NURS 625 Week 3 Managing Human Capital Paper Example

Many Members, One Body: Managing a Diverse Nursing Workforce on a Medical-Surgical Service Through a Christian Worldview

Introduction

The 6 West medical-surgical unit at Harbor Point Medical Center has 58 RNs on its roster, alongside 14 care technicians and three secretaries. The youngest nurse graduated last May; the oldest has worked on the unit since 1988. Nineteen of the nurses completed their first nursing education outside the United States, in eleven countries from the Philippines and Nigeria to Jamaica, India and Ukraine. The staff speak at least nine languages, observe several faiths and keep different holy days, and range from new graduates working their first nights to grandparents who want only day shifts. Over the past two years, the unit's turnover has run above the hospital's average, and exit interviews have mentioned feeling unwelcome, being passed over for charge roles and conflicts over holiday scheduling.

Units like 6 West are now typical rather than unusual. Diversity in a nursing workforce is not a goal that an administrator decides to pursue; it is a fact the administrator must manage well or poorly. This paper examines the elements of managing a diverse nursing workforce. It reviews recent evidence on how diversity relates to team and patient outcomes, what exclusion costs, and what organizational inclusion achieves; it sets out a Christian worldview for the work; and it proposes concrete management practices for 6 West in recruitment, onboarding, communication, scheduling, conflict, development and measurement.

Dimensions of Diversity in a Nursing Workforce

Roussel et al. (2020) describe human resource management as the set of processes through which an organization attracts, develops and retains the people it needs, and they note that a workforce's composition shapes every one of those processes. In nursing, diversity has many dimensions. The most visible are race, ethnicity and gender. Others matter just as much to how a team works: age and generation, years of experience, country of education, first language, religion, educational level, and employment pattern, meaning whether a nurse works full-time, part-time or per diem. A nurse educated in Manila and a nurse educated in Ohio may share a license and a unit but bring different expectations about hierarchy, physician communication and family involvement in care. A nurse who observes a Saturday Sabbath and a nurse who needs every Sunday morning for church will both bring their faith to the holiday schedule.

For the administrator, the useful question is not which dimension is most important but which differences, on this unit, affect how people work together and whether they stay. On 6 West, the exit interviews point to three: international education, generation and religion, along with the race and ethnicity that run through all three.

Diversity, Team Functioning and Patient Safety

Recent research suggests that diversity within nursing teams is linked to patient outcomes in ways that staffing ratios alone do not capture. Vleminckx et al. (2026) studied 48 adult medical and surgical units in six hospitals across Belgium, Germany, Luxembourg and the Netherlands between 2022 and 2023, examining team composition beyond the usual counts of nurses and skill mix. Teams were highly varied in age. Age dispersion within a team showed the strongest association with patient safety: one standard deviation more variation in age was associated with half a standard deviation lower fall rates. Higher educational levels within teams were associated with fewer falls and less overtime. Uneven mixes of full-time and part-time employment, however, were associated with higher fall rates, and team stability lowered absenteeism while raising overtime. Because the units were measured at one point in time, the findings cannot prove that reshaping a team would prevent falls, but it suggests that a team mixing older and younger nurses may be safer than one drawn from a single generation, perhaps because experience and new knowledge check each other.

Whether diversity helps a team also depends on how the team handles it. Peppler et al. (2026) observed six highly diverse nursing teams in German hospitals and nursing homes, spending 203 hours on site and conducting 25 interviews and 8 focus groups. They identified three patterns. Routine-based teams treated diversity as normal and valued individual competencies within a stable framework. Transition-based teams were actively adjusting to changing membership with supportive structures but felt some friction as new practices met old routines. Friction-based teams took a defensive stance, guarding boundaries, disputing one another's competence and fragmenting under strain. The authors found that nursing management shaped which pattern a team followed and recommended that managers provide stable resources for knowledge exchange and address barriers to recognizing international qualifications. Diversity does not make a team safer or weaker by itself; management decides which kind of team the diversity produces.

The Cost of Exclusion

The other side of the evidence concerns what happens when a diverse workforce is not included. Mastro et al. (2026) surveyed 525 nurses in a large academic health system in the Mid-Atlantic using validated measures of racial climate, racial microaggressions, moral distress and intent to leave. Black nurses rated the racial climate as markedly worse than White nurses did, and 78.0% of Black nurses reported experiencing racial microaggressions, compared with 17.6% of White nurses. Experiencing microaggressions was associated with higher moral distress and with greater intent to leave, and racial climate moderated intent to leave across races. In practical terms, a unit where some nurses regularly experience subtle racism will likely lose them, and the loss will fall unevenly across the staff.

