Racism in Nursing - How Anti-Racism Initiatives Are Failing Nurses of Color (1 of 2)

Racism in Nursing - How Anti-Racism Initiatives Are Failing Nurses of Color (1 of 2)

by Kaz Weida and Gerard Soucy, RN CHPN

The fact that nurses have consistently rated as America’s most trusted professionals in polls over the past 25 years is undermined by more recent attention to the systematic and structural racism that runs rampant in modern nursing. While the significant lack of diversity in modern nursing leads to disparate health outcomes for society’s most vulnerable populations, racism from colleagues and those in positions of power also has profound negative effects on nurses of color at all levels of practice.

 Mapping the Landscape of Anti-Racism Efforts in Nursing is a 2023 study from the Manning Price Spratlen Center for Anti-Racism & Equity in Nursing at The University of Washington School of Nursing that sought to quantify the success of ongoing efforts to reduce structural racism in nursing practice and education. Researchers conducted 42 in-depth interviews of nurses and nurse educators to map the landscape of anti-racism initiatives to discover what’s working - and what’s not. The work was supported by the Robert Wood Johnson Foundation.

Their findings generated eight central themes that align closely with the objectives of AntiRacismNursing dot org and our featured coursework on racism in nursing, and the study can guide nurses to more powerful ways to engage in restorative justice. The study emphasizes the need for ongoing conversations about the role of race in health outcomes, equity in modern nursing, and how to create a safe, supportive, and equitable work environment for nurses of color.

 Learn more: Read the full report Mapping the Landscape of Anti-Racism Efforts in Nursing

 Central themes from Mapping the Landscape of Anti-Racism Efforts in Nursing

• Nursing culture reflects a society that is so deeply rooted in white supremacy and racism, that the bias in the profession has not been obvious to many nurses.
• Connecting inequities and a lack of diversity in nursing to a society steeped in white supremacy seems obvious, but it’s a bias that is not often acknowledged or articulated among nurses or the associations that purport to represent the profession.

“Every participant we interviewed was able to share personal and/or professional experiences of racism, including as witnesses to racist interactions and organizational policies or practices…”
Mapping the Landscape of Racism Efforts in Nursing

 Racism in nursing can be assessed in the contrasting cases of nurse DonQuenick Joppy and former nurse RaDonda Vaught, where accusations of professional and criminal misconduct generated substantially different responses from prominent nurses and nursing organizations.

 Learn more about the racial disparities in these cases in My Third Daisy Nomination, Just Culture Algorithm, and Characterized by Malice. 

• A restorative justice approach of truth and reconciliation is crucial for understanding and addressing implicit bias and structural racism.

In the aftermath of George Floyd’s murder and the Black Lives Matter movement, healthcare organizations launched a flurry of initiatives aimed at addressing structural racism and bias in nursing. The American Nurses Association (ANA) branded their undertaking as a “journey of racial reconciliation.” 

But the 2023 RWJF report on anti-racism initiatives in nursing characterized these efforts as prepackaged tool kits that fell short of the urgent need, and noted study participants advocated for a more nuanced and engaged approach centered on truth and reconciliation.

“Truth and reconciliation require ongoing conversations and careful listening for deep understanding of experiences of racism and a focus that moves from individuals to the organizations and society in which they live.”
Mapping the Landscape of Racism Efforts in Nursing

 Learn more about the ANA Enterprise and their attempts to talk about nursing’s racism in The Enterprise and Civility is a Most Treasured Value.

• Having a shared value for the work is essential; however, it is also necessary to have shared definitions and language.

 Agreeing on a baseline definition of what constitutes racism can be unexpectedly challenging, especially in a modern nursing culture where bias is not often acknowledged. The first step is to be open to exploring the role racism has in shaping modern nursing, and how bias can be found not only in its foundations but in present day practices.

“These shared definitions and language lead to shared understandings that can help people to move from the personal to the organizational and structural levels of racism. Understanding the level at which racism is operating is crucial to grasping where best and potential practices may differ from levers of opportunity or accountability.”
Mapping the Landscape of Racism Efforts in Nursing

 Learn more about racism and its role in the historical evolution of the modern nursing in Nursing Foundation Violence.

• Some tools to address racism already exist or are being developed.

 In charting an overview of existing initiatives, Mapping the Landscape of Anti-Racism Efforts in Nursing makes clear much of the work being done is either inadequate in scope, or lacks funding and accountability. And many study participants cautioned that some of the bias is embedded in the tools used to address the problem, including how data is gathered and subsequently generates protocols.

“Identifying the systems and protocols in health-care organizations that perpetuate racism can be a challenge, as they are not always obvious. This includes ongoing developments with myriad ways that artificial intelligence (AI) is being used in health care.”
Mapping the Landscape of Racism Efforts in Nursing

Learn more about how Title VII and the Civil Rights Act of 1964 affects modern nursing in Absolutely No Place.

To learn more about Dr Monica McLemore and related work - see the journal Health Equity and the University of Washington School of Nursing website.

 In our next blog post, we’ll cover additional findings from the study, including a dissection of how DEI initiatives can more effectively address racism in nursing, and why nurses can and should play a central role in dismantling bias in modern nursing.

 Kaz Weida is an editor and journalist covering topics in health, education, science, technology, social issues and advocacy.

Gerard Soucy, RN CHPN is a nurse and blogger practicing in serious illness, end of life, death care, final disposition, bereavement and legacy.