career path that appeals to many. People from all different backgrounds have the ambition and ability to become nurses, and it is fitting that they are supported to help realize those ambitions. If there are groups in the population who are left feeling that nursing is not for people like them, then it becomes harder for them to enter the profession. It is, therefore, only fair that people are encouraged into nursing regardless of their background. If there are some groups who are feeling discouraged, it is essential that steps are taken to redress this. A recruitment campaign that focuses on, for example, people of color is not being done to discourage white students. It is simply to make sure potential students with a different skin color feel equally encouraged.

Culturally competent care

We are all human, but this does not mean that illnesses and conditions impact us in the same way or with the same frequency. A heart attack, for example, can present differently in males and females. Having a diverse nursing staff allows there to be people who understand first-hand the physical or psychological differences that can impact how a patient is feeling or why it is occurring. Someone raised in a low socio-economic background will understand the physical and mental impact this has; a nurse from the LGBTQ+ community will know of the substance abuse and mental health issues that frequently affect that population; a male nurse will understand the psychological impact on a man of having his testicle removed; a black nurse will have insights into the cultural implications surrounding elderly care in their community. These are just a few of the ways that a diverse nursing staff can provide a unique understanding of the physical, mental, and cultural impact of illnesses and treatments.

Unconscious bias is a problem that can affect us all. Most of us indeed are people who embrace a diverse society and genuinely believe in equality. But all of us have also grown up in a world bombarded by stereotypes, where we do have specific ideas – and not necessarily negative ones – about what we expect from a man or woman, a white person, a black person, an Asian, Hispanic, or first nation person. This will inevitably affect how we behave in their company. A more diverse workforce will help counter that, and the more time people from diverse backgrounds spend working together for the common good, the weaker the influence of unconscious bias will become.

Increasing accessibility

Requiring healthcare for an illness or injury is never a good experience for patients. However, it can be made easier for patients by ensuring that healthcare facilities are places they feel comfortable in and include staff they feel satisfied with. It is human nature to find it easier to build a rapport with someone we perceive as similar to us, and for some groups, there are excellent reasons for not trusting other groups, even if a nurse from that particular group is 100% trustworthy. Women, for example, will often feel more comfortable receiving personal care from a female nurse.

Many cultures or religions have different rules. A Muslim patient who requires a Halal diet is likely to feel more comfortable discussing this with a Muslim nurse, confident that they will fully understand the needs, while a Sikh patient knows that a Sikh nurse will understand the significance of the turban, why they will be reluctant to remove, it and the acceptable alternatives if it has to be removed.

Language can often be a barrier to accessing healthcare. Medical terminology can often feel complicated, even in our first language. For those whose English is limited, it can be impossible to understand. If nurses are drawn from the local community, there is a good chance that there will be a nurse in the facility who will be able to communicate effectively.

People who regularly face discrimination in their daily lives, such as black or Hispanic people, may feel distrustful of an establishment that is staffed overwhelmingly with white people, making them reluctant to seek healthcare. This can result in a delay in treatment, which means a condition worsens. By having a diverse staff, healthcare becomes more accessible to all.

The nursing shortage

The demand for nurses is growing, resulting in a nursing shortage. By making nursing a career that is accessible and welcoming to people from diverse backgrounds, society can widen the pool of potential nurses. They must ensure that, once employed, nurses of all backgrounds feel comfortable carrying out their work so that medical facilities can retain their nursing staff. At a time when the need for nursing is more significant than ever, it is essential that all who have the ability and ambition to be nurses are welcomed into the profession.

How to promote diversity in nursing

With the advantages of a more diverse workforce becoming clearer, employers are actively using a range of strategies to include diversity in nursing. If well implemented, both the recruitment and retention of nurses from all backgrounds become more straightforward to achieve. Once a workforce starts to become more diverse, it will become even easier as more potential nurses recognize that nursing is a career for people just like them.

Diversify recruitment

If you are in charge of recruitment and you are aware that your nursing staff are predominantly white and usually female, it is time to reevaluate your recruitment strategies. Check for unconscious bias in your recruitment materials. Perhaps the images are showing only white people, or the language used is more relatable to a single group. It can be a good idea to involve others from your workplace, listening to what those from diverse backgrounds have to say about the recruitment process and taking on board any suggestions they have to make it more inclusive.

