DiversityNursing Blog

The National Commission to Address Racism in Nursing defines racism as "Assaults on the human spirit in the form of biases, prejudices, and an ideology of superiority that persistently cause moral suffering and perpetuate injustices and inequities."

The Commission surveyed over 5,600 Nurses and found racism to be a significant problem in the field. Results show:

63% of Nurses personally experienced an act of racism in the workplace with the transgressors being either a peer (66%), patients (63%), or a manager or supervisor (60%).

56% of Nurses say racism in the workplace has negatively impacted their professional well-being.

“We are still living through the structural racism that is embedded in America,” says Quanna Batiste-Brown, DNP, RN, Chief Nursing Officer in Ambulatory Care at UCLA Health. “I think addressing it in Nursing is one of the things we can do to move forward.”

Along with addressing the issue, health systems are using various strategies to help eradicate Racism in Nursing.  

Establishing A Task Force

A task force or Council is usually a group consisting of healthcare leaders such as Chief Nursing Officers (CNO), Chief Diversity Officers (CDO), clinical and non clinical staff.

Seattle Children's task force is comprised of Nurses, coaches, Inclusion Network members, Physicians, support staff, scientists and leaders who developed the Health Equity and Anti-Racism Action Plan. 

Nurses at UCLA Health established a council called Unity in Diversity (UID). The primary purpose of UID is to assess, plan, implement and continuously improve actions toward establishing an authentic environment of equity, diversity, and inclusion for patients, trainees, and Nursing staff. 

Karen Grimley, PhD, MBA, RN, Chief Nursing Executive for UCLA Health told Becker's Hospital Review, "That group dovetails into the health system steering committee that's been created by our Chief health, Equity, Diversity and Inclusion Officer. So, we've tried to put a system in place that's going to identify and begin to address cultural norms that may be contributing to systemic bias and racism."

Education And Training

Mount Sinai Health System created the United in Solidarity Resource Guide. This guide is a catalogue of educational articles and resources to learn about racism, prejudice, and bias in America as well as causes to support the fight against injustice. 

Mass General Brigham launched its first system-wide anti-racism educational program, titled Stepping Stones. Stepping Stones was designed to allow viewers to understand how racism exists and functions in our society - and how they can combat it.

RWJ Barnabas Health compiled a list of educational anti-racism resources such as implicit bias tests, white privilege checklist, and a systemic racism video series. 

Diverse Leadership

Hiring Nurses that represent diverse communities is essential. They provide opportunities to administer quality care because of their understanding of various cultures, languages, gender identities, ethnicities, etc. Having diverse Nurses in leadership positions can play a crucial role in breaking down barriers such as discrimination in Nursing.

Staff from diverse backgrounds with histories of discrimination in healthcare may feel reassured when they see people who look like them in leadership positions. They may also feel more comfortable coming forward and reporting an incident of racism or discrimination.

No matter which initiatives a hospital implements, it must start with awareness and identifying any structural biases or barriers.

Marcus Henderson, MSN, RN, lecturer from the University of Pennsylvania’s Department of Family and Community Health, said “To adequately and effectively address health inequities and social determinants of health, Nursing must first look inward to address the inequity, lack of diversity, discrimination, and racism that lies within the profession. It’s not hiding. It has always been in plain sight.”

Chief Nursing Officers have a wide variety of responsibilities. Their role has become more complex with the COVID-19 pandemic, social injustices, and systemic racism in the United States.

The pandemic is straining the healthcare profession. Nurses are under immense stress and Nursing leaders need to use best practices to address the mental and emotional trauma their teams are enduring.

In an article by HealthLeaders, Penn Medicine Princeton Health Chief Nursing Officer, Sheila Kempf, PhD, RN, NEA-BC said they are implementing many strategies to care for Nurses' mental health.

Some of those strategies include training staff to recognize the signs of being at high risk for emotional distress, and when peers should be referred to the Employee Assistance Program (EAP).

Also the hospital has contracted a trauma clinical Psychologist to talk with staff and run support groups with the EAP and the Ministries department.

CNO's should recommend frequent breaks or a quiet space for Nurses to retreat to.

Nurse leaders are also facing the challenges of short staffing, low resources, and supplies.

According to a survey by Inspire Nurse Leaders, 53% of Nurse Leaders reported difficulty meeting work and family needs due to inadequate staffing.

Risley-Gray also said, health systems need to hire outside help when Nurses become infected or get exposed to the virus. Aspirus is offering Nurses who have at least one year's experience a $15,000 signing bonus, as well as employing contract Nurses via private staffing companies.

2020 not only brought forth a pandemic, it also put a spotlight on systemic racism and racial health disparities.

Sharon Hampton, PhD, RN and Director of Clinical Operations at Stanford Health said, "We've discussed our ethical and moral responsibilities to deal with this crisis. Nursing is really in this position to help the public understand and to advocate."

Healthcare systems and Nurse leaders should be promoting diversity and inclusion at all levels of the workplace.

Kelly Hancock, RN, DNP and Executive CNO of the Cleveland Clinic Health System, said more diversity would help the Nursing workforce “provide more customized, culturally-sensitive and safer care” and “better assess, accommodate and cater to the healthcare needs of different minority groups.”

Those in leadership positions should reflect the diverse patient populations they serve.

According to HealthLeaders Media, a study by the Institute for Diversity and Health Equity found that racial minorities represented 32% of patients in hospitals that participated in the study, but similar representation wasn't found among the health care leadership. According to the study, 19% of first- and mid-level management positions, 14% of hospital board membership positions, and 11% of executive leadership positions were held by racial minorities.

Hospitals and health systems must commit to increasing diversity within their leadership to improve patient outcomes, reduce racial health disparities, and build stronger communities.