- Just ahead on "Black Issues Forum," an alarming drop in nursing professionals prompts the UNC system to award $29 million in grant money to system universities in hopes that it will increase the number of nursing graduates across the state.

We'll talk about why there's a shortage, what impact these dollars will have, and what's in store for the future of nursing.

Coming up next, stay with us.

- [Announcer] Quality public television is made possible through the financial contributions of viewers like you who invite you to join them in supporting PBS NC.

[upbeat electronic music] ♪ [upbeat electronic music] ♪ - Welcome to "Black Issues Forum."

I'm Kenia Thompson.

Black nurses make up approximately 10 to 12% of the nursing workforce in North Carolina.

It's a number that, while growing, still falls short of representing the broader Black population in the state.

However, despite this, Black nurses have been at the forefront of healthcare, providing compassionate care and serving as advocates for their communities for a long time.

We'll talk about what the current professional landscape looks like later in the show and how to navigate a nursing career.

But, first, let's talk about the recent investments by the North Carolina General Assembly, to the tune of $29 million to system universities and what that means for nursing programs and students across the state.

To kick us off, I'd like to welcome our first guest, Dr. Angelo Moore, associate professor in the School of Nursing at North Carolina Agricultural and Technical State University.

Welcome to the show.

- Good morning, glad to be here.

- Thank you so much.

I mean, I've been really waiting to have this conversation 'cause nursing has been in my life since I was a little girl.

My mom's a C, well, she was a CNA, she's now retired, happily retired at that.

Works long hours.

You know, she worked nights so that someone would always be at home with us.

So she was at home during the day, Dad was at home at night.

And I just always saw the fatigue, the stress.

And it was overwhelming a lot.

And I'm sure that that's just one iota of representation of the nursing population.

When we talk about the UNC system, you know, giving these funds, obviously, it's an indicator that there has been a lot of shortages.

I have some statistics I wanted to share.

North Carolina's community colleges and university systems are some of the largest producers of nursing in North Carolina.

And the UNC system has granted a total of 27,191 nurses with a bachelor's degree and 5,709 with a master's degree.

And the system's goal is to increase that output of nursing by 50% over the next 10 years.

I'd love to just hear your initial thoughts on that and how you think that can impact the industry.

- Yes, first, I wanna thank the UNC systems for actually investing in the profession.

Really good.

However, a lot of people don't realize, for the nursing profession, you have to have instructors, you have to have faculty members to teach students.

And unlike other professions, the Board of Nursing for North Carolina has a ratio.

So no more than 10 students per faculty member.

So it's not like you could have a large classroom of students.

You gotta have the faculty members to teach them as well as take them to clinicals so they can get the experience.

So while we may say, "Let's just increase enrollment," enrollment is capped because you don't have the faculty to support the enrollment of students.

So it goes hand in hand.

- Talk about why that ratio exists.

I mean, I think I know why, but let's explain it for the audience.

- Yes, the ratio exists for safety.

You know, you think about, you know, you having children, you think about a daycare center.

You only have but certain number of people that you can really supervise.

You providing healthcare.

And so the state says, you know, no more than 10.

And on average eight to 10 students you take to a clinical setting because you're responsible for the care that they're receiving.

Remember, you're training them.

And so you cannot have 20 students.

There's no way you can see what 20 students are doing or to effectively teach them and supervise them.

- So to clarify, these dollars are simply going for enrollment and not for administration?

- No, it's going for several things.

- Okay.

- You know, one of the main things is to help hire more faculty members.

- [Kenia] Okay, okay.

- You know, if you hire more faculty members, you could increase enrollment.

- [Kenia] Yes.

- So that's part of it.

Like for instance, at North Carolina A&T, we have a mobile unit.

So we are looking at increasing access 'cause we have a new doctoral program.

So in that doctoral program, we gonna train advanced practice nurses.

You know, we know mental health is an issue, and so we train individuals to be able to provide mental health services to individuals.

We have also, one of our tracks is leadership.

