Supporting Educational Excellence and Diversity (SEED) for SC Nursing

Sponsor/Type: The Duke Endowment
Project Period: 01/01/2021 – 12/31/2023


The State of South Carolina (SC) leads the nation in poor health outcomes (ranked 42 of 50) as evidenced by 26,248 deaths and 91,364 years per lives lost in 2016 due to chronic diseases. Health disparities abound, as African Americans are 30% more likely to die from heart disease and 43% more likely to die from stroke than non-Hispanic White South Carolinians. Chronic diseases are the leading causes of morbidity, hospitalizations and mortality among African Americans in SC. Nationally, minorities are more likely to be infected with COVID-19.

When minorities are infected, they have more severe disease and higher rates of mortality when compared to White Americans. Other factors associated with COVID-19 morbidity and mortality include urban living and poor socioeconomic status.

These statistics hold true for SC; according to the SC Department of Health and Environmental Control, the largest number of confirmed and estimated COVID-19 cases are in SC’s urban (Lexington, Richland, Sumter) and impoverished rural counties (Beaufort, Horry, Greenville), with Horry county leading in infections with an estimated 24,000 COVID-19 cases. These facts further elucidate the urgent need skilled nurses in SC’s rural and underserved communities. At MUSC College of Nursing (CON), 87% of our graduates obtain positions in SC. Rural clinical rotations can lead to graduates choosing to work and live in underserved areas.

Chronic disease management includes teaching the skills and behaviors patients and families need to improve health outcomes, increase quality of life, and decrease morbidity and mortality rates. Self-management is affected by, and highly correlated with cultural behaviors, health beliefs, and morays that have been passed down through generations. In acknowledgement of this, the American Nurses Association created Standard 8 which mandates culturally congruent nursing practice. Culturally congruent practice empowers the nurse to deliver evidence based care that considers the values, beliefs and worldviews of the patient.10 This is best done when providers representative of their communities work to improve access, health outcomes and reduce disparities.

There is an urgent need to increase the number of culturally congruent nurses in SC. South Carolina’s nursing workforce (82.6% White; 11% Black; 1% Hispanic) does not reflect its citizens (68.5% White; 27% Black; 5.7% Hispanic), which supports the need to increase diverse nursing student enrollment. South Carolina’s educational disparities also create challenges for a diverse group students, especially those attending primarily white institutions (PWI) of higher learning. The MUSC College of Nursing (CON) supports culturally congruent care and has developed a plan to facilitate student success improving SC’s nursing diversity and patient health outcomes that will be sustainable.

The purpose of SEED is two-fold: 1) promote diversity in the SC health care workforce by training diverse group of students in nursing with the knowledge, skills and behaviors to provide culturally and linguistically competent care in rural and other medically underserved communities 2) develop rural clinical training rotations with MUSC affiliate hospitals to improve the distribution of baccalaureate prepared nurses.

For more information contact
Kristen Poston