This past Saturday, we concluded the 5-week series of discussions “Overdue Reckoning on Racism in Nursing.” There were 100 to 120 participants present for each discussion.  Lucinda Canty skillfully hosted each discussion, guided by the “Principles of Reckoning” that set the stage for us to hear the voices of nurses of color, and for white nurses to be still and listen.  I will be honest – even with my commitment to this process, there were moments when I felt the desire, arising from my deeply embedded whiteness, to speak!  But everyone who participated honored the commitment on which these discussions were based – and WOW – what a powerful experience!  Here are a few of the comments on the feedback that we received in response to the feedback stem: “What I appreciated the most” . . .

• The vulnerability of those who spoke.
• The honesty, raw emotion, and thoughtful respect
• The opportunity to gain greater understanding of challenges I have not had to face
• How this was an open discussion and made racism in the workplace not an uncommon thing to experience. The discussion and platform allowed a safe space for people to share their stories and experiences, while also bringing awareness to an important issue that happens in the workplace..
• As a white woman, it is very important to listen to the experiences shared.
• I appreciated hearing the stories, the struggle, and the successes that people brought to this circle.
• Having had this space to listen to the stories of others, and reflection on my own history and goals moving forward
• The vulnerability and courage of the speakers in sharing their experiences
• growing awareness of what needs to change

We also asked participants to reflect on what made them uncomfortable:

• The stories of BIPOC nurses experiencing racism in nursing at all levels are extremely important in understanding the violence, the disrespect, the emotions etc… they experience in our culture. SO VERY POWERFUL. I appreciate it all! Thank you… will keep working at this. Thank you for sharing all the stories.
• I did not feel uncomfortable – I felt enriched and blessed
• Just sad that racism is still so prevalent
• For me it feels like trauma is revisited and it hurts. But it is also cathartic.
• Talking to white nurses about my experiences
• It was hard to hear the suffering of other black nurses and women of color.
• Nothing made me uncomfortable; good to get it out and hear from others
• It was hard to relive some of the traumas we’ve shared in the circle. So many brave women of color sharing really difficult situations they had been in.
• Continued exploration of my own prior complicity
• This session made me more aware about potential racism that can happen when I become a nurse and start working (as I am currently a student nurse). This discussion made me more conscious of people’s experiences and provides a take-away of what to look for (potential red flags and racism) in the workplace and how to possibly address them.
• Knowing I could have done more
• The reflection that I may think that I am more ‘woke’ than I really am.

For those of us who organized this series, we have felt the earth quake – we are forever changed by this experience!  And we know that many participants felt the same kind of change. We are sad that it has ended, but while realizing that we need to take a break, we are determined to take the next step forward. We know that white nurses need to enter into the discussion, so we anticipate that this will be a feature of whatever direction we take. We have encouraged all nurses, and particularly white nurses, to take a deep dive into the many resources available on our “Resources for Overdue Reckoning on Racism in Nursing” page.

We have connected with nurses of color who spoke during these discussions, inviting them to join in planning the next steps.  These discussions are open to anyone interested in participating, on October 24th  and October 31st from 4 to 5:30 Eastern.  If you are interested, please let us know! And follow this blog – we will post the next steps of this initiative here!

We are excited to announce a series of web discussions “Overdue Reckoning on Racism in Nursing” starting on September 12th, and every week through October 10th! This initiative is in part an outgrowth of our 2018 Nursing Activism Think Tank and inspired by recent spotlights on the killing of Black Americans by police, and the inequitable devastation for people of color caused by the COVID-19 pandemic.

Racism in nursing has persisted far too long, sustained in large part by our collective failure to acknowledge the contributions and experiences of nurses of color. The intention of each session is to bring the voices of BILNOC (Black, Indigenous, Latinx and other Nurses Of Color) to the center, to explore from that center the persistence of racism in nursing, and to inspire/form actions to finally reckon with racism in nursing.

Lucinda Canty, Christina Nyirati and I (Peggy Chinn) have teamed up to create the plan – you can see the details here; it is also easily accessed from the main menu above!

Contributors: Sarah Oerther, Barbara Dossey, and Mona Shattell

Opinion and editorial articles, also known as “op-eds,” are persuasive commentaries that are featured in most newspapers and other online popular press, which are excellent, effective ways for nurses to bring their authentic perspectives to the public. Op-eds are also crucial because nurses are seldom represented in print media healthcare coverage, according to the Woodhull Study Revisited, whom found that nurses were cited as expert sources in health-related news stories only 2% of the time. In 1998, the initial study found comparable outcomes (4% of news stories quoted experts who were nurses).

