Racism and its effects on the health and well-being of the American people has now elicited a direct response from nursing organizations.
Ernest Grant, PhD, RN, FAAN, president of the American Nurses Association, was appalled when he watched the video of a police officer kneeling on the neck of George Floyd, which ultimately led to Floyd’s death, a citizen the officer was sworn to protect.
Grant knew the tragedy demanded a response from the nation’s largest nursing organization.
“In my statement to our membership, I explained that we have a code of ethics that obligates nurses to be allies and speak up against racism and social injustice,” Grant said. “Whenever we see racism, we must call it out, even if it is occurring among colleagues. To remain silent is just as problematic as promoting racism.”
Numerous nursing organizations have responded to Floyd’s death by issuing statements, offering virtual discussions to increase awareness about racism and supporting peaceful protests.
As protests have erupted across the nation amid the COVID-19 pandemic, the ANA educated the public about the importance of wearing masks and practicing social distancing during the events.
“We are using the public’s trust of nurses to let people know that we care about their health and their concerns about social injustice,” Grant said.
The Black Lives Matter movement
A recent survey from Civiqs showed support for the Black Lives Matter movement has increased significantly as a result of the George Floyd incident, and now a narrow majority (51%) of American voters are in favor of the cause.
While some have reacted to the movement by responding that “All Lives Matter,” Grant said the phrase seems to be exclusive of black lives. “Until people understand the turmoil Black people have experienced, All Lives Matter misses the mark,” he said.
Grant experienced racism personally when he said he was overlooked for job promotions despite the fact that he was qualified or more qualified than other candidates, and when patients did not want him as a nurse because he was Black.
The racism Floyd endured is also reminiscent of an incident in the life of ED nurse Mawata Kamara, RN, a member of National Nurses United, which issued a statement in June. In 2008, Kamara was arrested and booked in jail in Hayward, Calif., because police said she did not pull over when they asked her to stop.
“I had stopped, and they gave me no explanation about why I’d been pulled over,” said Kamara, who had been on her way home from the night shift in the ED at San Leandro Hospital. “They asked me to get on my knees outside the car and put on handcuffs, and I was shaking throughout the ordeal,” Kamara said.
She was released nine hours later with the explanation that the officers had checked her record and she was clear.
Experiences of racism like this have led Black people to distrust not only police, but also healthcare providers, Kamara said.
In the ED, she has treated Black patients who appeared non-compliant, but the source of this behavior may be distrust. She recently cared for a Black patient who was rejecting medication suggested by a physician. Kamara asked the woman why she did not want to take the medication.
“She said that when people don’t have insurance, doctors do not care and want to get rid of the patient as quickly as possible,” said Kamara, who explained that she did not care how the patient paid and was there to take care of her.
Research also suggests racism affects decisions made by providers. According to a recent study highlighted in the New England Journal of Medicine, white patients typically had better access to specialized care compared to other racial groups at Brigham and Women’s Hospital’s Department of Medicine in Boston.
Access to healthcare, healthy food, safe drinking water and other social determinants of health also can be more limited for people of color, and nurse leaders hope the recent protests will lead to changes in communities.
“We have known for a long time that racism affects health, and the George Floyd situation and the higher incidence of COVID-19 in minority communities have brought this issue to the world’s attention,” said Jean Ross, BSN, RN, president of National Nurses United.
Initiating conversations, promoting change
Although tackling racism might seem like a daunting undertaking, Blake K. Smith, MSN, RN, president of the American Association for Men in Nursing, believes nurses are well-practiced in the art of leading discussions about sensitive topics.
“Nurses have difficult conversations frequently with patients, and we are experts when it comes to listening,” he said.
After the Floyd incident, Smith reached out to colleagues of color and asked how they were doing. “I wanted to provide a context where they could express their feelings, vent and confide in me so I could understand better,” said Smith, a clinical documentation senior analyst. “They are upset.”
When he encounters racism, he sees it as an opportunity to speak up. One time he was in a patient’s room with a Black colleague who was the primary nurse, and the patient asked Smith to answer a question rather than the Black nurse.
“I explained to the patient that this was a great question for the amazing nurse who was taking care of him,” Smith said.
AAMN also has started facilitating conversations between nurses and the public, such as a recent Facebook live meeting about how the social determinants of health that impact men relate to racism and discrimination.
Smith also plans to continue AAMN’s efforts to increase awareness about the dangers of toxic masculinity.
“We need to understand why men are less likely than women to access healthcare and more likely to internalize their feelings and then express anger,” he said. “This can potentially lead to violent acts and even suicide.”
Grant encourages nurses to use their voting power to instigate change.
“Vote for political candidates who have a proven track record of addressing racism,” he said. “And educate colleagues and the community about these candidates.”
Nurses also can host webinars or other events that allow leaders of color to share their stories and goals for change.
Members of the National Black Nurses Association are taking action by organizing peaceful protests, including one in Huntsville, Ala., led by member Frederick Richardson, RN, who works in the ED at Madison Hospital in Alabama. He invited the city’s mayor and representatives from faith-based organizations and the police department to attend.
NBNA president Martha Dawson, DNP, RN, FACHE, spoke publicly at the event about strategies to decrease racism. “In nursing, the Joint Commission ensures hospitals meet certain standards, and we could have something similar for the police,” she said. “Hospitals also get reimbursed based on the quality of care, and why not try something like this in police departments?”
Dawson said it is critical for nurses to partner with allies throughout the community to effectively develop strategies that will alter the status quo.
“The problem is racism, and it is in every institution — not just the police,” she said. “Are we willing to agree that change is necessary and work together to create new systems that will lead to change?”
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