Advancing Nursing Practice and Diversity

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1 Connecting Diverse Professionals to Diverse Careers TM $1.95 Advancing Nursing Practice and Diversity University of Maryland Nursing Dean Jane Kirschling Sees a Healthy Outlook Special Focus: Fostering Diversity in Nursing Schools

2 Earn a Jefferson Nursing Degree, Achieve a Jefferson Reputation BSN: full-time upper division 2-year program FACT: 12-month accelerated BSN RN-BSN: online or online/on campus RN-BSN/MSN: online or online/on campus MSN: multiple specialties; core/support courses online; clinical courses on campus; distance education via live webcasting DNP: online, may complete in 2 to 5 years explore.jefferson.edu/insight Philadelphia, PA THOMAS JEFFERSON UNIVERSITY

3 In partnership with The INSIGHT Into Diversity Higher Education Excellence in Diversity (HEED) Award recognizes an institution s superior achievement and commitment regarding diversity and inclusion on campus. APPLY NOW! insightintodiversity.com/heed-award Application deadline: June 15, insightintodiversity.com

4 insightintodiversity.com INSIGHT Into Diversity Connecting Diverse Professionals to Diverse Careers TM South Towne Square, Suite 203 St. Louis, Missouri FAX ISSN: Vol. 81 No. 1 & Potomac Publishing, Inc. Contacts: Lenore Pearlstein Publisher Holly Mendelson Publisher Janet Edwards Editor Daniel Hecke Art Director Our Next Issue: Community Colleges The June 2013 edition of INSIGHT Into Diversity will focus on diversity initiatives in America s community colleges. Editorial Board: Pamela W. Arnold Vicky Ayers Kenneth J. Barrett Edna Chun Deborah Dagit Tia T. Gordon Melanie Harrington Ozzie Harris II Gloria Johnson Goins Jeffrey Larroca Hollande Levinson Frank McCloskey Graciela G. Meibar Julia Méndez Tanya Odom James O. Rodgers Joe Santana Casandra Singleton Jennifer Wade-Berg Shirley J. Wilcher Anise D. Wiley-Little Damon A. Williams If your community college advances diversity and inclusion on campus through an innovative program or partnership, tell us about it. Your school could be featured in this issue! To advertise, Contributing Writers: Susan Borowski Jamaal Abdul-Alim Simma Lieberman The views expressed in the content of the articles and/or advertisements published in INSIGHT Into Diversity are those of the authors and are not to be considered the views expressed by Potomac Publishing, Inc. Connecting Diverse Professionals To Diverse Careers TM insightintodiversity.com

5 CONTENTS features April/May 2013 departments 8 Game Changers Nurses With Disabilities Work to Dispel Bias in Health Care By Janet Edwards 6 HEED Award Spotlight East Carolina University College of Nursing Puts Diversity First By Susan Borowski 11 End the Disability Debate in Nursing: Quality Care is Fact By Leslie Neal-Boylan, PhD, APRN 18 Recruiter s Corner When It Comes to Job Hunting, Less is More with Vicky Ayers 12 We Face a Shortage of STEM Teachers: True or False? By Jamaal Abdul-Alim 35 Legal Insights Obamacare in 2014: Stay Tuned with Jeffrey W. Larroca 19 Nine Strategies to Hire Diversity of Thought By Simma Lieberman 36 Career Opportunities 20 Meeting the Need Nursing Schools Chart Steps Toward Diversity University of North Carolina School of Nursing Vanderbilt University School of Nursing The Ohio State School of Nursing By Susan Borowski Forging New Paths in Nursing A conversation with UMSON s Dean Kirschling By Janet Edwards 24 New Books Help Frame Affirmative Action Debate By Dr. Edna Chun 26 PRIDE: Diversifying Nursing, Midwifery in Rural Regions Frontier Nursing University By Janet Edwards Making a Case for Diversity in Higher Ed By Shirley J. Wilcher KSU Clinic Partnership Serves Community and Students Kennesaw State University By Vanessa Robinson-Dooley, LCSW, PhD On the Cover: University of Maryland School of Nursing Dean Jane Kirschling Photo by Rick Lippenholz 14 Editor s Note: In the March 2013 issue of INSIGHT Into Diversity magazine, U.S. Senator Tammy Baldwin (D-Wis.) was incorrectly identified in a photo caption published in the print version of the story, New Congress Heralds Era of Diversity. We regret the error. 5

6 HEED Award Spotlight ECU s College of Nursing Puts Diversity First By Susan Borowski An ECU nursing student is pinned during an Up with Nursing program. As a recipient of INSIGHT Into Diversity s 2012 Higher Education Excellence in Diversity (HEED) award, East Carolina University s (ECU) commitment to diversity is well demonstrated. For the College of Nursing specifically, the top strategic goal is to educate nurses who can contribute to a global, culturally diverse and rapidly changing society. Established in 1959, the College of Nursing is the largest nursing program in North Carolina, enrolling more than 1,100 students in baccalaureate, master s, and doctoral programs. In 2012, ECU s College of Nursing was named a Center of Excellence for the second time by the National League for Nursing. The honor recognizes outstanding achievements in student learning and professional development, says Cheryl Elhammoumi, RN, MSN, CCRN, clinical assistant professor and co-chair of the Diversity Advisory Council (DAC). As an example, Elhammoumi points to the success of the College s Regionally Increasing Baccalaureate Nurses (RIBN) program, a statewide initiative involving partnerships between community colleges and universities to increase student access to bachelor of science in nursing (BSN) programs. We have cooperatives with several community colleges, says Elhammoumi. Students enroll at the community college for their two-year associate degree and finish their BSN at ECU. We have a phenomenal support program. It s very competitive. The school s online master s program is consistently ranked in the top 10 of Best Online Graduate Nursing Programs by US News & World Report. Advanced specialties are offered in midwifery, neonatal nurse practitioner, adult and geriatric nurse practitioner, and a highly recognized nurse anesthesia program. All online students meet at the College of Nursing a few times during the year. Clinical sites are scattered, but generally not too far from where the student lives. We have faculty all over the state, says Elhammoumi. The Diversity Advisory Council, which meets on a monthly basis, serves as a resource for faculty, staff, and students to increase diversity awareness and cultural competence, Elhammoumi says. 6

