Both the Mayor of Boston and the President of the American Nurses Association have declared racism a public health crisis. And we know it's true. The disparities in health access, care, social determinants of health, and outcomes are well known. It's of course much deeper than health alone, evident by our country's inspiring groundswell of activism for social justice for Black people. How do we navigate these waters as nurse leaders?
For science majors like us, it's illogical that a physiologic body organ-skin-is the basis for centuries of injustice, disadvantage, disproportionate opportunity, and inequitable social well-being. This is obviously a sociologic issue, not a physiologic one. Structural, systemic racism is exacerbated by racism at individual levels, which for many of us may be an unconscious bias. It takes a lot of self-awareness and self-reflection to dig deep and find your own unconscious biases.
There's so much to learn. When you really start listening to understand other perspectives, you'll be surprised. Hearing stories about lifetimes of fear, anger, and exhaustion from our Black colleagues is heartbreaking. And we must create environments that are safe for staff members to open up and share feelings before we can get to listening and understanding. Leading with the heart and authenticity is a good place to start. Responding to emotions takes energy-don't give up.
Diversity isn't enough without racial equity, inclusivity, and belonging. Work environments that promote those values are needed and serve as a foundation for organizational success. Our staff members are traumatized trying to care for racist patients who don't hide it. Why do we tolerate this in our workplaces? How are we supporting our team members who are subjected to it? This is another area that needs work in our organizations.
When you start looking at everything-and I mean everything-from different perspectives, you'll see disparities. Is your assessment of risk for a child's well-being and subsequent notification of children's services different for Black patients? Is your tolerance of patient behavior requiring a security code different too? What does the racial make-up of your workforce and leadership teams look like? Check your data, you may find some inherent bias in your organization. I'm sure you can think of other examples.
This is hard work. Keep peeling the onion. Business as usual is over. The country has spoken and clearly said, "We can't take it anymore." As nurses, we've always stood for ethical treatment of patients. Now we must take it further because what we've done so far is just not enough. Racism, whether overt or covert, conscious or unconscious, can't be endured any longer.
My lens as a successful White female nurse leader is, of course, biased. The guest editorial on the next page is from a successful Black female nurse leader. Her story describes systemic racism in personal detail and is about allyship before we called it such. Every one of us can be an ally to start. Every move forward, no matter how big or small, contributes to changing the culture of racism.
It's time to listen, learn, and act. It's never too late to start. This takes courage and leadership. The other public health crisis of racism must finally be wrestled down.
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