You know, you have to have leaders within the profession.

Also, some of the money's gonna be used for support students.

Like chemistry, a lot of the science classes, sometimes there are barriers for students to move forward in that nursing program.

So there's a lot of requirements.

And so some schools are using it for other things for enrollment as far as clinical.

You know, you have faculty that are at the university, but you also have adjunct faculty that will work for institutions, healthcare institutions, that's able to take on students.

So, that is how you build the infrastructure is by hiring more faculty members to be able to teach the students.

- Yeah.

Let's take a step back a little bit and let's talk about why there's a shortage in the first place.

I mean, I know since the pandemic, we've seen a significant decrease of nurses who are just like, I'm overtaxed, I'm burnt out, there was compensation issues.

But I say that with a caveat that maybe students coming into the profession don't quite know that though, or see that.

So, why is there a shortage in the student area and in the nursing profession?

- Well, there's not a shortage in the student area.

A lot of nursing schools have wait lists.

- [Interviewer] Ah, Okay.

- They have wait lists because we don't have enough faculty to increase enrollment.

But in the profession of nursing, we have to talk about compensation.

Nurses, we make everything go.

There's no facet of healthcare you don't see nurses.

However, nurses are not compensated.

We have to compensate nurses because of all that they do.

When you think about the nursing profession, it's a female dominated profession.

And a lot of female dominated professions, they're not valued, you know?

And so, when you look at the profession and you look at the profession itself, it's really a female dominated profession by white women.

So that was the pipeline.

And so they control who became nurses.

Now, a lot of those faculty members are older, they're retiring, you know and with the pandemic, it gave us an open eye of all the things that go on that nurses do.

And a lot of nurses become burnt out.

Because of working, because there's not enough nurses there.

So you have to have multiple nurses doing long shifts and just a thing that continues on and on and on so that people get burned out.

So, how are we gonna relieve these nurses?

We need to have more younger nurses to come into profession.

We also need to educate them because we have to get 'em in the profession, we have to educate them so they become faculty members so they can actually help with enrollment.

So that's how you grow the profession.

- Yeah, you touched a little bit on the predominant genre of white nurses, right?

And so, when we talk about black nurses and that lack of representation in this space, why is it that we've seen a lack of black nurses as much as we've seen white nurses?

- Yes.

So, the history of this country, segregation, discrimination, they would not allow nurses, black nurses into nursing schools.

So we had to form our own schools.

One of the big things that happened, the American Nurses Association would not allow nurses, black nurses to be a part of their association.

So in 1971, we formed the National Black Nurses Association.

And so now we're able to be professionals.

So, all those, important for us to be able to help diversify the profession.

- And, I'm just curious, is there a distinction, I guess why we were seeing maybe more CNAs and LPNs versus registered nurses, black nurses?

- Yes.

- Is this that?

- Yes.

- So when you think about nursing profession, there's many entryways.

You have the certified nurse assistant.

People say CNAs.

You have licensed practical nurses or licensed vocational nurses.

Normally they programs are 12 months to 18 months.

And then you have associate degree nurses.

You normally see those at the community college.

And then you have baccalaureate prepared nurses at the universities, the four-year degrees.

And so with all those different entry ways, that's how people come into the profession.

But also, there's different scopes of practice.

So, depends upon what type of degree you have is what you're able to do based on your training, your education.

- Right.

I'm curious, what ways do you see this, this grant money helping with diversity in this space?

- Well, I hope it helps with diversity.

I want to thank the UNC system for at least providing funds to four HBCUs nursing programs in the state.

And that's North Carolina A&T, Winston-Salem State, Fayetteville State, and North Carolina Central University, which we know they produce the most number of African-American nurses in the state.

So, I'm glad that they was able to do that.

But we have to make sure that we are putting in process to sustain that.

A lot of times we put band-aids on things.

But what happens when the money runs out?

We have to make sure we have sustained resources to make sure that we are including these nurses that other universities, PWIs, don't necessarily have the criteria that they think they can be enrolled into their programs.

