9 minute read
A Conversation About Addressing Racism in Nursing at the Bedside and Beyond
BY JANICE M. PHILLIPS, PHD, RN, CENP, FAAN
I interviewed two of the nation’s most influential minority nurse leaders, National Black Nurses Association President and CEO Martha A. Dawson, DNP, RN, FACHE, and National Coalition of Ethnic Minority Nurse Associations President Debra A. Toney, PhD, RN, FAAN, who serve as co-chairs for the National Commission to Address Racism in Nursing to gain their perspectives on the work of the Commission and implications for addressing racism in nursing at the bedside and beyond.
Phillips: What sparked a need for the Commission?
Dawson: The organizations that comprise the Commission have for years raised their individual voices to condemn all forms of racism within our society, health care system, and the nursing profession. However, to forge real change, we all knew that we needed to use our collective voices and influence to tackle the issue in our own backyard. Racism in nursing impacts a nurse’s overall quality of life and is in direct contradiction to the Code of Ethics for Nurses, which obligates all nurses to speak up against racism, discrimination, and injustice. In 2020, there was a renewed call for “America to reckon” with a dark history of racism and discrimination. We know that racism is historically rooted in the nursing profession and continues to taint our profession. Nurses from marginalized and underrepresented races and ethnicities experience demoralization, exclusion, and trauma from unfair structural and systemic workplace practices as well as micro and macro aggressions from predominantly white groups and others who may view themselves or their group as superior. A national reckoning aside, work to address racism in nursing has always been urgent because it impacts not only nurses, but the patients, families, and communities that they serve. It’s time for all nurses working in every health care setting to confront the prevalent systemic racism in our profession. It is not enough for us to be the most trusted, we must become the most caring profession. After all, this work and our profession is about Human Caring.
Phillips: What are some of the key priorities for the Commission?
Dawson: Since nurses are the largest group of health care professionals in the U.S. and work in nearly every setting, the issue and impact of systemic racism in nursing is vast and complex with many layers. The Commission is examining racism in nursing through the lens of education, practice, policy, and research. Across these four pillars, the Commission will address the role of leaders in dismantling racism, owning their work culture, and creating organization justice. Organizational Justice addresses perceived fairness in how resources and rewards are distributed, how policies and procedures are used, and fairness of decision-makers’ behaviors and support. Our approach is to help nurses acknowledge and unlearn some behaviors, learn new theoretical concepts to start crucial conversations, and to promote sustainable change from the top down. In tandem, we are also acknowledging and documenting the historical context of racism in nursing. This is hard, and calls for us to be in uncomfortable spaces, but it is necessary. Simply put, our profession has treated racism as a small, localized abnormality when it is an open wound.
Phillips: What do you see as some of the takeaways for nurses at the bedside and beyond?
Toney: In addition to the priorities Dr. Dawson mentioned, I also want to note that the Commission has conducted listening sessions and is capturing stories from nurses. Being intentional and thoughtful in creating safe spaces for nurses to share their first-hand accounts and lived experiences on racism is non-negotiable. This past spring, the Commission conducted five listening sessions specifically targeting Black, Indigenous, and People of Color (BIPOC). We are using these insights to inform our strategic approach and to help us authentically describe the shared experiences of BIPOC nurses in academic and health care settings, and the subsequent impact on their professional advancement. We have also issued an open call for all nurses to share their story anonymously and safely without fear of retribution. We encourage nurses to share the bad and the good, including stories of support, solutions, allyship, mentorship, resilience, and perseverance. The intent of both the listening sessions and call for stories is to inform the Commission on policies and practices to address systemic racism in nursing. There will be so many takeaways for nurses at the bedside and beyond as the Commission continues an in-depth exploration into this critical issue for the profession. At this current juncture, it is our hope that nurses will begin to acknowledge that racism in our profession is a real problem. Often, acknowledgement of an issue is a seemingly small but important step to activate action.
Phillips: When can we expect a report or key recommendations?
Toney: Our first report is a comprehensive analysis from the five listening sessions conducted this past spring. The nurses who participated confirmed, if you will, our “hypothesis” that the roots of racism in nursing run deep. In this report, the Commission offers first-of-its-kind analysis gleaned from the experiences shared by BIPOC nurses into the issue and impact of systemic racism in nursing. The report reveals uncomfortable truths about nursing’s role in oppressing BIPOC nurses, perpetuating limiting stereotypes and assumptions, propagating “Tokenism,” committing spirit murder, and more. If there is any silver lining, it is that this report validates BIPOC nurses’ feelings and experiences. We will also release an issue brief to help align all nurses in how we individually or collectively discuss the topic of racism in nursing or engage in work to address it. In this brief, the Commission, through the guidance of an expert scholar-in-residence, offers definitions and context for consideration. Words matter and alignment is key with so many lived experiences and perspectives at play in this body of work.
