In an act of unvarnished accountability, the American Nurses Association (ANA) has examined its past actions on race and found them wanting. “Through acts of omission, when we failed to act, and commission, when ANA’s actions negatively impacted nurses of color, we have caused harm and perpetuated systemic racism. … ANA recognizes that issues of racism persist today and continue to harm nurses of color.”1
Perennially in polls, nurses are seen as the most trusted profession. They are healers, and it is counterintuitive to see them as agents of harm. Yet the ANA is admitting just that, saying that they did not live up to their ethical standards on the matter of racism, which was defined in part as “an assault on the human spirit.”
Although the ANA did not make this excuse in their reckoning statement, some of the nurses’ actions and attitudes historically were reflective of the public — particularly before the Civil Rights Movement.
The association was in a position to do much better, but squandered some early partnerships with Black nursing groups, says Cheryl Peterson, MSN, RN, vice president of nursing programs at the ANA.
“If you look at some of our earliest history, we had direct connection and collaboration with a group called the National Association of Colored Graduate Nurses,” Peterson explains. “We had engaged with a group that was already representing African American nurses, and yet we still we didn’t do the right thing when it came to membership in the association. We can’t go back and change that, but we know that caused harm.”
Exclusion Policies
In the report, the ANA admitted beginning in 1916, “ANA purposefully, systemically, and systematically excluded Black nurses. … The membership rules shifted away from an alumnae-based membership to that of a state- and district-based membership. This resulted in Black nurses being denied membership in some state nurses associations.”
This practice of discrimination ended in the mid-1960s, but it caused lasting harm. “This timeline reflects the failure of ANA leaders to aggressively pursue changes in its discriminatory membership rules and allow for full membership regardless of race,” the ANA stated. “The full inclusion of Black nurses within ANA leadership and decision-making remains unrealized and elusive for all nurses of color.”
As evidence of continuing racism, the ANA cited reports from 2021 that included a survey of 5,600 nurses.2,3 Overall, 63% of respondents had personally experienced an act of racism in the workplace, with the transgressors being either a peer (66%) or a manager/supervisor (60%).
“We apologize to all nurses of color,” the ANA wrote. “Not only is the profession richer for your having persisted, but the people you cared for and continue to care for today have been better served.”
The unprecedented acknowledgment and apology from the ANA comes as the pandemic revealed the healthcare system is riddled with racial inequities that have harmed both patients and workers. This finding has been brought into sharp relief by the brazen rise of white supremacy movements in political and social commentary.
“This work that ANA is doing is really about trying to repair who we are as a profession,” Peterson says. “We are trying to create a more inclusive space for all of our colleagues. [Part of that] is addressing these harms. I believe within the industry there has been systemic racism. There was a time when whites were very much making the rules, and those became hardwired within the system.”
Impact Analysis
ANA is reviewing all its policies and positions, and will do so going forward in an “inclusion impact analysis” to ensure diversity and equity are carefully considered.
“We have been looking at this now and asking, ‘Is there an unintended consequence?’” Peterson says. “Is there an impact that we are not considering? We have to make sure in making policies that we are intentionally engaging with individuals who may look at this through a different lens. We hope that it has two impacts. One is that we as a profession are doing better with each other and our colleagues, but this also has an impact on families and patient care. We are going to create a more welcoming, more inclusive profession.”
REFERENCES
- American Nurses Association. Journey of racial reconciliation: Our racial reckoning statement. June 11, 2022.
- National Commission to Address Racism in Nursing. Defining racism. November 2021.
- National Commission to Address Racism in Nursing. Summary report: Listening sessions on racism in nursing. June 2021.
In an act of unvarnished accountability, the American Nurses Association has examined its past actions on race and found them wanting.
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