The purpose of this post is to highlight how nurses can share their knowledge by authoring op-eds. Below is a case study that exemplifies how nurses can a write op-eds to influence healthcare policy questions and legislative issues. Unique aspects of developing this op-ed included addressing current news stories, an assessment of health needs, and scientific evidence of best practices.

Case Study

In 2018, the U.S. government separated families who were seeking asylum in the US by crossing the border illegally. Dozens of parents were being split from their children each day — the children sent to government custody or foster care, the parents were sent to jail. The op-ed authors were enraged by local media stories of how parents and children were impacted by separation at the border. These stories are what inspired the op-ed. Nurses understood that a traumatic event like being separated from a parent could negatively impact a child. The authors worked together quickly to make sure their op-ed hit this current news cycle.

First, the authors identified the problem to be solved or issue to be addressed. For example, Federal officials at the U.S.-Mexico border separated nearly 2,000 children from their families between April 19, 2018, and May 31, 2018. To overcome this problem, nurses used evidence-based research to show parent-child separation may result in toxic stress.

Next, op-ed authors identified what had been done (or proposed) about the issue so far, they identified other organizations that had addressed the issue, and they looked for any pending legislative or regulatory proposals. For instance, for this op-ed, governmental organizations, including the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control (CDC) had already written clinical guidelines to address toxic stress.

Finally, the op-ed authors identified “why” government officials should address this issue. To assist legislators in influencing policy, the op-ed authors discussed the complex nature of toxic levels of stress from a scientific standpoint.

The op-ed, Toxic effects of stress on children separated from parents, was based on a nursing perspective and was provided to help tackle health disparities and injustices. Nurses linked the relevance of parent-child separation with evidence-based research on toxic levels of stress.

Nurses published this OpEd in The Hill – a newspaper mailed directly to all congressional offices and published online. The authors used evidenced-based research to show without the nurturance and calming support of a caring adult who is known to the child, these traumatic separations could alter the structure of the developing brain. Long term, this toxic level of stress can affect other organ systems, leading to long term adverse health outcomes such as mental illness, substance abuse, cardiovascular disease, and premature death.

This OpEd was shared at least 1,238 times online. As a result of this op-ed, a group of U.S. Senators (including Senators Kamala Harris, Dianne Feinstein, Cory Booker, Bernie Sanders, and Elizabeth Warren) wrote a persuasive letter to the Secretary of Homeland Security demanding that children be reunited with their families. The nurse-authored op-ed was cited as the first piece of evidence that separation could result in life prolonged trauma (see footnote on page 1). The policy that led to widespread family separations was ended and thankfully, no law currently mandates the separation of families. This is a clear example of why nurses need to express their voices in the public square. Unfortunately, the U.S. government continues separating some children from parents for questionable reasons.

Nurses make up the United States’ largest healthcare workforce and nursing is the most trusted profession. Nurses need to leverage that trust when it comes to educating the public and policy makers alike. Nurses, especially nurse researchers, should be sharing their knowledge by authoring op-eds. Will you?

About the authors

Sarah Oerther MSN, M.Ed., RN, F.RSPH, is a Ph.D. candidate at the School of Nursing, Saint Louis University where she is also completing a Family Nurse Practitioner post-master certificate. Sarah has published OpEds in The Missouri Times, The Hill, and HuffPost. In 2019, she received the Excellence in Nursing Award from St. Louis Magazine.

Barbara Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC, is internationally recognized as a pioneer in the holistic nursing and nurse coaching movement. She is a Florence Nightingale scholar and nurse theorist. She is Co-Director, International Nurse Coach Association (INCA) and Integrative Nurse Coach Academy, North Miami, Florida; International Co-Director and Board Member, Nightingale Initiative for Global Health (NIGH), Santa Fe, New Mexico, and Gatineau, Quebec, Canada.

Mona Shattell, PhD, RN, FAAN is associate dean for faculty development and professor at the Johns Hopkins School of Nursing in Baltimore, MD. She also holds a joint appointment in the Johns Hopkins Bloomberg School of Public Health, in the Department of Environmental Health and Engineering. She is the Editor of the Journal of Psychosocial Nursing and Mental Health Services, and the author of more than 140 journal articles and book chapters. She is an active social media user, content developer, and public thought leader. She has published op-eds in the New York Times, The Atlantic, Health Affairs Blog, Huffington Post, PBS, and others.