Re-posted from Nursology.net

Euro-American women who become involved in nursing and who adopt its values with respect to homogeneity and conflict avoidance must be prepared to accept the consequences of reproducing their own traditions and the means by which these traditions maintain racism in their profession and their society.BARBEE, 1993

On September 24, 2022, the Overdue Reckoning on Racism in Nursing reconvened after a summer hiatus. The break was a time to refresh, recharge and reflect on where we have been and where we are going in our anti-racism efforts. Our first discussion focused on American Nurses Association’s Racial Reckoning Statement.

When I initially read the statement, I didn’t feel anything. Then I thought for a minute to understand why. I have been here before only to then experience disappointment. I will explain why I have issues with ANA’s Racial Reckoning.  

First, nurses of color cannot be asked to forgive. This is a major flaw that I see in their statement. And in my opinion, it is offensive to ask for forgiveness. I will not forgive, not now. Not without action. What I want is to see action to heal the harm, action to confront daily acts of harm still being heaped on people of color, action to speak openly about racism that persists, action to heed the voices of nurses of color, action to center the voices of nurses of color in creating a just and nurturing new reality for nurses of color.  When I see your actions, I will gradually come to trust that your intentions are real. Forgiveness will not build this trust. Only action will. 

The actions outlined in the Racial Reckoning statement are a good start. Now we need to see these actions begin to grow into reality.  The reason I feel strongly about this statement is because through the writings of Black historians and Black nursing scholars, such as Dr. Darlene Clark Hine, Dr. Mary Elizabeth Carnegie, and Dr. Evelyn Barbee. I learned how racism has always been a part of nursing history. 

Racism has existed in nursing since the development of institutionalized nursing programs (Carnegie, 1986; Hine, 1989). Although nursing care existed in Black, Indigenous, and other communities of color, nursing programs denied admission to racialized people solely based on the color of their skin (Carnegie, 1986; Hine, 1989). 

The harm from racism in nursing runs deep; lost dreams, lost opportunities, trauma from doing the work without recognition, caring for patients in environments that were not safe. Nurses of color continue to work hard to demonstrate how they belong to all areas of nursing. For example, Filipino nurses were disproportionately assigned to care for the sickest COVID patients, relegated to night shifts, and subsequently suffered disproportionately from COVID, and many died (Nazareno and others, 2021).  A painful part of nursing history is when nurses of color have sought the support of professional nursing organizations, such as the ANA, and were rejected. Nurses of color were disappointed by lack of interest in the issues that impacted them (Barbee, 1993).

ANA needs to acknowledge this history and the harm that was caused. The historical beliefs about nurses of color not having the ability to be nurses, policies in place that created challenges for admission to nursing programs, the barriers that prevented nurses of color from having access to the resources for developmental and educational growth or safe working environments that are free of racism (Barbee, 1993; Nazareno and others, 2021; Spratlen, 2006). 

Everything about the ANA’s Racial Reckoning Statement is anonymous. There is no indication of who actually wrote any of this — the racial reckoning statement or the FAQs. Who from the ANA wrote the Racial Reckoning statement? Who wrote the questions and responses in the FAQs? The statement made frequent use of anonymous quotes.  Accountability requires agency. To demonstrate that one is ready for action, you cannot hide behind anonymity.

It is appropriate for the Apology to come from a “white voice” –  but the actions and the intentions moving forward need to reflect the wisdom and leadership of nurses of color. 

The FAQ’s are questions that white nurses would ask, but the FAQs require the voices of Nurses of Color. 

For nursing to become an anti-racist discipline, decolonization of racist structures is required. This begins by centering primarily on the knowledge generated by nurses of color. We who are Black, Indigenous, Latina/o, and other Nurses of Color, have drawn from our experiences to produce a significant and growing body of knowledge for the Discipline of Nursing. Although our work is underutilized, our literature provides guidance for decolonizing all areas of nursing, policy changes, nursing curriculum, nursing research, and nursing leadership (Barbee, 1994; Canty and others, 2022). 

Over the next weeks, months, year, nurses of color, allies and co-conspirators will continue to discuss the ANA Racial Reckoning and how we will move forward. 

