Aug 20, 2020
By Abe Oudshoorn

The unbearable whiteness of nursing

This article is among the first on Canadian Nurse to focus on the issue of racism — particularly anti-Black racism — in nursing and health care. Our aim is to give a voice to those who have experienced racism or want to speak out against it.

Takeaway messages

  • Nursing is too white to achieve the best for our profession and too white to achieve the best health outcomes for patients and communities.
  • While efforts to integrate concepts such as cultural safety and reconciliation into nursing are laudable, they will only yield a slow drift to increased diversity. That’s not justice, it’s simply the passing of time.
  • It’s time for us to move from talk to action in achieving diversity.

It was with dismay that I read a social media post by a Canadian nurse downplaying the role of Black Lives Matter protests in Canada, suggesting that it made no sense for “Canadians to be protesting an American problem.” The naivete required to write such a post — at least I hope it was ignorance rather than willful prejudice — suggested to me that we still have more work to do to help white nurses see the world through different lenses. I am writing this commentary to heed the call of Black Lives Matter leaders for “white people to talk to white people.” My premise here is to be straight-forward: Not only is nursing in Canada very white, it’s too white. Too white to achieve the best for our profession and too white to achieve the best health outcomes for our patients and the communities we serve.

I am writing this commentary to heed the call of Black Lives Matter leaders for “white people to talk to white people.”

To defend my premise, I sought the data; with 16 years in the profession I was confident that comparing workforce data with Statistics Canada data would show a clear disparity between our profession and the Canadian population. However, I encountered an unexpected challenge. Statistics from the College of Nurses of Ontario, the Registered Nurses’ Association of Ontario, the Canadian Nurses Association, and the Canadian Institute for Health Information were all notably lacking information on race and ethnicity in the nursing profession. It seems to me that a simple first step of understanding our current challenges as a profession would be to ensure that this data is included in all workforce reports. Therefore, I base my concerns related to the underrepresentation of Black, Indigenous and people of colour (BIPOC) in the profession on my subjective beliefs. I would welcome being proven wrong with some statistics.

So, as a white person, what would I like to say to an overwhelmingly white profession? To create a context where ignorance will be stamped out, we must actively, meaningfully, and willfully change the face of our profession. I laud the efforts within the profession to integrate concepts such as cultural safety and reconciliation. This is meaningful knowledge and will hopefully continue to be used toward teaching anti-racism and decolonization. However, changing curricula is insufficient to actively make space for BIPOC in our schools and to ensure broad representation of BIPOC in the leadership of our profession. Curricula change is passive; it is time for us to become active. A slow drift to increased diversity that constantly lags the general population is not justice, it’s simply the passing of time. To instead actively recruit, promote, highlight, celebrate, mentor, and listen to BIPOC nurses is how we can quicken the bend of the arc of the moral universe towards justice.

Action must be taken now and it should not fall on nurses who are Black, Indigenous or people of colour to take that action.

The actions to change the face of nursing are many and depend on your own context of practice, teaching, or research. However, it is not difficult to consider how you or your workplace might actively support BIPOC nurses to give them better opportunities or how you might welcome more BIPOC nurses into the profession. Recruit BIPOC students; hire BIPOC nurses; remove barriers to qualification of internationally educated nurses; resign from nursing boards and committees that are too white and demand replacement by BIPOC nurses; don’t participate in all-white conference panels; call out racism; and march in the streets with Black Lives Matter. Action must be taken now and it should not fall on BIPOC nurses to take that action. It is time for white nurses to help solve the unbearable whiteness of nursing. Anti-racism is active and means that as our profession has been prejudiced and exclusive, we must work hard to make it better.

To conclude, as a white nurse speaking to white nurses, I would say it’s time for us to move from talk to action in achieving diversity. Some of my personal pledges as an educator are to continue to focus on recruiting BIPOC masters and PhD students, to name racism where I see it happen, and to remove myself from opportunities of power and instead promote BIPOC leaders. I hope you also make a pledge today, for yourself, for the profession, and for justice.

Abe Oudshoorn, RN, PhD, is an assistant professor in the Arthur Labatt Family School of Nursing, Western University, in London, Ont., and a member of the Centre for Research on Health Equity and Social Inclusion.

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https://www.canadian-nurse.com/en/articles/issues/2020/august-2020/the-unbearable-whiteness-of-nursing