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Diversity and Cultural Inclusion In Nursing

  • Publish Date: Posted almost 4 years ago
  • Author:by Cathy Vollmer

What a year 2020 has been so far, now halfway through it. Each of us is having to look at our inner selves closer than we ever have. And being less mobile is affording more time for this reflection.

Australia forest fires, COVID-19, and now addressing something we had silently thought we had already addressed but realizing there may be even bigger gaps than what we thought: to treat all lives equally.  Ignorance is not bliss; it is ignorance. Whether it is Black Lives Matter, Black Lives Matter Too, White Coats for Black Lives or All Lives Matter, diversity and inclusion are more important than ever. Only 32% of American workers believe that their company has an effective diversity effort. Over two-thirds (69 percent) of executives rate diversity and inclusion as an important issue (up from 59 percent in 2014).

We all should be challenged to reflect on our own feelings, our own actions, and what diversity and inclusion mean now and what it should mean. But for the purposes here, the review is on its impact on healthcare.

Cultural diversity in the workplace encompasses a variety of experiences and perspectives that arise from each employee. Experiences and perspectives are different and can be based on race, gender, ethnic group, age, sexual orientation, personality, cognitive styles, religion, tenure, organizational function, education, heritage, and much more. Cultural diversity is born from the values, norms, and traditions of an employee that impact the way she/he typically perceives think, interacts, behaves, and makes judgments. 

Diversity impacts healthcare on many levels, both from the care provider (nurse) and from the healthcare recipient (consumer).

Care Provider (nurse)

We need to challenge ourselves. Diversity and inclusion need to start at recruitment for the education time period. In spite of all the efforts made by universities, hospitals, etc, are the same opportunities available to all in both education, career opportunities, and promotions? Additionally, culture, language, and religion need to be taken into consideration. The nursing team is a team, and. Care providers need to be and feel a part of this. It provides a sense of purpose and belonging.  Additionally, cultural competence is a necessary component; responding appropriately to people of varying backgrounds, recognizing differences, and allowing people to feel respected and valued.

Healthcare Recipient (consumer)

This is a very challenging and complicated area for consideration. Questions and barriers to health such as access to care, affordability of care, ability to maintain treatment of care, culture and potential language barriers can exist, many times unbeknownst to the care providers. As a nation, we have been silently aware that certain people were, but this especially came to the forefront during COVID-19

Many healthcare facilities have included diversity as part of their overall mission, but there needs to be diversity and inclusivity within internal teams. To be aware that each person is unique and brings their own perspective and valuable experience (both professional and personal), adds value to our own culture. Have a strong Mission/Value statement and live those values. Diversity, in regard to numbers and demographics, is not enough; being inclusive is required.

Myths vs. Facts

  • Diversity is a problem: No, it is an opportunity!
  • Diversity is the Human Resource department’s responsibility: No, it is my responsibility. It is your responsibility. We all play a significant role (employees, managers, supervisors).
  • Diversity is about race and gender: It is much broader than that. It used to be called cultural diversity, but the conversation should be more inclusive.
  • Diversity is about minorities and women in the workplace: Diversity is about your internal employees and external customers. Understand the diversity within your employee base and your customers and anticipate their needs.

Benefits of a Diverse Culture

  • Access to a variety of viewpoints to consider
  • Improve operations
  • Improve facility reputation
  • Employee recruitment
  • Employee retention
  • Patient satisfaction

So, where do we go from here?  Our immediate response is to protest, vocalize, etc., but what comes next should be continuous and ongoing.


  • The goal is to create an environment where cultural competence is both welcomed and rewarded.
  • Acknowledge and understand all the ways we are different and similar and come to grips with our own biases and prejudices. The intent is to minimize and eliminate prejudice and bias in your workplace and business practices. 
  • Create a more inclusive work environment for both employees and customers.
  • Create a culture where the nurse acclimates quickly to be part of the healthcare team.

Assess Your Team’s Culture

  • Start the process of managing cultural diversity by assessing the cultural competence of your own team and employees. 
  • The ability to be agile to collaborate effectively with people from various cultures.          
  • Determine awareness of your own cultural worldview, knowledge of other cultural practices and worldviews, spoken and unspoken attitude towards cultural differences.

Take Steps to Be More Culturally Diverse and Inclusive

  • Gain commitment from the C-suite
  • Engage all employees in efforts
  • Target key performance indicators
  • Align efforts with company goals 
  • Go beyond legal and policy requirements
  • Promote community and comfort
  • Treat others as they want to be treated
  • Ward off change resistance
  • Include as many employees as possible

Many healthcare organizations include diversity in a mission statement, but they need to put statements into action. Staffing companies can help in adding cultural diversification, especially through international nurses.