Walsh (2026) reviewed 11 US studies on nurses' workplace experiences with racial microaggressions and organized the findings into five themes: experiencing microaggressions, their impact on nurses, how nurses respond, their impact on patient care, and recommendations for practice. Nurses of color described comments and jokes about their race, assumptions about their competence and exclusion from opportunities. The review linked repeated exposure to effects on health, job performance and patient care. For an administrator, the lesson is that exclusion is rarely dramatic. It accumulates in remarks, in who is asked to precept or to take charge, and in whose concerns are taken seriously, which is why the 6 West exit interviews mentioned being passed over rather than any single incident.

Inclusion as an Organizational Practice

If exclusion has a cost, inclusion efforts at the organizational level may have a return. Yu et al. (2026) analyzed 2023 survey data from 742 nurse practitioners in 412 US hospitals and compared those working in hospitals that participate in the Healthcare Equality Index, a national benchmark of inclusion policies, with those working elsewhere. Nurse practitioners in participating hospitals were 15% more likely to strongly recommend their hospital to family and friends. Mediation analysis showed that the association was explained through more favorable views of the organizational climate, professional visibility and relations with administration. The sample was nurse practitioners rather than staff nurses, and participation in an index is a broad marker, but the study suggests that visible organizational commitment to inclusion improves how clinicians experience their workplace and how they speak about it to others, which matters for recruitment as much as retention.

Taken together, these studies suggest three principles for managing a diverse nursing workforce. Diversity can strengthen safety when teams are deliberately mixed and well supported. Exclusion carries measurable costs in distress and turnover. And inclusion works best as an organizational practice that people can see, not a private attitude of individual managers.

A Christian Worldview of a Diverse Workforce

The Christian worldview offers a foundation for this work that goes deeper than business advantage. Scripture begins by teaching that God created humankind in His own image, male and female (English Standard Version Bible, 2001/2016, Genesis 1:27). Every nurse on 6 West, whatever her country, language, faith or age, bears that image and carries a dignity that does not depend on her usefulness to the organization. A Christian administrator therefore cannot treat inclusion as a program that will be dropped when the budget tightens, since the worth of the people it protects does not change with the budget.

Paul pictured believers as a single body made of many parts, in which the eye cannot say to the hand that it has no need of it, and in which the members that seem weaker are indispensable (English Standard Version Bible, 2001/2016, 1 Corinthians 12:12-22). Although the passage addresses the church, it offers a model for any team that depends on different gifts working together. The nurse with forty years of experience and the new graduate who knows the latest protocol need each other, much as the European data on age-mixed teams suggests. Paul's warning against treating some members as less necessary speaks directly to a unit where some nurses are passed over for charge and precepting roles. Finally, John's vision of a great multitude from every nation, tribe, people and language standing together before the throne (English Standard Version Bible, 2001/2016, Revelation 7:9) shows that diversity is not something God tolerates but something He gathers and celebrates. A Christian nurse administrator can see in a multilingual, multinational staff a small picture of that gathering and manage it with corresponding care.

This worldview also shapes how an administrator handles religious diversity, which secular diversity programs sometimes overlook. A Christian leader who values her own freedom to worship should protect the same freedom for a Muslim nurse who needs time for prayer, a Seventh-day Adventist who keeps the Sabbath, or a colleague of no faith who should not be pressured to hold one. Respecting conscience is consistent with Christian conviction, not a compromise of it.

Elements of Managing a Diverse Workforce on 6 West

Table 1 sets out seven elements of managing a diverse workforce, the evidence or principle behind each, and the action proposed for 6 West.

Several of these actions deserve brief explanation. The onboarding element responds directly to the problem Peppler et al. (2026) described, in which experienced international nurses are treated as beginners because their prior education is not understood. A skills inventory on hire lets a nurse who managed a cardiac step-down unit in Lagos take a precepting role sooner, which both uses her expertise and signals respect. The scheduling element addresses the exit interviews about holidays. A posted rotation that treats Christmas, Eid, Diwali, Lunar New Year and the Jewish High Holy Days as legitimate requests, and that is applied the same way to everyone, removes a recurring source of resentment. The promotion element addresses the complaint about being passed over. When charge and precepting roles are offered by posted criteria and rotation, rather than by the manager's informal sense of who is ready, the opportunities become visible and fair.