7 Diversity discussions are also facilitated through a popular campus book club, an interest group for the LGBT community, and screenings of films such as the documentary, Crossing Borders, she says. Through the Global Health Advisory Council, the College of Nursing also works to achieve international diversity. When the earthquake happened in Haiti a couple of years ago, says Elhammoumi, the focus of our DAC program was on the nursing school in Haiti. The school was one of the few buildings left standing, and the school grounds quickly became a field hospital where students were able to provide emergency first aid to the victims. Faculty members conduct research and perform clinical practice in Nicaragua. Each spring, the nursing college opercheryl Elhammoumi, RN, MSN, CCRN, Diversity Advisory Council ates a cultural immersion co-chair, ECU College of Nursing program in Guatemala and similar initiatives in Africa and Finland are under consideration. Our graduate nurses are literally scattered around the world serving the health care needs of many diverse populations, says Elhammoumi. Honoring the Legacy... Advancing Opportunities Be a part of shaping the direction of diversity and inclusion work at HBCUs! The first annual Diversity & Inclusion Summit on HBCUs will be held on the beautiful campus of Alcorn State University (Lorman, Miss.), the nation s oldest historically black public land-grant institution. Co-sponsored by Alcorn s Office of Educational Equity and Inclusion and the National Association of Diversity Officers in Higher Education, the Summit will bring together faculty, staff, administrators, students, researchers, diversity professionals and others who are passionate about promoting diversity and inclusion at HBCU institutions. TOPICS INCLUDE: ECU s Brody School of Medicine The Medical Readers Theater is an innovative program sponsored by the College of Nursing. Led by Todd Savitt, PhD, assistant dean of the Office of Diversity Affairs at ECU s Brody School of Medicine (BSOM), it s one of two bookend diversity programs for medical students. The Medical Readers Theater is conducted during orientation week for first-year students. BSOM is the only school in the country that conducts these on a regular basis, Savitt says. We take short stories about bias and stereotyping in medical issues and we make a script out of the story, he says. The readers medical students sit in front of an audience and read their characters lines, so it s like listening to a story on the radio. Then we discuss how such bias and stereotyping have no place in medicine. The second program is part of Transition to Residency, a fourth-year course in which physicians discuss real-life scenarios involving insensitivity to diverse groups of people. BSOM s legislated mandate is to enhance the access of minority and disadvantaged students to a medical education. The Office of Diversity Affairs works in conjunction with the vice chairs of diversity, composed of representatives from every department in the medical school, and the Brody Women Faculty Committee to carry out that mission. Diversity Student Recruitment Developing a Vision for Diversity and Inclusion Black Male Success Partnerships in Diversity Panel of HBCU Presidents Diversity Programming Interactive Breakout Sessions featuring Best & Promising Practices Myrlie Evers-Williams Legendary Civil Rights Leader REGISTER TODAY Registration is $75 per person and includes three meals and snacks. Student registration is $35. M. Christopher Brown II 18th President of Alcorn State University For more information, visit Susan Borowski is a contributing writer for INSIGHT Into Diversity magazine. KEYNOTE SPEAKERS 7

8 Game Changers Nurses With Disabilities Work to Dispel Bias in Health Care By Janet Edwards As an avid climber, crawling high into trees didn t seem like such a risky proposition to Michelle Kephart, RN, MSN. However, midway through her nursing program, Kephart fell 25 feet from a tree, injuring her spinal cord. Returning to nursing school amid skepticism from the faculty, and with no idea how her quadriplegia would impact her education, Kephart found the support she needed in the National Organization of Nurses with Disabilities (NOND). I still wanted to be a nurse, but just didn t know how. I was looking for any kind of resources, Kephart says. NOND really helped me in finding out what my rights were and what I could expect from the school what sort of accommodations they could make and what was reasonable to ask from them in order for me to finish my program. Kephart, who graduated from nursing school in 2010 and joined the NOND board of directors that same year, was happy to learn such a resource exists. I don t think I would have been able to get through nursing school without their help, she says. Many nurses who acquire disabilities after licensure don t 8 know they can continue working, says Karen McCulloh, RN, a longtime disability advocate that is both hearing and visually impaired. The message many nurses with disabilities receive is they don t have a place, she says. McCulloh co-founded NOND, an Illinois-based national organization. She served as its first president and continues to serve as a member of the board s executive committee. She also serves as the project director of the LEAD Center at the National Disability Institute in Washington, D.C., funded by the Dept. of Labor Office of Disability Employment Policy (ODEP). McCulloh also serves on the AbilityOne Commission as a President Obama appointee. NOND evolved out of a 2003 national symposium directed to address nursing students with disabilities, McCulloh says. Among the attendees were nurses, nursing organizations, physicians, nurse educators, legal experts, disability rights advocates, and other health care professionals. McCulloh recalls, The whole topic of inclusion was controversial. It was an exciting but tense conversation in regard to both bias and acceptance. After hearing a nurse educator say,

