Each February, Black History Month celebrates the historical achievements of U.S. African American leaders. 2023’s theme, Black Resistance, explores how this community has historically resisted oppression in all forms. As Black History Month approaches, Maria begins to research ways to educate her team on Black resistance and its relevance in the healthcare profession.

Maria remembers the times when she experienced racist biases, attitudes, and stereotypes in the nursing profession from members of the interprofessional team and patients. In practice, this may look like assignment changes at the request of patients and family seeking care from non–BIPOC nurses; microaggressions in the form of insults, slights, and presumptions of lack of competence and ability; and barriers to career advancement. Maria recognizes the crucial need for individuals to learn to resist barriers that contribute to inequalities and racism in nursing practice by providing support, developing DEI policies, and standing against racist behaviors.

What Would You Do?

Maria is not alone in experiencing racism in the nursing practice environment: An American Nurses Association report indicated that more than 63% of nurses surveyed personally experienced an act of racism in the workplace. Of those surveyed, 92% of Black respondents reported that they have personally experienced racism in the workplace from their leaders (70%), patients (68%), and peers (66%).

In addition, more than three-quarters of Black nurses surveyed said that racism in the workplace has negatively affected their professional well-being. Being subjected to structural and cultural racism, discrimination, and microaggressions on top of an already demanding job can significantly affect an individual’s physical and mental health. This can result in decreased morale, retention, burnout, and, indirectly, patient safety.

A study from the National Commission to Address Racism in Nursing indicated that BIPOC nurses also experience self-doubt or internalized oppression from a lack of validation and support. In the study, the nurses’ responses “spoke of invisible boundaries and subsequent limitations and denial of opportunity set by power, privilege, and entitlement. Examples include denial of research opportunities, tenure, and professional advancement. There were multiple accounts of ‘stealing of credit’ where the nurse of color would put forth a thought or idea only to have it taken and presented by a White nurse who subsequently received credit for doing so.”

Maria shares this information with her colleagues and challenges them to develop and implement practices and policies that shut down racism before it begins. She encourages them to take a stand against racist behaviors by involving a supervisor or a trusted member of the interprofessional team right away. She also includes her institution’s DEI committee in the discussion to promote programs and policies that can help Black nurses and nurses of other minority backgrounds feel empowered in their practice and offer support as needed.

Citing examples from a National Commission to Address Racism in Nursing report, Maria explains that her institution should develop worksite policies to address and change the problems of bias, discrimination, and racism in the nursing profession:

• Implement relevant, meaningful operational definitions for dismantling racism in each setting.
• Create an organizational plan with buy-in from leadership, staff, and employees and built-in accountability for outcomes.
• Establish DEI as a programmatic approach with a line item in the organizational budget to make work sustainable.

After Maria shares her findings with her team, some of her colleagues decide to follow examples from the same report and introduce ideas to the DEI committee to establish a curriculum for the non-BIPOC leader that teaches management skills needed for a multicultural workforce, monitor and increase BIPOC hires, and designate a DEI officer to oversee strategy and serve as an employee resource. They explain that those actions would further the recruitment and retention of BIPOC nurses at the institution and set them up for a successful career trajectory and opportunities for career advancement and growth.

Maria’s involvement with fostering a positive work environment also ensures that her peers can reduce the other factors that contribute to burnout and a decrease in well-being and joy at work. To take a step further, Maria and her colleagues share some additional well-being and mental health resources:

• ONS Voice’s Nurse Well-Being topic tag
• ONS Nurse Well-Being Learning Library
• Connecticut Clearinghouse’s list of mental health and wellness resources for the Black community

Embody Resistance

Throughout both history’s and today’s events, the Black community continuously faces oppression in many forms. To embody resistance, think of innovative and strategic solutions to combat racist behaviors, use your voice to stand up for your beliefs, and encourage others to do the same. As Martin Luther King, Jr., said, “Our lives begin to end the day we become silent about things that matter.”