References

American Nurses Association. (2022) Racial Reckoning Statement. (https://www.nursingworld.org/~4a00a2/globalassets/practiceandpolicy/workforce/racial-reckoning-statement.pdf)

ANA. (2022). Frequently Asked Questions about Racial Reckoning https://epicmsdev.nursingworld.org/practice-policy/racism-in-nursing/RacialReckoningStatement/frequently-asked-questions-about-racial-reckoning/ 

Barbee, E. L. (1993). Racism in U. S. Nursing. Medical Anthropology Quarterly, 7(4), 346–362.

Barbee, E. L. (1994). A Black Feminist Approach to Nursing Research. Western Journal of Nursing Research, 16(5), 495-506.

Canty, L., Nyirati, C., Taylor, V., & Chinn, P. L. (2022). An Overdue Reckoning on Racism in Nursing. AJN American Journal of Nursing, 122(2), 26–34. https://doi.org/10.1097/01.NAJ.0000819768.01156.d6 

Carnegie, M. E. (1986). The path we tread : Blacks in nursing, 1854-1984. Lippincott.

Hine, D. C. (1989). Black women in white : racial conflict and cooperation in the nursing profession, 1890-1950. Indiana University Press.

Nazareno, J., Yoshioka, E., Adia, A. C., Restar, A., Operario, D., & Choy, C. C. (2021). From imperialism to inpatient care: Work differences of Filipino and White registered nurses in the United States and implications for COVID-19 through an intersectional lens. Gend Work Organ, 28(4), 1426-1446. doi:10.1111/gwao.12657

Spratlen, L.P. (2001). African American Registered Nurses in Seattle: The Struggle for Opportunity and Success. Peanut Butter Publishing.

Following up from the first “unveiling” of the video stories from participants in our “Overdue Reckoning on Racism in Nursing,” this zoom gathering will feature three thematic films that feature the storytellers.* The themes are “Racism in Nursing Education-Undergrad”, “Caring Against the Grain” and “Patient Race Bias”. After viewing the films, participants will engage with one another to discuss paths forward to create change.

When: Monday, October 17, 2022, 1:00pm to 4:00pm Eastern

American Sign Language and Live Captioning will be provided.

Register Here

*Made possible by Seedworks Social Justice Foundation.

2022-23 Theme

*Beyond Apology

*Moving Forward

*Taking Action

We return for our “Overdue Reckoning on Racism in Nursing” discussions on September 24, 2022 at 4 PM Eastern, continuing monthly on the last Saturday of every month!  Our discussions will again be hosted by Lucinda Canty, PhD, CNM, FACNM and will begin with a critical reflection on the recent apology issued by the American Nurses Association (download PDF here). Our discussions continue to be guided by our “Principles of Reckoning” (see below) with the focus in the coming year on developing our own solutions so that we can take action! 

Register here:

• When: Sep 24, 2022 04:00 PM Eastern Time (US and Canada) 
• Register in advance for this meeting:
  • https://us02web.zoom.us/meeting/register/tZIsfuqvqj0vH9JON1ORt26hQuu6miVr5etp
• After registering, you will receive a confirmation email containing information about joining the meeting

Principles of Reckoning

All of the activities related to “Overdue Reckoning” are guided by our Principles of Reckoning, which take a bold anti-racist stand for nursing. Our principles are:

• We claim the courage to join together through the experience of building our anti-racist capacity in nursing.
• We cherish the contributions and honor the voices of Black, Indigenous, Latinx and other Nurses of Color, and yield the floor to those voices throughout our time together.
• We recognize that we cannot move forward without a deep understanding of Black, Indigenous, Latinx and other nurses of color experiences with racism.
• The insights and recommendations of Black, Indigenous, Latinx and other nurses of color are vital to ground our thinking, and to guide our actions.
• We pledge to listen deeply and with respect to any and all expressions of anger, rage, despair and grief arising from racism.
• We commit to healing those harmed by racism.
• We commit to challenging, resisting and ending the voices and actions that sustain white privilege.
• We seek to nurture authentic anti-racist awareness.
• We will inspire and nurture action, as we boldly claim an anti-racist identity for nursing.

During the past week, President Biden announced his choice for U.S. Treasurer! Here are highlights featuring her many accomplishments!