- That was my next question, and last question for you is, how do you see this sustaining the industry and the future, and what impacts do you hope it will have?

- Yeah, we have to sustain it by committing resources to it every year.

To grow the nursing profession, we have to make sure we have resources for faculty.

We wanna make sure that we actually compensate nurses 'cause we want nurses to come into the profession and we want them to stay in the profession.

You know, we don't want them to get burned out because it's not enough, you know?

And so we have to make sure we sustain it, by educating nurses, through the system, higher levels of education, so they'll be prepared to actually give back and train the next generation.

And so that's how we sustain it over time.

- That's great.

Well, if a student's watching or potential nursing student is watching, wants more information about what you're doing at A&T, how can they get in touch with you?

- Yes, they can get in touch with me by going to North Carolina A&T website, the School of Nursing, or they can email me.

My email is admoore16@ncat.edu.

- Wonderful.

I'd love to come visit the department one day.

- Yes, come on down.

- I think it would be fun.

Well, Dr. Angelo Moore, thank you so much.

I appreciate your insight.

- Thank you for inviting me.

- Of course.

Well, historically black nurses have navigated a profession that has not always been welcoming.

From the days of segregated schools and hospitals to the ongoing struggles against systemic racism, these nurses have demonstrated resilience and commitment to their calling.

This week's Melanin Moment takes a look at their journey and just how far they've come.

[mellow music] Throughout history, black nurses have played a crucial, yet overlooked role in healthcare.

In the early 19th century, black women, many enslaved, were often passed with caring for the sick and wounded.

Black women were largely excluded from nursing schools, and those who did find training often attended segregated institutions with fewer resources.

Figures like Mabel Staupers, who led the campaign to integrate the Army Nurse Corps, and Estelle Massey Osborne, the first black woman to earn a master's degree in nursing were trailblazers who challenged the status quo during the civil rights movement.

Today, the legacy of these pioneers lives on.

Black nurses are leaders, educators, and innovators, but challenges remain.

As we honor their legacy, let us also commit to supporting the next generation of black nurses ensuring that their voices are heard, their contributions recognized, and their challenges overcome.

[dramatic music] Well, as North Carolina continues to grow and diversify the importance of a nursing workforce that reflects the population it serves cannot be overstated.

Black nurses bring unique perspectives and skills that are essential in providing culturally competent care.

Businesses and organization that employ, guide, and employ nurses understand that importance as well.

To share insight on the work being done professionally within the field, I wanna welcome our next guest.

We have Gordon Huggins, director of staff development at ComForCare, and Yvonne Dixon, health equity justice advocate and DEI educator, and member of the North Carolina Chapter of the National Black Nurses Association.

Welcome to you both.

- Thank you.

- Thank you.

- I'm so excited once again to have this part of the conversation, 'cause I think this is like the more, the practical, you know, we talked with Dr. Moore, the learning, and the education, and the preparation, and this is the implementation of all of that.

Like we had mentioned before, you know, we saw a decline after the pandemic.

Gordon, I know that your work is to find qualified nurses to give care.

Tell us a little bit about that work that you do.

- So at our company, ComForCare, what we do, we provide for PCAs and CNAs for our community because what we do, we help our seniors or geriatric community, as well as we work with the VA hospital and our vets, and then some independent living facilities as well.

- [Host] Yeah.

- And my job is to bring in talent and to make sure we could be able to take care of those people in our community.

- And we need that for sure.

Yvonne, you work, well, you also are an educator side too, but you also do a lot of advocacy work.

Share with us a little bit about what you do.

- Yes, in that, and good morning to you and thank you.

In the advocacy work, just being able to communicate and connect with students that are in the community, recognizing that these students have an interest in healthcare, but being able to hone in on what exactly is that interest, looking at a pathway forward in healthcare.

And I just reflect on my background because I started off in healthcare 45 years ago as a CNA.

Well, at that time it was a nursing assistant.

