Why Black History is Important in Nursing Education

[Stacy Winters, MSN, APRN, NP]

(Image: 1920, Library of Congress, Negro Red Cross Canteen, Meridian, Mississippi)

Forty-five years ago, President Gerald Ford declared February as Black History Month to recognize the many accomplishments of prominent  Black Americans throughout history. Black History Month also highlights the experiences of African Americans from 1619 when the first African slaves arrived in the United States to the present day. In nursing, we traditionally celebrate the memory and work of well-known African American nurses like,  Sojourner Truth and Harriet Tubman, but fail to acknowledge racism and the atrocities imposed upon the bodies of Black Americans for the sake of science. Black history is American history.  It is nursing history.

Nursing educational programs not only create and shape nursing practice, but thought. Interweaving Black history into the nursing curricula is the first step in decolonizing nursing curricula and reducing implicit bias in healthcare today.  As nurses, we must be aware that patients are people first with unique experiences, backgrounds and history.

It is more important now than ever that nurses understand the history of African Americans, their relationship with the medical community, and why some African Americans still fear going to hospitals or getting vaccines. The fear is real.  It is Iatrophobia or the fear of a medical examination, harm, exploitation and/or mistreatment.

Perhaps some historical accounts can shed some light as to why some African Americans avoid the healthcare system.  From 1619 to 1730,  African American slaves were treated as property, receiving little to no medical treatment.  In the mid-1800s,  James Marion Simms performed gynecological techniques on Black women without anesthesia or their consent in order to perfect his surgical techniques and to get published in medical journals. In 1913, sterilization laws were enforced. Anyone declared to have a mental illness could be sterilized. African Americans were four times more likely to be sterilized than their white counterparts. In 1932, the United States Public Health Service performed a study on sharecroppers in Tuskegee, Alabama to understand the effects of syphilis on Black men without their consent.  This experiment known as the Tuskegee Experiment lasted for 40 years.  The men remained untreated even though there was treatment available.  The treatment was penicillin. These are only a few accounts of systemic racism in healthcare throughout history.

Time cannot erase the indelible effects of medical apartheid. Mistrust persists today even as we battle Covid-19.  Currently, reports show that rates of Covid-19 are three times higher among African Americans, yet many refuse to get vaccinated for the virus.  According to the Pew Research Center, only 42% of African Americans state that they would get the vaccine compared to 61% of Whites. History provides insight into why some African Americans mistrust healthcare. Can we blame their skepticism? Perhaps not. 

The vestiges of medical racism stain the memories of many African Americans for generations. As frontline workers and trusted professionals, it is key that nurses be aware of the sorted history of medicine and the African American community.  Contextualizing culture creates compassion.  Understanding history is the first step in that process.

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References

Bennett, C., Hamilton, E. K., & Rochani, H. (2019). Exploring race in nursing: Teaching nursing students about racial inequality using the historical lens. OJIN Online J Issues Nurs, 24(2).

Funk, C. & Tyson, A. (3 December 2020). Intent to Get a COVID-19 Vaccine Rises to 60% as Confidence in Research and Development Process Increases. https://www.pewresearch.org/science/2020/12/03/intent-to-get-a-covid-19-vaccine-rises-to-60-as-confidence-in-research-and-development-process-increases/

Hollander, M. A., & Greene, M. G. (2019). A conceptual framework for understanding iatrophobia. Patient education and counseling, 102(11), 2091-2096.

Joyner, T. & Lee, J. S. (20 April 2020). Health and race disparities in America have deep roots: A brief timeline. https://www.freep.com/story/news/local/michigan/2020/04/20/timeline-health-race-disparities/5145641002/

Minority Nurse. (2017). Reflecting on Black History Month and Nursing. https://minoritynurse.com/reflecting-on-black-history-month-and-nursing/

Washington, H. A. (2006). Medical apartheid: the dark history of medical experimentation on Black Americans from colonial times to the present. New York: Doubleday.

[TheMoonisMyLantern, LPN, RN]

Thank you for this thread. I think you're absolutely right that there needs to be more education in nursing schools about the systemic racism an bias that has existed in medicine towards black americans. 

I admit, I'm still learning about the horrific history, and the more I learn, the more I have gained insight into certain behaviors from patients I've had over the years that at the time I didn't understand.

I completely support this.

[Stacy Winters, MSN, APRN, NP]

Thank you so much 

[LibraNurse27, BSN, RN]

Thank you for bringing this up! On the Podcast Good Nurse Bad Nurse the host has been telling the story of a Black person who contributed to healthcare every week for the past year. The first Black flight nurse, untrained Black scientist who invented cures and techniques that white scientists and doctors took credit for. The fact that she still has people to talk about a year later shows just how much Black Americans have contributed, all while facing pushback, lack of access to formal education, discrimination, and harassment.

[guest965675]

When will we be able to stop with the black and white. Anyone remember what the American Indians survived. Much, much more than any other group. Let’s start with a First Americans month in January. Then when we all celebrate that you can tell me what’s next. Stop with the political BS.

[Stacy Winters, MSN, APRN, NP]

Thank you for your comment.  My commentary is not political. It is a historic account. It basically provides the reader insight into atrocities that have occurred in the US and how that information can explain why some Black Americans may be afraid of the Covid-19 vaccine.  

You are correct. There are many atrocious incidents throughout history against Indigenous persons, LGBTQ, Latinx, etc.  I agree their stories should be included in nursing education as well. 

This was written to broaden the discussion and explain why nursing education should include more voices because we live in a diverse county.  Diversity is not political.  I respect your post but I disagree with you that this is a political post. 

I do hope more stories will be included in nursing education.  It is up to us to share what was NOT in the books with others.  

[guest965675]

I’m able to admit when I am wrong. I just want to heal people and every time I see distinctions between humans I get aggravated with the nonstop litany of what I should have or could have done.

[Stacy Winters, MSN, APRN, NP]

We are all learning. I’m learning too especially working in primary care.  I recognize fully I don’t know the history of everyone that comes in my office and strive to be more understanding.  Education is one way to help me connect with my patients and hopefully help them too.  No one is to blame for the past.  The commentary was written to inform not blame.   We all strive to do better.  That’s what nurses do.  We care.  Thank you for reading. 

[guest965675]

I appreciate your candor 

Keep learning. I will 

[NRSKarenRN, BSN, RN]

Reposting Mary Mahoney's story

 

 

[Charles Barrow]

8 hours ago, karllotta said:

When will we be able to stop with the black and white. Anyone remember what the American Indians survived. Much, much more than any other group. Let’s start with a First Americans month in January. Then when we all celebrate that you can tell me what’s next. Stop with the political BS.

One does not have to look too hard to find historical accounts of Black American experiences during Black History Month.  I find that writings about American Indians seem to increase in November (American Indian and Alaska Native Heritage Month), Asian Americans in May (Asian American and Pacific Islander Heritage Month), and Hispanic Americans between September 15 and October 15 (National Hispanic Heritage Month).  Seems apropos to me.

[TheMoonisMyLantern, LPN, RN]

Recognizing and reflecting on the mistreatment and oppression of one minority does not minimize of downplay the struggles or persecution of other minorities. Why do white people feel so threatened by acknowleding the misjustices and inequities that existed and still exist? As a white person I just don't get it, I appreciate being educated on disparities I didn't know existed so I can help contribute to a more equitable world. It's not a contest over who has suffered most, we can acknowledge and respect everyone's difficulties and journey. A lot of white people think that "white privilege" means that all white people have had it easy and become offended but that's not what it is, it just means that white people have not been set back in society because of the color of their skin.