Racism in Nursing: Is It Real?

Racism is still a part of nursing just as it is in society in general. And it is still hard to talk about. But by sharing with one another, maybe we can gain new insights. Let's listen and learn. Nurses General Nursing Article

Hope is invented every day. - James Baldwin

Racism Among Nurses is a Real Thing

Nurses on the non-caucasian spectrum of melanin content in their skin can tell you—if you ask. In this Summer of upheaval, we hear the headlines every day: Black lives matter, economic and racial inequities in COVID-19 care, police brutality, health care workers marching for justice for all, discrimination against immigrants—the list of troubles is long and complex. In all this turmoil, we want to make sure that we listen carefully, as nurses, to the stories our co-workers tell about their own experiences, because facts inform, but stories inspire.

Racial Discrimination: It is Real

I am a white, middle-aged nurse. I feel uncomfortable writing an article about racism experienced by my non-caucasian colleagues, but I would like to start a respectful conversation on this forum. I would like to hear your personal stories of times when you feel you might have been discriminated against because of the color of your skin.

I have been reading Ijeoma Oluo’s book, So You Want to Talk about Race? And, it’s hard stuff. No one enters the waters of a race discussion well. We all bring mounds of baggage to the table with us. We speak from our own limited perspective and we often lack the humility to truly listen to the people around us as they share their frustration and anger about how they are treated simply because of the color of their skin. We have a hard time allowing people who have suffered discrimination for years to tell their stories. We react sometimes by being defensive, by denying their emotional response, by walking away, even by closing down.

Oluo introduces the discussion about racism by telling a story of someone walking down the street, being repeatedly hit on the arm by passersby. The victim can’t leave. They don’t have the option of walking another way and are forced to suffer the pain and discomfort each time. Finally, someone, gesticulating wildly, hits his/her arm one more time, and it is the last straw. The victim lashes out angrily. The person gesticulating reacts defensively, of course, since they meant no harm. But the harm was already done many times over and the response was a spilling out of pent up rage, anguish, and pain. Her story spoke to me, because it is hard for us to listen well, to hear uncomfortable stories, especially when they come coated in a long history of abuse, discrimination, suffering—generations of it, really. We may not be the immediate cause, but by golly, being white, we are certainly part of the system that created the injustice to start out with.

White Privilege: It is Real

As a white, American nurse, I have benefitted, all my life, from white privilege, even though I have been largely unaware of it. The easements along the way may be small things, but in the scheme of life, they count.

“White people become more likely to move through the world with an expectation that their needs be readily met.”1

The system that perpetuates discriminatory behavior toward non-Caucasians, in general, and Blacks, specifically, has produced rotten fruit. The deaths of many innocents—Ahmaud Arbery, Breonna Taylor, George Floyd—have recently revealed anew the true danger of being Black in this country. Those dangers and disadvantages exist in the nursing community, as well. “Two studies examining racial/ethnic bias in RN promotions (Hagey 2001; Seago and Spetz 2005) found evidence of discriminatory practices that limited advancement opportunities for minority RNs."2

The systemic problems that lead to discriminatory practices in nursing are not going away overnight. Sadly, they are a product of lives lived in a system that perpetuates white wealth and advancement to the detriment of others. Changes will require a concerted effort on all our parts—especially in the white community—to be aware of inequities and do our best to put action behind our words of solidarity. Yes, we must pass laws, train and re-train, but we also must live awake and alert, watching for those unconscious biases that frame these differences from the beginning. We must find ways to learn more and to listen better. When our co-workers speak up, let’s believe them and not discount their stories of injustice. Let’s be careful of how we talk, the things we say casually, the hurtful putdowns that slide out unaware. Let’s pursue ways to help each other succeed because it is truly in our mutual success that we find the fulfillment we seek.

We Can Reinvent Hope

We can have the hope that James Baldwin assures us of in the quote at the top, but we must also let go of complacency, ignorance, and white privilege in nursing, while continuing the difficult conversations.

