Case Study: Nursing Organizational Approaches to Population and Workforce Diversity

  • Lucille A. Joel
  • Dula Pacquiao
  • Victoria Navarro


A group of Filipino internationally educated nurses (IENs), who entered the USA as legal immigrants to join their families, applied to take the registered nurse licensure examination. After evaluation of their school transcripts, the state Board of Nursing rejected their application because the clinical laboratory component of their nursing courses was not taken concurrently with the theory portion of the course. They were deemed ineligible and mandated by the Board of Nursing to retake these nursing courses in an accredited program of nursing. It should be noted that the additional requirement of concurrency of theory and clinical courses was a problem in this state, which is in keeping with states’ rights.


  1. AACN (2014) Fact sheet. The need for diversity in healthcare workforce.
  2. Aiken LH (2007) U.S. nurse labor market dynamics are key to global nurse sufficiency. Health Serv Res 42(3 Pt 2):1299–1320. CrossRefPubMedPubMedCentralGoogle Scholar
  3. Aiken LH, Sloane DM, Bruyneel L et al (2014) Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet 383:1824–1830. PMCID: PMC4035380 CrossRefPubMedPubMedCentralGoogle Scholar
  4. Allutis C, Bishaw T, Frank MW (2014) The workforce for health in a globalized context – global shortages and international migration. Glob Health Action 7:23611. CrossRefGoogle Scholar
  5. CGFNS (2016) Milestones.
  6. Department of Veterans Affairs (2000) Pain as the 5th vital sign toolkit. Geriatrics and Extended Care Strategic Healthcare Group National Pain Management Coordinating Committee Veterans Health Administration, Washington, DCGoogle Scholar
  7. Donley R, Flaherty J (2008) Revisiting the American Nurses Association’s first position on education for nurses.
  8. HRSA (2006) The rationale for diversity in the health professions: a review of evidence. http://bhpr-hrsa-healthworkforce-reports-diversityreviewevidenceGoogle Scholar
  9. Institute of Medicine (2010) The future of nursing: leading change, advancing health. National Academies Press, Washington, DCGoogle Scholar
  10. Jurado L (2013) Social construction of Filipino nurses in the Philippines and as foreign-educated nurses in the United States. PhD Dissertation, Rutgers, The State University of New JerseyGoogle Scholar
  11. Kingma M (2006) Nurses on the move: migration and the global health care economy. Cornell University Press, IthacaGoogle Scholar
  12. Kingma M (2008) Nurses on the move: historical perspective and current issues. Online J Nurs 13(2).
  13. Kutney-Lee AM, Sloane DM, Aiken LH (2013) An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgery mortality. Health Aff 32:579–586. PMCID: PMC3711087 CrossRefGoogle Scholar
  14. National Center for Cultural Competence (NCCC) (2017) Self-assessment: an essential element of cultural competence. Accessed 13 May 2017
  15. Office of Minority Health (OMH), US DHHS (2017) The national standards for culturally and linguistically appropriate services in health and health care. Accessed 10 May 2017
  16. PNAA (2016) Mission.
  17. Stimpfel AW, Sloane DM, McHugh MD et al (2016) Hospitals known for nursing excellence associated with better hospital experiences for patients. Health Serv Res 51(3):1120–1134CrossRefPubMedGoogle Scholar
  18. The Joint Commission (2010) Advancing effective communication, cultural competence, and patient- and family-centered care: a roadmap for hospitals. The Joint Commission, Oakbrook Terrace, ILGoogle Scholar
  19. Walker J (2010) Migration, brain drain, and going forward. Johns Hopkins Nursing.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Lucille A. Joel
    • 1
  • Dula Pacquiao
    • 1
    • 2
  • Victoria Navarro
    • 3
  1. 1.School of NursingRutgers UniversityNewarkUSA
  2. 2.School of NursingUniversity of Hawaii, HiloHiloUSA
  3. 3.Joint Commission InternationalOakbrookUSA

Personalised recommendations