9 The courageous thing that nurses with disabilities can do is to retire, she realized it was time for nurses with disabilities to step up and speak for themselves. McCulloh says she was excluded from nursing for nearly 13 years because of having multiple disabilities. In response, she says, McCulloh set up her own for-profit small business where she developed a new area of nursing, Community Health Disability Education. Empowered by that discussion, McCulloh brought five nurses with disabilities together, without a mission or bylaws, and identified symposium attendees they wanted to recruit to the board of directors 15 members were recruited by the end of the day. We were at the right place at the right time and with the right people, McCulloh says. The majority of board members are now nurses with disabilities, proving the stereotype wrong, says McCulloh. About 200 members are active in the organization s advocacy, education and outreach efforts, which have broadened beyond nursing to include other careers in health care and underserved populations. In an effort to enhance opportunities for people with disabilities to enter healthcare careers and become employed in healthcare industries, NOND was accepted by ODEP as an Alliance member in May Nurses with disabilities face stiff challenges in their journey to become accepted and those objections often begin with misperceptions by nursing faculty, says Beth Marks, PhD, RN, president of NOND. Marks is a research associate professor and director of the HealthMatters Community Academic Partnership, and is coproducer of the film, Open the Door, Get Em a Locker: Educating Nursing Students with Disabilities. Despite the potential for students with disabilities to enrich the nursing profession, nurse educators may be perpetuating historical attitudes, values, and practices that exclude students with disabilities from gaining admission or identifying themselves as people with disabilities, Marks wrote in Cultural Competence Revisited: Nursing Students with Disabilities, a Journal When you have people that are very successful people who can say this is wrong that s a game changer. Parul Arora, RN, BSN of Nursing article. Educators in nursing schools continue to ask whether people with disabilities have a place in the nursing profession, while the more salient question is, When will people with disabilities have a place in the nursing profession? 9 Parul Arora, RN, BSN, also a NOND board member, had nearly completed her nursing program when she first heard about the organization. It was exactly what she was looking for a community that would inspire her to persevere. As a low-vision person, she had faced strong faculty resistance throughout her nursing education, a second-career path that followed six years in social work. I needed to see nurses with disabilities that were successful. You want to be inspired by people who have had obstacles who are successful, she says. In any program you have to prove yourself, but I had to prove myself more than my fellow students. It was dispiriting, but Arora says she learned a lot about herself, including how to be her own advocate because no one else would do it. Kephart retains some function in her shoulders and arms, but no hand movement and no movement below her waist. After her injury, she resumed nursing school, but with some stipulations. I was allowed to return for one semester and take half a class load to see if I was capable of handling it, she says. I took two classes and did really well. Then we had to start talking about how I would get through my clinical experience. I ve lost all my hand function so I don t have any dexterity. During clinicals, she was provided an assistant who did everything under Kephart s guidance. If I had to use a stethoscope on somebody that was in a hospital bed and I couldn t reach them, she would help me place it on his chest so I could listen. Or, if we were giving meds through IVs, she could set up the IV under my direction and I could watch what she was doing because I couldn t reach it. We worked as a team, that was the accommodation I got. The assistant stayed with Kephart for the first three weeks of her clinical rotation, but then we realized there wasn t much she needed to do. I was able to do everything I needed to do, but we didn t know that until we got out there and tried, she says. What people perceive as the role of nursing paints too narrow a picture, Kephart says. There are a lot of types of nurses. People only think about being a bedside nurse and them giving shots or drawing blood, but I think if people start to realize that there are so many more ways to be a nurse they ll be more accepting of nurses with disabilities in general. Marks says the emphasis is misplaced when considering a student s potential success in a nursing program. As we accept and accommodate people with disabilities as nursing students and professional nurses, we will discover that a student s success is highly dependent on the availability of accommodations, not the type or severity of disability, she wrote in the Journal article. Arora did her clinical rotations with a pocket full of magni-

10 fiers and attachments that she bought on her own. She used one magnifier that fits on syringes so she could fill them properly, another for reading lab value reports and other small print, and a hands-free magnifier for miscellaneous tasks. She also found a computer screen device that reduced glare and offered some magnification. Software that provides better onscreen enlargement capability is available. When Arora asked about having the software installed on the hospital s computer, she was told her faculty would need to request it. When I asked the faculty, they never pursued it, she says. I purchased all these things because I wanted to be successful and I didn t want to make any errors, she says. It s not rocket science, but there are so many different tasks it can be difficult to figure out which device works best with this syringe or what works best with that task. Learning how to accommodate on her own, while trying to master the practice I was able to do everything I needed to do, but we didn t know that until we got out there and tried. Michelle Kephart, RN, MSN (front row, left) of nursing, was a hardship, she says. While Arora anticipated the clinical faculty might not know how to accommodate her disability, the level of resistance she encountered surprised her. They had this attitude, How is this girl going to be a nurse? and not so much, How can we help her be successful? McCulloh acknowledges that relinquishing the traditional model of nursing is a challenge for schools, but is quick to point out that Some faculty have been quite supportive of connecting students with student disability services to obtain accommodations for their success in a nursing program. Existing faculty resistance results in part from weak enforcement of the American Disabilities Act, says Suzanne Smeltzer, EdD, RN, FAAN, professor and director of the Center for Nursing Research at Villanova University. The law is not enforced very rigorously. As a consequence, unless someone with a disability is really committed and willing to take it to the next level, if he or she is stopped at the schoolroom door the individual may turn around and try someplace else, or they may say, Well, I guess I can t do nursing. Fellow health care providers perpetuate an additional obstacle, Smeltzer says. Health care professionals think about, What can this person not do? as opposed to What are the strengths this person brings to the situation? That s because safety is a major buzzword, Smeltzer says, and while health care providers and faculty assume safety issues are a concern when it comes to nurses with disabilities, that s simply not the case. There s no research to suggest that they re any less safe than health care providers without disabilities. But nevertheless that s what people go to, it s a safety issue well, no, it s not. It s an attitude issue. As a student, Arora frequently questioned her decision to pursue nursing. I love the field. I have the qualities for it, but I thought, Maybe they re right, maybe I shouldn t be a nurse because it s more difficult for me. You need others to believe in you, for you to believe in yourself, she says. It was a constant advocacy in my head: You can do this. I m smart enough. I have good qualities and I can go forward. Kephart, who lives in Georgia, is now an adjunct faculty member in the medical assistant program at South University teaching classes in medical terminology and clinical competency, among others. She is also an educator in disease management and wellness at Community Health Mission. When she first began teaching, Kephart wasn t sure what to expect. I was a little nervous, but the students have been wonderful, she says. It probably startles them when they first see me, but once we start talking about what they re learning and the reason that they re there, they forget that I m talking to them from a wheelchair. Arora is completing her master s program in nursing, while working at NorthPointe Resources in Zion, Ill. As part of her job, she works on a diabetes prevention project for children and adolescents with intellectual and development disabilities, often giving presentations. In my new job, there s no resistance, it s amazing. I don t drive. The job requires it but my colleagues have bent over backwards. Two others on my team do the driving and they re very willing, she says. Her experience with NOND during her own struggle to become a nurse has impassioned Arora to reach out to young people with disabilities as a mentor and a resource. I hate to say this, but my story is not unique. However, when you have people that are very successful and have tons of experience people who can say this is wrong that s a game changer. Sometimes you don t know the treatment you re getting or the obstacles in your way are wrong. McCulloh agrees: Often, we do not realize the power of experience and how that experience can make such a difference for opening opportunities for others. Janet Edwards is the editor of INSIGHT Into Diversity magazine. 10