Chief Mutáwi Mutáhash (Many Hearts) Marilynn “Lynn” Malerba

• Became the 18th Chief of the Mohegan Tribe in 2010, a lifetime position.
• Follows in footsteps of many strong female role models in the Mohegan Tribe, including her mother, Loretta Roberge, who holds the position of Tribal Nonner (elder female of respect) as well as her great-grandfather Chief Matagha.
• Prior to becoming Chief, Malerba served as Chairwoman of the Tribal Council, and performed in Tribal Government as Executive Director of Health and Human Services. 
• Questioned why federal policy continues to severely underfund Indian Health resulting in diminished health status and quality of life with a life expectancy below that of mainstream America for our first peoples in her DNP project at Yale
• Authored “The Effects of Sequestration on Indian Health Funding” in the Hastings Center Report in 2013, providing background for in American Indian Health and Nursing (edited by Margaret P. Moss, Springer Publishing Company) in 2016.
• A leader in the return of hundreds of sacred objects to the Mohegan Tribe and Tantaquidgeon Museum in Uncasville, Connecticut In 2018, restoring wholeness to the Mohegan people.
• Testified in 2020 before the Connecticut Senate in favor of teaching children the history from the perspective of the first peoples of Connecticut who were harmed by colonization, instead of “Manifest Destiny” perspective.
• Chaired the Tribal Self-Governance Advisory Committee of the Indian Health Service Secretary for the United South and Eastern Tribes board, is a member of the Justice Department’s Tribal Nations Leadership Council, NIH and Treasury Tribal Advisory Committees.
• Named in 2022 the first Native American U.S Treasurer and first overseer of the Office of Tribal and Native Affairs at the Treasury Department.
• The first in Tribal leader and Native woman in history whose signature [will be] penned on U.S Currency, along with Janet Yellen’s signature.

Obama accepted the “Rhythm of the Land” blanket as Chief Lynn Malerba helped drape President Barack Obama in a blanket at the White House Tribal Nations Conference in 2016 During a moving ceremony that showcased the diversity of Indian Country. Photo credit: Pete Souza.

“The blanket continues as a standard of exchange; and as a gift, the blanket is an important acknowledgement of friendship, gratitude, and respect.” (Source) Also see Kapoun R.W. with Lohrmann, C.J. (1992). Language of the Robe. Peregrine Smith Books, p. 19.

More Information

Malerba, M. (2013). The Effects of Sequestration on Indian Health. Hastings Center Report, 43: 17-21.     https://doi.org/10.1002/hast.229

Malerba, Marilynn (2015).  “Indian Health Funding: Time For Change” Yale School of Nursing Digital        Theses. 1037. https://elischolar.library.yale.edu/ysndt/1037

Malerba, Marilynn (2016).  Northeastern Woodlands .In Moss, M.P. American Indian health and nursing (Moss, Ed.). Springer Publishing Company.  

Education Committee of the State of Connecticut Public Hearing Friday, March 6, 2020. Testimony of      Chief Mutáwi Mutáhash (Many Hearts) Marilynn “Lynn” Malerba Chief of the Mohegan Tribe, In Support of S.B. No. 314 An Act Concerning the Inclusion of Native American Studies In The Social Studies Curriculum. https://www.cga.ct.gov/2020/eddata/tmy/2020SB-00314-R000306-Malerba,%20Marilynn,%20Chief-The%20Mohegan%20Tribe-Support-TMY.PDF

Indian Health Service (IHS) Tribal Self-Governance Advisory Committee (Tsgac) Quarterly Meeting
March 28-29, 2017 https://www.tribalselfgov.org/wp-content/uploads/2017/04/TSGAC_Combined_Packet_March2017.pdf

The Mohegan Tribe: Our Current Chief Marilynn “Lynn” Malerba, Lifetime Chief.

Yale Peabody Museum (ND). The Native American Graves Protection and Repatriation Act.             https://peabody.yale.edu/explore/collections/anthropology/native-american-graves-protection-repatriation-act

Yale School of Nursing (ND). Yale Nursing’s Malerba ’15 DNP Will Make History as First Native American US Treasurer https://nursing.yale.edu/news/yale-nursings-malerba-15-dnp-will-make-history-first-native-american-us-treasurer