Pay Equity as a Diversity Practice

Compensation is the human resource element most often left out of diversity discussions, because pay scales in many hospitals are set by grade and step and appear neutral. Recent evidence suggests that neutrality on paper does not guarantee equal pay in practice. Gupta et al. (2026) used microdata from the 2021 Canadian census to compare the earnings of nurses aged 20 to 64 by gender identity and ethnic origin, adjusting for personal and professional characteristics. Black nurses and Filipino nurses were both over-represented in the workforce compared with the general population, yet Black nurses faced a relatively wider earnings gap compared with White nurses, while the gap for Filipino nurses was narrower. Women also earned less on average than men in the same profession. The data are Canadian and observational, and earnings gaps can arise from differences in shifts, hours, specialty and promotion rather than from unequal base rates. That is exactly why they matter to an administrator: a gap that grows from who is offered charge differentials, overtime, specialty certification pay or promotion is a gap the organization creates through decisions it controls.

For 6 West, I propose an annual pay review that compares total earnings, including differentials and incentive pay, across race, gender, generation and country of education among nurses with similar experience. Where gaps appear, the review should trace them to their source, such as who receives charge pay or which nurses' prior international experience was credited at hire. Crediting foreign experience at the correct step is a particularly concrete fix, since an experienced nurse placed at a new-graduate rate will notice the difference on every paycheck. Scripture warns against withholding the wages of the hired worker (English Standard Version Bible, 2001/2016, Leviticus 19:13), and fair pay is one of the plainest ways an organization tells its workers that it values them equally.

Measuring Progress

An administrator who manages a diverse workforce well should be able to show it. For 6 West, I propose five measures reviewed each quarter: turnover and intent to leave broken down by race, generation and country of education; the share of charge and preceptor assignments held by each group compared with its share of the staff; the number of microaggression reports and the time to follow-up; a short belonging scale added to the annual engagement survey; and falls with injury, to watch whether more deliberately mixed shifts are associated with safer care. Breaking the turnover data down by group matters most, since an overall turnover rate can look acceptable while one group is leaving at twice the rate of others.

Conclusion

Managing a diverse nursing workforce is part of managing human capital, and it calls for the same discipline as managing budgets or supplies. Recent research suggests that mixed teams can be safer, that exclusion through a poor racial climate and microaggressions raises distress and turnover, and that visible organizational inclusion improves how clinicians experience their workplace. Through the Christian worldview, the reason for this work becomes clearer still: every nurse on 6 West bears God's image, and the unit, like the body Paul described, needs every member. The seven elements proposed here give a nurse administrator practical ways to act on that conviction in recruitment, onboarding, scheduling, conflict and promotion, and to measure whether the staff of 6 West, in all their variety, decide to stay.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Gupta, N., Miah, P., & Waite, S. (2026). Workforce diversity and earnings differentials in Canadian nursing. Health Policy, 172, Article 105716. https://doi.org/10.1016/j.healthpol.2026.105716

Mastro, K. A., Khan, B. H., Burchill, C. N., Giordano, N., Monturo, C., Thomas-Hawkins, C., & Polomano, R. C. (2026). The moderating effects of racial climate and racial microaggressions on moral distress & intent to leave in nursing: A cross-sectional study. International Journal of Nursing Studies Advances, 10, Article 100545. https://doi.org/10.1016/j.ijnsa.2026.100545

Peppler, L., Feißt, M., Apelt, M., & Schenk, L. (2026). Reconstructing a typology of approaches to navigating diversity: A comparative qualitative study of German nursing teams. BMC Nursing, 25(1). https://doi.org/10.1186/s12912-026-04854-y

Roussel, L. A., Thomas, P. L., & Harris, J. L. (2020). Management and leadership for nurse administrators (8th ed.). Jones & Bartlett Learning.

Vleminckx, S., De Meulenaere, K., Van Bogaert, P., Abrams, S., Willem, L., & Haegdorens, F. (2026). Beyond staffing ratios: Team demographic diversity, workforce stability, and their effects on patient safety and workforce sustainability: A multi-country analysis. International Journal of Nursing Studies, 181, Article 105570. https://doi.org/10.1016/j.ijnurstu.2026.105570

Walsh, H. (2026). Racial microaggressions in nursing: A scoping review. American Journal of Nursing, 126(8), 28-35. https://doi.org/10.1097/AJN.0000000000000350

Yu, H., Connell, K. A., Golinelli, D., McHugh, M. D., Hanneman, T., Bauermeister, J. A., & Brom, H. (2026). The impact of organizational inclusion for a diverse workforce on organizational climate assessments and hospital recommendations among nurse practitioners. Health Care Management Review, 51(4), 357-365. https://doi.org/10.1097/HMR.0000000000000505