11 IID Perspective End the Disability Debate in Nursing: Quality Care is Fact By Leslie Neal-Boylan, PhD, APRN Misconceptions abound regarding the abilities of people with disabilities and this holds true in the nursing profession, as well. While nurses with experience and expertise are often denied jobs or lose their jobs because of a physical disability, research shows appropriate accommodations can be made to retain these highly skilled and much-needed health care professionals. Four research studies involving registered nurses with selfidentified physical and/or sensory disabilities reveal common themes about their work life experiences. The studies occurred over a period of five years ( ) and included interviews and surveys of nurses with a variety of acquired and congenital disabilities. Nurses from all levels of nursing education (associate degree, bachelor s degree, master s degree, and doctoral degree) and from inpatient, outpatient, and community settings participated. In addition, one study compared the work life experiences of physicians and nurses with disabilities. These studies confirm the value of nurses lies not in whether they can lift 50 pounds, (often stipulated in nurse job descriptions), but in what they know. A nurse thinks critically and makes judgments that directly affect patient outcomes. A nurse is taught to question, consider, and ensure that doctors orders are appropriate for the patient because first and foremost, the nurse is a patient advocate. Patients and families rely on nurses to help them navigate the complex health care system, translate complicated medical jargon, and better understand the diagnosis and treatment plan. Concerns have been raised about whether a nurse with a physical disability might impact patient care or safety; however, hospitals and healthcare agencies are being encouraged to acknowledge that with proper accommodations, nurses who have a disability can perform the necessary tasks involving direct and indirect patient care without jeopardizing patient safety. For instance, a nurse who has trouble walking can monitor telemetry on a cardiac unit, work in a poison control center, manage a unit, or be in charge of quality improvement. A nurse with a hearing impairment can function effectively in just about any milieu as long as TDD devices are placed on telephones and people face the nurse when speaking. Research also shows that nurses with disabilities know their limitations, and are likely to leave their position over the slightest concern about their ability to provide safe, high quality care. To date, there are no documented incidents of a patient injury caused by a nurse with a physical disability. Furthermore, patients report little concern over being cared for by a nurse who has a disability. In fact, they feel the nurse is more likely to be empathetic. Patients want the people taking care of them to be competent and confident. They seem to understand that the knowledge nurses provide is their most important skill. In the event that adequate accommodations are unavailable, other opportunities exist. The most recent research study found that if they are persistent, nurses can find jobs in which they can perform as nurses and be appreciated for what they bring to the job. Interestingly, most of the nurses interviewed for this study were employed by someone who was either a nurse who had a disability or a chronic illness, or by a non-nurse who had no preconceived notions about how much a nurse can lift or can do physically and was only interested in the nurse s expertise. It is ironic that non-nurses would be more accepting of hiring and retaining nurses with disabilities than are health care providers or agencies. Nurses with disabilities have found satisfying positions in school nursing, informatics, case management, and as advice nurses, to name a few less typical nursing roles. Studies of nurses with physical disabilities confirm what research has previously shown about people with disabilities: they often suffer discrimination despite the Americans with Disabilities Act, they are rarely given a chance to show what they can do, and people make inaccurate assumptions about their abilities. It is important that employers and colleagues look beyond disability to discover what skills truly make a person valuable to the organization. Leslie Neal-Boylan, PhD, APRN, is associate dean and professor of the Quinnipiac University School of Nursing in Connecticut. She is the author of Nurses With Disabilities: Professional Issues and Job Retention (Springer Publishing), the first research-based book to confront workplace issues facing nurses with disabilities. 11