Will You Tell Your Story?

Maybe some of you can share your stories below. Let’s share and support one another respectfully as we try to come to a better place together in this anti-racism journey.

References

1 - What Is White Privilege, Really?

2 - Racial/Ethnic Pay Disparities among Registered Nurses (RNs) in U.S. Hospitals: An Econometric Regression Decomposition

Specializes in Critical care, tele, Medical-Surgical.

I believed him, or at least gave him the benefit of the doubt when I heard him tell of the kindness of night shift nursing staff on the Merv Griffin Show. Please read the entire opinion piece.

Forgiving George Wallace By John Lewis Sept. 16, 1998

Mr. Wallace, first as a circuit judge and then as Governor, fought the civil rights movement with every fiber of his being. He was a demagogue whose words and actions created a climate that allowed for violent reprisals against those seeking to end racial discrimination.

As one of the leaders of the civil rights movement, I remember that George Wallace well. But the George Wallace who sent troops to intimidate peaceful, orderly marchers in Selma in 1965 was not the same man who died this week. With all his failings, Mr. Wallace deserves recognition for seeking redemption for his mistakes, for his willingness to change and to set things right with those he harmed and with his God.

Rarely does our country witness such a conversion by an elected official. Such a conversion of principle can be shaped only by courage and conviction...

... The very essence of the civil rights movement was its appeal to the conscience of those who beat us with batons, attacked us with dogs and stood defiantly at the schoolhouse door. We wanted our enemies to know that every blow they struck was a blow against another human being. The bloodshed that resulted was the blood of all humanity.

When I met George Wallace, I had to forgive him, because to do otherwise -- to hate him -- would only perpetuate the evil system we sought to destroy.

George Wallace should be remembered for his capacity to change. And we are better as a nation because of our capacity to forgive and to acknowledge that our political leaders are human and largely a reflection of the social currents in the river of history...

https://www.nytimes.com/1998/09/16/opinion/forgiving-george-wallace.html

Specializes in Med/Surg, LTACH, LTC, Home Health.

Fortunately or unfortunately, some of us are more forgiving than others. There are far too many victims who have run out of cheeks to turn.

Specializes in Faith Community Nurse (FCN).
15 hours ago, BSNbeDONE said:

Fortunately or unfortunately, some of us are more forgiving than others. There are far too many victims who have run out of cheeks to turn.

Powerfully said. It is time for us in the white community to look inward, question ourselves daily, educate ourselves, and begin the process of change. It has been far too long. Joy

Specializes in Faith Community Nurse (FCN).
15 hours ago, herring_RN said:

I believed him, or at least gave him the benefit of the doubt when I heard him tell of the kindness of night shift nursing staff on the Merv Griffin Show. Please read the entire opinion piece.

Forgiving George Wallace By John Lewis Sept. 16, 1998

Mr. Wallace, first as a circuit judge and then as Governor, fought the civil rights movement with every fiber of his being. He was a demagogue whose words and actions created a climate that allowed for violent reprisals against those seeking to end racial discrimination.

As one of the leaders of the civil rights movement, I remember that George Wallace well. But the George Wallace who sent troops to intimidate peaceful, orderly marchers in Selma in 1965 was not the same man who died this week. With all his failings, Mr. Wallace deserves recognition for seeking redemption for his mistakes, for his willingness to change and to set things right with those he harmed and with his God.

Rarely does our country witness such a conversion by an elected official. Such a conversion of principle can be shaped only by courage and conviction...

... The very essence of the civil rights movement was its appeal to the conscience of those who beat us with batons, attacked us with dogs and stood defiantly at the schoolhouse door. We wanted our enemies to know that every blow they struck was a blow against another human being. The bloodshed that resulted was the blood of all humanity.

When I met George Wallace, I had to forgive him, because to do otherwise -- to hate him -- would only perpetuate the evil system we sought to destroy.

