Pioneer Spirit
Changing health care system requires diversity, flexibility in the profession

By Joellen Koerner, Ph.D., MSN, RN
Midwest Edition Editor
November 19, 2001

When our ancestors came to America, they landed in uncharted territory. Our family histories are filled with stories of bravery and courage, risk and reward, along with failed experiments and ventures. The drama of life was played out in a big way as we became a nation. Throughout its rich history, America has opened its doors to multiple nations and nationalities. The diversity enjoyed in this country is without peer. Providing culturally sensitive care requires us to increase our understanding of the beliefs and values of others. This can best be accomplished as we work alongside nurses from various cultures, learning from them as we collaborate in the provision of care.

A nursing shortage of unparalleled magnitude is sweeping this country and the globe. Many nations are implementing strategies to recruit from other cultures. While it may be an instant antidote to address our vacancy rates, it tends to exacerbate problems for others with a similar situation. For those nurses who join us, there is a cultural adjustment that must be addressed. A more powerful antidote is the exciting work being done on the recruitment of many cultural groups into the nursing profession. Colleagues in Caring and other workforce initiatives are highlighting innovative efforts to attract caring individuals from all walks of life into nursing.

Unfortunately, a prevalent image is that of nurses as dependent practitioners carrying out medical orders. Many young people selecting careers today are seeking a profession that allows them to be autonomous, creative and innovative. Specific cultures are looking for ways to maintain healing practices that are consistent with their worldview. The public has not yet recognized that nursing in our increasingly complex health care system calls for just that kind of practice.

In the 1960s, humankind landed on the moon. The resulting technology fostered the emergence of high-tech health care. Nurses became skilled in managing technology and applying the data to patient care management; the world of critical care nursing began. These nurses are experts at managing acuity of the highest degree. Now, we are entering a new era of healing, one with a holistic focus. Nurses who become experts in holistic nursing are increasingly practicing in ways that draw on the best of culturally specific protocols as well as the dominant Western science strategies learned in nursing school.

Today, the chronic patient population, moving rapidly across the continuum of care, demands a new kind of care management. Multiple environments require a more reflective practitioner who can manage complexity. Many patients have comorbid conditions and challenging life situations nested within issues of diversity on many dimensions. Sending a patient home with a treatment regimen is different for a basically healthy 45-year-old mid-level executive than it is for a 32-year-old homeless individual with a comorbid condition such as diabetes. Exposure to patients is brief, fostering the need to educate them in managing their own health issues rather than doing it for them. Traditional diagnosis-focused solutions are giving way to patient-focused interventions co-created in partnerships between nurses and patients.

As your world and work become known and experienced by more of the public, the image of nursing will shift as dramatically as it did in the 1960s. The challenges, opportunities and richness of these new roles will be a magnet for people of all cultures seeking a career that is both rigorous and rewarding. They will see, through their encounter with you, that the privilege of standing with someone in a moment of crisis, challenge or need is among the greatest that life has to offer. By becoming all you can be in the role you have chosen, you will address the nursing shortage in ways that all the advertisements in the world cannot.

Study our pioneering ancestors and professional colleagues, identifying the qualities they demonstrated: courage, risk-taking, integrity, intellect and passion for what they were about. By incorporating them into your work, you will help the profession evolve into a relevant, powerful and multicultural healing force for society in the 21st century.

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