Bringing Underrepresented Populations Into Nursing
Karen Crone

At its best, nursing is a practice of intimate caring. It is a relationship that transcends fear and pain to make a connection that brings the patient comfort, confidence, and trust. To achieve this highest standard, we must convey our understanding of those we serve. In this country, there are many cultural barriers to that connection. The best way to meet the needs of our diverse society is through diversity within the profession of nursing.

Though I had hoped to become a nurse, I faced defeat in my first years after high school. I was lost in the freedom of college life. A series of personal tragedies compounded my struggle. Soon, I found myself sitting on the curb of the road to my dream, without the courage or motivation to continue. After a brief period of stagnancy, I was discovered by a U.S. Navy enlisted recruiter. Soon, my journey in the Navy began. I served proudly as a Hospital Corpsman.

I considered my Navy experience while I planned my approach to this essay’s topic. As they are in most every white-collar profession, ethnic minorities are largely underrepresented in nursing. The NSNA has long recognized our society’s need for diversity within the nursing profession. Although we certainly don’t have the Defense Department’s budget, we can still be inspired by the military recruitment system.

The military, unlike the nursing profession, does have a proportionate number of ethnic minorities serving. Some demographics indicate that the military actually has a disproportionately high number of minority recruits (MFRC, 2003). Although there are many explanations for the military’s success in recruiting minorities, I believe it comes down to one concept: Military recruiters make it happen one individual at a time.

While the uniformed services do utilize many forms of advertisement, they do not rely on it. Advertisement doesn’t remove the obstacles in a recruit’s path. The bread-and-butter of military recruitment is the enlisted recruiter. There are thousands of enlisted recruiters working one-on-one with individual recruits. They offer guidance and mentorship. They facilitate the recruit’s transition into military life. The NSNA’s Breakthrough to Nursing Project has emphasized the importance of mentorship in recruiting prospective minority nurses. We must reaffirm our commitment to seeking out and guiding our future nurses. Through mentorship, we can help counter the obstacles in these students’ paths by educating them on financial aid opportunities, preparing them for the nursing curriculum, and supporting them in meeting their obligations to themselves and their families.

Military recruiters have one undeniable advantage: Uncle Sam is footing the bill. The significant cost of nursing education is an obstacle which quickly becomes a barrier for minority students, who are often at the greatest socioeconomic disadvantages. This is perhaps our largest challenge. How do we make it happen for those students with the desire, but without the means?

I believe a part of the solution may lie within our high schools, in particular, within their Vocational-Technical programs. Across the country, there are Health Science Technical Education programs in many of the secondary Vo-Tech schools. Students in these programs are preparing for a wide variety of health careers. Many will become certified nurse assistants, even licensed professional nurses, upon graduation. While curricula vary, several such programs allow the students to gain college credit while simultaneously earning credit toward their high school graduations. Most operate in association with local community colleges, and the majority cover the cost of the students’ tuitions. The U.S. Department of Education’s Office of Vocational and Adult Education (OVAE) calls these programs Dual Enrollment Programs. Although these programs have traditionally been geared toward high-achieving students, OVAE is hopeful about their usefulness for all students. They are being shown to help transition students into college and decrease the need for costly remediation (a factor commonly blamed for college drop-out).

Health Science Dual Enrollment programs provide us with a unique opportunity to reach, mentor, and advance students with an interest in nursing, especially those populations that are currently underrepresented in the profession. Statistics have indicated that disadvantaged and minority students are more likely to enroll in vocational education programs than their peers (Levesque, 1998). As Dual Enrollment Programs gain more recognition and become more regulated, we have an opportunity to bring some nursing education to disadvantaged students while the dream of an education is still attainable. If we couple a focus on educational preparedness with guidance and facilitation into local nursing schools, we can bring students from Vo-Tech programs into nursing careers one individual at a time. We should be recruiting nurses from these programs.

I believe in the importance of mentorship, and I am very hopeful that Vo-Tech schools can make nursing education more attainable for disadvantaged students. Still, while looking at the issue of low minority participation in nursing, I would be remiss in ignoring the cause at the root of this problem. Though we have made important strides, our nation is still sick with racial prejudice. This illness manifests as inequality. The treatments administered through government legislation have been insufficient. It is time for some nursing intervention. Our obligation to serve extends beyond our hospitals and clinics. Respect and care for all individuals are qualities we should carry with us into our communities, into our homes.

How will I encourage members of underrepresented populations to become nurses? There are so many things I hope to do, but I know where I will start: I will start at the beginning. I will start by examining my attitude and behavior toward those outside my race. I will start with my children, with my neighbors, and my fellow students. I will start within my community through advocacy, and through my vote. I will start with me.

Karen Crone