The Profession of Nursing Cannot Help the Public Save Itself

Nurses and nursing organizations have yet to demonstrate a unified national public health intervention strategy for containing the unfettered global disaster of COVID19. Here’s why.

White nursing leaders haven’t the mental schema to operate outside of the white group think and attributes of white group dynamics which maintain, support, deny, and inoculate racism in nursing.

The cost of being white is literally bad for everybody in the nation as white nursing leaders responsible for presenting a clearly organized, unified, national nursing intervention strategy for protecting ourselves and the public from COVID19 embrace Trumpism in nursing.

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, choose to promote and uphold structural racism and the normalization of Trump-supporting nurses, with the endorsement of Trump in the November 2020 election.

This crippled the organization’s ability to take leadership on a national COVID19 strategy as Trump endorsing nursing leaders tainted the ability of the organization to act in good faith on behalf of the public and all nurses.

The American Nurses Association breaks the promise to Black Nurses.

The fact that the ANA felt compelled to succumb to membership demanding a Trump endorsement speaks to their evident position in maintaining structural racism in nursing while ignoring the moral contract made to the National Association of Colored Graduate Nurses (NACGN) in 1951 to represent and uphold the interest of all nurses regardless of race.

Indeed the professionalization of nursing grew along the same lines of segregation entrenched into American culture against black people of the late 1800s and early 1900s. 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, Hampton, and Chicago.

In 1908 Estelle Massey-Riddle, the first black nurse to graduate with a masters in nursing degree founded the National Association of Colored Graduate Nurses, NACGN, in an effort to fight against the exclusion of the American Nurses Association, ANA, and the limited opportunities for and adequate nursing training and professional growth. At that time only 10 out of 432 nursing schools in the country were accepting black nurses, however by 1948 and WWII, black nurses made major strides in integrating the profession to the degree that members of the NACGN voted to be incorporated into the ANA.

Mary Eliza Mahoney, the co-founder of NACGA, was among the first women to register to vote in Boston in 1920. The ANA (who incorporated the NACGN in 1949) awards the Mary Mahoney Award to those nurses who exemplify integration in their field.

Attributes in nursing that perpetuate and sustain racism

Medical Anthropologist Evelyn Barbee in her 1993 article, “Racism in Nursing”, outlines four attributes of nursing which promote a climate in nursing that openly allows and even encourages nurses to openly avoid dealing with racism in the profession. These attributes are clearly seen employed by ANA, as they sought to endorse the Trump-supporting nursing viewpoint in the name of “balance” no matter how unethical or antithetical to nursing’s mission of social justice sacred activism and advocacy for the poor.

Instead, the ANA gives clear evidence of the organization's commitment to upholding and perpetuating white supremacy and the encroaching threat of fascism in the United States by repeating tired professional characteristics and white intergroup dynamics that keep the profession of nursing from truly having more power in the national conversation over front line worker protections.

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 as they support, promote, and grow unqualified white nurses to the detriment of the entire profession, “essentially dumbing down the profession” for the sake of maintaining white group dominance. Even at the expense of the larger whole.
2. A need to avoid group conflict — typical of white culture is the need to avoid conflict amounting to a “cancel culture” within nursing and healthcare which further denies access to care. Racist providers are allowed to terminate care or simply fire nurses that dare to go against the system. In order to avoid actually having to face discipline, apologize or improve practice when called out for racist care, the profession does all it can at every level to cancel the need to examine their own racist values.
3. An emphasis on empathy — nurses view themselves as 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 in the face of caring.
4. An individual orientation — professional standards of nursing practice hold the individual accountable for upholding and maintaining individual 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 available for the individual nurse to perform according to the standards of professional practice, they are still held liable for any mistakes or harm to the patient as an individual. Indeed, nurses are encouraged to have individual malpractice insurance because we can be personally sued for damages. Even worse, Nursing leadership refuses to hold each other accountable to their own professional standards which leads to a culture lacking professional accountability from leadership, cohorts, or colleagues. Here we go back to the need to avoid group conflict.

The political stance to appease Trump nurses with a Trump endorsement and promotion has effectively diminished the ability of the organization to present a national intervention strategy and united nursing front to combat COVID19.

It’s evident Trump is clearly an autocrat with a greater interest in destroying democracy than providing nurses with PPE at the bedside, yet the ANA endorsed his Presidency to appease racists nurses without a belief in science as well.

With what I estimate to be at least 50% of white nurses voting for Trump, in spite of open and unregulated racism, xenophobia, hate, disbelief in science, and endorsement of violent behavior against peaceful protestors, just to name a few human rights atrocities. ANA has put itself in a precarious position of aligning with the enemy of nursing and public health while trying to appease racist nurses and structural racism.

When half of the members in a professional organization based on scientific principles refuse to believe the science and may not implement basic infection control practices for an airborne vector because their leader is misdirecting them with improper information, it seems impossible to present a unified message or national intervention plan that adequately protects everyone at risk, including nurses and patients of color.