The School of Nursing Takes Active Role in Diversity & Inclusion
In the wake of last year’s high-profile murders of unarmed Black men and women and the subsequent worldwide Black Lives Matter protests, nursing students Patrice Turnipseed and Jayana Greene were inspired to step away from the sidelines and become advocates. In fall 2020 they founded the Multicultural Student Nurse Organization (MSN0).
“We want to bridge the gap between nursing students of color and nursing faculty and staff to ensure that students of color are equipped with equal opportunity and adequate resources to successfully complete the nursing program. Ultimately, we want to create a culture in the School of Nursing that embraces diversity and is deliberate about inclusion,” she says.
First, however, Turnipseed and Greene had to fight for inclusion of their own organization among the roster of student organizations.
“When we submitted our application to Student Community Government to approve our organization, we were turned down at first,” Turnipseed says.
“We were told that an organization like ours already existed – the Student Nurse Association. However, we don’t believe that student organizations are a one-size-fits-all. We are a multicultural student organization. We believe that the faculty and staff in the School of Nursing, who place cultural competence as a requisite skill, will be better equipped to prepare students for real-world situations by closely working with an organization of students who live these experiences daily.”
MSNO comprises LatinX, Asian, African American, African, and Indigenous students of color. One of MSNO’s first orders of business was to “bring a level of awareness to the School of Nursing about the experiences of students of color.” This was achieved via a panel discussion made up of five MSNO members and held during a virtual faculty development workshop.
“We titled the panel ‘Who Am I?’” Turnipseed says, “and we shared our personal stories and experiences as students of color in the School of Nursing.”
“When we talk about diversifying the nursing workforce, we need to ask why there is a lack of diversity,” says Turnipseed. “Why are student nurses of color struggling? What is different about their experiences than their white counterparts? What can the School of Nursing do to help students of color succeed?”
“Some of us are first-generation college students or English is our third or fourth language,” she says. “If I am taking an exam and my second language is English, I have to first read the question in English and then translate it in my head into my own language in order to understand how to answer it in English.”
The five MSNO members addressed ELL issues, implicit bias and other issues that can impede academic success. They pointed out the disproportionate number of course and standardized test failure rates among nursing students of color and ELL students. They expressed the need for inclusiveness and cultural competence in courses across the nursing curriculum and the need for more diversity among faculty and students.
“What the faculty heard moved them deeply,” says Assistant Professor of Nursing Deborah Kutenplon, who assisted in organizing the presentation.
“I can’t tell you how many emails I received from faculty thanking the students for putting it together.”
Kutenplon is chair of the School of Nursing’s Diversity and Inclusion Taskforce, an organization founded at the same time as MSNO and that works in partnership with MSNO. Kutenplon says both organizations were met with enthusiastic support from the School of Nursing’s new dean Carolynn Masters.
“Dean Masters, Patrice, Jayana and I felt that we needed both a student group and a student/faculty group working on these issues in collaboration,” Kutenplon says.
“The taskforce is made up of faculty and students and has three subcommittees: The first provides academic support for students of color and ELL students,” says Kutenplon. “The second focuses on faculty development to help faculty become more equipped to address issues of diversity and inclusion and to teach cultural competence in their courses. And the third focuses on supporting faculty who are integrating into their courses the knowledge and skills students need to be prepared to provide culturally competent care.”
This January the MSNO and the Diversity and Inclusion Taskforce joined forces to organize a faculty development workshop on cultural competence that featured two guest speakers: alumna Valerie Almeida-Monroe ‘11, director of clinical services at Clinica Esperanza, a free clinic for uninsured Rhode Islanders; and Dionne Poulton, vice president and chief diversity officer at Care New England.
According to Almeida-Monroe, often a lack of cultural competence interferes with the quality-of-care patients of color and non-English-speaking patients receive.
