By Karen Roush, PhD, RN, FNP-BC
The murder of George Floyd under the knee of a police officer, following so quickly on the murders of Ahmaud Arbery, shot down while jogging in February, and Breonna Tayler, an EMT with plans of becoming a nurse who was killed by police in her own home in March, coalesced years of anger, fear, and despair into an extraordinary outcry for racial justice that has not been seen since the civil rights movement.
Black Lives Matter.
Credit: National Nurses United
The chilling casualness with which Derek Chauvin ended George Floyd’s life over nearly nine agonizing minutes exposed more dramatically than anything else why we need to insist that black lives matter. The fact that it took four days for any charges to be brought against Chauvin, and over two months for the murderers of Mr. Arbery to be charged, only serves to reinforce what many have been saying for a long time, that all lives do not matter equally.
People have filled the streets of large cities and small to march in solidarity for racial justice and the end of police brutality. (Looters and rioters are not part of the protests and unwelcome by those marching for justice.) Not everyone may agree on how to achieve these aims, but all recognize the urgent need for action to address racial injustice in all its forms.
Nurses are called to participate in that reform.
The four elements of our foundational model recognize that nursing is an art and science that calls for human beings to be treated holistically within an environment that provides for their cultural, physical, and psychosocial needs so that all can reach their highest level of health. This cannot happen as long as structural and institutional racism persists.
We are called upon to act by our code of ethics. In their 2017 statement on ethics and human rights, the American Nurses Association (ANA) made a “call for all nurses and nursing organizations to advocate for the protection of human rights and social justice,” including respecting the inherent dignity and worth of all people and responding to human rights violations wherever encountered.
This is a nursing issue because racism is a public health issue.
Racism destroys quality of life and health. It kills people through illness and violence. And it it is tied in obvious and subtle ways to broader inequities and the health care disparities they are associated with. We know that persons of color face much higher rates of chronic illness, trauma, and early death. Black mothers die in childbirth at three times the rate of white women in the US, and as much as 12 times the rate in urban areas. African Americans are 60% more likely to be diagnosed with diabetes and twice as likely to die from it. Black men are 10 times more likely to die from homicide than white men.
The COVID-19 pandemic is no exception. African Americans are getting sick and dying at two to three times the rate of white Americans. In Chicago, an astounding 70% of COVID-19 deaths were black people, the same in Louisiana, though in both cases African Americans only make up about 30% of the population.
Health disparities are not due to racial differences in genetic factors—genetic research has taught us that there are no distinguishing genetic differences among different races. Nor are they due solely to lack of education or being poor; studies consistently find that racism is associated with poorer health regardless of income or education level.
They are due to structural and institutionalized racism. A system of sustained oppression and discrimination that limits opportunity, restricts access to resources, and places unrelenting stress on persons of color. Stress that leads to biophysical mechanisms that cause physical illness—heart disease, hypertension, stroke, and diabetes, to name a few.
Nurses and other health care workers are joining protests or holding their own.
Some join to be part of the demand for justice, others to provide care to demonstrators. They join because they have seen how racism affects the health and well-being of those they care for. Some have experienced racism firsthand.
Last week I joined thousands of protesters marching here in New York City. I did this despite my fears of COVID-19. It was not an easy decision; but ultimately, after weighing the risks as realistically as anyone can considering all the unknowns with this virus, I decided that the need to address the risks black people are living with due to racism far outweighs any personal risk to my health. Others I met during the march expressed the same rationale for their participation.
I was struck by the diversity of the crowd. There were black, Latino, Asian, and white, across every age range. There was the older man with his dog riding along in a shopping cart; there were shirtless men with tattooed torsos and middle-aged men in neatly ironed polo shirts and khaki shorts; there were gay couples, teenagers, a woman who told me she had marched back with Martin Luther King. People looked out for each other; many handed out masks and gloves, as well as bottles of water and snacks. And all along the route, in neighborhoods of all kinds, thousands more people leaned out windows or stood on balconies, clapping, banging on pots, and cheering in support.
Nurses should join in that support. Regardless of political or ideological differences, we can all agree that no one should be denied health or life because of the color of their skin. We, the most trusted profession for good reason, are called to do what we can, as individuals and a profession, to operationalize our nursing ideals and values. In the words of one of our greatest nursing heroes for social justice, Lillian Wald:
“….the call to the nurse is not only for the bedside care of the sick, but to help in seeking out the deep-lying basic causes of illness and misery, to protect and to prevent, that there may be in the future less sickness to nurse and to cure.”
Some resources for learning about and addressing systemic racism.
National Association for the Advancement of Colored People (NAACP)
Local and Regional Government Alliance on Race and Equity
A deep understanding of historical trauma make us formidable in the fight for health equity.
Having been a nurse now 17 years, I have felt the sting of racism at the hands of my co-workers and some patients. If the culture of racism is the “norm” in society in general, it is not surprising that it will be seen in nursing. There is no room for this in nursing. Nurses are who we are and we should be defined by our character and not the color of our skin..
An important read, well said. I hope this gets to Instagram to reach more young readers and nurses.