Increasing Diversity at the Highest Levels of Nursing: Perspectives of a Doctor of Nursing Practice Graduate
- Independent Author, Florida, US.
*Corresponding Author: Monica Jaramillo DNP, MSN/Ed., RN-NLC, CNE®n, CCRN.
Instructor, mentor, and tutor of various healthcare programs. I am not affiliated with any institution when writing and submitting this manuscript to the NSC journal for open-access publication.
Florida, US. Email: MonicaJaramilloDNP@Gmail.com
Open Researcher and Contributor ID: https://orcid.org/0009-0005-0572-4061
Cite this article
Introduction: There is a need to increase diversity at the highest levels of education in nursing to ensure competent transcultural services for the growing multicultural population worldwide. The Doctor of Nursing Practice (DNP) is a terminal degree that significantly impacts change advocacy. This commentary includes the perspectives of an immigrant nurse in her journey to completing a doctoral degree while contributing to diversity.
Discussion: Diversity, Equity, Inclusion, and Accessibility (DEIA) positively impacts nursing and healthcare systems at many levels. It is imperative to advocate for equal services for all individuals while inspiring nurses and other healthcare professionals to further their careers by achieving advanced education degrees conducive to propelling health services forward. The author seeks to inspire nurses worldwide to continue their educational journey and encourage immigrants to believe they can do it despite their fears and hesitation.
Keywords: Diversity; Equity; Inclusion; Accessibility; DEIA; Doctor of Nursing Practice.
Immigrant nurses can face many challenges when trying to succeed in a place away from home, and this can negatively affect their desire to return to school and achieve higher degrees of education, especially terminal degrees such as the Doctor of Nursing Practice (DNP). Individuals moving to different countries must perform under the same standards as those with inherent language and culture.[1,2] Recent literature suggests that many challenges employees, employers, students, and organizations face regularly relate to the lack of adequate cross-culturalism competencies. Furthermore, professionals from different geographic areas, such as Taiwan and Mexico, report experiencing multiple challenges in succeeding in scholarly endeavors with English as an additional language. Accordingly, increasing diversity at all levels of health care and the nursing profession is imperative to ensure competent transcultural services for the growing multicultural population. This article aims to inspire other nurses to pursue their call for further education while adding to diversity in nursing at the doctoral level worldwide. This author is a Latin-American intensive care nurse and nurse educator who completed the DNP program in the United States despite multiple fears resulting from being an immigrant nurse and a busy young mother in another country with English as an additional language. The author shares her journey through international open access, hoping it will inspire others experiencing any dilemmas related to Diversity, Equity, Inclusion, and Accessibility (DEIA) while considering achieving advanced education degrees. This commentary article includes a discussion and a conflict of interest statement while exploring the importance of taking the first step, believing in self, and abiding by solid values.
Taking the First Step
Coming from a country where English is not the primary language can pose a significant barrier to diverse nurses from various geographic areas since advancing their careers in a different country by increasing their education without having the full command of the new language can slow down the learning process by adding fear and intimidation. In addition, English remains the dominant language for academic projects and scientific publications worldwide. At first, the author experienced hesitation in enrolling in the DNP program due to language and other barriers that could arise due to disparities. But the persistent call to serve others and the burning passion for adding to diversity while advancing her career inspired her to take the first step. That initial decision was to continue advanced education programs like the master’s degree and related certificates until reaching the highest degree in nursing without forgetting to embrace her differences as an immigrant and follow her passion for the profession and service. Since then, the author has enjoyed inspiring nurses and allied health students to put their fears aside. After overcoming all fears and limiting beliefs, the author became a role model for other nurses. As a role model for the profession, the author has ensured excellence and professionalism in clinical and academic practices while engaging in life-long learning conducive to expanding knowledge, skills, and attitudes personally and professionally. In this author’s experience, taking the first step, per their individual goals and aspirations, can initiate a cascade of events that eventually will lead to empowerment and successful decisions.