Almeida-Monroe is of Haitian heritage and speaks three languages: Haitian Creole, English and Spanish, the latter of which she learned while working at Clinica Esperanza for the last 10 years. She learned other critical matters, too, like the very real cultural differences in the way patients express and manage pain.
“About 70 percent of the people who come to Clinica Esperanza are Hispanic,” she says. “When our patients come in for pain, the pain is usually high, but they often don’t rate it that way. They may rate it a 3 out of 10. But the fact that they’re taking a day out of work, uncompensated, to come to the clinic tells me the pain is higher than that. The people we see also tend to live with pain for longer periods of time before coming in for help. They will have had that pain for nine months or for over a year.”
When healthcare workers don’t understand cultural differences, it can lead to health disparities, she says.
“We had a patient who we referred to a rheumatologist,” says Almeida-Monroe, “but the rheumatologist was somewhat dismissive and told the patient she didn’t need to see a specialist because her pain was well managed on ibuprofen. It turns out that the patient had lupus, which was missed on the initial visit. Culturally competent care goes a long way in decreasing health disparities.”
Poulton, who five months before George Floyd’s murder and the subsequent global Black Lives Matter protests, was made chief diversity officer at Care New England, describes cultural competence as looking at patients through the lens of their culture.
“We have to make sure we are considering the communities they live in and the health disparities they face to make sure we are treating the whole person,” she says.
Poulton notes that the highest health disparities are around race. “My Ph.D. was on unconscious biases with respect to teacher educators,” she says. “In my research I found that race is the most enduring, recognizable and inflammatory feature of identity of a person, which impacts how we see and treat people.”
To become more culturally competent, Poulton recommends that institutions conduct sensitivity trainings and that institutional leaders make a commitment to inclusivity, which may mean mandating sensitivity trainings and establishing an accountability system.
It is also extremely important, she says, to have a diverse health-care workforce.
“From a personal perspective, as a person of color, I know that when I walk into a health-care institution, I look for people who look like me,” says Poulton. “I look to see if a concerted effort has been made to ensure that there are diverse people working in these environments who are reflective of our society, which is multicultural.”
Care New England and the School of Nursing are working on formalizing a partnership to further both of their diversity efforts and to create a pipeline of prospective nurses of color who come from Rhode Island College. MSNO is assisting indirectly in that effort.
“We plan to reach out to intended nursing majors to encourage them to join MSNO,” says Turnipseed. “We’ll check in on them periodically so that they know they have someone to talk to about nursing-related issues. It will give them a familiar face when they’re admitted to the program. We’d also like to be a part of the effort to hire more nursing faculty of color.”
MSNO asked for and was provided study groups led by professors in each subject area that are more personalized. They organized workshops for nursing students on topics such as test taking and time management. They asked for and were given a voice in decision making within the School of Nursing. MSNO members now sit on all three of the Diversity and Inclusion Taskforce subcommittees, as well as the Admissions Committee, the Curriculum Committee, and the Dean’s Advisory Board Committee.
At the same time, the Diversity and Inclusion Taskforce is making strides. The school has mapped out its courses and examined what it can do to incorporate culture-specific topics and activities into the nursing curriculum. Faculty also have access to a diversity and equity toolbox, which is a list of websites, online resources, and activities to further faculty development and to use as a resource with students.
“I think the Black Lives Matter movement opened doors and made people who weren’t paying attention to these issues more willing to pay attention,” says Kutenplon, who represents Rhode Island College on the American Association of Colleges of Nursing’s Diversity, Equity, and Inclusion Committee. “Establishing this taskforce, in light of the Black Lives Matter movement, was a lot easier than it might have been three or four years ago. The movement focused the attention of white people in power and made them start to think that it’s time we really addressed these issues. We can’t keep pushing this to the bottom of the agenda.”
Indeed, diversity and inclusion are issues that require the strength of a community. It can’t be done alone. Together, MSNO and the Diversity and Inclusion Taskforce are making a difference.