Practice Tip of the Week | Tackling Social Injustices: Nurses Ending Racism

By Serena Bumpus, DNP, RN, NEA-BC

Racism is one of the greatest threats to our country. We live in a society that marginalizes people of color through systemic injustice, yet we consistently avoid the topic of racism despite the fact it is in our face every day. As nurses, we are in a unique position to tackle these injustices and lead the way toward acknowledging, addressing and ending racism in America once and for all. In order to care for the lives of all Texans, we must take steps to directly dismantle the structures that prevent some Texans from getting the health care they need.

Racism is real and is more than the sum of individual prejudice or stereotypes. Many people believe that just by treating everyone equal, they are doing enough. But racism is a conscious or unconscious act that combines prejudice with power. Pretending that race does not exist means perpetuating the existing racist system while also ignoring the identities of those marginalized by that system. Furthermore, when those who profess to be “colorblind” deny any role in perpetuating systemic racism, they also abdicate responsibility to help dismantle it.

Being Anti-Racist

Nurses must have a goal of not just being non-racist, but actively being anti-racist. We need to create social policies and institutional practices that challenge a system that historically has dominated and exploited people of color. We must be able to identify the subtle and overt forms of racism in our organizations and communities.

The Nursing Code of Ethics directs nurses to “respect the inherent dignity, worth, unique attributes, and human rights of all individuals.” Already, nurses play a critical role in addressing the prevalence of adverse outcomes experienced by people of color. However, the ways in which we address racism and how it contributes to health inequities need to be challenged. If systemic injustice remains unaddressed, we will continue to have a public health crisis on our hands that will fester like an infected wound.

Recent events have highlighted the need for nurses to pay attention and discover ways to talk about racism and tackle it. Cultural sensitivity and unconscious bias training are no longer enough. Goodwill and good intentions are not enough either. We need to learn how to see prejudice and speak up against it, even if we are speaking up against our family members, our peers or our administrators. This requires embracing our own vulnerability and building up our courage to make foundational change.

Examining Race and Health

Race, ethnicity and socioeconomics have a large impact on health and health outcomes, which we now commonly to refer to as health disparities. For a long time, the influences of stigma and prejudice on health were studied separately, but both are causes of discrimination leading to poor health outcomes.

When people of color perceive their health care needs are not being treated equally, they will often delay seeking out health care, resulting in poor health outcomes. This feedback loop caused by how the system treats them leads to much greater rates of morbidity and mortality in communities of color. A Black person is 20% more likely to die from heart disease than a white person; a Black man is 200% more likely to die from cancer than a white man; and a Black woman is 400-500% more likely to die from pregnancy-related causes than a white woman.

One reason that choosing to personally be non-racist cannot address these mortality rates is that the severity of racism experienced is less influential than the chronic nature of living in a society imbued with systemic racism. Growing evidence shows that chronic exposure to unfair treatment strongly correlates with higher morbidity and mortality rates. While nurses may strive to treat everyone equally regardless of race and socioeconomic status, the system we live in does not. Therefore, nurses must also pursue a systemic change to improve the health and wellbeing of people of color.

Creating a Just System

What actions can we take now to begin ending the racial biases in healthcare?

1.      Listen! Follow the expertise, leadership and guidance of community networks focused on racial injustices and offer your support as a volunteer or by providing a donation to their organization.

2.      Advocate! We all know how to write our legislators and local community leaders. Share your thoughts and advocate with ideas on how to make meaningful change.

3.      Educate! If you are unsure what to do, or want to learn more, educate yourself. Talk with a person of color to hear their personal experiences and how racism has impacted them. However, do not ask a person of color to take on the burden of educating you, especially since the internet is full of resources you can find in seconds. (Start here and here.)

There is no place for racism in nursing practice or in health care. As nurses, we must begin talking about how we treat one another and our patients, which includes discussing why we avoid having conversations around racism. This is a crucial first step toward ending prejudice, and nurses should be leading these efforts.