Believing in Self
Another crucial element of success in higher education degrees is to believe in and honor the self. Self-confidence is vital to ensure not only the completion of projects but also positive outcomes. In this author’s experience, this means being confident in individual abilities and embracing all skills and differences. Early in her educational journey, while living in a country away from home, the author learned that having a solid and positive relationship with herself was vital to her growth and expansion. Self-reflection while exploring innovative ways to cultivate self-love and self-motivation was crucial to her drive to complete all advanced nursing education. This author has always seen herself as a person with big dreams. Still, it was not until she started trusting in her competencies and believing she could accomplish anything that she started impacting herself and others around her. All nurses, immigrants or not, worldwide must believe in their abilities and capabilities while ensuring a positive self-image and respect for their differences.
Abiding by Solid Values
Values and beliefs are also vital components of successful educational pathways. Values in the nursing profession are essential foundations to ensure safe, effective, and meaningful practices.[7,8] This author knew she needed to be true to herself while expanding her nursing knowledge and skillsets, mainly since she lives far from most of her family and support systems. Since the author’s values represent the framework influencing her decisions as a nurse and student, she needed to align all core values with her selected terminal degree. For example, her values have always helped her carry out the nursing practice with integrity while doing what is best for everyone involved. Also, one of this author’s passions is translating research evidence into all professional practices with active participation in change advocacy conducive to diversity and equal opportunities for all human beings. Therefore, she sought advanced educational programs that would lead her to give back to the nursing profession through leadership, scientific publications, and professional endeavors while engaging in cutting-edge research, evidence-based practice, and professional literacy. The author is now using all those experiences and her background as an immigrant to contribute at a grander scale to diversity in nursing while advocating for others to join similar efforts.
In conclusion, these personal and professional stories seek to inspire many to believe in themselves and advocate for DEIA. Overcoming the fear of being an immigrant nurse in another country wanting to achieve a terminal degree of education entitles taking the first step, believing in self, and abiding by solid core values. The author sincerely hopes nobody lets their diverse and unique talents die without exploring and sharing them with the world. People can accomplish anything they desire with hard work and determination. The world needs diversity today more than ever, considering the growth of multicultural groups, and each nurse’s unique background can signify a tremendous contribution to inclusion at all levels of the nursing profession.
This research received no external funding.
Conflict of Interest Statement
The author declares no conflict of interest.
- Larsen R, Mangrio E, Persson K. Interpersonal communication in transcultural nursing care in India: A descriptive qualitative study. Journal of Transcultural Nursing. 2020;32(4).
- Oducado RMF, Sotelo M, Ramirez LM, Habaña M, Belo-Delariarte RG. English Language proficiency and its relationship with academic performance and the nurse licensure examination. Nurse Media Journal of Nursing. 2020;10(1).
- Comeaux E, Grummert SE, Mireles DC. A critical review of the literature on cultural competency in student affairs: Toward transformative cultural responsiveness. Journal of Diversity in Higher Education. 2021.
- McFarland MR, Wehbe-Alamah HB. Leininger’s Theory of Culture Care Diversity and Universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing. 2019;30(6).
- Hanauer DI, Sheridan CL, Englander K. Linguistic injustice in the writing of research articles in English as a second language: Data from Taiwanese and Mexican researchers. Written Communication. 2018;36(1).
- Costa RR de O, Medeiros SM de, Coutinho VRD, Mazzo A, Araújo MS de. Satisfaction and self-confidence in the learning of nursing students: Randomized clinical trial. Escola Anna Nery. 2020;24(1).
- Poorchangizi B, Borhani F, Abbaszadeh A, Mirzaee M, Farokhzadian J. The importance of professional values from nursing students’ perspective. BMC Nursing. 2019;18(1).
- Turale S, Meechamnan C, Kunaviktikul W. Challenging times: Ethics, nursing and the COVID‐19 pandemic. International Nursing Review. 2020;67(2).