As I write this guest editorial, it is 1 month out from the killing of George Floyd at the knee of a police officer. Protests are occurring in all 50 states of the United States and in multiple countries across the world. Professional organizations, including the International Association of Forensic Nurses (IAFN), have released statements condemning discrimination, racism, and violence. Many individuals are making efforts to adopt an antiracist stance. For the first time in history, the top books on most bestseller lists are about racism, White privilege, and implicit bias.
As you read this several months later, I hope that this spirit of angst, desire for change, and quest for learning are still as strong. I am cautiously optimistic. After all, we have been here before.
The IAFN statement addresses multiple ways that forensic nurses can work as individuals to increase representation in the organization and to educate fellow members (IAFN, 2020). However, racism occurs at individual, institutional, and structural levels. The challenge ahead is to leverage the privilege of members to address racism at an institutional level within IAFN and then to approach societal or structural change. I offer an examination of forensic nursing education to address institutional level change and partnerships with the criminal justice system to address structural change.
Forensic Nursing Education
As an organization, the IAFN has a myriad of opportunities to educate nursing from an antiracist framework. The first step is a fearless examination of current content, modules, and tests for racist or biased content along with a gap analysis to determine any missed opportunities. For example, case studies can represent well-intentioned attempts to include diverse patients who fall prey to stereotypes. Case studies that depict Black persons as poor, public benefit recipients; drug using; single parents; and so forth reinforce rather than confront racism. Although this is the experience of some Black persons, it is not representative of all Blacks. Furthermore, creating an environment that promotes awareness and challenges stereotypes prepares our nurses to provide competent and ethical care for a wide range of patients. Imagine the power of a case study depicting a young, Black college student whose parents are a doctor and a lawyer.
Our early nursing educators set the lens for our discipline. Our content and practices center on the perspective of the dominant group, White, middle class women. Beyond nursing, White, male, middle/upper class, heterosexual, and cisgender perspectives set the frame for much of our knowledge. With the changing demographics of this country, the normative lens is shifting. Our nursing education also has to shift to reflect the experiences and perspectives of a more diverse group of patients.
When content is presented through a "White" normative lens, it feels exclusionary to anyone in the room who is not White. Furthermore, when an instructor presents stereotypical information as fact, it feels dismissive and marginalizing. The challenge for us as educators is to identify whose voice is telling the story, who writes the narrative, and, more importantly, whose voice is excluded. It is then important to seek out those whose voices are excluded so that the whole story can be told. For example, in nursing, the description of normal skin tone often uses white skin as the example, and in forensic nursing, we recognize that many of the tools used to assess and document injuries were designed for fair skin. Think of all of the ways that a White, middle class, heterosexual, and cisgender lens guides nursing education. It is incumbent on educators to recenter the content and to facilitate meaningful conversations.
Criminal Justice System
As members and as an organization, we sit at the intersection of the healthcare and criminal justice systems. We work in partnership with police officers, lawyers, and judges to ensure that our patients and their loved ones receive high-quality care and justice. As forensic nurses, we witness the injustices that occur for people of color. It is only fitting that we work to transform the criminal justice system.
An African proverb tells, until the story of the hunt is told by the lion, the hunter will always be the hero. The voice of the colonizer writes and controls the narrative of the history of the United States. The perspective of native or Indigenous people or Africans brought as slaves is not prominent. When we understand how the historical underpinnings of colonization set the foundation for our current institutionalized and systemic racism, we realize it is not enough to not be racists. We must be antiracists. We must fight for change and justice.
As the colonists came to the new world, the Indigenous people they met looked, spoke, dressed, and behaved; they were seen as savages. Native people of this land were massacred in wars, attacks, and raids as their land was taken and they were displaced. This was state-sanctioned harm, brutality, and killing of a group that was different from the colonists. Enter Africans brought to the United States as slaves, and the same narrative exists-different look, language, behavior, and culture. The Fugitive Slave Act allowed law enforcement to enlist the help of federal marshals but also local citizens to help find fugitive slaves. Slave patrollers tracked runaway slaves and traveled to the plantations to help maintain order. During the Civil Rights era, police and sheriffs routinely teamed up with citizens to help them to fight an enemy-at that time, Negro citizens. Police/sheriffs also deputized members of the Ku Klux Klan to fight against U.S. citizens who were asking for basic human rights.
Historically, U.S. sheriffs and police forces have worked to deny people of color their rights; historically, they have not been allies of people of color. What we are seeing today has deep historical roots that are engrained in U.S. society. It will involve intentional work for this to change.
Closing Reflections
How can we help bend the arc of change further? How can we contribute to not only change but also sustained progress? How can we leverage the power of the IAFN to help to transform modern-day police forces so that they are advocates and collaborators with, and for, all citizens? As the most trusted professionals, in an organization that values access to forensic nursing care and a commitment to social justice, surely we can be instrumental in the creation of a world without violence.
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