How Nursing Diversity Helps Improve Patient Advocacy and Outcomes
September is Hispanic Heritage Month, a wonderful opportunity to celebrate and highlight the critical work of the National Association of Hispanic Nurses. Though the Hispanic population makes up more than 18% of the U.S., Hispanic nurses represent approximately 6% of the nursing workforce. Adrianna Nava, PhD, MPA, MSN, RN, president of the National Association of Hispanic Nurses (NAHN) shares her perspective on the importance of, and barriers to, a nursing workforce that represents the communities it cares for, and how workforce diversity is an important path to patient advocacy.
With 44 chapters in 24 states, NAHN is the leading professional society for Hispanic nurses, founded in 1975 by Ildaura Murillo-Rhode, PhD, RN, ND, FAAN. NAHN’s mission is promoting safe, quality health care to Latino communities, recognizing excellence among Latino nurses, providing mentorship opportunities for its 1,700 members, and developing highly qualified Latino nurses through educational, professional and leadership opportunities.
In addition to her work with NAHN, Nava is also a registered nurse, and passionate about increasing access to care. After witnessing how access-related disparities lead to poor health outcomes, she’s focused on decreasing health disparities in her community by growing the leadership capabilities of Hispanic nurses. Nava currently serves as a Research Scientist at the National Committee for Quality Assurance (NCQA).
What’s your perspective on the critical need for Hispanic nurses, and how is NAHN supporting expanding this workforce?
Adrianna Nava: The Latino population is increasing in this country, so it’s important to have workforce representation that reflects our community, both at the bedside and in leadership roles. Diversity leads to advocacy – when there’s more representation within an organization, there’s more insight into how the population might react to certain clinical procedures and policies, and better ways to address barriers to care.
When you have a senior leadership team that is reflective of the workforce, the organization, or even the patient population, there is ample opportunity for increased engagement of diversity of thought.
We encourage our members to pursue leadership opportunities to be the voice of their community, to be the person that represents a different perspective, one that traditionally hasn't been brought to light very often. And when it comes to addressing health disparities and health equity, it’s about elevating those voices that historically have been marginalized.
In addition to expanding the Hispanic nursing workforce, what is your long-term vision for the future of NAHN?
AN: At NAHN, we aspire to be a national leader of Latino health. When there are Latino health issues, as organizations and as nurses, we represent our community, we have our ears to the ground. Our volunteers go out and help those communities – a lot of individuals don’t necessarily have access to care, because they’re uninsured or under-insured, or they are undocumented. So, we want to have that presence – we want to be the go-to organization when there are issues pertaining to Latinos and be a part of coming up with solutions.
And to do that, we would need to have representation in every state in the country. Currently we don't, and that would be the biggest wish list for us – to have a chapter in every state. If there isn’t a chapter in your state, we can help you develop one. To initiate a chapter, you need at least 10 members, and you must be 40 to 60 miles away from another chapter. Those who are interested are also welcome to join virtually for another chapter’s meetings, or they can participate at our annual conference.
We’re also teaching nurses how to impact policy — including the organizational, state, and national levels. We have established our annual NAHN Latino Leadership Institute (LLI), where we provide leadership and policy skill building to our local Chapter leaders. In addition, in February 2023, we are hosting our Hispanic/Latino Health Policy Summit-where we’ll join our interdisciplinary counterparts in medicine, dietetics, and pharmacy in Washington, DC. We’re excited to come together and elevate priority-level health issues to our members of Congress.
What’s your perspective on the national shortage of nurses? What do you think is making it harder for nurses to enter and stay in the workforce?
AN: I think the trajectory of nursing as a profession has led us to this point, where we’ve been consistently undervalued and invisible. The work of nurses isn’t tied to anything within the healthcare system, including payer reimbursement. Nurses know this, so they’re no longer choosing to work at the bedside as they pursue promotional and leadership opportunities, sometimes even outside the profession. Our career paths are more mobile and versatile than ever.
Although the profession itself has changed, unfortunately, the way nursing is run within hospitals has not, and there’s a lot of opportunity for innovation. So many people are interested in nursing, but the profession must evolve and re-engage the workforce.
NAHN is engaged in finding short-term and long-term solutions here, too. In Florida, we’ve partnered with Keiser University, which is a member of the Hispanic Association of Colleges and Universities, on the creation of the Keiser University Nursing Advisory Council. This group is focused on developing practical solutions for nursing shortages in Florida. which is expected to be especially impacted by shortages. Our hope is that we can learn from being innovative in Florida and spread it out to other states.
What are some of the historical barriers that have kept more Hispanic individuals from entering the nursing profession?
AN: First, many Hispanic students lack role models in academia, so one of our missions at NAHN is to support and mentor students. We recently created a membership category for unlicensed personnel for guidance as they pursue a nursing degree.
There also aren’t enough nursing faculty members and leaders who represent the Latino community, and we’ve found that students feel more comfortable approaching and learning from someone who looks like them. If you don’t have representation, you may not feel like you belong within the profession. Within NAHN, members often feel inspired by the academic progression of their peers, and develop life-long mentors and friends who provide support to those who enter the organization seeking guidance.
There’s also the financial component. If you’re the first generation in the U.S., it can be a challenge to even think about the possibilities of where you can go. There are a lot of great universities providing funding, but sometimes if you think you don’t belong, that can be a limiting factor. This past year, we awarded $10,000 in scholarship to eight nurses through the Abbott Scholarship Fund. And for those who do enter the profession at the bachelor’s or associate’s level, we help nurses looking to grow by providing funding for advanced degrees and licenses.
Our Latino students sometimes come from underserved communities, so their education didn’t necessarily prepare them to be competitive when it comes to math and science, and that can put them at a disadvantage when they apply to nursing school. Pipeline programs are one way for students to attain their goal of becoming a nurse and pursuing advanced degrees in the future, and it may also be helpful to have education policy-oriented solutions, focused on universal pre-school as a start. Studies have shown that early interventions have resulted in positive results, including higher school achievement over time. It would also be beneficial for the nursing profession to be recognized as a STEM field. Students may not be aware that nursing requires extensive coursework in math and science and may de-emphasize the importance of these classes.
What resources or advice do you recommend to current and future nursing students?
AN: Well, I actually was rejected by my dream nursing school, and I ended up taking some time off. But while I was working as a nurse assistant, I would see other nurses doing the work that I could do and I thought to myself, I can keep going. So, I applied again to a different school, and was accepted. And while I was in that nursing school, I became really interested in public health, which led to a health policy internship in Washington, DC. It was there that I was introduced to professors at the University of Pennsylvania, which is where I obtained my master’s degree.
So, a lot of times you might not get the pathway that you initially wanted; but in those moments, you’re opening yourself up to opportunities that you might not have pursued otherwise. This opens doors that you never knew were there.
Also, look to a professional nursing organization so you don’t have to navigate your professional career on your own. By joining an organization like NAHN, you can be part of a larger network with access to new experiences and broad connections across the country. If you’re looking for career advancement or leadership opportunities within the nursing profession, there’s room for you at NAHN.
To learn more about NAHN, visit www.nahnnet.org.