An effective toolkit to address racism in nursing and health care
The profession of nursing has a long history with racism, classism and institutional inequalities. Even today, various forms of racism and discrimination still permeate the industry, studies show.
“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.”
Dr. Batiste-Brown says she’s experienced first-hand the legacy of racism in health care and education. Growing up in New Orleans, “my parents went to segregated schools and I went to a school far away from my home because of segregation and busing,” she says.
For her contribution to the Racism in Nursing and Healthcare Workgroup toolkit, Dr. Batiste Brown was granted the Public Policy Award by the American Nurses Association (ANA) California Chapter in April 2021.
She is part of a 10-member taskforce/workgroup that developed a user-friendly toolkit for nursing staff and management to eradicate racism, injustice, inequity and inequality in nursing and health care.
After a June 2020 panel on the impact of racism in patient care following the murder of George Floyd, the taskforce was developed from “all of the energy and frustration that came out of the protests and discussions like the White Coats for Black Lives movement,” Dr. Batiste-Brown says.
“We wanted to channel that energy into something positive to move the conversation forward,” she says.
The taskforce created the toolkit after 10 months of research, data analysis, live dialogue forums and discussions where lived experiences could be shared.
First, they identified four barriers preventing nurses from making transformative change on racism and inequity in patient care:
- Lack of sustainable conversations (the topic of racism too often devolves into ideological and semantic, rather than constructive, debates);
- Lack of accountability and confidence in reporting systems;
- Lack of awareness and unified standards among decision-makers;
- Lack of diversity among decision-makers.
Specifically created to address these barriers, the toolkit begins with an individual assessment of the level of awareness and understanding a person has regarding racism in nursing and health care.
“We understand that individuals are at different points in their journey towards anti-racism and we want to meet everyone where they are,” Dr. Batiste-Brown says.
An action plan from ANA\California is then sent to the individual based on their score. It provides tangible steps to take in developing an anti-racist mindset, such as finding an accountability partner, and exercises that include crossword puzzles, videos and book recommendations.
For example, one exercise is to develop an elevator pitch for what you would say if someone were to ask about racism in nursing and health care, she says.
Nurses are also encouraged to look at their own organizational policies to understand what actions are being taken to address and eradicate racism and inequality.
The toolkit is now being disseminated across health systems like UCLA Health. Besides influencing individual action plans, the initial assessments will provide the organization with a baseline of what nurses know regarding racism in nursing and health care, and specific areas to improve.
Dr. Batiste-Brown is also thinking about how the toolkit can be adapted for academia to improve the education in nursing schools.
“We need to start with undergraduate programs to make social justice a part of the curriculum so that we equip nurses with the tools necessary to engage in conversations,” she says.
“We learn how to care for patients who are white in nursing school, but we don’t learn a lot about Black people and people of color, or about what diseases look like on other skin tones, because it’s not published in textbooks.”
Though this toolkit is a step in the right direction, more institutions and states should move collectively to address racism in health care “so that it’s not flavor of the month,” Dr. Batiste-Brown says.
“This is something we’re really committed to moving forward,” she says. “There’s a lot that needs to be done and I think this is just scratching the surface.”
Take the assessment and learn more about the Racism in Nursing and Healthcare Workgroup.