Leaning In:

Interviews were conducted with 4 thought leaders on diversity and inclusion. The intention of these interviews was not to formulate solutions, but enrich readers’ perspective regarding racial ethnic disparities in nursing leadership. Key Points•Racial exist the leadership workforce.•There is no one-size-fits-all solution for how make structural improvements increase inclusion within leadership.•It necessary understand why change essential; begins self-reflection self-awareness. •Racial A heightened awareness blatant health care inequities tensions, stemming from COVID-19 pandemic loss life, violent tragedies sparking Black Lives Matter protests our country internationally, call action. How do we intensify understanding disparities, improve minority representation nurse positively impact reflect diverse population serve? And uphold ethical obligation valuing individuality, being respectful, impartial?1American Nurses AssociationCode Ethics Nurses.https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/Date: 2015Date accessed: September 9, 2020Google Scholar According 2017 National Nursing Workforce Survey by Council State Boards Nursing, minorities represent 19.2% all registered nurses, which includes 6.2% black/African American; 7.5% Asian; 5.3% Hispanic; 0.4% American Indian/Alaskan Native; 0.5% Native Hawaiian/Pacific Islander; 1.7% 2 or more races; 2.9% other nurses.2Smiley R.A. Lauer P. Bienemy C. et al.The Survey.J Nurs Regul. 2018; 9: S1-S88Abstract Full Text PDF Scopus (150) Google cascading implication a less workforce. I had an opportunity interview black leader colleagues, offered fascinating insights can self-examine own biases behaviors while ensuring are guiding promoting ranks included:Linda Burnes Bolton, DrPH, RN, FAAN (LBB)Senior Vice President (SVP) Chief Health Equity Officer (former SVP chief executive)Cedars Sinai Medical Center, Los Angeles, CaliforniaM. Lindell Joseph, PhD, (MLJ)Clinical Professor Director, Graduate Systems/Administration ProgramThe University Iowa College City, IowaStephan Davies, DNP, FACHE (SD)Assistant Master Administration North Texas, Sciences Fort Worth, TexasJacqueline Herd, NEA-BC (JH)Executive President, Officer, Grady System, Atlanta, Georgia AS: cultivate inclusion? LBB: In my experience, believe there comes time when everyone questions “equitable treatment.” What’s new that people willing stand up speak about systems, nation, world. individuals who have their experiences react what happening? When think equity inclusion, need push forward idea it means be equitable at its highest level. Acknowledge set ways living—but where find common ground place get along advance each others’ humanness achieve equity? We “melting pot”—we want promote individualism—be inclusive accept they are. Instead focusing differences, should celebrate them learn take differences apply toward identifying harm close gaps continue exist. MLJ: Nurse modeling authentic true ourselves—building honest relationships people, terms attributes he/she brings table; build trust open, fair current potential leaders. mental model empower nurses—how acknowledge talent, strengths, individuality; it’s creating connections. If know someone has essential develop meaningful provide opportunities gain insight leverage this knowledge help succeed. intentional process mentoring offering tools vital connections based inherent attributes. SD: must diversity, equity, belonging priority organizations. you currently Suppose highly seasoned predominately white, all-female team, uncommon given population's demographics. case, step back ask whether represents workforce serve. Additionally, obtaining perspectives sound decisions organization. not, action steps recruit would contribute teams' diversity? More importantly, environment “different” experience long-term success? answer “no,” upon underlying reasons foster JH: career development nurses different compared nonblack nurses. recognize problem before strategies resolve issue. leadership, did job because black, wanted white particular position. There also genuinely work ethic color skin. your inform field? My first as undergraduate Arizona University. one only few “nonwhite” students accepted school. It became apparent needed educate variations approaches—we councils facilitate education. worked well colleagues. began L&D quickly realized trying helping others healthy possible. Institutional racism exists; look promoted not. vice president Cedars African 1 females executive team. credited progressive board committed me early As role others, advocated respect, advanced equity. nurse, if business degree. At first, seemed odd, say “no.” However, 25 years later, why. consider field: professional identity. From day graduate recognized issues environment. felt driven fix them. This drive made think, feel, act leader. That “sense self” always lead promotion. “owning” one’s identity leader, researcher, academic. am advisory Society Professional Identity Nursing. member, validated domains define nurse’s These include values ethics, knowledge, comportment. Today, tell optimally executed behaviors, peers noted it. second attribute emotional intelligence. 