Understand the difficulties

There are often complex reasons why some groups are so underrepresented in nursing –reasons that go beyond fear of discrimination, harassment, and not fitting in. A primary reason may be poverty. Training to become a nurse is expensive and time-consuming. And since some ethnic backgrounds are generally over-represented in the economically poor, it is no surprise that they do not feel able to enter nursing. An excellent way to counter this is to increase awareness of the different ways to enter nursing. For example, an online Bachelor of Science in Nursing (BSN) is likely to be cheaper than attending a university in person. It will also attract more people from poverty-high rural areas who do not have a university in easy reach. Once they understand that this is an option and that the courses are just as rigorous and challenging as an in-person course, they may be able to see their way into nursing. Once they start nursing and earning, it may be possible for them to undertake further study either in person or online to advance their career, improving the rates of nurse retention.

A significant part of any course is the clinical placements, and many people worry about this not being available with online courses. However, this is not the case with high-quality online providers who understand the importance and necessity of clinical placements so that student nurses can undertake the required number of hours for licensure.

Many will also give full support to their students in finding clinical placements. This, too, will help diversify the new nursing recruits since it makes the course more accessible to those who have no contacts within the medical world to help them secure a place. One of those universities that offers support in securing a nurse practitioner clinical placement for their students is Texas Woman’s University. Their faculty and clinical placement coordinator organizes and prepares students for all aspects of the clinical posts, helping to ensure that this vital part of the course is a success. TWU’s Master of Science in Nursing – Family Nurse Practitioner program teaches students about various health policies and healthcare advocacy to ensure students graduate knowing how to offer inclusive healthcare to all.

Zero tolerance of discrimination

There should be no place for discrimination or harassment for any reason in the workplace, and this is particularly true for those of diverse backgrounds. Nurse managers should have clear policies in place for dealing with any problems, including making sure victims of harassment or discrimination feel comfortable reporting it. They must make sure there are obvious and severe consequences in place for those who perpetrate harassment or discrimination.

In the workplace, we should encourage a culture where people are able to feel comfortable talking about their different backgrounds so we can recognize the events that are important to people of all backgrounds. Through more excellent knowledge and understanding of each other’s cultures, the workplace becomes a more inclusive environment.

Look to leadership

Recruiting nurses from diverse backgrounds is just the beginning of the process. It is not enough to simply have more significant numbers of nurses from diverse backgrounds as students and registered nurses (RNs). Instead, the diverse nature of society should be reflected at all levels of nursing. If you already occupy a nurse leader role, look for ways to encourage your RNs from diverse backgrounds to consider their future careers. From nurse practitioner roles in family or gerontology to specializing in different areas of nursing, becoming a nurse midwife, management opportunities, and research positions, nursing is a rich and varied career full of opportunities for advancement.

When the nurse leaders in medical facilities are themselves from a variety of different backgrounds, it will make it easier to recruit more from those same backgrounds. Those nurse leaders will make fabulous role models, demonstrating to their colleagues how far it is possible to go.

Start young

The best time to demonstrate to people of all backgrounds that anyone can become a nurse is when they are young. Building partnerships with the community, particularly with schools and universities, can help present nursing as a realistic and viable career option at a point when young people are still making their minds up about their place in the world.

When involved in community activity, try to demonstrate the diversity currently in the workforce; if a particular group is heavily represented in that population, a nurse that reflects that can go a long way toward emphasizing the possibilities of a nursing career. While it may be a few years before those young people can become nurses, the demand for good nurses is not going away. Instead, with an aging population, the market is going to become greater. Community initiatives to motivate young people into nursing will pay off in the long term and help secure the future of nursing.


Building diverse nursing teams in hospitals and other medical facilities across the country is beneficial for nurses, patients, each diverse group, and the entire country. Encouraging people who are not typically nurses to consider pursuing nursing can help increase equality in society as a whole, as people from all backgrounds are able to become respected professionals. The more people that can be encouraged to enter and remain as nurses, the better the prognosis for the future of nursing appears.

Nurses from a range of different backgrounds benefit patients who are nervous about hospitals. They can help assure those who are held back by language barriers or fear of mistreatment. This may encourage them to seek medical assistance at an earlier stage of the problem, helping prevent it from becoming more serious.

No matter what your background, if you want to help others and are looking for a career where every day makes a difference, nursing may well be for you. It is well worth looking at your training options with a variety of both in-person and online courses available. If you are already a nurse, be ready to take advantage of the vast array of promotion opportunities available. As well as giving you better pay, they may also allow you to work with a greater degree of autonomy. And no matter what your background, those opportunities are for you.

Working in a diverse environment is an enriching experience. The bottom line is that we are all human and, in many ways, all the same. But we are also unique, and that should be celebrated in both nursing and society as a whole.

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