The Lack of Diversity in Dermatology Nursing Education & Business
I wrote about the lack of diversity in dermatology nursing education for the Inaugural DNPs of Color Magazine, and it has been my most popular article to date – by a landslide – and it took me completely by surprise. For the last two years, I’ve published a weekly article on the Mahogany Dermatology writing about dermatology nursing education, nurse-led research (including ideas for dermatology DNP Projects and nurse scientists), and entrepreneurship. I’ve published over 100 articles and released over 100 videos on The Melanin Initiative podcast. This has been in alignment with our mission: to increase access to dermatology nursing education with an emphasis on skin of color, business acumen, and digital fluency. When I was invited to write an article for DNPs of Color, I saw it as an opportunity to bring attention to a gap in nursing education, which ultimately leads to gaps in patient care.
The Lack of Diversity in Dermatology Nursing Education & Business
Nursing education is poorly understood by the public, media, our peers in healthcare, and intraprofessionally amongst nurses. Some of the problems I’ve seen over the last 15 years:
• There are over 5 million nurses, and we are the largest segment of the healthcare workforce. Yet people don’t know what we do, we work in silos, and suffer in silence. We don’t talk enough about what we do outside of nursing and healthcare.
• We are a female-dominated profession. We rarely question how this has shaped our definition, practice, and the marketing of our profession to the world and intraprofessionally. It is likely why we continue to agree to subpar working conditions and compensation, some going as far as working for free, especially when it comes to helping students and caring for vulnerable populations. Subpar compensation and women being seen as less reliable because of motherhood and maternity leave have led to less pay for faculty, which can likely be linked to the faculty shortage. As much as nurses don’t talk about money, we are all motivated by money. If faculty and preceptors were paid as much as CRNAs, we wouldn’t have a faculty or preceptor shortage problem. The lack of faculty preparation and their ability to influence and develop a scarcity mindset in impressionable students is a topic for another day.
• The name Nursing School is a misnomer. It’s primarily patient-care school, hospital-based school, and primary care school, and it can’t teach us everything we need to know. More students, parents, and prospective students need to be informed of this limitation, the importance of investing more money (being specific about the projections) in additional education and training for the entirety of your practice, and the steps to take. This is especially true in cosmetics. People understand CEs, but even that is limited. We need to expand our education, not just continue limited education, especially as it relates to business, law, finance, and technology, where some of the best people to learn from are people doing this work: mentors, sponsors, and coaches. Certifications are a sign of completion and, like most things in this country, a way to capitalize. They can be a sign of dedication to one’s profession or specialty, but at the end of the day, it’s a made-up symbol we as a culture have decided to assign value to – this needs more transparency, especially for newer clinicians who are trying to appraise different education programs – that may or may not end with a certificate and additional debt.
• We don’t understand what it means to be an adult learner and steward of information, where we don’t just consume, ask for study guides, and think someone can teach us everything we need to know in 1 hour, 1 weekend, 1 semester, or at one clinic.
• We work too much. When someone graduates, the first thing people say is: What’s next? We don’t allow or encourage enough time for rest, reflection, and creative thinking. We’re more fixated on the doing than the becoming. Becoming requires strategy. Doing comes from mimicking, which is why so many struggle with finding their identity and seeing how they add value that surpasses competition and any saturated market.
The gaps in dermatology nursing education, research, clinical practice, and business, as it relates to SOC:
• Faculty
• Key Authority Figures with credibility and visibility
• Medical textbooks
• Diverse images in medical and nursing textbooks
• Clinical trials, Principal Investigators, and the problems being solved
• Nurse-led research at the bachelor’s, master’s, and doctoral levels
• Federal safety and testing regulations when it comes to research and development of products and pharmaceuticals
• Standards of care in medical, surgical, and cosmetic dermatology, specifically when it comes to the assessment, diagnosis, safe and appropriate treatment, and evaluation of skin of color
After being in the industry for over 15 years, I’ve earned the right to critique the profession I love and have dedicated so much of my life to. I have paid my dues and continue to pay dues in the form of student loans – something I do not recommend. I have obtained all the degrees available in nursing and studied biology and biomedical engineering before becoming a second-degree nursing student. But I want you to know that if you’re a nursing student, a retired colleague, or somewhere in between, your voice also matters, even if you have LVN, LPN, AD, or CNA at the end of your name.
We have to speak up and ask for the education and training we need to safely treat skin of color, build trust, and improve health outcomes. Not just clinicians of color, but all people, because there are not enough people of color to meet the needs of all the people of color. I’ve chosen to do it by supporting Cosmetic NP Entrepreneurs because there’s an increasing trend of practicing and aspiring nurses and NPs practicing aesthetics. Some people are only going to nursing or NP school solely to open a medspa. Currently, there is a lack of standardized guidance, mentorship, community, competencies, and business acumen. NPs are opening businesses and closing them within 2-3 years. It doesn’t have to be that way.
“Just because you know how to take care of patients, it doesn’t mean your business will be successful.”
I Have a Dream Too
I believe, as we see with Social Determinants of Health (SDOH), there is a trickle-down effect in business. When business owners stay in business, patients get the care they need when they need it.
Call to Action: It's Time to Lead the Change.
I first wrote about the critical gaps in diversity within dermatology nursing education for the inaugural issue of DNPs of Color Magazine. That article struck a nerve – and sparked vital conversations that I knew needed to go even further.
This paper is meticulously crafted for nurses, educators, doctors, and entrepreneurs who are ready to:
• Understand the roots of disparities: Grasp why gaps in dermatology nursing education persist.
• Explore entrepreneurial impact: Discover how business ownership by NPs directly influences and expands access to care, particularly in provider shortage areas.
• Build a more just future: Gain actionable insights to challenge the status quo and create more culturally sensitive practice models.
Kimberly Madison, DNP, AGPCNP-BC, WCC
I am a Board-Certified Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research™, I aim to expand access to dermatology research, business acumen, and innovation using artificial intelligence and augmented reality while also leading professional groups and mentoring clinicians. Through engaging and informative social media content and peer-reviewed research, I empower nurses and healthcare professionals to excel in dermatology and improve patient care.
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