patient and staff furniture and work tools will be needed to decrease the risk of injuries to patients (and nurses as well). Changes in hearing and vision also have implications for the design of work and technology used in patient care—for example, the need for increased lighting and larger size of print material (Curtin, 2002). There could be implications as well for shift lengths and rotations. Research has shown that adapting to shift work is more difficult for workers over age 40. A recent study of the effect of age on performance found that older individuals (mean age 43.9) had less ability to maintain performance on standard neurobiological tests across a 12-hour shift compared with younger individuals (mean age 21.2) (Reid and Dawson, 2001).

A Workforce That Does Not Yet Fully Reflect the Racial and Ethnic Diversity of the U.S. Population

The U.S. population is becoming more racially and ethnically diverse. At the beginning of the 1900s, one of every eight Americans identified himself or herself as a race other than “white.” At the end of the century, one of four did so, as the white population had grown more slowly than every other racial/ethnic group. This increase in diversity accelerated in the latter half of the century. From 1970 to 2000, the population of races other than “white” or “black” grew considerably, and by 2000 was comparable in size to the black population. The black population represented a slightly smaller share of the total U.S. population in 1970 than in 1900, while the Hispanic population more than doubled from 1980 to 2000. In the 2000 census, 36 percent of the population reported belonging to “two or more” races (the 2000 census was the first to include this reporting category). The racial/ ethnic composition of the U.S. population according to the 2000 census was as follows: 75.1 percent white, 12.3 percent black, 3.8 percent Asian or Pacific Islander, 0.9 percent American Indian or Alaska Native, 2.4 percent claiming two or more races, and 5.5 percent claiming a race other than those already cited. Individuals (of any race) claiming Hispanic origin constituted 12.5 percent of the U.S. population (Hobbs and Stoops, 2002).

The nursing workforce does not yet fully reflect this diversity. In 2000, a higher proportion of RNs (88 percent) than the general U.S. population (75.1 percent) was white; however, the 12 percent of racial/ethnic minority RNs was an increase from the 5 percent of 1980. Significantly, the increase in the overall RN population between 1996 and 2000 is attributed largely to the growth in the numbers of RNs from racial/ethnic minorities (Spratley et al., 2000). In contrast, the NA workforce has a higher proportion of such minorities than the U.S. population overall. Approximately 40–50 percent of NAs working in hospitals, long-term care facilities, and home health care are nonwhite racial/ethnic minorities (GAO, 2001b).

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