George Wallace should be remembered for his capacity to change. And we are better as a nation because of our capacity to forgive and to acknowledge that our political leaders are human and largely a reflection of the social currents in the river of history...

https://www.nytimes.com/1998/09/16/opinion/forgiving-george-wallace.html

People can change. And this alone gives us hope and keeps us all moving forward. I remember reading, "Rising Out of Hatred" by Saslow. It delienates the powerful transformation of a born and bred white nationalist, Derek Black, through acts of kindness at his university. His "enemies" invited him to meals, befriended him, and in the process he abandoned the vicious mantras he has been raised to believe and threw off the mantle of leadership in the white supremacy movement that was destined to be his. Yes, people can change. But they also don't change unless we begin by pointing out the need for change. Joy

Specializes in LPN.

Yes, racism is real in nursing. I am a black nurse and I’ve experienced it often from both the patient and the employer. Although we aren’t supposed to discuss salary, we do and white nurses get paid higher but are required to do less. I work in home health as a provider and I’ve worked as a supervisor as well. I’ve been referred to as “my girl” referring to me as the help and the maid rather than a nurse who provides skilled care. I’ve been told to wash windows and clean the hardwood floors by hand, when I called my agency CEO, I was told to do whatever I was told. Needless to say, I quit that day.

As a supervisor doing home visits, I’ve had families specifically request no black nurses, no Nigerian, Caribbean or anyone with African-decent, no Hispanics either. These same families prefer white nurses but our nurse pool is predominantly black. I’ve seen exceptional black male nurses called thugs......racism is very real in every aspect of life. To question it and ask if it’s real is ridiculous.

I’ve seen white nurses high on drugs and under the influence while at work and they weren’t reprimanded. Meanwhile, I’ve known of black nurses who were fired for not wanting to wash dishes or clean someone’s house when that isn’t apart of skilled nursing and not in the job description. Racism is everywhere and it’s never going away. Management, from my experience are reluctant to intervene. They’d rather lose a great nurse rather than have conflict with a patient.

On 7/26/2020 at 2:24 PM, herring_RN said:

I believed him, or at least gave him the benefit of the doubt when I heard him tell of the kindness of night shift nursing staff on the Merv Griffin Show. Please read the entire opinion piece.

Forgiving George Wallace By John Lewis Sept. 16, 1998

Mr. Wallace, first as a circuit judge and then as Governor, fought the civil rights movement with every fiber of his being. He was a demagogue whose words and actions created a climate that allowed for violent reprisals against those seeking to end racial discrimination.

As one of the leaders of the civil rights movement, I remember that George Wallace well. But the George Wallace who sent troops to intimidate peaceful, orderly marchers in Selma in 1965 was not the same man who died this week. With all his failings, Mr. Wallace deserves recognition for seeking redemption for his mistakes, for his willingness to change and to set things right with those he harmed and with his God.

Rarely does our country witness such a conversion by an elected official. Such a conversion of principle can be shaped only by courage and conviction...

... The very essence of the civil rights movement was its appeal to the conscience of those who beat us with batons, attacked us with dogs and stood defiantly at the schoolhouse door. We wanted our enemies to know that every blow they struck was a blow against another human being. The bloodshed that resulted was the blood of all humanity.

When I met George Wallace, I had to forgive him, because to do otherwise -- to hate him -- would only perpetuate the evil system we sought to destroy.

George Wallace should be remembered for his capacity to change. And we are better as a nation because of our capacity to forgive and to acknowledge that our political leaders are human and largely a reflection of the social currents in the river of history...

https://www.nytimes.com/1998/09/16/opinion/forgiving-george-wallace.html

I can't forgive George Wallace. That mindset is still rampant here in AL. Damn near everything is named after him and many other bigots of the past, especially confederate generals. He changed but the people he indoctrinated, turned around and indoctrinated their children, and so forth, haven't.

AL has improved in certain areas but it still has far too many original George Wallace minded people.

Specializes in Critical care, tele, Medical-Surgical.