Phillips: Are there any connections between the Commission’s work and the recently released Future of Nursing Report?
Dawson: The Commission joins other nursing organizations in commending the release of The National Academy of Medicine’s recent 2020-2030 Future of Nursing report. The Commission has reviewed the report and we are pleased that language that speaks to the issue of racism in nursing is incorporated. The report urges nurse leaders to address racism and build systems to achieve health equity. This call-to-action aligns with our work to address racism in nursing. From our perspective, the Commission stands ready to lead the national discussion about the issue of racial inequities in nursing as well as the social determinants of health within nursing. However, the Commission’s focus is on upstream work addressing racism in the profession, colleague to colleague.
Phillips: Any parting comments you would like me to share regarding to your leadership role in moving the agenda on racism and nursing forward?
Toney: The Commission cannot tackle this work alone. Our goals are bold and can only be achieved with the help of all nurses at all levels and across all health care settings. This body of work will take us into uncharted territory that will challenge our belief systems and push us to move beyond our comfort zones. But that is how we will make progress. This work is urgent because when nurses have safe and liberating environments, they are best positioned to provide quality and culturally relevant care for all patients and communities.
Janice M. Phillips, PhD, RN, CENP, FAAN, is an associate professor at Rush University College of Nursing and the director of nursing research and health equity at Rush University Medical Center.
About the Commission
The National Commission to Address Racism in Nursing is leading a national discussion on racism in nursing and is exploring the experiences of nurses of color across diverse settings and roles to understand the impact of systemic racism and to develop an action-oriented approach to address racism across the spectrum of education, practice, policy, and research.The Commission is led by nurse leaders from leading nursing organizations including Ernest J. Grant, PhD, RN, FAAN, President of the American Nurses Association (ANA); Martha A. Dawson, DNP, RN, FACHE, President of the National Black Nurses Association (NBNA); Deborah A. Toney, PhD, RN, FAAN President of the National Coalition of Ethnic Minority Nurses Association (NCEMNA); and Daniela Vargas, MSN, MPH, MA, RN, PHN, member of the National Association of Hispanic Nurses (NAHN).
Member Nursing Organizations
• American Academy of Nursing
• American Association for Men in Nursing
• American Association of Colleges of Nursing
• American Nurses Credentialing Center
• American Nurses Foundation
• American Organization of Nursing Leadership
• ANA Eastern Region of Constituent and State Nurses Associations
• ANA Midwestern Region of Constituent and State Nurses Associations
• ANA South Eastern Region of Constituent and State Nurses Associations
• ANA Western Region of Constituent and State Nurses Associations
• Asian American/Pacific Islander Nurses Association
• Chi Eta Phi
• Minority Fellowship Program at the American Nurses Association
• National Alaska/Native American Indian Nurses
• National Association of Licensed Practical Nurses
• National League of Nursing
• Organization for Associate Degree in Nursing
• Philippine Nurses Association of America
• Minority Nurse
For additional information on the Commission and related activities, visit:
• https://www.nursingworld.org/news/news-releases/2021/leading-nursing-organizations-launch-the-national-commission-to-address-racism-in-nursing/
• https://www.nursingworld.org/~49be5d/globalassets/practiceandpolicy/workforce/commission-to-address-racism/final-racism-in-nursing-listening-session-report-june-2021.pdf
The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4.2 million registered nurses. ANA advances the profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA is at the forefront of improving the quality of health care for all. For more information, visit www.nursingworld.org.
The National Association of Hispanic Nurses (NAHN) is actively involved in issues affecting Hispanic nurses and the health of Hispanic communities on local, state, regional, and national levels. The organization is committed to providing equal access to education, professional, and economic opportunities for Hispanic nurses and towards improving the health and nursing care for Hispanic consumers.
Founded in 1971, the National Black Nurses Association (NBNA) is a professional organization representing 308,000 African American registered nurses, licensed vocational/practical nurses, and nursing students in 108 chapters and 34 states. The NBNA mission is “to serve as the voice for Black nurses and diverse populations ensuring equal access to professional development, promoting educational opportunities and improving health.” NBNA chapters offer voluntary hours providing health education and screenings to community residents in collaboration with community-based partners, including faith-based organizations, civic, fraternal, hospitals, and schools of nursing. For more information, visit https://www.nbna.org/. #NBNAResilient ###
The National Coalition of Ethnic Minority Nurse Associations (NCEMNA) is a coalition of five national nursing organizations that represent diverse communities. Our members include the Asian American/ Pacific Islander Nurses Association (AAPINA), National Association of Hispanic Nurses (NAHN), National Alaska/Native American Indian Nurses Association (NANAINA), National Black Nurses Association (NBNA), and the Philippine Nurses Association of America (PNAA).
