January 6, 2023 – Black, Latin American, and other underrepresented groups continue to receive inadequate representation among students and faculty at US neonatal nurse practitioner (NNP) training programs, reports a survey in Advances in Neonatal Care, the official journal of the National Association of Neonatal Nurses. The journal is published in the Lippincott portfolio by Wolters Kluwer.
"There is a significant difference between the racial and ethnic backgrounds of neonatal ICU RNs and NNPs and the neonates they serve," concludes the study by Desi M. Newberry, DNP, NNP-BC, of Duke University School of Nursing, Durham, N.C., and Tracey Bell, DNP, NNP-BC, of Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta. They believe that strategies to increase recruitment and retention of students and faculty from underrepresented groups are essential to addressing disparities in NICU care.
Underrepresented groups make up less than 20% of NNP faculty and students
The researchers designed a survey to determine the racial/ethnic composition of NNP faculty and students in accredited NNP programs in the United States. The findings were compared to available data on the racial/ethnic composition of newborns admitted to US NICUs.
Responses were received from 23 of 41 NNP education programs. Data on 198 NNP faculty suggested that populations included were 83% White, 7.4% Black, 5.6% Asian, 2.8% Latin American, and 0.9% "other" race/ethnicity. Of 403 NNP students over a two-year period, populations were 79.4% White, 6.5% Black, 5.7% Latin American, 4.5% Asian, 2.0% multi-race/ethnicity, 0.2% Native American (one student), and 1.7% other. There was no significant difference in racial/ethnic composition between NNP faculty and students.
However, there were discrepancies in the rates of underrepresented groups among NNP students compared to national data on newborns admitted to US NICUs. Eighteen percent of newborns admitted to NICUs were Black, compared to 6.5% of NNP students; while 19.5% of NICU admissions were Latin American, compared to 5.7% of students. All racial/ethnic groups showed significant differences between NNP students and NICU admissions.
Increased representation needed to address disparities in NICU care and outcomes
The findings are consistent with data on "glaring health disparities" in the NICU. Drs. Newberry and Bell write, "Underrepresented infants are born prematurely at higher rates and have increased rates of mortality and morbidity." Despite recommendations to increase diversity among nurses and other healthcare providers, an "ethnic discordance" remains between NICU providers and patients. The findings mirror those of a recent national survey of nurse practitioners.
"The discordance between NNP students and neonates in the NICU is important to addressing disparities in the NICU and begins in nursing school," according to the authors. They discuss the challenges facing underrepresented nursing students as well as faculty and outline strategies to promote inclusive recruitment and retention at all levels of nursing education.
Recognizing and addressing the barriers faced by underrepresented nursing students and faculty will "increase the diversity of NNP students and faculty and ultimately practicing NNPs," Drs. Newberry and Bell conclude. "The ability to diversify the NNP workforce will result in improved neonatal outcomes."
