The Many Faces of Diversity: Providing Culturally Competent Care
July 5, 2021
Response by Tatiana Baiza and Lucine Francis to “Exploring Race in Nursing: Teaching Nursing Students about Racial Inequality Using the Historical Lens” by Bennett, Hamilton, & Rochani (May 31, 2019)
“Exploring Race in Nursing: Teaching Nursing Students about Racial Inequality Using the Historical Lens” reflects on critical crossroads that society, and by extension nursing, has been forced to confront - especially in 2021. The subject of racial inequity and our participation in perpetuating it is of particular importance when exploring race in nursing education. We have witnessed extensive efforts by nursing faculty to integrate racial issues into the nursing curriculum. However, while recognizing and appreciating racial inequities and their impact on health have been widely adopted, the prevailing teaching model in nursing education has not significantly reduced health inequities (Sharma et al., 2017). Furthermore, according to the authors, our current educational strategy can lead to increased negative attitudes in the classroom.
As members of the “most trusted profession,” most nurses come into this career intending to provide patient-centered care. Integrating racial inequity content into the nursing curriculum is necessary to prepare nurses to confront their biases and recognize how their nursing role fits within a broader historical context. As the scope of nursing practice expands, nursing programs are responsible for not only equipping new nurses with the skills to identify and contextualize racial inequities but address them. In doing so, it is equally important to employ compassion to those unfamiliar with the power-privilege dynamics between Whites and Blacks or those who may be encountering these issues for the first time in a meaningful way. The truth is: individuals who are completing challenging degrees to care for others don't like being told that either A) they have contributed to another's suffering or B) their position was acquired by way of privilege. The use of Affirmation, Reflection, Teachable moment, and Summary (ARTS) (Bennett, Hamilton, & Rochani, 2019) in a respectful classroom is a promising strategy for integrating this topic.
While backlash may stem from the uncomfortable feelings students may face, it is vital to foster a constructive and empathetic environment for all students to connect with these issues and each other. After all, we, as nurses and students, share much in common and a special pride for what we do. We have found great value in checking our biases early and often.
With the deep appreciation we have for the authors in shedding light on such a complex topic, we were disappointed with the definition of racism outlined by Bennett, Hamilton, & Rochani (2019), which focuses on inequities of “white people and black people.” It fails to acknowledge the nuances and marginalization of other ethnically diverse minority groups. It may perpetuate feelings of invisibility among minority nurses and faculty that these authors discuss and seek to eliminate. We must remember that the ANA code of ethics challenges nurse educators to teach students about their duty to address bias and commit to social justice and health. The authors’ investigation and synthesis of information associated with race in nursing education serve as helpful contextual tools in developing nursing curriculum to address current and historically based race issues in nursing. The classroom strategies offered are encouraging. While this is a step in the right direction and draws attention to the proverbial “elephant in the [class]room,” it would be valuable to include other minorities in developing such curricula as we cultivate a more inclusive nursing future.
Tatiana Baiza, BA, MSN student
Lucine Francis, PhD, RN
Johns Hopkins University School of Nursing
Bennett, C., Hamilton, E. K., & Rochani, H. (2019). Exploring race in nursing: Teaching nursing students about racial inequality using the historical lens. OJIN: The Online Journal of Issues in Nursing, 24(2). doi:10.3912/OJIN.Vol24No02PPT20
Sharma, M., Pinto, A. D., & Kumagai, A. K. (2018). Teaching the social determinants of health: A path to equity or a road to nowhere? Academic Medicine: Journal of the Association of American Medical Colleges, 93(1), 25–30. doi:10.1097/ACM.0000000000001689