Workforce Diversity Toolkit
A Resource for Employers
Anne Chinenye Nsonwu, BSN, RN
Background
The United States is a diverse melting pot. It is estimated that by 2043, racial and
ethnic minorities will constitute more than half of the U.S. population (U.S. Census
Bureau, 2012). With the nursing profession constituting the largest segment in the
U.S. workforce (over 3 million members), increasing diversity in the workforce is
crucial (IOM, 2010).
Nurses are on the front line of patient care, yet the progression towards a diverse
nursing workforce had been rather slow and overdue (IOM, 2010). Minority groups
experience decreased access to health care, worse health outcomes, increased
morbidity and mortality, and shorter life expectancy (Shobha & Shanita, 2014). They
have poorer health outcomes from diseases like asthma, cancer, cardiovascular
disease, and human immunodeficiency syndrome than the majority (Gracia &
Jackson, 2014). Having a diverse workforce will increase trust among minority
patients and help improve patient outcomes.
More than one-third of the U.S. population identifies as racially/ethnically diverse, yet
literature indicates only 16.8% of the nursing workforce come from such background
(Bleich et al, 2015). This calls for employers and their leaders to strategize ways to
increase nursing diversity, as nurses are not representative of the population they
serve.
Nursing leaders need to implement and support initiatives that will help recruit and
retain minority nurses in their organizations. Healthcare organizations need to support
a workforce that is culturally competent through recruitment and retention of a
diverse workforce, a workforce that mirrors the faces and values of the people they
serve.
This toolkit has been developed as a resource for healthcare leaders to create
awareness and to support the development of workforce diversity plans.
What is diversity?
According to the National League of Nursing [NLN] (2009), diversity is “the
development of a culture where individuals and institutions move beyond simple
tolerance to embrace and celebrate the richness of our differences” (pg. 1). The
definition of diversity is multifaceted; it is not limited to tolerating individual
differences in gender and ethnicity and, most importantly, involves conscious
practices that involve:

Understanding and appreciating interdependence of humanity, culture, and the
natural environment;

Practicing mutual respect for qualities and experiences that are different from
our own;

Understanding that diversity includes not only ways of being but also ways of
knowing;
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
Recognizing that personal, cultural and institutionalized discrimination creates
and sustains privileges for some while creating and sustaining disadvantages
for others;

Building alliances across differences so that we can work together to eradicate
all forms of discrimination (CUNY - Queensborough Community College).
Why is diversity important?
Organizational leaders need to understand the multifaceted nature of diversity as well
as acknowledge the need for workforce diversity. An organization that is successful in
increasing diversity has a competitive advantage and will be able to recruit and retain
the best nurses.
The fact that a diverse nursing workforce will help improve patient outcome cannot
be over emphasized (Kagawa-Singer and Kassim-Lakha, 2003). “A diverse healthcare
workforce will help to expand healthcare access for the underserved, foster research
in neglected areas of societal need, and enrich the pool of policy makers to meet the
needs of a diverse population” (Wisconsin Center for Nursing).
Strategies to improve workforce diversity
Healthcare organizations can begin by making diversity initiatives a priority.
Organizations should not only have diversity reflected in mission statements and core
values but also should create an environment that is welcoming to minority staff.
Dedicated efforts should be made in recruitment and retention of minority nurses.
This will require use of creative and innovative strategies.
A recent literature review identified strategies for successful recruiting and retention
of minority nurses. They include, mentorship, working with community partners and
providing academic and financial support (Phillips, J. and Malone, B. 2014).
The following table highlights key objectives for healthcare organizations and
educational institutes in increasing workforce diversity.
Make diversity an organizational priority & system-wide approach.

Include diversity in the institution’s mission statement, core values, and strategic
plan.

Support diversity-specific departments, positions, or councils.

Establish an organizational structure that ensures accountability for recruiting and
retaining a diverse nursing staff and/or student population.

Focus on student recruitment at earlier stages of educational progression.

Create mechanisms to support the success and retention of underrepresented
populations.

Establish collaborative academic-practice-community partnerships among schools
and healthcare, community, and consumer organizations.
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
Dedicate efforts to seek funding to support diversity growth through innovative
approaches and outreach to new philanthropy sources.

Set goals for attainment of specified metrics in diversity to track data and evaluate
outcomes.
Provide a variety of support mechanisms for underrepresented populations in both
academic and practice settings.

Provide specific programs that support underrepresented populations, e.g.
mentoring, coaching, student/employee academic & employment resources, and
social networks.

Develop support systems for assimilation of underrepresented populations into the
workplace.

Offer funding support for academic education and continuing education of staff.

Establish interdisciplinary approaches for collaboration with admissions, human
resources, and other educational departments for obtaining data on enrolled
underrepresented students to assess the types of support needed for success.
Train all staff and students to ensure higher levels of cultural competency.

