Why Black History is Important in Nursing Education

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(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.


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.

Specializes in Stepdown . Telemetry.
On 2/3/2021 at 12:14 PM, guest965675 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.

Well, hmm...lets see...black v white? Well white enslaved black for 250 years who then spent the next 150 years in a country that left them disadvantaged ever since. Top that off with a deep seed of racism in this country that has been present for 300 years and still exists today. So WOW! are u talking about?

PS: in a thread about black history you feel the need to discuss “black vs white”. You answer your own question by posting the question. 

Specializes in Hospice.
5 hours ago, kaylee. said:

Well, hmm...lets see...black v white? Well white enslaved black for 250 years who then spent the next 150 years in a country that left them disadvantaged ever since. Top that off with a deep seed of racism in this country that has been present for 300 years and still exists today. So WOW! are u talking about?

To add to this poster’s point, it’s not a zero-sum proposition. To minimize a community’s  historical experience because a different community is not mentioned is a fairly common tactic in these discussions. It serves to trivialize the experience of one community because it isn’t the same as another’s. The old divide and conquer.

21 hours ago, nursel56 said:

I just feel bad we apparently scared the author away. She tried to respond politely to the topic derailer at first-- then fatigue or disgust set in? 

Anyway, I read somewhere that 60% of communication is nonverbal, which can be frustrating I am sure for people who can't fathom how what they were writing about so quickly turned into something they don't recognize based on the responses they're getting. 

I’m here.  Unfortunately my father died. 
 

I appreciate the discussion and pleased that this article generated discussion.   We must be able to discuss race and history without attacking one another.  Communication requires listening and reflection.  I do hope we can continue to share discussions on race, class, lgbtq, elderly and how we interact with people different from who we are.  We are all learning.  Listening is key. 

Specializes in Psych (25 years), Medical (15 years).

My condolences, Ms. Winters. I am sorry for your loss.

Your article and replies are quality and you also have my highest regards.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
57 minutes ago, Stacy Winters said:

I’m here.  Unfortunately my father died. 
 

I appreciate the discussion and pleased that this article generated discussion.   We must be able to discuss race and history without attacking one another.  Communication requires listening and reflection.  I do hope we can continue to share discussions on race, class, lgbtq, elderly and how we interact with people different from who we are.  We are all learning.  Listening is key. 

Condolences on the loss of your father. Thank you for responding.

Specializes in Education, FP, LNC, Forensics, ED, OB.

My sincere condolences, @Stacy Winters

2 hours ago, Stacy Winters said:

I’m here.  Unfortunately my father died. 

I cannot fathom the grief. My condolences.

Quote

 Communication requires listening and reflection.  I do hope we can continue to share discussions on race, class, lgbtq, elderly and how we interact with people different from who we are.  We are all learning.

 Indeed! ?

 

Specializes in retired LTC.

OP - So sorry for the loss of your father. Holding good thoughts for you and close others.

This post seems to have taken a different direction that I think I, personally, interpreted from the opening post. My question is "how would Black History be integrated into nsg programs that already lack sufficient classroom time, and woefully limited clinical time, for other nsg & science topics? Like what could you delete to sub in Black History?

I would take it further (and some many have touched upon this) but all varying ethnic histories should be considered. Are NOT the backgrounds of Latinx, Jewish, Asian, American Natives and others just as important?

And for what long-term purpose? To enhance pt care of the diverse populations and/or to encourage enrollment of ethnical diverse practitioners? Both are worthwhile reasons.

But would not similar history classes be of worth to collegiate programs in  Physics, Agronomy, Family Law, French History or Medieval Art, etc?

While worthwhile, I think we'd be selectively determining CERTAIN professions as more WORTHY to consider ethnicities in their curricula.