In the early 1990s when we filed for union representation we on the bargaining team were shocked to learn the discrepancies in pay. In our CCU hourly pay was higher for those hired during a shortage of RNs and much lower for more recent hires. Our staff was very diverse. Some most experienced CCRN certified nurses were being paid less than new grads hired two years before. Our union was and still is a great equalizer.

I may be ignorant and naive, but at the two hospitals where I worked for decades I don't remember any racism from nursing staff. It was common from patients, and a handful of physicians. The doctors were reported and stopped their blatant racist remarks. Their behaving better made it easier on all of us. We cared for racist patients and/or their family members with kindness, but not letting them abuse us. Our nurse managers, supervisors, and chaplains were helpful. When anyone verbalized racism we called a meeting with the patient and often the family. With the exception of a patient with dementia we didn't have to be treated that way. We think that sometimes they began to change, and other times just had to keep quiet as we provided safe, effective, therapeutic nursing care with compassion and kindness.

We know we have been fortunate and that all too many facilities don't respect their nurses. We got just a couple years of that. Working to make things better didn't ONLY result in improved staffing by law, it lifted our spirits and self esteem. After all the need for NURSING CARE is the ONLY reason for a hospital to exist!

Safe-support.jpg Safe Staffing_download.jpg Safe_BLM_Blog_Image_4.png Safe_ProtectNurses.jpg Safe Staffing.jpg

Safe-support.jpgSafe Staffing_download.jpgSafe_BLM_Blog_Image_4.pngSafe_ProtectNurses.jpgSafe Staffing.jpg
Specializes in Faith Community Nurse (FCN).
17 hours ago, herring_RN said:

In the early 1990s when we filed for union representation we on the bargaining team were shocked to learn the discrepancies in pay. In our CCU hourly pay was higher for those hired during a shortage of RNs and much lower for more recent hires. Our staff was very diverse. Some most experienced CCRN certified nurses were being paid less than new grads hired two years before. Our union was and still is a great equalizer.

I may be ignorant and naive, but at the two hospitals where I worked for decades I don't remember any racism from nursing staff. It was common from patients, and a handful of physicians. The doctors were reported and stopped their blatant racist remarks. Their behaving better made it easier on all of us. We cared for racist patients and/or their family members with kindness, but not letting them abuse us. Our nurse managers, supervisors, and chaplains were helpful. When anyone verbalized racism we called a meeting with the patient and often the family. With the exception of a patient with dementia we didn't have to be treated that way. We think that sometimes they began to change, and other times just had to keep quiet as we provided safe, effective, therapeutic nursing care with compassion and kindness.

We know we have been fortunate and that all too many facilities don't respect their nurses. We got just a couple years of that. Working to make things better didn't ONLY result is improved staffing by law, it lifted our spirits and self esteem. After all the need for NURSING CARE is the ONLY reason for a hospital to exist!

Safe-support.jpg Safe Staffing_download.jpg Safe_BLM_Blog_Image_4.png Safe_ProtectNurses.jpg Safe Staffing.jpg

Thank you for sharing with us. It is good to hear about your experience and perspectives. You sound like a person that works hard to make the world a better place. Joy

20 hours ago, NurseBlaq said:

I can't forgive George Wallace. That mindset is still rampant here in AL. Damn near everything is named after him and many other bigots of the past, especially confederate generals. He changed but the people he indoctrinated, turned around and indoctrinated their children, and so forth, haven't.

AL has improved in certain areas but it still has far too many original George Wallace minded people.

You make some valid points. Some people have changed but many have not. Joy

Specializes in Faith Community Nurse (FCN).
On 8/3/2020 at 9:56 AM, Lgunter84 said:

Yes, racism is real in nursing. I am a black nurse and I’ve experienced it often from both the patient and the employer. Although we aren’t supposed to discuss salary, we do and white nurses get paid higher but are required to do less. I work in home health as a provider and I’ve worked as a supervisor as well. I’ve been referred to as “my girl” referring to me as the help and the maid rather than a nurse who provides skilled care. I’ve been told to wash windows and clean the hardwood floors by hand, when I called my agency CEO, I was told to do whatever I was told. Needless to say, I quit that day.