Require cross-cultural competency training and/or courses for all students, faculty,
and staff, including specific courses and programs on cultural awareness and
building and maintaining positive interracial relationships.

Establish peer mentoring for faculty, students, and staff to encourage and support
diversity initiatives and maintain effective interpersonal behaviors.

Host system-wide diversity events.
Source: (Wisconsin Center for Nursing)
To assist healthcare organizations in creating diversity plans, healthcare leaders
should ask the following questions:

What retention strategies have been implemented to retain and promote the
success of faculty and staff from underrepresented groups?

Which recruitment and retention strategies have been most successful? Which
have been least successful?

What is the advertising and outreach strategy employed in the recruitment of
employees from underrepresented groups?

Is there an assessment procedure in place to gauge the outcomes of the
recruitment and retention process?
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
What strategies are employed to maintain relationships with community
organizations?

How are outcomes of partnerships with community organizations evaluated?

Is there a formal mentoring program for diverse employees?

What strategies are in place to retain diverse leaders?

What strategies are employed to identify underrepresented groups with
leadership potential and the necessary qualifications to achieve leadership
positions?

What percentage of the institution’s administrative leaders do nurse educators
represent from underrepresented racial/ethnic groups? (National League for
Nursing, 2009).
Nursing leaders and managers play a huge role in an organization’s diversity efforts.
Preparing minority nurses in leadership positions will help in the effort to reduce
health disparity. “Minority nurses in influential leadership roles are more likely to be
better positioned to directly influence resources allocation and the recruitment and
retention of a diverse workforce” (Phillips, J. and Malone, B. 2014).
Some organizations have programs created for the sole purpose of increasing
workforce diversity. These programs promote inclusion by encouraging participation
of the employees in the program and making it clear to them that their voices matter.
They are set up to provide mentorship as well as financial support to the minority
employees in the program.
In educational settings, there are nursing programs created to increase diversity by
establishing a pathway for LPN-to-BSN degrees. These programs support minorities
in obtaining higher degree, which increases their chances of getting employed in
hospitals or other healthcare organizations.
Diversity of the nursing workforce is an issue that demands attention. Healthcare
organizations need to take active measures to recruit and retain minority nurses. With
the growing diversity of the US population, it is crucial for healthcare organizations to
have a nursing workforce that mirrors the people they serve.
Diversity program examples

Brigham and Women’s Hospital. Centers for Faculty Development &
Diversity.
http://www.brighamandwomens.org/medical_professionals/career/cfdd/default
.aspx

Brigham and Women’s Hospital Bulletin (2014). “BWH and Roxbury
Community College Scholar Program Launches.”
http://www.brighamandwomens.org/about_bwh/publicaffairs/news/publicatio
ns/DisplayBulletin.aspx?articleid=6314
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
Fitchburg State University. Nursing LPN-to-BSN.
http://www.fitchburgstate.edu/academics/undergraduate-dayprograms/nursing/

Massachusetts General Hospital. Diversity Program.
http://www.mghpcs.org/pcs/Programs/diversity.asp

Pachter, L. M., & Kodjo, C. (2015). New Century Scholars: A Mentorship
Program to Increase Workforce Diversity in Academic Pediatrics. Academic
Medicine: Journal Of The Association Of American Medical Colleges,

Schmidt, Bonnie J., and Brent R. MacWilliams. 2015. "Evaluating an
accelerated nursing program: A dashboard for diversity." Journal Of
Professional Nursing 31, no. 2: 82-88. PsycINFO, EBSCOhost (accessed June
13, 2015).

Sporing, E., Avalon, E., & Brostoff, M. (2012). A nursing career lattice pilot
program to promote racial/ethnic diversity in the nursing workforce. The
Journal Of Nursing Administration, 42(3), 138-143.
doi:10.1097/NNA.0b013e318248093e

Swinney, J., & Dobal, M. (2008). Embracing the challenge: increasing
workforce diversity in nursing. Hispanic Health Care International, 6(4), 200204.

Worcester State University. Nursing LPN to BS.
http://www.worcester.edu/LPN-BS/
Resources on diversity strategies

Brooks Carthon, J. M., Nguyen, T., Chittams, J., Park, E., & Guevara, J.
(2014). Measuring success: results from a national survey of recruitment and
retention initiatives in the nursing workforce. Nursing Outlook, 62(4), 259267. doi:10.1016/j.outlook.2014.04.006

Diversity Templates
http://nlhrmanager.ca/index.php?option=com_content&view=article&id=174
%3Adivtemp&catid=98&Itemid=28

Diversity Policy Template
http://fbe.unimelb.edu.au/__data/assets/pdf_file/0003/772023/Diversity_polic
y_template.pdf

Ferriero, D. S., (2012). Diversity and Inclusion Strategic Plan: National
Archives and Records Administration. Retrieved June 2015, from
http://www.archives.gov/about/plans-reports/strategic-plan/diversityinclusion/diversity-inclusion-plan.pdf