12 We Face a Shortage of STEM Teachers: True or False? By Jamaal Abdul-Alim While many bemoan the shortage of STEM graduates and worry about a lack of STEM teachers at the K-12 level, some scholars caution the claims are not as dire as they seem. A conference titled, Under the Microscope: Examining STEM Education, was hosted recently by the Education Writers Association at the University of Maryland, Baltimore County. During a panel discussion on STEM pipelines, Mark Schneider, vice president of American Institutes for Research and president of CollegeMeasures.org, said his research into labor market demands reveals a reported lack of STEM graduates has been overblown. One basis for his conclusion is that biology and biological sciences majors typically earn less than English majors an indication that they are not in very high demand. We wouldn t say there s an English crisis. But we say there s a science crisis. But demand as indicated by salaries of biologists in the labor market in every state is lower than English majors, and chemistry is a little higher than English majors, Schneider said. Schneider based his presentation on information from a report his organization produced titled, The Earning Power of Recent Graduates from Virginia s Colleges and Universities: How are graduates from different degree programs doing in the labor market? The report found that biology and biological science majors in Virginia earned an average of $27,893, whereas English majors earned $29,222. Schneider is at the forefront of a movement to tie state wage data for employees to their individual college transcripts in an effort to calculate the average earnings of graduates from specific schools down to the program level. Virginia is one of about a half a dozen states where Schneider has done his work. Several federal lawmakers last year introduced legislation to require all colleges and universities to report information on the earnings of their graduates. The goal is to give prospective college students a better sense of how much they can expect to earn upon graduation if they pursue a particular major or go to a particular school. If you think of student debt as an investment to get higher income, you need to make sure the debt is reasonable in relation to (future) income, Schneider said. The rule of thumb is that you should not have debt exceeding what your first-year earnings are. In a separate panel on recruiting and training STEM teachers, Richard Ingersoll, PhD, Board of Overseers Professor of Education and Sociology at the University of Pennsylvania, said the shortage of STEM teachers is a nuanced problem. There is a big gap between the conventional wisdom and what the data tells us is the case, Ingersoll said. The conventional wisdom, he said, is that we have a shortage of math, science and STEM teachers, mostly at the high school and the middle school level. Every president since Dwight D. Eisenhower, he said, has addressed the need for more math and science teachers; the latest example is the Obama administration s involvement in the 100K in 10 initiative, which calls for 100,000 new, excellent STEM teachers over 10 years. The reality, Ingersoll said, is that we do not under-produce math and science teachers by whatever numbers we can come up with. The real problem, he said, is that math and science teachers don t stay on the job. It s not rocket science. It s working conditions and it s not just salaries, Ingersoll said. It s student discipline problems. High turnover in the teaching profession also has to do with teachers feeling that they have a lack of discretion and autonomy in the classroom which is, Ingersoll said, the leading complaint. Many teachers feel they must deliver a scripted education, particularly in an environment where there is growing emphasis on teacher accountability for how well students do on tests, he said. Teacher recruitment initiatives and fellowships in the areas of STEM are worthwhile and have worked so well they re an unheralded victory, Ingersoll said. However, we lose the investment because of unabated turnover in the field, he said. Jamaal Abdul-Alim is a contributing writer for INSIGHT Into Diversity magazine. 12

13 Faculty Diversity Success and Support at the University of Pennsylvania School of Nursing The importance of diversity to nursing science is incalculable. In an era of increasing health disparities and lack of access to quality healthcare, it is crucial to have diverse faculty conducting research, educating future nurse leaders, and shaping practice to improve health worldwide. Success Penn Nursing is one of the world s premier research institutions in nursing, influencing practice, policy, and education. Penn Nursing faculty consistently receive more research funding from the National Institutes of Health than any other private nursing school. Many Master s programs are ranked first in the country. The Center for Health Equity Research, directed by Dr. Loretta Sweet Jemmott, and the Center for Global Women s Health, directed by Dr. Lynn Sommers, are international leaders in evidence-based efforts to eradicate health inequities and disparities across the lifespan. Support Penn Nursing is committed to a diverse faculty and student body supported by: A dedicated Office of Diversity and Cultural Affairs A long history of outreach programs and curricular initiatives on cultural competence Stellar faculty conducting community-based participatory research to improve the health status of marginalized and underserved populations The Penn Nursing Faculty Mentorship Program which offers guidance and counsel for faculty at all stages of their careers An Office of Nursing Research fully supporting faculty through every stage of the grant process. Penn Nursing faculty are internationally renowned researchers and policy leaders who create new knowledge that is reflected in cutting-edge teaching and refreshes evidence-based practice. For faculty opportunities at Penn Nursing, see To learn more about Penn Nursing s commitment to diversity, see The University of Pennsylvania is an equal opportunity employer. Minorities, males, veterans, and individuals with disabilities are encouraged to apply. I want to add a BS to my RN, but I need to keep working. Apply now for the RN/BS degree from ipace, the online bachelor s degree completion program that works at your pace. n Taught by expert Pace University nursing faculty n Blended online and in-person curriculum that fits your busy schedule at an affordable cost n Cutting edge evidence-based theory courses linked to your clinical practice n No entrance exams required U.S. News & World Report ranks Pace University as a top performer in online bachelor s degree programs. Attend a Virtual Open House on April 24 or an in-person Information Session on April 10 or May 8. To learn more and to RSVP, contact us at or (212)

14 Jane Kirschling, PhD, RN, FAAN University of Maryland School of Nursing Forging New Paths in Nursing A Conversation with Dean Jane Kirschling By Janet Edwards In her dual roles as the new dean of the University of Maryland School of Nursing (UMSON) in Baltimore, Md., and as president of the American Association of Colleges of Nursing Board of Directors (AACN), Jane M. Kirschling, PhD, RN, FAAN, monitors the pulse of a workforce that boasts 3.1 million members, the largest of any health care profession. While recognizing that nursing must continue to diversify its ranks in order to reflect the changing face of the broad community it serves, Kirschling is confident proper pathways are in place to achieve that important goal. She is also boldly optimistic about recent innovations in advanced practice education, research, data sharing, and technology. Prescribing nursing for those seeking career flexibility, she insists the field deserves a fresh look from new and returning college students. Continuing a long and accomplished career that spans psychiatric nursing, palliative and end-of-life care, and a decade of research in workforce development, Kirschling is now dedicated to ensuring the next generation of nurses is well trained and highly educated. Kirschling was appointed dean of UMSON and director of interprofessional education in January She received her bachelor s degree in nursing from Viterbo College in LaCrosse, Wis., and her master s and doctoral degrees from Indiana University School of Nursing (IU-PUI) in Indianapolis, Ind. Recently, Dean Kirschling spoke with INSIGHT Into Diversity s editor, Janet Edwards. She shared some thoughts about the work being done at the University of Maryland School of Nursing, and about the current health of the nursing profession. You ve been charged with taking the UMSON to the next level. How will you approach this challenge? The University of Maryland School of Nursing has a long tradition we re approaching our 125th anniversary in 2014 of preparing nurses not only for entry into practice, but also for graduate study, whether that be advanced practice, nursing science, or doctoral programs. My charge from our University president, Dr. Jay A. Perman, is to continue to strengthen the excellence of our academic programs. Being within a research-intensive environment, there s also a strong commitment and desire at UMSON to advance the science that informs health care in this country and to generate knowledge through collaborative work between scientists in the other disciplines represented in all health professions. 14

