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Commission's Foundational Report on Racism in Nursing

Nurses are human beings, so our personal experiences and biases naturally influence our relationships and profession. Additionally, we work in health care systems that have evolved over centuries within the context of racism in the United States: systemic and institutional practices, policies, and laws that have directly disadvantaged others because of their race or national origin. As a result, racial biases exist in every aspect of nursing.

These reports explore how racism shows up in our profession. We invite you to read each document with an open mind and heart, and with the empathy and thirst for knowledge that define excellence in nursing. How might this information influence you and your nursing practice? How might it be fuel for improving our profession, and the health, educational, and social systems in which we engage and work?

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The History of Racism in Nursing

This report centers the experiences of nurses of color in U.S. history and how structural and systemic racism have hindered access to educational and professional opportunities as well as institutional power. The report also reviews some of the ways in which these nurses resisted, challenged, and achieved within the structures of racism.

Additionally, the report explains and critiques the central place that whiteness has occupied in histories of American nursing. More contextualized historical studies about the experiences of nurses of color and studies that explore the complicity of the nursing profession in perpetuating racism are needed.

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Contemporary Context

What does racism look like in the 21st Century? This essay examines power, privilege, and prejudice in nursing today. By looking at our history, we can understand the current inequities and discriminatory practices that hinder the progress of nurses of color.

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Education

Racism in nursing education has been prevalent since its beginning with roots in white supremacy. Today both students and faculty of color experience negative environments and limited opportunities.

Creating equitable and inclusive learning environments will lead to increased access and opportunities for students, faculty, and staff. This will eliminate many barriers and gaps that prevent success.

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Policy

Due to the systemic nature of policies, they are a significant means by which racism within nursing is perpetuated.

A commitment must be made to eliminate racism in existing policy. Additionally, new policies that address past harms and advance the nursing profession are needed.

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Practice

The impact of racism in the nurse’s work environment has significant implications on staff retention and physical and psychological safety. By viewing racism as a preventable harm, it is possible to see how it can be confronted through changes to structures, beliefs, policies, and practices.

This report also explores the ethical obligations to develop a culture where all staff and patients are treated fairly. Included are suggestions for how health care organizations can create an inclusive and civil culture.

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Research

Nursing research is overwhelmingly conducted by white nurse researchers. Research done with minoritized communities leaves impressions of exploitation and mistrust. Minority nurse researchers are key to address health disparities and inequities.

Current structures for research funding from healthcare institutions and governmental agencies are inequitable and must change. Bold funding decisions can level the field and lead to positive disruption.

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