In January 2021, the American Nurses Association formed the National Commission to Address Racism in Nursing. The purpose of the Commission is to investigate and address the problem of racism in nursing and its impact on patients, communities, and the nursing profession. In January 2022, the Commission released the results of a nationwide survey about racism in nursing conducted in October 2020, which showed that 63% of the nurses surveyed had personally dealt with racism during their career. The research reported that this racism stemmed from leaders, peers, and patients. Nurses reported that as both victims and witnesses, these experiences impacted their overall well-being. You can read the full research report here. In March of this year, the Commission launched an 8-week series called Project ECHO: Addressing Racism in Nursing. This series brought nurses from across the nation together virtually to hear national speakers discuss different aspects of racism, like microaggressions, unconscious bias, and retaliation. Attendees then broke out into virtual workrooms to review a case scenario-true stories which attendees had submitted prior to the launch of the series.
In addition to addressing racism in nursing, there has been a national call for nurses to become more involved in addressing systemic racism in healthcare. One area that continues to be studied is implicit bias in healthcare workers. Implicit bias is the unconscious behaviors, attitudes, and preferences that negatively affects groups of people, typically related to race or ethnicity, although it can extend to sexual orientation, gender, age, socioeconomic status, and other characteristics. Implicit bias impacts our ability to provide equitable care to everyone. In fact, implicit bias has been linked to nursing care disparities, or the provision of different care to patients based on one or more patient characteristics (age, gender, race, diagnosis, etc.). Missed assessments, missed care, less time spent with patients, and poor patient education are just a few examples in the literature of disparate nursing care. Disparate nursing care most significantly impacts racial and ethnic minorities, who are already at risk of healthcare disparities related to social determinants of health.
One of the first ways we can address systemic racism in healthcare is through self-examination of our attitudes and beliefs. What do you believe about people groups of different races/ethnicities than yourself? What were you taught by your family? What do your friends say about other races/ethnicities? How are different racial/ethnic people represented in the media you’re exposed to? Our environment and our community transmit their messages into our consciousness, both positive and negative. Over years and years, this informs our reactions and behaviors. The first line of defense against implicit bias is acknowledgement that racism exists and that our unconscious biases can contribute to it if we do not make ourselves aware of it and consider our actions. Recently, the ANA engaged in self-examination and released a racial reckoning statement as part of a Journey to Racial Reconciliation. The statement began with a formal apology for failing to represent the views and needs of nurses of color. It went on to detail examples of systemic racism extant within the history of the ANA. The ANA acknowledged and apologized for the actions and inactions of the organization and concluded with a pledge to seek reconciliation for the hurt caused and outlined actions for moving forward.
The ANA is offering the Project ECHO series again, this fall, free of cost to anyone who is interested in learning more. You can register for this series here. I hope this will be the beginning of many more conversations about how we, the most trusted profession, can engage in antiracist activities to positively change outcomes for both our patients and our colleagues.