Panelists at the DNPs of Color 2022 second annual meeting discussed leadership roles, health equity, and systemic racism among other topics. The conference was held October 21 to 23 in Baltimore, MD, and can be viewed here. Highlights of the panel discussion Changing the Game and Forging New Paths are below.
Geoffrey M. Roche, MPA, Senior Vice President, National Health Care Practice, Core Education PBC (moderator): When we consider the nursing workforce crisis, why haven’t we asked our nurses what the problem actually is?
Danielle McCamey, DNP, APRN, ACNP-BC, FCCP, founder, CEO, and president of DNPs of Color: A lot of that is grounded in the fact that as nurses, we don’t advocate effectively for ourselves. Given the sheer number of over 4 million nurses, why aren’t we forerunners of health? What have we done to ourselves as a profession that prevents us from leveraging that collective power? We need to find opportunities to navigate what physicians have done so beautifully, lobbying for legislation and having the resources to single-handedly dictate their practice and our practice. We need to be the change.
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Madeline Feliciano-Weiser, MSN, RN, DNP candidate at Penn State University: A lot of barriers are created because the systems or organizations that we work for are led by businessmen who know nothing about clinical practice. We have to get into leadership positions so that we can continue driving change from a clinical perspective in conjunction with operations.
Celia McIntosh, DNP, RN, FNP-C, PMHNP-BC, SCRN, CCRN, CEN, CNRN, Vice President of Rochester Black Nurses Association( RBNA), family and psychiatric mental health NP and owner of McIntosh Advocacy and Consulting: Organizations need to think of more innovative solutions to preventing and managing burnout such as wellness packages and allocating money towards improving nurses’ lifestyles.
We think a lot more about recruitment than we do retention, and we need to start investing some of those dollars into the people who have stayed in our health care systems. For example, allocating childcare dollars for working mothers will improve financial strain and improve burnout.
Patrice F. Little, DNP, FNP-BC, senior policy advisor for the Future of Nursing: Campaign for Action and CEO of NP Student: If you don’t know how to take care of yourself, you’re going to have issues with taking care of other people. It’s all about modifying some of the frameworks that are in place. We need to teach them how to have a work-life balance.
I tell nurses to consider different aspects of their life such as faith, health, personal development, and relationships. We need to have systems in place to help them be able to navigate those different aspects when challenges arise. For example, we have noticed that when nurses go back for an additional degree, if there are challenges in their relationship, it is going to impact their performance. If their spouse gets diagnosed with cancer or if they lose a family member, it is going to affect how they perform in school the same way it will impact how they perform in the acute care setting. Nurses need to have coping mechanisms in place so they can be able to really keep themselves centered as they serve others.
Stephan Davis, DNP, MHSA, NEA-BC, CENP, CNE, FACHE, executive director of Inclusive Leadership Education at Virginia Commonwealth University: When it comes to business acumen and leading with an administrative mindset, nurses need to obviously be at the table and also need to be prepared to have those types of dialogues. I can say from having led masters of health administration programs and in my space now where my academic appointment is in health administration, I’m often either the only nurse in the room or among the few nurses in the room and that’s really unfortunate because we know so much about health and running the hospital. Unfortunately, this knowledge is not always tapped into effectively. We as nurses don’t advocate for ourselves, particularly people of color. We need to do a better job of having the credentials and skill to walk into all of those spaces and command the respect that we are due.
Roche: Why do you think nurses of color are rarely included in medical boards? How do we forge our own path?
Dr Davis: A lot of our efforts around diversity, equity, and inclusion will not be truly meaningful until we have medical boards that represent the communities that we serve. The health care industry is dominated by nursing, which is a female-dominated profession, and there are more female medical school graduates than males. However, 60% of board positions are held by men and 80% are White persons. Less than 4% to 6% of hospital boards have a nurse who is a voting member of the board.
I think that part of this discrepancy has to do with preparation such as having DNP and other academic credentials, being skilled, and having business acumen. In organizations like the Healthcare Financial Management Association (HFMA), the number of members who are nurses is small. However, nurses make up a sizeable portion of fellows at the American College of Healthcare Executives (ACHE).
If we want to be in tables where decisions are being made, we need to get business credentials.