And just thinking about my journey, I share with them my journey from a CNA, to an LPN, to an RN.

And through my storytelling with those students, it helps them to see, "Oh, I can identify with that.

Oh, that looks like me."

Because I was one that in the very beginning, I did not want to go into nursing.

I didn't want to.

- Really?

- I didn't because I was taking care of family members at home- - Yeah.

- and that was enough nursing for me.

But as I told my story to students as well as, I would say, even older individuals who were kind of floundering just a little bit, trying to decide, you know, should I continue and become a registered nurse?

- Yeah.

- I talk with them to help them to understand, you know, this is what will be for you.

If you have the heart to be able to do it.

Not only the heart, but the will to be able to do it as well.

- I'm sure it's much appreciated to have someone with your level of experience in the classroom mentoring and guiding in that way.

Gordon, I wanna come back to you.

You, I think have a perspective that might be a bit unique 'cause you see the families in the communities that are impacted by the nursing shortages.

How has that impacted our black community specifically?

- It's just, it's about research.

And the thing about it is we worked so hard to make sure we can maintain our community and maintain the nurses in the community.

But unfortunately, with certain areas, we just don't have them.

And so you gotta figure it starts from home or it starts in the churches.

So how one church, I mean, one nurse can affect a community.

You know, so you have someone you can call and it's like, my baby has a fever what I need to do?

If there's someone in that community, it's like, oh, you need to do this, you know?

And that's the whole thing.

And it's just they're not there.

And it's just trying to get 'em out there.

- Wow.

Yvonne, when we talk about the specific challenges that black nurses face in healthcare, what are some of those that are causing them not to be there in community?

- Well, as was mentioned earlier in regards to COVID, you know, that really took the veil off of a lot of different behaviors that existed within the community.

And nurses at the bedside already were experiencing workplace discrimination coupled with 2020, COVID, and people coming in out of their minds as to not knowing whether I'm gonna live or die.

And nurses at that point became all things to patients.

And because of that, a lot of the nurses decided that I no longer want to be at the bedside because it's not only the colleagues that I work with that are giving me the problems, but it's also the patients that are coming in and demonstrating behaviors of racism to patients, I mean, to our nurses.

And with that, the violence that continues to exist within healthcare, I mean, it's really very real.

And because it is so real, there are many that just do not want to go into nursing for that reason alone.

- Wow.

Wow.

You know, I've had heard levels of it, but I'd never heard it put that way.

You know, I've heard stories of discrimination in nursing, people not wanting to accept care from black providers.

And that was always disheartening to me because at the end of the day that could have been a life or death situation, but you are truly choosing not to receive care simply because of the color of my skin.

What is ComForCare doing in that advocacy space?

Or just being cognizant that we need to diversify the employee pool?

- The more importantly part of my role is that I reach out to the community.

So I go to the hair salons.

You know, you meet people where they're at.

Because there's a lot of talented, wonderful people out there.

- Indeed.

- And so I hit the community.

I go to, like I said, to the community colleges and cosmetology places, even your local store and your churches, to find those people that want to be able to find purpose through taking care of others.

- And do they... Share with us what requirements they have to have in order to come through.

- With our company is really simple.

We just ask you to have at least six months of working experience.

So either at a facility or at another agency such as ourselves.

And what our CNAs?

Have a CNA in good standing.

- Right.

Yvonne, when we talk about addressing those challenges that black nurses may face, like discrimination, how are you working to provide advancement in that space with your activism work?

- I'm so glad you asked that question.

- [Host] Of course.

[Yvonne and host laughing] - You know, I'm a voice for many people that do not have a voice.

And I recognize that my voice is very important, and being able to share the feelings of those individuals in the community that have had that experience, but yet chose not to say anything.

And I go and counsel individuals, talk with them, seek to understand exactly, you know, what is the barrier that keeps you from pursuing nursing as a career.

And then we talk through those things, not only with students that may be interested, but also those nurses that are working within facilities, being able to talk with them.

