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How Racism Impacts the Nursing Culture

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Across the nation, February is known as Black History Month. Each year Americans dedicate this month to studying the history and accomplishments of African Americans. That is why it seems fitting to look at the state of racial relations in the profession today. Is there racism in nursing?

Racism is a set of beliefs, behaviors, or attitudes that people from any industry, workplace, or community may hold. Individuals from all walks of life may exhibit racism. And unfortunately, healthcare and the nursing profession are affected, even in today’s modern society.

If you want to know the how, where, and what you can do about racism in nursing, read on.

Is there Racism in Nursing?

According to the Anti-Defamation League, racism occurs when people or institutions show more favorable treatment of an individual or group based on race or ethnicity. Well-known American author, professor, and anti-racist activist Ibram X. Kendi said racism is a marriage of racist policies and ideas that produce and normalize inequities. Racism can manifest at different levels. Beliefs and attitudes can be internal, interpersonal, or systemic.

Regardless of where or how racism shows up, it has detrimental effects. Studies have shown that racism negatively impacts health in these ways:

  • reduced access to employment, housing, and education
  • increased exposure to risk factors such as crime
  • adverse cognitive/emotional processes with associated psychopathology
  • diminished participation in healthy behaviors (e.g., sleep and exercise)
  • increased engagement in unhealthy behaviors (e.g., alcohol consumption) either directly as coping, or indirectly, via reduced self-regulation
  • physical injury resulting from racially motivated violence

Nurses undoubtedly see the effects of racism in caring for the public. But do nurses themselves experience racism directly in their practice? Studies show that overwhelmingly, nurses do see and experience nursing on the job.

One year ago, leading nursing organizations joined forces to launch the National Commission to Address Racism in Nursing. As it’s called, the Commission was tasked with examining the issue of racism in nursing nationwide. Since beginning their work, they’ve uncovered some interesting findings. The Commission published results from a recent survey of 5600 nurses that found startling statistics:

  • 63% of nurses reported personally experiencing racism at work
  • 81% of nurses reported witnessing racism directed toward a peer
  • 57% of nurses reported that they had challenged racism in the workplace 

A racist belief system can show up in many places. In the profession of nursing, nurses may experience racist attitudes or actions from patients and families, peers, or even management.

In 2020, The American Nurses Association (ANA) 2020 Membership Assembly Stated declared racism a public health crisis. It further said that racism impacts all people’s mental, spiritual, and physical health. 

These findings suggest that, yes, there is, in fact, a significant problem with racism in nursing. We can also agree that this is a problem that deserves our attention. As a profession, we must combat individual and systemic racism. But first, nurses have to know what it looks like and the forms it takes. 

What Racism Looks Like in Professional Nursing

Nurses can find racism on every rung in the career ladder. At a recent nursing conference, Marcus Henderson, MSN, RN, said that Black, Indigenous, and People of Color (BIPOC) nursing students face racism even in nursing school. He listed some of the following unfair assumptions and barriers:

  • Dissuasion from pursing nursing
  • Lack of acknowledgment of their role
  • Stereotypes
  • Presumed incompetence
  • Retaliation

After graduation, he says wage disparities and outright denial of advancement opportunities are racial discrimination. As a result, less than 1% of university deans and chief nursing officers come from diverse backgrounds.

What Nurses Can Do About It

Nurses have a professional responsibility to fight racism. The revised Nursing: Scope and Standards of Practice, 4th Edition (2021) Code of Ethics obligates all nurses to:

  • Respect the dignity and rights of all individuals regardless of race
  • Provide care according to need, setting aside bias or prejudice
  • Contribute to a moral environment that demands respectful interactions among colleagues
  • Integrate social justice to address unjust systems and structures.

Moreover, nurses have a position of influence. They can change the culture and the future. Here are three more ways nurses can fight against racism.

  1. Education. Nurses can educate themselves on the issue. Trying to deeply understand the problem and how dangerous the effects are on the profession, patients, and our communities.
  2. Personal Reflection. Thinking about your own beliefs and attitudes is critical. Self-awareness is the first step to being able to advocate for others. If you are not aware of how your own beliefs, attitudes, and actions are perceived, you may do more harm than good for the cause.
  3. Challenge racism in the workplace by outing it. Call attention to it. When you see someone acting out of a racist belief or attitude, bring it to light with your manager or leader. Be the one to open up the dialogue that can end discrimination and injustice. The first step to change is admitting there is a problem. 

Summary

In summary, nurses can use their influence professionally and personally to fight racism. We can stand up for those affected, including ourselves. And we can work together to make workplaces better. As we reflect on the history and accomplishments of our black brothers and sisters this month, let’s stand with them to fight racism.

Have you witnessed racism on the job? Share your experience and how you dealt with it. And share this post with your team to start important conversations.

Sarah Falcone BSN, RN

Sarah Falcone BSN, RN

Author

Sarah S. Falcone BSN, RN is a dedicated nurse based in Dallas-Ft. Worth, TX. Her first nursing gig, was night-shift floor nurse in women's services (PP, L&D, nursery). Through a series of fortunate events, she found home health and a passion for helping seniors age in place. Connect with her on LinkedIn.

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