As a supervisor doing home visits, I’ve had families specifically request no black nurses, no Nigerian, Caribbean or anyone with African-decent, no Hispanics either. These same families prefer white nurses but our nurse pool is predominantly black. I’ve seen exceptional black male nurses called thugs......racism is very real in every aspect of life. To question it and ask if it’s real is ridiculous.

I’ve seen white nurses high on drugs and under the influence while at work and they weren’t reprimanded. Meanwhile, I’ve known of black nurses who were fired for not wanting to wash dishes or clean someone’s house when that isn’t apart of skilled nursing and not in the job description. Racism is everywhere and it’s never going away. Management, from my experience are reluctant to intervene. They’d rather lose a great nurse rather than have conflict with a patient.

You raise some really valid points and your stories are sad and enlightening. I am sorry about the title. Of course racism in nursing is real, just as it in all facets of our society. It is time for change--real and lasting. Joy

Specializes in med-surg.

I too acknowledge my privilege as a white female RN. It is something that I consider regularly. Heck, I may not even be a nurse today if I were born black because I could have been arrested, killed, or severely traumatized. I'm not saying that I engaged in illegal activities before becoming a nurse, it's just common knowledge that black people, especially those in certain urban neighborhoods, are targetted by the police and situations can escalate quickly. I am proudly in solidarity with BLM. It's momentum right now is coming at an already tumultuous time but clearly connected to the pandemic in the health outcome disparities we have seen. I am so glad that there is an abundance of conversation about this right now. It's long overdue.

One thought I have is how are white nurses treating their black patients? Is there a way that we can provide mandatory education for nurses to allow them to work on these biases and (at the very least) check them at the door? I know that having these conversations are painful for many Caucasians. I approach it with an open mind and fearlessness, ready to learn and grow but also think it is important that we recognize the pain associated with this growth. I haven't been completely free from pain, I have lost friends I really appreciated over this and my relationship with my best friend is constantly threatened by my views mostly due to the fact that her fiance is a white police officer who has been working at protests. I actually balled my eyes out last night when she started yelling at me and told me that she has felt like she can't express her opinions with me. One fundamental tenet of mine is to communicate with an open mind, listening to others, and engaging in non-violent discussion. So, basically my BEST friend told me that she can't truly be herself around me. That was so heartbreaking. I'm glad she said it though because we can work on it now. Or not...

My coworker bestie RN at the last facility I worked in is from Africa with an accent and deep brown skin. From an organizational perspective, I can't speak for what he experienced but it appeared that he was highly respected and trusted as a high caliber nurse. However, there were many times where I would hear patients being hyper-critical of him in a situation that I wouldn't have encountered that (IMO). There were several times where pts would say ....."you know, THAT man nurse..." inferring that he wasn't doing his job or was treating them poorly which I was absolutely certain was not the case. I experienced this in another facility which was a mix of LTC/SNF/MC. When I worked as a CNA, I would have another person helping me and when they weren't looking, sometimes a resident/pt would give me an eye roll when they weren't looking (almost like they expected me to be grasping their sentiment that the person was 'less than' somehow). It really infuriated me. These were mostly pre-baby boomer pts/residents. I wonder how the culture will change with the evolving movement and a new generation of elderly to care for who were children during de-segregation.

What I would want to know is how I can contribute to change in my work environments. What types of things should I say and do to patients other than what I have been: sticking up for my coworker and telling the patient how strong of a nurse they are, not engaging with subtle racist comments or non-verbal communication? How can I ensure that my organization is exploring its biases and maintaining equal pay, treatment, and hiring opportunities? These are all questions I have been asking myself ever since I had the first hint of racism from a pt/resident. Now, more than ever, I am wanting to be more conscious of this and work toward change. Perhaps, I can form a committee? Maybe anonymous polling at the facility? Possibly lead people, in my unit, to embrace the idea of racial bias training then approach the manager with this desire for education? I really want to dig my heels into my leadership skills to create change where I am.