We call that stay interviewing.

Meaning that you interview them while they're still here.

Maybe they will consider staying, you know?

[chuckles] And that's just truly very important because just to think about when nurse leaves the organization, to recruit other nurses to come in, the amount of money that goes into recruitment of one nurse is astronomical.

- Oh wow.

- So we don't think about that when individuals are with us.

But then when they go, then that's that thought process.

So really honing in on who has the skill and who has the will to stay within an organization?

And I seek out those individuals.

And I share with them, you know, there's the social media that you can go to to be able to get more information about nursing.

There's the NBNA and the local affiliate, which is Piedmont Black Nurses Association in my area, being able to talk with nurses.

And I'm one of those that are part of those associations.

Just to be able to have mentoring and have sponsors to be able to have that voice for that individual.

So there are many different ways, but I always share with individuals to seek, to have more education.

Read different types of books.

That's very helpful.

- Yeah.

- And so there's just many different ways, but learning to discover self.

- Right.

- To be more innovative with self and to seek out those individuals that are for you.

Exactly.

- Let's talk about some of the broader strategies to amplify nurses' voices.

I think you raise a great point.

Social media has been such a vehicle for so many professions, just awareness.

And when we talk to Dr. Moore about the money that's being granted, I think that having this topic on this show, having the presence in the news, it brings awareness.

But what are you two doing to increase that awareness through comfort care and then through your work?

I'll start with you first.

- Obviously, social media.

- Yeah.

- So Facebook, Instagram, even radio advertisement.

Right now, we do advertisement with our local magazine, Raleigh's Best.

- [Kenya] Okay.

- And we actually got nominated.

We won.

- Oh, congratulations.

- We're doing good.

- Good.

- But it's actually because the type of just social media.

- Yeah.

- Like that is where it's at right now.

- [Kenya] Gotta meet them where they're at.

- Yes, ma'am.

- Yeah.

Yvonne?

- I'm a community person, and I love to talk.

[all laughing] Gordon will say, yes, I agree with you.

[all laughing] - [Kenya] And you guys have been chatting this morning.

- Oh, absolutely.

- You can imagine.

I mean, this is [indistinct].

- And we didn't call each other either.

- It was meant to be.

- But being the fact that Gordon is community, and I'm more inside the facility.

- [Kenya] Yeah.

- But at the same time, in the facility that I am in, it's in four different markets.

- [Kenya] Right.

- So when I go to all four different markets, I'm really talking with individuals in the community to be able to understand who are you?

Why are you here?

Why do you stay here?

What do you need?

- Yeah.

- In terms of healthcare.

And so just being able to reach out and talk with people.

- Yeah.

- To seek and understand what they need.

- [Kenya] Right.

- Because everybody needs something.

- Yeah, well, if someone wants or needs to talk to you, how can they reach out to you?

- Absolutely, you know, I'm on LinkedIn.

I mean, I am social media.

I'm on LinkedIn, Facebook, Instagram, under Yvonne Dixon.

And then I am also at YvonneWDixon@novanhealth.org.

Also novonwd@icloud.com.

- Perfect, Gordon?

- I'm simple.

[Kenya laughing] G Huggins, that's G H U G G I N S @comfortcare.com.

And that's C O M F O R C A R D .com.

I'm sorry, C O M F O R C A R E .com.

- Perfect, wonderful.

Thank you, Gordon.

Thank you, Yvonne.

Appreciate you both.

- Thank you.

- Thank you.

- And I thank you for watching.

If you want more content like this, we invite you to engage with us on Instagram, using the hashtag BlackIssuesForum.

You can also find our full episodes on pbsnc.org/blackissuesforum, and on the PBS video app.

I'm Kenya Thompson.

I will see you next time.

[upbeat music] ♪ [upbeat music continues] ♪ [upbeat music continues] ♪ [upbeat music continues] ♪ - [Announcer] Quality public television is made possible through the financial contributions of viewers like you, who invite you to join them in supporting PBS NC.