In May, as we celebrate National Nurses Month, it’s a good opportunity to reflect on how the profession of nursing has grown along the same lines of segregation. Both have been entrenched into the American culture against Black people since the late 1800s and persist today. Eighty percent of registered nurses are White, controlling the majority of executive, management and academic leadership positions in the country. While Black nurses compose only 7% of the profession, they hold the highest number of advanced nursing degrees at 15%, demonstrating the tremendous efforts we as Black nurses must undertake to have recognition within the profession.
Before slavery was abolished, it was a crime for Black people to read, and after abolition, Black women were denied entrance into nursing schools, creating the need for separate schools of nursing for Black women, established at Tuskegee, Atlanta, Chicago and Hampton, Virginia.
Indeed, the past president of The American Nurses Association, the most powerful voice in nursing and the primary regulator of the basis of every nurse practice in the United States, deemed Black nurses “unintelligible” and denied them admittance to the organization at the state and national level in the early 1900s.
In response to exclusion by the ANA, Estelle Massey-Riddle, the first Black person to graduate with a master’s in nursing degree, in 1908 founded the National Association of Colored Graduate Nurses, NACGN, to push back against the limited opportunities for adequate nursing training and professional growth for Black nurses.
At the time only 10 of 432 nursing schools in the country were accepting Black nurses. By 1948 and World War II, Black nurses made strides in integrating the profession to the extent that members of the NACGN voted to be incorporated into the ANA in 1949. This was a huge mistake in my opinion, as the profession failed to keep its moral contract with Black nurses.
Medical anthropologist Evelyn Barbee in her 1993 article “Racism in Nursing” outlines four attributes of nursing that promote a climate that openly allows and even encourages nurses to avoid dealing with racism in the profession. These include:
1. A preference for homogeneity — the hallmark of any oppressive culture wishing to hold onto and maintain the power and dominance of the group. This is clearly present in the White group dynamics of professional nursing, which support and promote White nurses over people of color to the detriment of the entire profession.
2. A need to avoid group conflict — the profession does all it can at every level to avoid the need to examine its own racist values.
3. An emphasis on empathy — nurses view themselves as in a caring profession, therefore, how could they possibly be racist since caring is a paradigm of nursing? This attitude absolves the profession from any responsibility for examining bias.
4. An individual orientation — professional standards of nursing practice hold the individual accountable for upholding and maintaining professional practice and individual state licensure. If the nurse is working within an organization that fails to maintain a high standard or provide nurses with the resources needed for the individual nurse to perform according to the standards of professional practice, individuals are still held liable for any mistakes or harm to the patient. Indeed, nurses are encouraged to have individual malpractice insurance because we can be personally sued for damages. Nursing leadership fails to hold itself, linking back to the need to avoid group conflict.
It is my view as a Black nurse that the profession has not sufficiently addressed its institutionalized racism.
Clearly, we still have a long way to go, yet I remain encouraged. My voice as a Black nurse and board-certified holistic nurse is rare in mainstream media. With only 2% of nurses represented as experts in the media, The Omaha World-Herald is revisiting the historical antiracist collaboration between public health nursing and journalism by featuring my voice, that of a Black, holistic public health nurse leader and social activist. Kudos to Omaha.com for being on the leading edge of mainstream media by supporting the profession of nursing and the health of our community in this month of the nurse.
Courtney Allen-Gentry, an RN with a master’s in nursing, is a board-certified advanced holistic nurse, nurse educator and coach specializing in the integration of science, spirit and plant medicine into public health.