15 What is UMSON doing surprisingly well that other schools would be smart to emulate? At the national level, it has been recommended that advanced practice nurses certified nurse-midwives, nurse anesthetists, nurse practitioners, and clinical nurse specialists become educated in the Doctor of Nursing practice (DNP) program. In fall 2014, UMSON will open its BSN (Bachelor of Science in Nursing)- to-dnp degree program. This is a very new movement and is extremely important because the complexity of health care will continue to escalate. There is a broadening of knowledge and skills that advanced practice nurses need for the future to best meet the health care needs of the populations they ll serve. The other piece that UMSON is well positioned to do and that we have a long history of doing is that, because of our proximity to Washington, DC, we have a rich tradition in terms of health policy. It s always very exciting when our students not only spend time with the Maryland legislative body, but also interact and interface at the federal level with representatives of the House and Senate to advance health care in this country. We educate nurses who are very interested in, and capable of, working in the policy arena, whether they are setting policy or representing us as elected officials. How are nursing and diversity connected, especially in regard to the nation s demographic shifts toward greater ethnicity and aging? Diversity in nursing is extremely important because we look for people who look like us. We want to receive care from people we are most likely to be comfortable with, who understand the values and culture that we bring, and who can help us interpret what s happening with the health care we re receiving. Historically in nursing, we haven t been able to do that because we were predominantly a white woman s profession. I also think that it is about being able to have quality of care knowing that you re getting the best care possible, and Students practice skills in a clinical lab at the University of Maryland School of Nursing. also feeling that you re not being singled out in some way to get inferior or lesser care. UMSON is known for being the first school to establish a graduate level program in nursing informatics. Why is this emerging field so important? One of the realities of health care delivery is that a tremendous amount of information is generated within the industry. The question is, how is that information used to inform the care that is provided in this country and best practices? Our informatics program gives the nurse who has been working in the field, and who knows firsthand the individual patient experience, the ability to look at the aggregate of the individual and all patients to use this extremely powerful tool, that being data, to inform care for the patient as well as potentially drive practice change. In 2004, a commissioned report titled, Missing Persons: Minorities in the Health Professions, found that minorities were severely underrepresented in the health care workforce, including nursing. Nearly a decade later, how much progress have we made? The nurse scholars program through the American Association of Colleges of Nursing (AACN) encourages persons of color to come back to nursing school through second-degree programs. It s a national model. We have to encourage all students to think about a health professions career, and to look at nursing as a career that has rich opportunities. There isn t just one way to be a nurse in this country. There are multiple ways to do it and there are tremendous opportunities. We need to have an inclusive environment so that all people recognize the opportunities. Then we have to nurture those students, encourage them to pursue graduate education, and help them to excel. I became a nurse in My graduating class had very few men. I was educated in Wisconsin and I don t remember having minority classmates in my undergraduate program. Today, at UMSON, in terms of our baccalaureate program, one-third of the class is made up of minorities. That s posi- 15

16 moreinsight University of Maryland School of Nursing Mission: We shape the profession of nursing and the health care environment by developing leaders in education, research, and practice. Diversity: Of the total 1,700 students, 35 percent are minorities and 12 percent are males; 12 percent of UMSON faculty members are minorities. Funding: UMSON received total extramural funding of $12.8 million in 2012, including more than $4 million in National Institutes of Health grants and research funding of $7.6 million. Research: Cutting-edge research is largely conducted under the auspices of two Organized Research Centers Biology and Behavior Across the Lifespan and the Center for Health Outcomes Research. Current studies include chronic pain, impulsivity and drug abuse, neuromuscular disorders, sleep, web-based interventions, health care organizational issues, and bone health. Giving Back: UMSON operates a mobile health clinic for people who are uninsured and underserved, and provides nurse practitioner faculty members who practice at three school-based health centers in neighboring counties. Policymakers: Two nurses currently serving in the Maryland Legislature are UMSON alumnae: Shirley Nathan-Pulliam, (D-Dist. 10), Class of 1980 (BSN); and Adelaide C. (Addie) Eckardt, (R-Dist. 37B), Classes of 1978 (BSN), 1981 (MSN). tive change. It probably isn t enough, but we ve had to find ways to encourage persons other than Caucasians, as well as men, to come into the discipline. It s a process of continuous building. Currently, 14 percent of our baccalaureate enrollment consists of men. We are also seeing more diversity in our master s Clinical Nurse Leader (CNL) program for persons with previous degrees in other fields. Enrollment in the CNL program currently consists of 40 percent minorities and 15 percent males. How does nursing today differ from a generation ago? From a nursing perspective, or any health professional s perspective, there s tremendous variability and flexibility in terms of where you re going to do your work. You may start in a hospital setting with medical-surgical patients, or start in an emergency room, or you may start your career doing community-based care. The other piece is the tremendous ability to shape your career; you re not locked into one single path. You can change the area you practice in three or four times over the course of your career. There s a mobility that you sometimes don t get in other careers. We need to do better in getting that message out as an attractive option. As you think about the changing demographics, one of the struggles for men is that it s hard for a high school male to say that he wants to become a nurse because it s still very much perceived as women s work. One of the very positive changes we ve seen is a real commitment across the U.S. to open what are called second-degree programs. These programs are designed for people who already have a degree or multiple degrees but they now want to change their career to nursing. We see larger numbers of men coming into those programs, which is a really positive change because it helps change the face of nursing to be more inclusive. Also, research has become a viable option for nurse scientists. That most likely wasn t the case a generation ago. How can the nursing industry best meet demands for a more diverse faculty across nursing programs? The ability to continue to prepare the next generation of nurses is totally dependent on our ability to have a sufficient number of nursing faculty members who are qualified and available to teach that next generation. If you think about the pipeline, not only when we go into a clinical care situation do we do look for people like us, but when we re thinking about going into a profession thinking about, do I want to be a nurse? we need minority role models because our students look to the faculty to provide role models. This is an important piece in fostering and encouraging people to become nurse educators. Why is it so difficult to fill nursing faculty positions? There are some amazing advantages to being a nursing faculty member, but there are a couple of drawbacks. The competitiveness of salary is the biggest drawback. If you look at your salary as an advanced practice nurse, then look at the salary of a faculty member, there s a discrepancy; the salary of the faculty member is considerably less. An advantage is the ability to shape one s career around juggling the multiple demands of family and outside commitments; there is a degree of flexibility that teaching provides. Also, health care today is extremely fast-paced. Demands that are placed on people who are providing direct patient care are pretty intense. The work that we do in academia doesn t necessarily have the same sense of urgency as direct patient care. It s a different environment; the work by its nature is different, and some people find that to be very attractive. Core competency standards: have they changed in the past decade, especially in regard to a changing demographic? Our curricular work is guided by the Essentials documents put forward by AACN. Nurses have to be prepared to provide quality care that is sensitive to the issues of race and ethnicity. For example, when I went through a health assessment course in my nursing program in the late 1970s, a white, 16