A program such as Transcultural Approach to Healthcare Accessibility, Diagnoses, Interventions and Client Compliance to Determine & Facilitate Positive Ethnic Diverse Population Outcomes sounds terrific to me (I'm impressed with myself for thinking up that class!) But then should it not be also be presented to schools of Medicine, Chiropractice, Dentistry, ancillary professions like Mammography, Nuclear Med, Xerography, etc??? Why clients in New Orleans Lower 9th Ward are/are not vaccinating, getting breast exams, dental visits, etc and what can be done???

Is a mandatory Black History course encompassing enough to really be a real an enhancement to the gen'l population? I just don't see it. JMHO.

 

Specializes in Hospice, Geri, Psych and SA,.
12 minutes ago, amoLucia said:

OP - So sorry for the loss of your father. Holding good thoughts for you and close others.

This post seems to have taken a different direction that I think I, personally, interpreted from the opening post. My question is "how would Black History be integrated into nsg programs that already lack sufficient classroom time, and woefully limited clinical time, for other nsg & science topics? Like what could you delete to sub in Black History?

I would take it further (and some many have touched upon this) but all varying ethnic histories should be considered. Are NOT the backgrounds of Latinx, Jewish, Asian, American Natives and others just as important?

And for what long-term purpose? To enhance pt care of the diverse populations and/or to encourage enrollment of ethnical diverse practitioners? Both are worthwhile reasons.

But would not similar history classes be of worth to collegiate programs in  Physics, Agronomy, Family Law, French History or Medieval Art, etc?

While worthwhile, I think we'd be selectively determining CERTAIN professions as more WORTHY to consider ethnicities in their curricula.

A program such as Transcultural Approach to Healthcare Accessibility, Diagnoses, Interventions and Client Compliance to Determine & Facilitate Positive Ethnic Diverse Population Outcomes sounds terrific to me (I'm impressed with myself for thinking up that class!) But then should it not be also be presented to schools of Medicine, Chiropractice, Dentistry, ancillary professions like Mammography, Nuclear Med, Xerography, etc??? Why clients in New Orleans Lower 9th Ward are/are not vaccinating, getting breast exams, dental visits, etc and what can be done???

Is a mandatory Black History course encompassing enough to really be a real an enhancement to the gen'l population? I just don't see it. JMHO.

 

Certainly all minorities have faced challenges when it comes to receiving appropriate healthcare but bringing attention to the challenges of one minority such as in this thread does not minimize the challenges and need for education for other minorities.

Curriculums make to room and expand for new topics all the time, education is living and breathing and not set in stone. I would much rather take a course in a nursing program about the history and current state of healthcare disparities than a medieval art program.

6 minutes ago, amoLucia said:

OP - So sorry for the loss of your father. Holding good thoughts for you and close others.

This post seems to have taken a different direction that I think I, personally, interpreted from the opening post. My question is "how would Black History be integrated into nsg programs that already lack sufficient classroom time, and woefully limited clinical time, for other nsg & science topics? Like what could you delete to sub in Black History?

I would take it further (and some many have touched upon this) but all varying ethnic histories should be considered. Are NOT the backgrounds of Latinx, Jewish, Asian, American Natives and others just as important?

And for what long-term purpose? To enhance pt care of the diverse populations and/or to encourage enrollment of ethnical diverse practitioners? Both are worthwhile reasons.

But would not similar history classes be of worth to collegiate programs in  Physics, Agronomy, Family Law, French History or Medieval Art, etc?

While worthwhile, I think we'd be selectively determining CERTAIN professions as more WORTHY to consider ethnicities in their curricula.

A program such as Transcultural Approach to Healthcare Accessibility, Diagnoses, Interventions and Client Compliance to Determine & Facilitate Positive Ethnic Diverse Population Outcomes sounds terrific to me (I'm impressed with myself for thinking up that class!) But then should it not be also be presented to schools of Medicine, Chiropractice, Dentistry, ancillary professions like Mammography, Nuclear Med, Xerography, etc??? Why clients in New Orleans Lower 9th Ward are/are not vaccinating, getting breast exams, dental visits, etc and what can be done???

Is a mandatory Black History course encompassing enough to really be a real an enhancement to the gen'l population? I just don't see it. JMHO.

