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Although more people of color are entering the medical field, Black nurses and educators are underrepresented compared to the percentage of Black people in the U.S.

Mariah Lowery, a senior nursing student at Queens University of Charlotte, was the 2021 scholarship winner for the Great 100 Nurses of North Carolina.

“I was nominated by Dr. [Janie] Best, who just retired from Queens,” said Lowery, who earned a biology degree from the school. “I was very grateful that she chose me, and I just really appreciated it. It was a huge honor.”

Following graduation in May, Lowery, 29, aspires to become a DNP, or Doctor of Nursing practice, in women’s health or family medicine.

Prior to the COVID-19 pandemic, there was a shortage of nurses. However, the global health crisis has shined a light on the shortage, especially among nurses of color in the field. Blacks, who make 13% of the U.S. population, make up 8% of registered nurses and 6% of physicians. Although more people of color are seeking careers in medicine, college nursing schools suffer from a lack of Black professors and students.

“There’s a shortage I would say in black health care educators,” said JoAndrea Costner, assistant professor and chair of the nursing program at Queens. “People want to be taken care of by a provider that looks like them. Every now and then, students want to see an educator who looks like them. It’s not always possible, but it’s not what’s happening as the norm.”

An expensive and highly competitive pathway to nursing could deter some from the field. Also, racial discrimination is rarely discussed and often swept under the rug.

“Oftentimes people don’t know how to talk about racism – the students don’t know, the professors don’t know,” said Joelle Ceremy, who graduated Queens in December with a degree in nursing. “And so, it’s really difficult and it was frustrating for me at times, to have an entire semester or entire class where we’re taught, we’re dancing around the subject, we’re not really saying this is what racism looks like in nursing and here’s how we address these implicit biases.”

Out of more than 150,000 nurses in North Carolina, only 13% are Black. Nationally, Blacks make up 22% of the pool. In Mecklenburg County, there are 12,534 registered nurses and 1,576 licensed practical nurses, according to the North Carolina Board of Nursing, second only to Wake County, which has more than 18,000 practicing nurses.

Education
According to the website nursingschool411.com, 85 North Carolina schools have a nursing program, including 26 that confer bachelor’s degrees. But massive student loan debt and stiff competition are a deterrent to candidates. More than 70% of graduates leave school with at least $37,000 in debt.

At Queens, the average tuition for undergraduate students is $37,348 for the 2021-2022 academic school year, according to the school’s website.

Pre-licensure students in their first year of the nursing program can expect to pay an additional $1,000 to $1,500 on books, uniforms, stethoscopes, immunizations, and other clinical requirements. Once undergrad and graduate students obtain a registered nurse license, they can anticipate paying an extra $300 to $500 on top of tuition and fees.

Most nursing majors apply during their junior year for a spot in a nursing program. Since most take two years to complete, they can only be accepted during the third year. If a student is not accepted then, they are unable to reapply by enrolling in graduate school for a master’s degree in nursing to be considered again.

Between 100-150 students are accepted into nursing programs at East Carolina University and UNC-Chapel Hill School yearly based on factors ranging from a school’s budget and number of faculty to the ability to locate clinical sites for students to complete clinical rotations.

With the competition to be accepted into programs and schools able to accept only a limited number of students, it’s harder for new nurses to enter in the field. Another issue is the difficulty to replace retired nurses.

“The fact that we can't accept the number of nursing students in nursing schools that we need to replace these aging nurses, it's a real problem for us,” said Dr. Pamela Reis, an associate professor, PhD program director and chair of the department of nursing science at East Carolina University College of Nursing. “So, the profession of nursing is very concerned about our aging workforce, and how we’re going to replace people.”

At East Carolina, there are 132 Black nursing students out of 1,329 enrolled in the program, according to Reis.

At UNC, nearly 30% of undergraduate students are identified as a person of color compared to 47% of graduate students, according to the school’s website.

Both nursing programs are taking holistic admissions approaches to focus more on what makes applicants stand out as person versus the traditional grade point average and test scores. This method is used by more colleges across the U.S. to diversify enrollment of students with different backgrounds, skills, and talents needed to succeed in the profession.

“Some of what we also do is try not to, for example, show the ZIP code where someone came from because it gives them away,” said Dr. Rumay Alexander, a professor at UNC-Chapel Hill School of Nursing. “We might blind the name so that you only have to deal with the application because we believe as humans, well if they've got this kind of name, they must be this way and then the biases jump in.”

Discrimination
Historically, nursing has been a predominantly white female field in North Carolina. Men account for about 9% overall with Black men accounting for 10% of that group.
That reality plays out in the classroom as well.

“We do have, maybe five total African American students in the class out of I believe, about 36 students,” said Shatoya Walker, a senior in Queens’ accelerated nursing program. “I do feel like it is predominantly white in the program.”

The students also added that implicit biases among white doctors and as a minority working in the field was not taught in the curriculum. In 2021, 92% of Black nurses reported they had experienced racism in the workplace with 70% from leaders, 68% from patients, and 66% from peers according to a survey by the National Commission to Address Racism in Nursing.

More than three quarters of Black nurses said racism negatively impacts their professional well-being.

“Unfortunately, I have not received any knowledge about that in school,” Lowery said.

Nationally, low teacher pay nationally could also explain why there is a lack of Black nursing professors. Nurses, who earn around $60,000 annually, often command a larger salary than teachers.

“Black students like to see Black faculty to know that they’ll be supported in their program,” Reis said. “However, schools of nursing have been very challenged to recruit diverse faculty into faculty positions for a number of reasons.”

Queens University Presbyterian School of Nursing aims to hire more Black professors to increase diversity.

“It’s good to see that we have several adjuncts (professors) that are Black Americans, mostly female,” Costner said. “We don’t have any male adjuncts who are Black, but we are working on it.”

Upon graduation from Queens for a second time, Lowery is considering graduate school to pursue a master’s degree in education to keep her nursing skills fresh. Her goal is to reduce health disparities that impact Black women and how they view health care.

“It’s unfortunate that a lot of African American women die during childbirth,” she said. “In general, I just want to make a difference in how our people see health care because a lot of people don’t trust health care. If there’s more people like us that are able to help, then they might be more likely to take more control over their health.”

Aaliyah Bowden, who covers health for The Post, is a Report For America corps member.

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