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Dismantling Systemic Racism in Nursing

More than ever, recent events are prompting healthcare organizations to reevaluate their policies and procedures to work toward health equity. Racism, bias, discrimination and other structural barriers can lead to poorer health outcomes for people from some racial and ethnic backgrounds. It is up to healthcare workers, including nurses, to work to dismantle systemic racism in the healthcare field.

What Is Healthcare Racism and the Nurse’s Role?

The injustice of healthcare racism goes both ways, from patients who shows harmful behavior or language against a provider and patient discrimination from clinicians. To achieve the best possible health outcomes, each care team member must do their part in combating racism. Administrators must tackle structural and systemic racism and ensure that each employee can customize their care. Nurse educators can guide nurses to educational resources on racism in healthcare. Every nurse must adopt a patient-centered approach to care for all patients in the same way.

What Are 5 Steps Nurses Can Use to Ensure Health Equity?

A patient’s health outcomes depend on more than just their healthcare. Social determinants of health such as socioeconomic status, housing, employment, education and environmental factors, all play a role. Although, these are systemic problems without a simple fix, there are steps nurses can take to enhance health equity.

1: Advocate for inclusive and culturally sensitive workplace policies.

Nurses are often the patient’s main advocate in an unfamiliar healthcare setting, from prevention to end of life. Therefore, every nurse needs to fight for patients at a policy level. Ask yourself the following questions: Are there aspects about your workplace that you feel are upholding racist practices instead of breaking them down? Do you see gaps in holistic health offerings for diverse groups?

Addressing health equity is more than a human resource responsibility; it is every person’s job. Each nurse can create a culture of belonging by advocating for holistic patient care.

Nurse leaders can develop an inclusive environment by encouraging the growth of a robust, diverse and culturally competent workforce. Leadership can evaluate team diversity, so consider ways to attract a variety of talent and encourage staff to develop their cultural competency.

2: Hold yourself and others accountable in maintaining inclusivity and respect for all patients.

In addition to advocating for inclusive policies, all nurses must take accountability for each patient. Nurse leaders are responsible for holding themselves and their team accountable for respecting all patients. Nurse educators can foster inclusive learning with content like the free, eight-part podcast series that helps nurses explore practical strategies to advance health equity. Content is part of The National Academy of Medicine initiative: The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.

3: Engage in self-reflection activities to identify and combat implicit biases.

Biases impact every aspect of our lives, including patient care. An implicit bias is an “attitude or stereotype that affect[s] our understanding, actions, and decisions in an unconscious manner.” Racism is frequently subtle, such as an unintentional or implicit change in body language. Therefore, each nurse needs to identify these biases and actively work to combat them. While biases will not be eliminated overnight, awareness is an excellent first step toward dismantling them or lessening their impact on nursing practice.

 4: Know your workplace, online and community resources for diverse patient groups.

Nurse educators and navigators can work with multidisciplinary team members to create inclusive resource lists. Locate ethnically diverse support groups, low-cost mental health services or even free social work services in their native language. List financial resources, which are often vital for marginalized communities when seeking healthcare. Finally, consider producing lists in multiple languages or curating lists of resources in specific languages.

5: Empower all patients to ask questions.  

Often, patients don’t know what they don’t know. Many struggle to identify questions or appropriate resources. Additionally, healthcare settings or disturbing news can cause patients to forget their questions or “not hear” information.

Empower your patients to ask questions using the Ask Me 3 method that focuses on three critical questions:

1) What is my main problem?
2) What do I need to do?
3) Why is it important for me to do this?  

Racism is a threat to healthcare equity. Treating people equally, while important, is simply not enough. Action needs to be taken against systemic racism in multiple areas: structural racism (the environment, legal and procedural aspects), cultural racism (societal beliefs and customs) and interpersonal racism (individual decisions and actions). Nurses need to prioritize learning more about race and health and participate in helping to create a just, inclusive system. Nurses, everywhere, can help ensure quality treatment for all patients, regardless of race, background or ethnicity to address health disparities.

Learn more about The University of Texas at Arlington online Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program.

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