Increasing the racial, ethnic, gender and social diversity of the nursing workforce is essential for providing culturally competent care that addresses the growing diversity of the U.S. population. A diverse nursing workforce will improve communication, tolerance, trust and decision-making between patients and providers, leading to expanded health care access and improved quality outcomes.
The Expert Panel on Global Nursing and Health of the American Academy of Nursing published 12 Standards of Practice for Culturally Competent Nursing Care in 2010. One of the recommended standards is for nursing to engage in activities around recruitment and retention of a multicultural nursing workforce. Akron Children's Hospital recognized that its current nursing workforce did not mirror the diversity in the patient population the hospital served and responded with an intentional, planned approach to diversify its workforce.
Exposing interns to a variety of clinical and community experiences
After reviewing population data and conducting an evidence-based review of the literature, the hospital restructured an existing nurse technician program into one that would recruit nursing students of diverse backgrounds. The new program, Assuring Success with a Commitment to Enhance Nurse Diversity (ASCEND), consists of an internship to drive the goal of hiring nurses into the organization's workforce upon graduation.
ASCEND provides a mechanism for the strategic recruitment of nurses from underrepresented racial, ethnic, gender and LGBTQ groups. It exposes diverse nursing students from local and regional nursing schools to the welcoming, open and inclusive nursing culture at Akron Children's.
The formal program includes a 10-week hospital summer internship, followed by ongoing cultivation of the relationship over the final year of the students' education. Implemented in summer of 2014, ASCEND has provided internship opportunities for more than 100 nursing students over the last five years.
During the 10-week program, the interns experience clinical time working alongside a registered nurse mentor in a clinical area of interest. Professional development activities are also a core component of the program, providing information and experiences in areas such as communication skills, family- centered care, role exploration, shared governance, professional boundaries and compassion fatigue. Students who have successfully completed the program receive offers for positions as nurse technicians and remain at the organization as permanent employees.
Participants in ASCEND conduct community outreach events, such as connecting with local middle school students to create enthusiasm around a career in nursing. Interns have also recorded public service announcements, conducted letter writing campaigns, hosted on-site career exploration days and poster displays as creative initiatives to connect with students.
The importance of diversity and the effect on the community is recognized across area businesses, which have provided grants to support the program and summer stipends for ASCEND interns. The grants have allowed the program to offer students tuition support during their senior year in return for a commitment to work at Akron Children's after graduation for 18 months. This external support assures the hospital's ability to sustain the work of ASCEND in diversifying the nursing workforce for years into the future.
Fueling a passion for pediatric nursing
Over the course of the program, ASCEND students who have chosen to remain employed at Akron Children's as nurse technicians upon completion of the program has steadily increased from 53% in 2014 to 83% in 2018. After graduation, the retention rate of ASCEND program graduates as registered nurses at the hospital ranges from 85% to 100% since inception of the program.
The greatest improvement on overall diversity of the nursing workforce has been demonstrated in the increase in males joining the pediatric nursing workforce at the hospital, increasing from less than 4% to 5.5%. The percentage of African American nurses has had a modest increase from 1.2% to 1.8% since the program's inception.
The effect of the program has been meaningful for the participants, fueling their passion for pediatric nursing. One participant commented, “Akron Children's opened its doors to us as students and gave us the opportunity to explore a setting that not many people get to experience prior to graduating from nursing school. Essentially, they paid us to learn and grow in our early nursing careers, be hands-on, and be a part of the decision-making team in the units.”
