Iversity conflicts in ethnically diverse populations

Using the below case study titled, Diversity Conflicts in the NICU”, discuss how language, culture, race, etc. affects the delivery of quality care/services to ethnically diverse populations. Please support your response with external research and organizational examples.

Diversity Conflicts in the NICU”

Susan sighed and closed her office door so that she could have a few moments to herself
and figure what her next step should be. The events of the last hour had been very
difficult for Susan, nurse manager for the neonatal intensive care unit (NICU) at Pleasant
Valley Memorial Hospital. Susan had to discuss with Pamela, one of her most dedicated
nurses who has worked in the NICU for the past four years, that she cannot reassign her
patient load to other nurses because she has a?issuesa? with the mothersa lifestyles of some
of the babies in the NICU. Over the past several years, Susan has found that she has had
more and more of these types of conversations with her nursing staff.
Susan reflected on the change in the cultural makeup of the nursing staff during the past
decade. Over the past 10 years, she has observed the nursing staff change from what were
once predominantly white non-Hispanics to approximately 75% black made up mostly of
Caribbean Island nurses. For the most part, the Caribbean Island nurses were educated in
the British education system. Susan also noticed that most of the Island nurses were
deeply religious. Many brought their Bibles to work and were often seen reading at the
patientsa bedsides or discussing their religious beliefs with one another. Susan wondered
if cultural backgrounds played a part in the increased number of conflicts occurring in the
NICU over the years between her staff and the patientsa families. Should she change her
hiring practices to avoid these increasing conflicts?
Susan recalled a particular incident two years ago involving one nurseas refusal to take
care of a baby because the mother had an abortion with a prior pregnancy. Nurse Karen
had requested that she not be assigned to this baby and had gone so far as to ask her
friends on the 11pm to 7am shift to make sure of it before she would report to work each
morning. When Susan found out about the reassignment of Karenas patient load, she
requested a meeting with Karen. It was during the meeting that Karen explained to Susan
that abortion was against her religious beliefs and she would not take care of a baby
whose mother had a previous abortion. Susan explained to Karen that she was in the field
of nursing and was obliged to take care of any patient assigned to her no matter what
religious beliefs she held. Susan also explained that as a nurse, Karen had no right to
judge the mother because she did not know what the motheras circumstances were at the
time of the abortion or if the abortion was spontaneous or deliberate. Over the course of
the next few weeks, Karen did take excellent care of the baby, although reluctantly.
Karen was one of her nurses who could often be found reading the Bible at the patientsa
bedsides and frequently requested not to be scheduled on Sundays so she could attend
church services. Susan had a difficult time understanding how someone with such strong
religious beliefs could be so judgmental towards another person?
Another incident that Susan recalled occurred several months ago which involved several
nurses and a family member of one of the babies in the NICU. The parents of the baby
were 16 years old, African Americans and not married. The father of the baby dressed in
the a?hip-hopa? style of todayas youth with oversized pants and shirt, tattoos and
dreadlocks. One morning, the babyas father asked if he could have a few minutes of
Susanas time. He had a list of complaints about the nurses taking care of his baby. He
claimed that the nurses treated him as if he was invisible with no parental rights. He went
on to say that some of the nurses always ask him for identification even though for the
past 3 weeks he visited the baby daily and sometimes twice a day. He said that he noticed
that many of the other babiesa parents were never asked for identification. He also said
that whenever he asked a question about his babyas condition he was told that he would
have to ask the doctor, but again he noticed that many of these same nurses gave
information freely to other babiesa parents. Susan assured the father that she would look
into the matter. After quietly observing the interaction between the nurses in question and
the babyas father, Susan had concluded that the fatheras allegations were correct. Should
she enroll her nurses in a Customer Satisfaction Program?
Susan also noted an increasing trend for assigning Hispanic nurses to Hispanic babies.
Susan became aware of this trend when several of her Hispanic nurses complained to her
that the charge nurses automatically assigned Hispanic babies to them, without regard to
their current patient load. When asked by Susan if patients were assigned to nurses
according to their cultural make-up, all four charge nurses admitted to this practice with
the explanation a?Hispanics understand each other better so there is no need to call for a
translator.a? Susan remembered that she was so surprised by the charge nursesa response,
she asked them if they also assigned the black babies to black nurses and white babies to
white nurses! Should she arrange for a cultural competency workshop for her staff?
Susan came to the conclusion that enough was enough and that all these issues needed to
be out in the open and discussed with her nursing staff. Now she wondereda¦how could
she best accomplish her goal?


Goldman, M. (2005). Case Study a Diversity Conflicts in the NICU. In N. Borkowski, Organizational
Behavior in Health Care, Sudbury, MD: Jones and Bartlett Publishers.