 

While I appreciate the skeptical questions that you have raised, I think it's injudicious to focus on trees and miss the entire forest. I don't think that anyone is advocating for a mandatory black history course in nursing.

Currently, there are several completed studies focusing on black people that impact the healthcare setting significantly. For instance, there are studies showing discrepancies in maternal morbidity and mortality among African Americans (AA) compared to other groups. There are studies that show certain antihypertensive medications affect AAs differently relative to effectiveness.

A nurse who is keenly aware of diverse backgrounds and wide-ranging patients' needs will be more efficient in delivering healthcare than one who is naïve with a limited scope. In graduate school, we had one lecture period about transgender people and the inherent needs and complexities of that group. I did not feel compelled to complain about why other groups were not covered. I think being receptive to learning about demographics that are dissimilar to oneself is profoundly paramount in not only being a 21st century nurse, but also an empathetic and insightful human.

Moreover, knowing history helps one become a better advocate. Understanding the repercussions of the Tuskeegee experiments would expand one's perspective about certain complexities in the affected community. In the 70's-80's thousands of Black women were sterilized under the auspices of new contraceptives being propagated in areas like Atlanta. A well-informed nurse might have seized that opportunity to be an advocate of those who were marginalized.

Therefore, no, it does not need to be a course, but it behooves us as individuals to yearn to learn about those who are dissimilar to us. 

Specializes in Hospice, Geri, Psych and SA,.
6 hours ago, cynical-RN said:

While I appreciate the skeptical questions that you have raised, I think it's injudicious to focus on trees and miss the entire forest. I don't think that anyone is advocating for a mandatory black history course in nursing.

Currently, there are several completed studies focusing on black people that impact the healthcare setting significantly. For instance, there are studies showing discrepancies in maternal morbidity and mortality among African Americans (AA) compared to other groups. There are studies that show certain antihypertensive medications affect AAs differently relative to effectiveness.

A nurse who is keenly aware of diverse backgrounds and wide-ranging patients' needs will be more efficient in delivering healthcare than one who is naïve with a limited scope. In graduate school, we had one lecture period about transgender people and the inherent needs and complexities of that group. I did not feel compelled to complain about why other groups were not covered. I think being receptive to learning about demographics that are dissimilar to oneself is profoundly paramount in not only being a 21st century nurse, but also an empathetic and insightful human.

Moreover, knowing history helps one become a better advocate. Understanding the repercussions of the Tuskeegee experiments would expand one's perspective about certain complexities in the affected community. In the 70's-80's thousands of Black women were sterilized under the auspices of new contraceptives being propagated in areas like Atlanta. A well-informed nurse might have seized that opportunity to be an advocate of those who were marginalized.

Therefore, no, it does not need to be a course, but it behooves us as individuals to yearn to learn about those who are dissimilar to us. 

Spoken very eloquently.

Specializes in Vents, Telemetry, Home Care, Home infusion.

Condolences, @Stacy Winters ---may your memories  of your father sustain you.

 

Along with understanding Black History, its important to increase numbers of Black Nursing Educators who understand and can share their ethnic background and cultural roots to educate nursing students and expand their horizons.

Philadelphia Inquirer 12/23/20

Real health-care equity means diversity everywhere — including nursing school faculty | Opinion

Quote

...The following year, my classmates and I gave culturally specific maternal health presentations. In a gross misinterpretation of the eating disorder pica, one of my classmates exclaimed, “Black people eat dirt!” Our professor asked me about the accuracy of this statement. I was mortified. What would make my classmate believe Black people eat dirt? And why wasn’t my professor culturally aware enough to call her out? Why did she call on me to be the spokesperson for all Black people?

These and other racially charged experiences led me to pursue a career as a nurse educator because I wanted to help diversify nursing faculty. I didn’t want future Black nursing students to feel the way I felt. I wanted them to have a faculty member with a shared ethnic background and cultural roots. I didn’t want them to feel alone....

 

 

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