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i want to learn more about black nurses and the challenges they faced.

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multiple nurses across the uk sector have dealt with a lot more racism since the corona outbreak

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july 10 ,2020

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black nurses battle twin pandemics of racism and coronavirus - cnn

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From the front lines, Black nurses battle twin pandemics of racism and coronavirus

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Nurse Efe Obiakor stood at the front of the crowd, looking up proudly as her 18-year-old daughter Ada took center stage at a Black Lives Matter rally in central London.

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a survey was conducted about how racism was happening in the work place 63% of people had dealt with discrimination

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within the last 12 months 40% of the racism was from the patients

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Ernest J. Grant, president of the American Nurses Association, discusses how racism is a 'public health crisis' and affects nurses and patients.

Protests calling upon Americans to address racism and its effects have taken place in multiple cities across the country in recent weeks. The most recent catalyst for these events was the death of George Floyd, a 46-year-old black man, who died while a Minneapolis police officer knelt on his neck for over 8 minutes. The four Minneapolis police officers involved in the incident have been arrested and charged in connection to his death.

Multiple nursing groups, including National Nurses United, the American Association of Colleges of Nursing, the American Association of Nurse Practitioners, and the American Nurses Association, have issued statements regarding Floyd's death and the issue of racism in the United States.

"As a nation, we have witnessed yet again an act of incomprehensible racism and police brutality, leading to the death of an unarmed black man, George Floyd. This follows other recent unjustified killings of black men and women, such as Ahmaud Arbery and Breonna Taylor to name a few," said Ernest J. Grant, PhD, RN, FAAN, president of the ANA in the association's statement. "As a black man and registered nurse, I am appalled by senseless acts of violence, injustice, and systemic racism and discrimination. Even I have not been exempt from negative experiences with racism and discrimination. The Code of Ethics for Nurses obligates nurses to be allies and to advocate and speak up against racism, discrimination and injustice. This is non-negotiable."

I recently spoke with Grant about racism, its effects, and how nurses can work for change.

The following is a lightly edited transcript of our conversation.

HealthLeaders: I think, in today's society, there's a misconception about what racism means. People think, "I'm not racist. I'm not mean to other people. I don't discriminate against them." What they're not realizing is that racism can come from unintentional bias and that it is also systemic. Could you explain what forms racism takes?

Ernest J. Grant: Off the top of my head, I can think of three examples. The first one is in education. For the black community, there are perhaps less opportunities for an even playing field, if you will. There are stumbling blocks in the way and [black men and women] may feel they have to work a little harder to achieve the same things that their white counterparts do.

Second, there's an unconscious bias that happens in the healthcare setting as well. For example, two people come to the emergency room with identical chest pain and symptoms, but one may be given a stronger medication or receive a more extensive workup than the person of color receives.

And the third one is stereotypes. Sometimes just because of a person's skin color or their culture or religious belief, [people] automatically [assume] things.

HL: How does racism in the healthcare work environment affect patients and nurses?

Grant: [In the work] environment, obviously if left unchecked, [racism] is allowed to perpetuate so it just becomes deep rooted and ingrained. Pretty soon, you've got a culture of, "Well, we've always done it this way." Or if someone is from a certain part of the community or town they may not be treated in the same fashion as someone who's from another part of town.

Nurses need to speak up whenever they see racism going on. [It doesn't] matter if it's a physician or another nurse or another member of the healthcare team, we need to call it out.

The other thing along those lines is that, from a nursing perspective, if you've got a patient from a different culture, they should be able to receive [care] from someone who is familiar with that culture, or who at least understands that culture and their healthcare beliefs.

Do you think the environment within a healthcare system can prevent people of color from attaining leadership level positions?

Grant: I do. One of the things that I've always said is I think management should be reflective of the people we care for. So, [as a healthcare system] if you look at your management team and they are all white, then there's something wrong, especially if most of the patients that you care for are from the black and brown communities.

HL: You touched on it a little bit with your example about two people getting a different workup for the same symptoms, but could you explain the role racism plays in the health of minority communities and populations?

