There is no public health without racial justice

As Black History Month comes to a close, nurses are fighting forward for Black health

For the past few months, nurses at the VA in Tuscaloosa, Alabama have been driving their cars around their hospital and around downtown, honking their horns and displaying signs with slogans such as “Racial discrimination will not be tolerated.” The nurses, members of National Nurses United — the largest union of registered nurses in the United States — have been protesting, with support from the Southern Christian Leadership Conference, to call attention to a lack of Black nurses in leadership positions at the facility, and to reports of harassment faced by Black nurses.

“In the workplace, there’s no place for harassment,” said Juanetta Jemison, a Tuscaloosa nurse practitioner. Jemison emphasized that hiring Black nurse leaders is important for nurses’ sense of equality, and given the large Black patient population at her facility, Black leadership could also help address systemic racial bias in health care. A 2016 study published in the Proceedings of the National Academy of Sciences found that a significant number of white medical students and residents hold racial biases that negatively impact the perception and treatment of pain for Black patients.

“It’s important to me as a Black female and a veteran that I’m treated equally,” said Jemison, noting that weekly protesting has created movement, although meaningful change is still slow going. “We’ve had some breakthroughs, but we are still not where we want to be.”

The Tuscaloosa nurses are not alone in fighting for racial justice in the health care setting and in the wider world. Nurses across the country vow to help and heal all people, and it’s not enough to care for our patients after they already suffer illness or injury, after it’s already too late. As patient advocates, a natural extension of our job is to be out in our communities, addressing the issues that injure and sicken our patients, hopefully keeping them from needing medical care in the first place.

Covid-19 has made it more obvious than ever before that structural racism is hurting and killing our patients — and our nurses. According to the CDC, Black or African American people are 3.7 times more likely to be hospitalized with Covid than their white counterparts, and 2.8 times more likely to die from it. Only one quarter of registered nurses in the United States are people of color, but more than half of the RNs who have died of Covid-19 have been nurses of color.

Union nurses know that winning systemic change takes collective action, so we are fighting hard for that change, a fight fueled by the Black-led uprisings for racial justice in the summer of 2020.

“As nurses, we see social injustice every day,” said Cathy Kennedy, RN, president of NNU affiliate the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC). “We understand the work of social justice — which includes advancing racial justice — to be central to what it means to be a nurse, what it means to provide care.”

NNU and its affiliates have released statements on racial justice as a public health crisis, including statements by the Minnesota Nurses Association and the Michigan Nurses Association. At its national convention in September, 2020, NNU affiliate CNA/NNOC even passed a resolution on promoting racial justice and eradicating health disparities. NNU also developed a “safer protesting” guide for people who were protesting for racial justice during Covid. Of course, our decades-long fight for Medicare for All is also a fight for Black health.

“We have an obligation as patient advocates and union nurses to do everything in our power to make sure that we are as effective as we can possibly be [at fighting racial injustice],” said NNU President Zenei Cortez, RN. “And, even then, we must always strive to do better.”

Nurses have also been holding racial justice actions at their individual facilities and have taken action through their health systems and home communities. In addition to facility actions, nurses in the University of California (UC) health system also held a racial justice town hall this summer. They are now in the process of building a statewide racial justice committee. UC leaders from across the state will meet and organize around how to implement a racial and social justice program among members, linking up with organizations doing racial justice work in the community.

In Illinois, UChicago Medicine ER nurses got active on a number of issues of racial disparity this past year. They’re now moving forward on improving working conditions, such as providing equal access to training and specialized assignments. RNs at UChicago Medicine Ingalls in Harvey, Illinois fought for and won important racial equity gains in their first-ever contract this month. They closed a wage gap of nearly $4 an hour between white and Black nurses, and they also got the hospital to remove the barrier to accessing quality jobs by agreeing to hire nurses with an associate degree.

In the hospital or in the community, nurses fight for Black health.

“We are very proud we were able to secure these opportunities for associate degree nurses, who are too often shut out of acute-care hospital settings although they prove themselves to be fully competent as they must pass the same board exam as nurses with bachelor’s degrees,” said Donna Dubois, RN. “This important commitment will go a long way toward providing opportunities for nurses who are graduating from the surrounding community colleges.”

In response to the devastating impact the pandemic has had on communities of color, Michigan Nurses Association nurses have been supporting groundbreaking initiatives to reduce bias in healthcare throughout the state. A Michigan RN was asked to serve on the Protect Michigan Commission’s Vaccine Deployment Work Group for African Americans. Another RN was appointed to Michigan’s Implicit Bias Task Force, in line with implicit bias training that is part of the state-required knowledge and skills necessary for renewal of licenses and registrations of health professionals in Michigan.

Black History Month 2021 is the first February in our lifetime to happen during a pandemic. The month is coming to a conclusion, but nurses’ fight for racial justice is only growing. It’s who we are; it’s how we care for our patients.

“When we put our principles and priorities in their right place, I’ve seen nurses who were told they should be quiet and stay on the margins refuse to stay quiet. I’ve seen them lead our fights for justice,” said Kennedy. As union nurses, we know that when we stand up together, in numbers too big to deny, we can win.

NNU members can sign up for our FREE new workshop, “Structural Racism and Racial Justice: A Workshop for Nurses.” Learn more here. And visit the website for NNU’s racial justice campaign for printable resources and more.

Union Nurse Leader & Medicare For All Activist. Executive Director of @NationalNurses, the Largest U.S. Organization of Registered Nurses. #TIME100

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