Nugent, K. E., Childs, G., Jones, R., Cook, P., & Ravenell, K. (2002). Call to
Action: The Need to Increase Diversity in the Nursing Workforce. Nursing
Forum, 37(2), 28.
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
Public Sector Commission (2014). Workforce & Diversity Action Plan
Template (Agencies with less than 100 employees). Retrieved June 2015, from
https://publicsector.wa.gov.au/document/workforce-diversity-action-plantemplate-agencies-less-100-employees

U.S. Department of Veterans Affairs (2008). Diversity & Inclusion Strategic
Plan. Retrieved June 2015, from
http://www.diversity.va.gov/products/plan.aspx

Wilson, A. H., Sanner, S., & Mcallister, L. E. (2010). An Evaluation Study of
a Mentoring Program to Increase the Diversity of the Nursing Workforce.
Journal Of Cultural Diversity, 17(4), 144-150.
Resources on diversity leadership

Bleich, M. R., MacWilliams, B. R., & Schmidt, B. J. (2015). Advancing
diversity through inclusive excellence in nursing education. Journal Of
Professional Nursing: Official Journal Of The American Association Of
Colleges Of Nursing, 31(2), 89-94. doi:10.1016/j.profnurs.2014.09.003

Coulam, R.F. & DiSimone, J, D. (2006). Building diversity in the leadership
of healthcare organizations:Summary and implications. Forum presented at
Simmons School for Health Studies, August 2006.

Georges, C. A. (2012). Project to expand diversity in the nursing workforce.
Nursing Management - UK, 19(2), 22-26

Hendricks, J. M., & Cope, V. C. (2013). Generational diversity: what nurse
managers need to know. Journal Of Advanced Nursing, 69(3), 717-725.
doi:10.1111/j.1365-2648.2012.06079.x

United States Department of Commerce. Best Practices in Achieving
Workforce Diversity. http://govinfo.library.unt.edu/npr/library/workforcediversity.pdf
Other Resources

Johnson & Johnson Campaign for Nursing’s Future/American Association of
Colleges of Nursing Minority Nurse Faculty Scholars Program.
http://www.aacn.nche.edu/students/scholarships/minority

MinorityNurse.com http://www.minoritynurse.com

National Association of Hispanic Nurses. http://www.nahnnet.org

National Black Nurses Association, Inc. http://www.nbna.org

National Coalition of Ethnic Minority Nurse Associations.
http://www.ncemna.org

New Careers in Nursing scholarship program supported by the Robert Wood
Johnson Foundation and the American Association of Colleges of Nursing.
http://www.newcareersinnursing.org
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
U.S Department of Health and Human Services, Health Resources and
services Administration, Bureau of Health Professions diversity grant
programs. http://bhpr.hrsa.gov/grants/diversity
References
Bleich, M. R., MacWilliams, B. R., & Schmidt, B. J. (2015). Advancing diversity
through inclusive excellence in nursing education. Journal Of Professional
Nursing: Official Journal Of The American Association Of Colleges Of
Nursing, 31(2), 89-94. doi:10.1016/j.profnurs.2014.09.003
Gracia N. J., & Jackson C. S., (2014). Addressing Health and Health-Care Disparities:
The Role of a diverse workforce and the social determinants of health. Public
Health Reports, 129 (suppl 2), 57-61.
IOM 2010. http://www.iom.edu/Reports/2010/The-Future-of-Nursing-LeadingChange-Advancing-Health.aspx
Kagawa-Singer, M., & Kassim-Lakha, S.
(2003). A strategy to reduce cross-cultural miscommunication and increase the
likelihood of improving health outcomes. Academic Medicine, 78(6), 577–
587.
National League for Nursing: The Voice for Nursing Education (2009). Diversity
Toolkit. Retrieved June 2015, from http://www.nln.org/professionaldevelopment-programs/teaching-resources/toolkits/diversity
Phillips, J., & Malone, B. (2014). Increasing Racial/Ethnic Diversity in Nursing to
Reduce Health Disparities and achieve Health Equity. Public Health Reports.
129 (Suppl 2), 45-50
http://www.ncbi.nlm.nih.gov.ezproxy.lib.umb.edu/pmc/articles/PMC3863700/
Queensborough Community College. Definition for Diversity. Retrieved June 2015,
from http://www.qcc.cuny.edu/diversity/definition.html
Shobha, S. & Shanita, W. (2014). Transitioning from Health Disparities to a Health
Equity Research Agenda: The Time is Now. Public Health Reports. Retrieved
May15th from,
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863705/?report=printable
U.S. Census Bureau (2012). Projections Show a Slower Growing, Older, More
Diverse Nation a Half Century from Now. Retrieved June 2015, from
https://www.census.gov/newsroom/releases/archives/population/cb12243.html
Wisconsin Center for Nursing. Diversity Toolkit for Recruitment and Retention of
Minority Nursing Students.
http://www.wisconsincenterfornursing.org/diversity_int.html