Dr. Susan Moore, 52, died of complications related to COVID-19 in St. Vincent Carmel Hospital in Carmel, Indiana. A Black physician, she posted on social media about her treatment in and discharge from another area hospital. Her post describes what she felt was “racist” treatment by her medical team and her attempts at self-advocacy in the midst of her severe disease.
Racial and Ethnic Minority Group Disparity
Her course of treatment and subsequent death highlight the disparities some persons of color face in their care. The disparities have become more visible during 2020 with the coronavirus pandemic. The inequities in health care may have been in the background all along, but they have begun to stand out starkly in the past few months as Blacks and persons of color suffer and die disproportionately.
Long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19. The term “racial and ethnic minority groups” includes people of color with various backgrounds and experiences. But some experiences are common to many people within these groups, and social determinate of health have historically prevented them from having fair opportunities for economic, physical, and emotional health (CDC.gov).
"If I Were White"
Dr. Moore posted several times to social media during her course of treatment. She described, with the knowledge of a physician, her plan of care, and necessary actions. She was diagnosed with COVID-19 on November 29 and was hospitalized for treatment of respiratory symptoms. During that hospital stay, she reported her symptoms, treatment, and concerns that she was being treated differently because of her skin color. She said, “I put forth, and I maintain, if I were white, I wouldn’t have to go through that.”
While the particulars of her case are difficult to ascertain, the CDC and the U.S. Department of Health and Human Services have determined significant disparities in the Social Determinates of Care and access to related to ethnicity, poverty, discrimination, and access to care (healthypeople.gov).
As professional nurses, we are part of the access and delivery of treatment outside the hospital and at the point of care. What is our role in identifying discrimination and inequities and addressing those?
Surely we would never discriminate against a patient because of the color of their skin. Would we? Not on purpose, anyway. The problem of possible racism and inequality of treatment based on skin color is impossible to deny and monumental to address.
What Can We Do in Our Day-to-Day Practice that Makes a Difference?
Assess
While we may not feel we are racist in any way, studies and our own experience show us that we all have a racial bias. Often it is hard for us to see and acknowledge racist attitudes in ourselves. Still, it is a first step in addressing the problem, especially as it relates to our professional behavior. Attending training, reading, watching movies, educating ourselves can all be steps to help us, but in the end, we must sit with the fact that we all have work to do as humans. None of us is exempt. But there is hope. With grace, compassion, and love we can come together to see the problem and do something about it. Grace and love are the only actions that can truly change racism. Everything else just points a finger at it and stirs it around.
Acknowledge
Acknowledge that the change begins with me. As Mahatma Gandhi said, “If we could change ourselves, the tendencies in the world would also change. As a man changes his own nature, so does the attitude of the world change toward him.” It is always easier to point fingers and shame/blame others for their bad behavior. But for racism and racial bias and discrimination to stop, we must come together to identify the problem and pull it out by its roots—every day. This is not a training session that we can attend to fix what is wrong—this is an attitude of the heart.
Advocate
When you hear labels being tossed about—“ drug addict” or “difficult patient” or “trouble maker”—be aware and alert to your own feelings and the possible need to speak out. Advocacy is not mean, and it doesn’t employ shame. It simply provides a human perspective. People who are hurting need care—even if they aren’t nice or thankful or kind themselves. While we all know this and practice it every day, we all need encouragement to stay the course. It can be wearing to care for someone who doesn’t reciprocate with appreciation. A friend once said, “Hurt people, hurt people.” We don’t know what our patients are going through and what their lives are like outside of their illness. When they lash out, we cannot strike back. We provide care. Excellent care. Every time and to every patient.
Appreciate
As nurses, we get tired. We have bad days, too. As we walk through difficult days, we want to continue to help each other be our best selves. This begins by not denigrating other staff or talking negatively about our patients in the lounge's privacy. Negativity breeds negativity, and soon the contagion overwhelms the unit with discouragement. Be aware of co-workers who have a tendency toward negativity and work to maintain a positive balance. While we don’t want to be always countering with “the bright side,” we also don’t have to enter into the negativity. We can stay the course, remaining neutral. If we are in a leadership position, we help set the tone: finding ways to express appreciation and allowing nurses to vent when they need to in appropriate and supportive ways.
Hope and Grace
Dr. Susan Moore was a Jamaican-born immigrant who graduated from the University of Michigan Medical School. According to Alicia Sanders, who has established a GoFundMe account, “Susan was a phenomenal doctor. She loved practicing medicine, she loved being a member of Delta Sigma Theta Sorority, Inc, she loved helping people, and she was unapologetic about it.” May she rest in peace, and may her self-advocacy propel us forward on our journey toward more compassionate care.
jeastridge, BSN, RN
83 Articles; 560 Posts
Thank you for your helpful comment. I think this article is about how we deal with the racism that exists. It is not asking a question, it is stating a known fact and asking us to look at where we go from here. How do we change? How do we assess our own behaviors and find ways to improve. One of the answers lies in your first sentence, "...tread lightly with the way we treat others..."