Grant: Sure. One, its effect on access to care. We are well familiar with healthcare deserts, [which is] when someone from the black community has to travel, maybe to the other side of town, to get healthcare. That could mean they miss a whole day's worth of work in order to have that 15- or 20-minute visit with the physician or the nurse practitioner. Also, when the healthcare system doesn't address social determinants of health, that perpetuates poor health in certain communities. For example, when you have poor drinking water or air pollution or other conditions that can perpetuate illnesses.

Another example is food deserts. If a person has to go to the corner store or the dollar store to buy canned goods, which tend to be much higher in sodium, but they have a heart condition, high blood pressure or kidney problems, that doesn't help them [manage their disease].

Those are some of the examples that racism may play in the health of a community. If the resources are not there to create a better community, then it perpetuates the cycle of the community remaining unhealthy.
In the ANA news release, you mentioned you personally have had "negative experiences with racism and discrimination." I know those experiences can be difficult to recount but do you ha ve any examples you are willing to share? What can nurses do to adhere to the ANA's Code of Ethics to be allies and advocates against racism?
Grant: One example is applying for a position or for a promotion, and even though [I] was just as qualified or even more qualified than the person who got the promotion, when I asked, "What are some ways I can improve myself?" you're given the usual evasive talk.

Another [experience is] taking care of a patient and then having the nurse manager be approached and asked, "Is there someone else who can care for my family member?" That happens all the time. I've taken care of patients who were white supremacists and they made it very blatant that they did not want any black person taking care of them. It's something that we experience in healthcare all the time.
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.
Grant: The Code of Ethics obligates us to speak up when we see [racism]. As I mentioned before, if we see [it], then we need to call it out, and make sure there is a system in place that allows for it to be addressed. The only way we're going to see change is if people don't become complacent and they speak up and be the voice of change.

Racism is a public health crisis, and I think as nurses, the most important thing that we can do is to educate ourselves and use the fact that we do have the trust of the [public] to influence and educate others and to realize the systemic injustice that is going on. And, of course, [nurses can] encourage people to educate themselves and to vote for political candidates who have a proven track record of working against racism and injustice. What's going to help to promote change is to realize the power of the vote that you have and the power of the voting box to help bring about change and reform.

Photo credit: (at top) Ernest Grant, PhD, RN, FAAN (photo courtesy of Brett Winter Lemon/Getty Images)

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Nurses Must Fight Against Racism. ANA's President Shares How

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Protests calling upon Americans to address racism and its effects have taken place in multiple cities across the country in recent weeks. The most recent catalyst for these events was the death of George Floyd , a 46-year-old black man, who died while a Minneapolis police officer knelt on his neck for over 8 minutes.

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president ernest feels as though nurses should speak up more and call them out for their mistakes

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some nurses feel as though the management is not helping to take the proper precautions with dealing with racist people

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During the coronavirus pandemic, nurses are among the nation's front-line workers. Over the years and to this day, the contributions of Black nurses are hard-fought, unrecognized and under-appreciated.

Nurses are essential in care delivery, policy directives and in shaping the health-care system. The year 2020 is the year of the nurse and midwife. Yet, Canada's history of racism and segregation has contributed to residual anti-Black racism that remains present in Canadian nursing.

Nursing, as a profession, was established on Victorian ideals of "true womanhood", including notions of dignity, purity, morality and virtue. Think: white caps and pristine white smocks.

Historically, people who did not meet these "ideals" were prevented from practising nursing. It was believed that Black women did not possess these ideals of "true womanhood" and in turn, were prevented from pursuing nursing as a career. Many of these unconscious biases and stereotypes about nursing are still believed today, with evidence showing that the exclusion of Black folks and anti-Black practices persist in nursing.

Beginning with oppression

In Canada, the first nursing training facility opened in 1874 in Ontario. The first baccalaureate nursing program started in 1919 at the University of British Columbia.

Moving Beyond Borders, Karen Flynn's 2011 account of the racial segregation in Canadian nursing, vividly describes the experiences of Canada's earliest Black nurses.

As Flynn notes, Black folks were not permitted to attend nursing programs. Instead, prospective Black nurses in Canada were told to go to the United States. American schools began allowing Black folks into nursing in the 1870s while Canada continued to restrict admissions to Black folks until the 1940s, granting admission only after pressure from community groups and organizations.