17 middle-aged male was the norm everything was based on being able to look at white skin and say is this normal or abnormal. If you think about assessment today in light of our increasingly diverse population we have a responsibility to prepare students to be able to assess appropriately what is happening with all persons. That has to be emphasized in the curriculum. When making a clinical diagnosis, skin that has one pigment may require a more complete understanding for people of different ethnicities; there may be other appropriate benchmarks in assessing a different person. That s a dramatic, very basic illustration, but it is important that nurses have the ability to assess every individual and to do that appropriately, with the necessary knowledge. What attracted you to nursing and what do you continue to find most exciting about it? I was on the back end of that era when (as a woman) you became a nurse or you became a teacher. I chose to become a nurse because I had an inclination toward science. I stayed in nursing school because I absolutely fell in love with psychiatric nursing and its complexities. My life took an interesting turn when I was headed to graduate school to specialize in caring for the chronically mentally ill. I experienced some personal losses in my life, and that got me interested in endof-life care. Opportunities aligned themselves and I ended up doing palliative care and end-of-life care. Then, I went on to become a nurse educator and that s been my career preparing the next generation of nurses and being able to support new nurses throughout the lifelong learning process. I ve had an incredibly rich and full career. My energy is now devoted to the pipeline in nursing, making sure we have a well-qualified, highly educated nursing workforce to meet the future needs. Nurses need to remain open to possibilities. They need to listen to those who are around them and not necessarily be so quick to say, No, no, I can t do that, because a nursing education offers so many career options. I could never have predicted where my career was going to end up if we were talking in the late 1970s. There s no way in the world I would have said I would be a nursing faculty member or the dean of the University of Maryland School of Nursing. I am truly honored to have this opportunity and to build on the amazing strengths available in the School and University. Janet Edwards is the editor of INSIGHT Into Diversity magazine. Our global success is based on the diverse backgrounds, outlooks and experiences of OUR PEOPLE. If you have the drive and desire to be a part of a team where EXCELLENCE IS EXPECTED and DIVERSITY MATTERS, we want you to come to the Acushnet Company. IT ENGINEERING ACCOUNTING Opportunities are available in Southeastern MA and Southern CA. For more information, check out our website. PLEASE SEND RESUME TO: Acushnet Company Human Resources P.O. Box 965 Fairhaven, MA fax: (508) Brigham Young University College of Nursing Faculty positions are available in the undergraduate and graduate programs Doctoral degree in nursing is preferred (PhD or DNP) Salary and rank commensurate with experience and qualifications Send letter of interest to Dean Patricia K. Ravert Brigham Young University College of Nursing 500-A SWKT Provo, UT Phone: JOIN THE TEAM BEHIND THE BRANDS. An equal opportunity employer, m/f/d/v. 17 BYU is an equal employment/affirmative action employer, sponsored by The Church of Jesus Christ of Latter-day Saints. Employees are required to observe Church standards.

