AANP Member Spotlight: Celebrate Diversity Month With AANP Regional Director Captain James Dickens
Hear from James LaVelle Dickens, DNP, RN, FNP-BC, FAANP, Manager of the Survey Branch for the Centers for Medicare & Medicaid Services, on diversity and inclusion in health care—and how we can all be agents of change.
Q: Why is it so important that we discuss and encourage diversity in health care?
A: Research has shown that when people who look like you are the ones who take care of you, your outcomes are better. Nurse practitioners (NPs) are uniquely positioned when it comes to diversity and inclusion. Oftentimes, we grew up in the communities we now serve. Our patients are our neighbors, teachers, coaches and community leaders. Our friend and colleague, the late Mona Counts, PhD, CRNP, FNAP, FAAN, FAANP, was from Appalachia. While many others may not have been able to fathom life in this community, she understood the culture on a personal level and was able to bring that unique perspective to her work. Coming from the Northeast Louisiana delta, I understand the cultural norms of the people who live there. I understand the significance of living off the land and eating wild game, as well as the challenges this population may have because of that diet. That ability to understand, communicate with and effectively interact with people across cultures is what cultural competency encompasses.
From a business perspective, if we’re to increase or even maintain market share, we have to mix it up to reflect our growing, diverse country. If we don’t meet the needs of these diverse populations, they’ll get their needs met somewhere else.
Q: There are many barriers to receiving adequate health care, including practice restrictions, language or dialects, cultural differences and more. How can we help address these barriers?
A: Using my experience as the first African-American and uniformed Regional Director for the American Association of Nurse Practitioners® (AANP), I can share that Region 6 is very unique, for both the U.S. Department of Health and Human Services (HHS) and for AANP. There are more federally declared disasters than any other region—we’ve had two devastating hurricanes hit two separate cities within this region. We claim two-thirds of the U.S.-Mexico border. We’re extremely culturally diverse, with more than 49 million people, several federally recognized tribes and one of the most diverse zip codes in the country. In simplistic terms, our social determinants of health are where we eat, sleep, live and play. Even your zip code can help us predict chronic conditions or cause of death in many cases. Adequate lighting, green space, food deserts—these all affect our health, and it means that we need to know the socioeconomic conditions that impact our patients.
What can we do to change this? I’ll use the example of e-cigarettes, which I’ve been concerned about for the past five or six years. We’ve found that these are more addictive than cigarettes and more popular with younger generations who are getting addicted earlier and require earlier interventions. We know the effects of nicotine in cigarettes, but we don’t have studies on how the higher amounts of nicotine in these newer devices affects the human body. I saw a large community of Latino females using these e-cigarettes near The University of Texas Rio Grande Valley, so I investigated and was appointed to an advisory board for Minority Serving Institutions. Now, everyone is ringing the alarm about these harmful devices.
Ultimately, we need to bring diversity to the table and understand that a team that thinks and looks exactly like you is prone to groupthink, one of the main dysfunctions of a team. We need to invite people with different perspectives, work approaches and backgrounds to the table to widen our discussion and increase information sharing.
Q: What has it meant for you to have been able to call very accomplished, respected NPs—who are also persons of color and men in the nursing profession—your mentors?
A: The first African-American I saw on stage at an AANP conference was Yvonne Moragne-Coon, PhD, CRNP, FAANP, who was the co-chair of the Conference Committee for many years. To see someone on stage whose books you’ve read is beyond inspirational. I wanted to grow up and be like her. Then, to be able to connect and develop relationships with Randy Rasch, PhD, RN, MSN, FNP, FAANP, and Sheldon Fields, PhD, RN, FNP-BC, AACRN, FNAP, FAANP, FAAN, who have so many firsts—words cannot explain what they mean to me. Any time I’ve brought someone to conference to mentor them, Randy and Sheldon were two of the first I’d seek out. We all touch base before national conference to catch up, like a family reunion.
When I was inducted as the third male, African-American Fellow of the American Association of Nurse Practitioners (FAANP), it really resonated with me to see Randy and Sheldon as the only two men of color in the room. Others welcomed me with open arms, but it’s special to be with these men and to be told, “We started off just like you, and you are just like us.” There are so many others at AANP who have given me countless opportunities to engage in every level of the organization, from being named President of the American Academy of Nurse Practitioners Foundation to my work on the Nominations Council, encouraging the most well-qualified individuals to find the positions where they are best suited to make a difference.
Q: Now as a leader yourself, how does it feel being able to provide that same guidance and mentorship to future generations?
A: I feel that it’s my responsibility and duty to do what was done for me. I come to the AANP conferences on a mission to influence and motivate. If you feel disenfranchised, I’m who you need to talk to. It’s now my second year of mentoring NPs through the FAANP Mentorship Program, and I take that very seriously. I believe you get as much out of this program as you put in. I make myself available on weekends, in the evenings and beyond, because that’s what was instilled in me.
I recently heard from an NP looking for information on occupational health. Well, I know one who just so happens to serve on the AANP Board of Directors, and I made that connection to help her find the information she needs. Truly, I’m a connector of NPs. I don’t know everything, but I know people who have the answers, and it’s my privilege to be able to share that.
It’s about modeling the behavior and being the change—and I hope to inspire others to be role models for the profession.