Inclusivity is the embodiment of practices and strategies that cultivate belongingness amongst individuals, groups and communities who represent different backgrounds, ethnicities, traits, perceptions and experiences by encouraging meaningful interactions between them (Bleich et al., 2015). The aim of this article is to critically appraise the strategies for inclusivity in nursing practice.
Nursing practice is connected by profession, regardless of their diversity in age nationality, age, race, ethnicity, disability or ability and socioeconomic status (Zlotnick & Shpigelman, 2018). This inclusivity is essential to provide culturally appropriate care to the patients across all the dimensions of cultural diversity.
“Pedagogical strategies such as learning student names, organizing diverse study groups, modifying teaching aids, and employing a mentoring style of advising can be an effective strategy to teach inclusivity as a concept to nursing students” (Metzger et al., 2019). This requires the school staff including the dean, department chairs and administrators to provide opportunities for the cultivation of leadership skills and role models by the faculty.
The faculty should be able to set an example as well as help the students learn how to be culturally proficient and competent including interventions in cases of discrimination. Advocating the students to show acceptance of peers, patients and other healthcare professionals irrespective of their background. Setting up committees for diversity and inclusion at nursing schools with workshops regarding cultural competence and training on topics such as a breach in inclusivity.
While this strategy focusses on teaching inclusivity to nursing students at the grass-root level it fails to focus on the issue of cultural diversity and inclusivity not being taken seriously at professional healthcare settings. The current nursing professionals might not be open or tolerant towards the other professionals or patients of other backgrounds which can have a negative impact on the overall healthcare services.
A framework for cultural proficient practice was given by Nuri-Robins and Bundy (2016) which includes guiding principles, ways to implement a cultural proficiency continuum, recognition of barriers to cultural proficiency and essential elements required to practice inclusivity beyond the barriers. Nuri-Robins and Bundy stated when the organization is culturally competent it grows, heals, teaches, helps and serves better.
The systemic framework offers cultural proficiency through the creation of a diverse, inclusive and healthy culture while also addressing the barriers to cultural competence. The barriers may include systems of privilege, implicit bias, misuse or abuse of power, resistance to change as well unawareness of the requirement of a change.
The essential elements of the strategy focus on assessing the culture, valuing diversity and adapting to diversity. While practical examples may be given to indulge in the essential elements of cultural proficiency, there has been no mention of the practical ways to overcome the barriers to cultural competence. While the framework gives a basic idea to understand the various aspects of cultural proficiency, no concrete methods for a favourable outcome have been mentioned.
The third strategy involves an increase in the enrolment of students belonging to different cultural backgrounds, ethnicities and even geographies along with the cultural diversity of the faculty appointed for the nursing courses (Breslin et al., 2018). This helps understand as well as inculcate values of cultural inclusivity with a practical approach wherein students learn these values spontaneously while they mingle with their peers and faculty.
It was reported according to the study conducted by Breslin et. Al (2018) that majority of the higher education institutes have lower retention rates for the faculty who belonged to culturally different backgrounds. It was also noted that the nursing student body was predominantly constituted by white, single female students.
This approach offers a practical and achievable solution, however, it depends on various institutions how far they are ready to go to adopt this strategy. There exist a few institutions who have set aside quota for students as well as faculty belonging to culturally diverse groups and train their students for an all-inclusive and holistic healthcare provision. While there also are institutions who do not act on this approach.
Nursing is a profession devoted to taking care of a diversified patient population. Strategies and frameworks for inclusivity in nursing are crucial for the provision of better healthcare services and this inclusivity extends to other healthcare professionals and patients. Adopting an inclusive and cultural proficient approach right from the start of the nursing practice is significant. It helps develop a healthcare system that works in synergy with the other healthcare professionals and works towards providing equal healthcare services irrespective of the cultural background of the individuals and groups. Thus, the inclusion of diversity results in equity.
Bleich, M. R., MacWilliams, B. R. & Schmidt, B. J. (2015). Advancing diversity through inclusive excellence in nursing education. Journal of Professional Nursing, 31, 89–94.
Breslin, E. T., Nuri-Robins, K., Ash, J. & Kirschling, J. M. (2018). The changing face of academic nursing: Nurturing diversity, inclusivity, and equity. Journal of Professional Nursing, 34(2), 103–109.
Metzger, M., Dowling, T., Guinn, J. & Wilson, D. T. (2019). Inclusivity in Baccalaureate Nursing Education: A Scoping Study. Journal of Professional Nursing, 1-8.
Nuri-Robins, K. & Bundy, L. (2016). Fish out of Water: Mentoring, Monitoring and Self-Managing People Who Don’t Fit In. Corwin.
Zlotnick, C. & Shpigelman, C.-N. (2018). A 5-step framework to promote nursing community inclusivity: The example of nurses with disabilities. Journal of Clinical Nursing.
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