Ruth Bailey and Gwennyth Barton were the first Black nurses to earn a nursing diploma in Canada from the Grace Maternity School of Nursing in Halifax, graduating in 1948 - almost three-quarters of a century after the first school opened.

Black nurses in Canada

Overall, Black nurses are largely absent from leadership positions and specialty practice areas such as intensive care. Instead, Black nurses are often streamlined into areas that are more physically demanding and strenuous. At the same time, Black people are concentrated in entry-level positions, non-specialty roles or in non-licensed clinical roles such as personal care workers.

Beyond physical challenges and visibility, Black nurses are subjected to micro-agressions and racism from patients, colleagues and superiors.

Gender and class have a substantial impact on Black women nurses with the nursing profession having successfully racialized gender and class discrimination. Men who enter nursing usually ride the glass escalator: leadership, higher wages and other substantial advantages.

It's a marked contrast to Black women who do not encounter a glass ceiling but rather they hit a concrete wall from simultaneous racism and sexism; their existence is invisible, yet their mistakes and flaws are amplified.

(Shutterstock)

Racism reinforced through nursing education

In 2013, I proudly graduated from a nursing program with more than 10 Black soon-to-be nurses. At that time, there were designated seats for qualified Black applicants resulting in a 100 per cent increase in enrolment for Black students.

After the removal of these designated seats, the program now graduates far fewer Black nurses each year. I hear similar findings from nursing graduates at other universities. Yet, despite evidence regarding inequity amongst faculty appointments in universities, most Canadian institutions do not collect nor publish race-disaggregated data related to the student population.

Multiple barriers limit access to post-secondary education for Black students. However, issues within nursing education go beyond admissions.

Considering what is taught in nursing school, we see stark examples of anti-Black racism embedded within a curriculum that not only reinforces the invisibility of Black nurses but also exacerbates health inequities.

What is taught is largely void of the contributions to nursing made by Black pioneers. For example, nurses are not taught about Bernice Redmon, who was refused admissions to Canadian nursing programs, trained in Virginia before returning to Canada in 1945. Redmon became the first Black nurse appointed to the Victorian Order of Nurses in Canada.

The nursing curriculum continues to be riddled with colonial, anti-Black, heteronormative and hegemonic content. For most of nursing's history, aspiring nurses have been taught how to care for white, straight and gender-binary patients. If this is not you, even a routine hair, skin or health history assessment can pose a challenge.

(Shutterstock)

Anti-Black racism in nursing is detrimental to Black nurses and to the health of all Canadians, especially since Black folks suffer from high rates of chronic illnesses including diabetes, high blood pressure and mental illness. These health inequities are worsened by an undertone of mistrust towards a health-care system that does not have health-care workers who look like you nor who understand your health needs - leading to misdiagnosed or undertreated conditions.

Read more: Study: Racism shortens lives and hurts health of blacks by promoting genes that lead to inflammation and illness

Towards an anti-racist profession

There are successful initiatives in place. The Faculty of Medicine at the University of Toronto has made great strides in combating anti-Black racism through the Black applicant stream and the collection of race-disaggregated data.

At the Dalhousie Schulich School of Law, a successful program established in 1989 has increase the representation of indigenous Black and Mi'kmaq students in the legal profession. Select universities, like Dalhousie, offer entrance scholarships for Black students as a means to alleviate financial barriers.

Nursing can learn from these bold, innovative ideas and work towards adopting anti-racist frameworks in education and practice. This begins by actively recognizing, appreciating and celebrating Black nurses and their contributions in nursing.

Despite the persistence of anti-Blackness in society, nursing education and health care, Black nurses continue to provide care. Now, more than ever, we must recognize and celebrate their contributions.

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Recognizing history of Black nurses a first step to addressing racism and discrimination in nursing

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During the coronavirus pandemic, nurses are among the nation's front-line workers. Over the years and to this day, the contributions of Black nurses are hard-fought, unrecognized and under-appreciated. Nurses are essential in care delivery, policy directives and in shaping the health-care system. The year 2020 is the year of the nurse and midwife.

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nurses in canada are not even allowed to have the bigger roles these nurses are kept on the side lines of bigger operations

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people do not think to educate themselves and realise when they are wrong

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racism is a public thing when it comes to the health field

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nurses can only ask people to be respectful and whether they listen and take the advice is their decision as in its out of their control.