The Nurse’s Role in Color Disparity
A Plea to My Fellow Nurses
As nurses, we know the truth. We’re awesome and nursing is an amazing profession! We impact the lives of people inside and outside our clinics and hospitals every day. But we can do more.
In 2003, the Institute of Medicine issued a report that found that “racial and ethnic minorities receive lower-quality health care than white people–even when insurance status, income, age, and severity of conditions are comparable.”
Fast forward 17 years and not much has changed. We are still struggling with racism and color disparity in healthcare. And it’s not going to change until nurses step up and make the changes needed to eliminate the idea of race from healthcare.
Because nurses are on the front lines of care, we are perfectly positioned to stop racial and ethnic disparities in healthcare delivery.
So, my fellow comrades, here are two things you can do right now to change the healthcare world where you live.
1. Become Colorblind
Race–which is a biological myth!–should never be considered in clinical decision making. We’ve been trained and taught as nurses that clinical judgment should identify and summarize critical factors that impact the health of our patients. We’ve been taught that race is one of those factors, but it’s not.
With the upsurge of precision medicine, some have argued that race plays a crucial role in healthcare decisions. But according to Dankwa-Mullan and colleagues, precision medicine is a tool to “better understand the complex biological and environmental mechanisms underlying a patient’s health, disease, or condition, and to better predict which treatments will be most effective.”
Since race is NOT biological or environmental, then it should never enter the clinical setting. Not for nurses, doctors, NPs, PAs, RTs . . . no one.
Race is a clumsy surrogate for pointing us toward the specifics of patient care because it does not allow us to account for unique and individual differences in the genes, environments, and lifestyles of our patients.
2. Update The Nursing Process
Nurses impact the healthcare field by their sheer numbers. According to the World Health Organization, nurses and midwives account for more 50% of the healthcare workforce across the globe. That’s a lot of pull!
As we unite and broaden our vision, we’ll be able to see the enormous impact we can make on public health and things will change.
As we move beyond race, we will begin to understand that it is our patients’ ancestry and their sociocultural environment that should be factored into clinical decision making. As we begin to drop the mindset of race, we’ll see that genomic differences are the markers from which we should seek information to treat our patients.
Broaden your decision-making with me by updating the nursing process.
- Collecting data (race is not a valid biological category)
- Interpreting the collected date (race does not dictate genetic information nor does it determine behavior or belief)
- Planning nursing interventions (race does not direct understanding of health or disease)
- Evaluating the results (race does not impact disease prevention, detection or treatment)
We live in a time of dense healthcare and resource-rich science. We have within our power to narrow existing health disparities by refusing to allow our ethnic minorities and socially disadvantaged populations to fall into a one-size-fits-all category of race-driven healthcare.
I urge you to start here but know . . . this isn’t all you can do as a nurse.
You can scrutinize your own racial biases, expose racial narratives as they arise in the workplace, educate yourself on Race and Cultural Diversity in America, or propose that your institution address the structural factors contributing to color disparities in your communities.
Whatever you do, do something. Today.
Open your eyes to the potential you have to create a world without color. We’re nurses, we’re the good people who should never remain silent.
“We will have to repent in this generation not merely for the vitriolic words and actions of the bad people but for the appalling silence of the good people.” Martin Luther King Jr. from Letter from a Birmingham Jail April 16, 1963