Thank you for this post. It's really well done and gives me much to think about.

Specializes in Faith Community Nurse (FCN).
3 hours ago, Falcon RN said:

I too acknowledge my privilege as a white female RN. It is something that I consider regularly. Heck, I may not even be a nurse today if I were born black because I could have been arrested, killed, or severely traumatized. I'm not saying that I engaged in illegal activities before becoming a nurse, it's just common knowledge that black people, especially those in certain urban neighborhoods, are targetted by the police and situations can escalate quickly. I am proudly in solidarity with BLM. It's momentum right now is coming at an already tumultuous time but clearly connected to the pandemic in the health outcome disparities we have seen. I am so glad that there is an abundance of conversation about this right now. It's long overdue.

One thought I have is how are white nurses treating their black patients? Is there a way that we can provide mandatory education for nurses to allow them to work on these biases and (at the very least) check them at the door? I know that having these conversations are painful for many Caucasians. I approach it with an open mind and fearlessness, ready to learn and grow but also think it is important that we recognize the pain associated with this growth. I haven't been completely free from pain, I have lost friends I really appreciated over this and my relationship with my best friend is constantly threatened by my views mostly due to the fact that her fiance is a white police officer who has been working at protests. I actually balled my eyes out last night when she started yelling at me and told me that she has felt like she can't express her opinions with me. One fundamental tenet of mine is to communicate with an open mind, listening to others, and engaging in non-violent discussion. So, basically my BEST friend told me that she can't truly be herself around me. That was so heartbreaking. I'm glad she said it though because we can work on it now. Or not...

My coworker bestie RN at the last facility I worked in is from Africa with an accent and deep brown skin. From an organizational perspective, I can't speak for what he experienced but it appeared that he was highly respected and trusted as a high caliber nurse. However, there were many times where I would hear patients being hyper-critical of him in a situation that I wouldn't have encountered that (IMO). There were several times where pts would say ....."you know, THAT man nurse..." inferring that he wasn't doing his job or was treating them poorly which I was absolutely certain was not the case. I experienced this in another facility which was a mix of LTC/SNF/MC. When I worked as a CNA, I would have another person helping me and when they weren't looking, sometimes a resident/pt would give me an eye roll when they weren't looking (almost like they expected me to be grasping their sentiment that the person was 'less than' somehow). It really infuriated me. These were mostly pre-baby boomer pts/residents. I wonder how the culture will change with the evolving movement and a new generation of elderly to care for who were children during de-segregation.

What I would want to know is how I can contribute to change in my work environments. What types of things should I say and do to patients other than what I have been: sticking up for my coworker and telling the patient how strong of a nurse they are, not engaging with subtle racist comments or non-verbal communication? How can I ensure that my organization is exploring its biases and maintaining equal pay, treatment, and hiring opportunities? These are all questions I have been asking myself ever since I had the first hint of racism from a pt/resident. Now, more than ever, I am wanting to be more conscious of this and work toward change. Perhaps, I can form a committee? Maybe anonymous polling at the facility? Possibly lead people, in my unit, to embrace the idea of racial bias training then approach the manager with this desire for education? I really want to dig my heels into my leadership skills to create change where I am.

Thank you for this post. It's really well done and gives me much to think about.

You bring up so many important points!! Thank you for this thoughtful response. You point out some of the personal pain involved in true transformation. Yes, we must change. Now.

Sure, racism is everywhere... but this is a nursing forum. So, let's address racism in nursing. I, for one, am glad that there are more conversations happening about this. I hope it continues.

I've had to deal lots of "Karens" in almost all of my nursing jobs. Each time, senior leadership was white, HR was white... and neither were culturally competent.

In the meantime... I'm off to buy some lottery tickets ?