18 Recruiter s Corner with Vicky Ayers When It Comes to Job Hunting, Less is More I heard my colleague, Isaac, who was in the next office processing the resumes of candidates for an executive position, groaning as though something was really driving him crazy. I stuck my head in his door, but before I could ask what was wrong, he asked, Why do candidates send all this extra stuff? Since I ve been in the recruiting business, coming up on 14 years, I have never written into a position announcement a request for candidates personal philosophies, letters of recommendation, newspaper or magazine articles in which they are referenced, copies of books or articles they have written, their letters to the editor, strategic plans they helped craft, printouts of Wikipedia articles they edited, supplements of any sort, photocopies of their entries in Who s Who, or anything but a cover letter and a resume or curriculum vita, yet I have received all of this and more. Why? The simple answer is, candidates entering a search are trying to impress, and who can fault that? After all, they are applying for a position and want to make the best and most distinctive impact they can, as early in the search process as possible. They fire off as much information as they can muster, in hopes that, other qualities being equal, the Who s Who article will push their candidacy ahead of other applicants. Does this strategy work? Not usually. To see why, you have to consider the search process from the other side of the table, from the perspective of the person looking for new employees, either for themselves or on behalf of a client institution. Most searches start with a very general announcement of position availability and outline the minimum requirements for candidacy. Such announcements request very little in terms of information from candidates. I ask simply for a letter expressing interest in the position and a resume or curriculum vita. I ask only this for three reasons. First, those documents will tell me if you meet the minimum requirements. At this point I have no use for extra documents, and they just get in my way. For example, if the position calls for a doctorate, and you only have a master s, a Who s Who article isn t going to help. Second, in the initial stages of a search it is imperative that my office and search committees who are accountable to administrators, governing bodies, human resources, personnel policy, and accreditors are able to demonstrate an objective candidate screening. Letters of reference or work samples, submitted by one candidate To stand out, job applicants often submit much more info than is required. Does this strategy work? Not usually. only, often cannot be considered, since to do so would tilt the supposedly level playing field all candidates have a right to expect, and regulation and law demand. Third, using our firm as an example, in our regular search process we have no way to preserve and then present those extraneous materials to a client institution. Like mine, most search firms and human resources offices now keep nearly all records electronically. Thus, a magazine article you wrote will simply be set aside, unless all candidates have been asked to provide articles they have written. In my usual practice, nothing but the resume and cover letter is presented initially to the committee, although I may mention that other material exists. Unless the committee requests to see it, which I don t remember ever happening, extraneous materials end up being filed unseen, or thrown away at the close of the search. Once I receive the documents I ve asked for, the letter and resume, I send a request to the candidate for specific additional information. Again, I am not looking for a pile of supporting publications and documentation. I just want a more refined picture of what skills, experience, values, and characteristics you bring to the table. Now, here is the surprising thing: generally, there are as many candidates in a given search who either refuse or neglect to provide that additional information, as there are candidates who swamp me with documents I don t need. Sometimes, they re the same candidates! 18 If you are really interested in a position, and want to be seriously considered, you need to provide the information solicited, no more and no less, and at the time it is requested. For some, this is difficult. You worry that no one will really look at your material, that there s only one chance to impress the employer or recruiter, and that if you don t throw all those materials into the mix, you reduce the chances of advancing in the search. If this is how you think, take comfort in the fact that employers and the recruiters who serve them really do look at requested materials. Our goal is to find the best candidate the employer can attract, so qualifications won t be overlooked or minimized. As more and more detailed information is elicited, you should provide it in a thorough and timely manner, which will demonstrate commitment, energy, and interest in the employer and the position. If your anxiety about being overlooked is too strong to ignore, you can call the recruiter or search chair and ask whether it would be helpful to send additional information. In the later stages of most searches, when candidates are being invited to meet with the employer, there are ample opportunities to present the kinds of materials that, at this stage, may actually influence the employer favorably. This is when to bring out the portfolio from your solo-artist gallery show, a copy of your book, the printout of your peer-reviewed article in a professional journal, or your letter of recommendation from the state governor. At this point, these things are no longer extras. Instead, they re confirmation that the employer has made a sound decision to advance you in the search, and that you may be the very person they ve been looking for. Vicky Ayers is senior director for Executive Recruitment at RPA Inc., Williamsport, PA, a private national firm serving the recruiting needs of higher education and nonprofits. Vicky is a member of the INSIGHT Into Diversity Editorial Board. If you have a question for Vicky you can her at

19 Nine Strategies to Hire Diversity of Thought By Simma Lieberman If you always recruit from the same places, with the same methods, you will always get the same people. In today s competitive market you need to be creative. You have to go where the candidates are and have a long enough lead time to get a good selection of candidates. If you want to be ahead of the competition, and bring in more innovation, then think with a diversity of thought mindset. Here are nine winning strategies to ensure you hire employees that bring diversity of thought, and ideas: Research and develop a list of colleges that historically have large numbers of women, people with disabilities, and people from different cultural, ethnic and racial backgrounds. Send recruiting teams to those schools. Consider expanding your recruiters perspective. They may be conscious of recruiting people across the diversity spectrum, but are they looking for people who are the exact right fit meaning people who think exactly like you? Determine whether they are listening and looking for people with new ideas, who are creative problem solvers and innovators. Train recruiters to interview people who look different from them, who don t buy their suits at the same place. Insist they recruit employees who can bring diversity of thought and innovation to your business. Case study: A CEO of a facilities management company wanted to hire more female managers. Instead of recruiting from his industry, he started attending meetings of women in real estate. I wanted to find women who would bring different experiences so we could get fresh ideas. I looked for women who understood property management from the client s perspective, and would challenge the way we ve always worked. We now have several women in decision-making positions as a result, and we ve been able to better serve our clients. Your criteria for interviewing and hiring should never be based on someone who went to the same school, is the same religion or shares your gender or sexual orientation. Have a diverse panel conduct interviews so you get other perspectives. Start recruiting early, from middle and high schools. Attend career days and come prepared to discuss the benefits of working for your organization and your industry. Talk to teachers and other students, to find out if someone has an interest in a subject related to your industry. Case study: A client recently told me a story about going to a high school and meeting a student who didn t have the highest grades, and at first glance didn t appear to be a potential candidate for their organization. However in talking to one of the science teachers, he discovered that the young man was brilliant in physics and math. My client jokingly said, I think I may have found our next Nobel Prize winner. He was so impressed with the young man, he established a mentoring relationship with him, and would like him to be an intern when he gets to college, and of course, ultimately be hired. Contact various student groups on mainstream campuses and ask them to suggest the best candidates, or include notices about your organization in their newsletters, LinkedIn groups, or other social media. Post links to articles about your company on Twitter, Facebook, LinkedIn, etc. Student peers may be aware of the hidden genius of others who are not in the limelight. Develop relationships with diversity-related campus organizations, such as groups representing black, Native American, Asian American and LGBT students, and sponsor events with them. Spend time listening, and getting to know people who are potential recruits. Ask them for their insights and observations about your organization, and what they would change or do differently. Organizations grow dramatically, and exponentially increase their market share, when they bring together people who are different from each other across the spectrum, including culture, religion, sexual orientation, gender and ethnicity, and outside interests. But you must also provide opportunities for them to share different experiences, talents, and perspectives in order to solve problems and create new products. One of your jobs as a leader is to access and mine that diversity of thought and let it shine. Otherwise, your organization and the people in it will wilt and fall behind. The choice is yours. Hire creatively. Simma Lieberman, internationally known as The Inclusionist, is a diversity and inclusion/culture change consultant and coauthor of two books: Putting Diversity to Work, How to Successfully Lead a Diverse Workforce (Crisp, 2003) and The Diversity Calling: Building Diverse Communities, One Story at a Time. 19

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