Feliciano-Weiser: The system is doing exactly what it was designed to do. First and foremost, it was a system built by White physicians. Then it was built to keep nurses out and then it was built to keep nurses of color out. The system keeps doing what it was designed to do, and that is to serve white physicians. It is going to continue to do that until we collaborate and truly create a force in order to disturb and unsettle that system.
Roche: What do we need to do to give nursing students hope and desire so that they can become our next leaders?
Dr Davis: It is so important for faculty to instill in all nursing students that they are leaders and that leadership is broadly defined. You don’t need to be in an administrative or managerial position. You don’t have to be on the board of directors. You could be leading a change in your unit. You could be leading a new clinical policy in your organization. You could be advocating for legislation. All of those are examples of demonstrating leadership.
Feliciano-Weiser: What became very important to me when I started my role in acute nursing was that first mentor. She was the one who taught me the responsibility that you hold when advocating for your patients and to use your evidence base when challenging the questioning of the physician. Those are all leadership skills. It took someone to coach me and make me realize that the things that I did on a daily basis and was doing well were the equivalent of having leadership skills.
Dr McCamey: Redesign curriculum to center nursing as a leadership role, because it’s built on the foundation of being advocates and advocacy. You’re being driven by your passion. You’re being driven by a mission, and that’s the definition of leadership. When I speak to my mentees and my students, I say “let’s dismantle the structure around the word leadership. We all can lead in some way, shape, or form.”
Roche: What can we do to root out systemic racism in all facets of medicine?
Feliciano-Weiser: We have to enforce cultural competency in a way that is much more than taking 1 computer-based learning course. There has to be forced interaction of individuals who don’t look like us and who don’t think like us. You’re coming with humility both as the person who doesn’t know and the person who’s going to disseminate information. It’s a cooperative relationship. There are always going to be those who refuse, and that goes back to executive leadership. You can’t put a mission statement in place and expect everyone to fall in line except for specific groups of people. You have to call it out. You have to hold those individuals accountable. There has to be consequences.
Dr Little: Courses on racial competency should be included in continuing education. We want to make sure that care is equitable. If patients don’t have access to certain types of care, we need to be aware of tools and resources to connect them with so they can be able to get what they need.
Dr Davis: It all goes back to the boards. Our board of directors and our organizations are ultimately responsible for everything that happens from a performance perspective at a high-level that goes on in that organization. When you look at the quality of care that’s being delivered, when you look at the financial metric, and everything in that organization from a balanced scorecard perspective, it all goes up to the board. If the board doesn’t look like us if we’re not reflected in the board, then how can we ensure that what’s important to us and important to our diverse communities will actually matter as the board is making decisions?
We need diverse perspectives on our boards because it changes the questions that are being asked. It changes the issues that are being advanced and ultimately the decisions that are being made and the metrics that the senior management team is then held accountable to meet.
Dr McIntosh: We know that we have to diversify the workforce, it’s up to us to help individuals that are interested, nurses of color that are interested in being at the table. And if there’s an issue with the applications, how can you help them so they’re not declined from the program because their application doesn’t meet the standard?
Roche: How can we diversify the workforce when our education system is still systemically racist?
Dr Little: We need to have more standardization to make this process a little bit easier for people of color. We encounter a lot of the challenges that our counterparts don’t, and if we could just address those at the very beginning, even have things in place where we identify those areas that could possibly impact how they move throughout the program and provide interventions very early, that will be a great way to make sure that we’re not only diversifying the workforce but also ensuring that we are making sure that they have the support they need to progress.
Dr McCamey: Start funding HBCUs and Hispanic-serving institutions. These institutions put out the highest volume of physicians and nurses, but they also are the most underfunded.
Start looking to build up those institutions because these students of color are going to these institutions because there’s that sense of belonging. When you have that sense of belonging, creativity flourishes, innovation flourishes, and you start solving world problems and coming up with solutions for world peace because you don’t have that stress of trying to belong and trying to deal with microaggressions.
Visit Clinical Advisor’s meetings section for more coverage of DNPs of Color 2022.
Source
McCamey D, Little P, McIntosh C, Davis S, Feliciano-Weiser M, Roche G. Signature Panel Discussion: Changing the Game and Forging New Paths. Presented at: DNPs of Color Conference 2022; October 21-23, 2022.