20s, reported director education research. conversation, she stated “politically savvy.” time, clear meant. used intelligence; self-aware, disciplined, motivated, socially aware happening environmentally. complex, repair Therefore, studied processes adapted thinking interactions conflicts, generate change. Being Black, gay, millennial, male affected journey. experienced witnessed expressions bias even outright discrimination. historically underrepresented excluded groups field providing prism through see seek dynamics hospital (staff patients) located South Central Angeles (Watts), relief charge nurse. decided jobs, applied staff position catholic patients predominantly mostly white. During interview, asked interested since some Initially, said decided, not? beginning ethic, skin color. black. happy great team except EMT, loved included. feel same While pleasant professional, excluded. remember writing annual evaluation, practical, calm drama. sure instances coaching; however, believed help, seen sign managing therefore, ineffective Fast opportunities; received several promotions never interviewed positions. CNO. CNO me, held high standard higher expectations. Many receive coach mentor keenly careful avoid “too environment.” continues shortage young advancing nursing, alone. candid conversation worry silence fear offending Without outlet, remain silent. Do wrong; phenomenal whom conversations, very conservation Describe Change starts self. don’t perform self-assessment figure out world belief systems are, things like, really cannot else. It’s OK biases—but those prohibit treating dignity respect? Once identify have, then say, “What going ensure daily activities, allow preconceptions interfere treat human beings respect.” self-assessment, failing yourself professional. organization, group, association you—it tough self-critical. bad thing, move forward. ago, discussed LGBTQ community profession—we too scared—now do, embrace came just small group inclusive. Diversity “black brown male, female”—that’s counting. By inclusive, “I you, anywhere be, skills, ability.” Let’s count instead difference succeed life career—as much be. reality—there problem. bubbling literature. promoted, social unrest country. profession society awareness—awareness causes “how contributed situation situation?” become empathetic engage create What during his her skin; “token leaders.” societal paradigm positions information, resources, opportunity, support. will best. They reimagine system chaos equitable. gifts talents. calls specific skill set, having employee complete strength-based profile utilize individual profiles select best fit using objective criteria exemplifies “correct qualifications” sought. nepotism go “happy hour” together. connect intellectual stimulation task list check box; making allowing future thrive. moment, well-qualified sought after, specifically, executives holding doctoral degrees certification demand. prepare members academically experientially qualified roles? them, retained? focus academic pathways, measurement, advocacy. leaders' preparation degree either baccalaureate (ANA, AACN, AONL). may face additional barriers pursuing choosing institution program ease access rather than prioritizing alignment goals. All schools including leading institutions challenges student recruitment, evaluate policies practices organization's assess happens over time. long Are promoted? leave, going, why? measuring intersecting identities. For instance, seeing levels turnover among males versus females? enough us practices; measure finally, advocacy; allies advocate metrics part accrediting bodies appraisers awards community, majority composed color, yet governing asked. leaders, accreditors hold accountable explain rationale. important note Magnet® does racial/ethnic composition compares Additional included, assert practice expanded agencies, such Joint Commission Association Colleges especially institutional governance. allowed ability requires units organizations, encouraging supporting path. CNO, route challenging promotion equal. require goals targeted increasing and, seeking listen remove actual perceived today. Where now, like leaders? 49th year 50th inspire “human first.” People “drive” acknowledged being, encouraged admit biases, makes difference. commitment responsibility table present voice. hope able “Here person lengthy profession, enjoyed it, grateful transition senior role. role, successfully notion caring.” essence “about caring ourselves”; ourselves others. ground, kinds energize us, good happen. Based events numbers “revelations” literature hiring promotional patterns highlights systemic positive revelations awareness, challenge shift model; reflective exercise. Think reality cost–benefit matrix. case change; this; cost status quo? organization racially patients, influence bedside without approach? healing—to society—to well-being. mandate. right needs serve, effectively leading. boils down accountability models perceptions begin. evolve way treated, massive people. It's complicated dilemma ourselves, “How resonate people?” easy work. example, level comfort many younger exhibit speaking minds. ways, inspiring. But done times challenged leadership—I strived diplomatic. response hearing faculty member statement bias, listened exclaim, “That's racist”—direct straightforward language on-point. respond educators, self-reflection? future? so long, expected oppressed now non-black, boldly declaring “Black lives matter” rightfully so. most trusted America, contract well-being nursing's safer show truly about. Language matters. shut conversation. united voice—it matter.” Part via ANA policy eradicate related race forms oppression—we raising issue inequalities public issue, imperative address 6% nurses; number fearful black.” positions, envision themselves—being leader; helps motivate inspire. readership, Anne Schmidt, APRN-BC, CENP, CPHQ, officer Novant UVA System Manassas, Virginia. She AONL Board Directors reached [email protected] .