Britney Daniels, RN, MSN, is a Black queer ER nurse from Chicago who is passionate about social justice and healthcare equity. She’s also the author of Journal of a Black Queer Nurse, a memoir about her experiences navigating the inequities she faced as an ER nurse on the front lines of COVID-19.
Minority Nurse spoke with Daniels to learn more about her memoir and what she hopes readers can learn about what nurses of color experience at work.
What made you decide to enter nursing, especially in the ER?
I decided to enter nursing after being fired from my job as an ER tech for applying Dermabond to a patient’s laceration. Before being fired, I pushed back against attending school to advance my career. After losing my job, I quickly realized that I should be working to advance my education and professional career. I started my nursing career in the emergency department because I enjoyed seeing patients from different backgrounds of all ages. I did not want to limit myself to any specialty because I craved experience in all body systems.
Can you tell us more about your book, Journal of a Black Queer Nurse? What can readers expect from the memoir?
My book, Journal of a Black Queer Nurse, was born from years of journaling during and after ER shifts. It was important for others to view and understand my perspective on healthcare. The intersection of my identities gives me a unique perspective and experience with patient and healthcare professional interactions. Readers can expect to walk in my shoes throughout the book and truly understand the implications of being a racial and sexual minority in medicine.
How did it feel to publish your memoir about your experience navigating the COVID-19 pandemic as a Black queer nurse?
Publishing this memoir felt simultaneously liberating and nerve-wracking. The COVID-19 pandemic changed how we, as nurses, experienced our day-to-day workflow. At the same time, racial injustices and violence against Black people in the United States wore me down psychologically. Being able to share the stories that impacted my life so deeply felt healing and gave me hope that others would realize the importance of their unique experiences.
How has it felt navigating the pandemic? Did you feel like you had more pressures and responsibilities from your coworkers as a nurse of color?
I felt hypersensitive and hyperaware of everything happening around me. As a nurse, I feared contracting COVID-19 and being unable to work. As a Black woman, I was terrified of being pulled over or harmed outside of work because of my skin color. My coworkers during the pandemic were wonderful for the most part. I was surrounded by people who cared about me, valued my work, and respected me. However, a few coworkers made my job much more difficult during the pandemic by refusing to communicate or help me in difficult situations. It was a difficult time for so many reasons. George Floyd was on my mind, Breonna Taylor and the disproportionate number of people of color dying from COVID-19.
In your book’s synopsis, you gave your extra clothes to a homeless man during a shift. Can you tell me more about that?
I gave my clothing to patients on many occasions. Most were houseless, but some were in situations where their clothes were cut off for a rapid assessment. While working in California, I realized how drastic the wealth gap was. I realized that most people not part of a multigenerational household, multiple income households, or born into money could not afford to live comfortably in California. I quickly realized how fortunate and privileged I was as a travel nurse to afford housing, a car, and food. My responsibility as a nurse does not end when a patient’s symptoms are cured. My job as a nurse is to ensure the best possible outcomes for each individual I encounter. So if someone departs the hospital and does not have proper clothing, and the hospital does not have their size, I will give them my clothing every single time.
If you could have readers take one piece of advice from your book, what would it be?
It would be to lead with love in everything you do. In every encounter, in every situation. If you open your heart and mind to other people’s stories, you will better understand the why behind everything they do and say. We all have a story. And every single story matters. Yours too.
After going through the experiences in your book, do you have a new outlook on life? How does your life look different (if at all?)
I continue to go through these experiences to this day. Unfortunately, the world is still full of racist, homophobic, sexist individuals who need medical care. However, writing my book has started difficult and uncomfortable conversations that must be had. These conversations will be life-changing.
Where can readers buy your book?
My book is available for purchase at all major bookstores. It is also available through my amazing publisher, Common Notions.
Nurses have been front and center of every medical crisis, and after the COVID-19 pandemic, nurses were recognized as frontline heroes.
However, more nurses are stepping up and admitting that although they were able to save lives, the pandemic exacerbated unequal workplace conditions, which made their job harder, longer, and more stressful.
As a result, a safe space nurses joined to advocate for their needs was nurse unions.
Nurse unions have existed since the 20th century, but it wasn’t until 2005 that union membership among nurses started to increase, according to a 2010 article in the Journal of Clinical Nursing.
Since then, more nurses have become advocates to eliminate workplace violence, uneven nurse-to-patient ratios, and unfair hiring practices within the healthcare system. This is certainly true with the recent strikes in New York, California, Minnesota, and the U.K.
Strikes for Safe Staffing and Fair Contracts
Although hospital executives and management have set standards such as how many nurses can be hired and what benefits they get, nurse associations like National Nurses United (NNU) have fought to protect nurses’ safety when these contracts don’t reflect nurses’ needs in the workplace.
One issue that has been a significant cause of nursing strikes across the U.S. is safe staffing.
Many hospitals are faced with uneven nurse-to-patient ratios, which diminishes the quality of care among patients. This leaves nurses to make up for the lack of staff in hospital units through increased hours and fewer mandated breaks–and in turn, that can lead to more medical errors.
California is the only state to have mandated minimum nurse-to-patient staffing ratios in all hospitals. Therefore, many would think that having a law to prevent understaffing already existed. Still, according to the President of National Nurses United, Zenei Triunfo-Cortez, RN, this was not the case.
Zenei Triunfo-Cortez, RN, is the President of National Nurses United
“Since beginning my nursing career, we have always fought for safe nurse-to-patient ratios. It was a lot of work, persuasion, and real-life stories about what happens to us every day in our work life that helped us show legislators that we need this because this is what’s happening in our lives day in, day out.”
However, there is no nationwide federal law for safe staffing. Triunfo-Cortez and other union nurses at NNU are looking to change that. In other affiliate states with NNU, nurses who are part of the organization also hold rallies to build awareness of the need for safe staffing and legislative laws protecting nurses’ right to organize.
“We will not stop until working conditions are a lot better for all of our nurses, no matter which state you are in, and it doesn’t matter which area of practice you are in. We’ll make sure that our nurses are well provided for in all areas,” says Triunfo-Cortez.
Ethnic Minorities and Nurse Unions
Nurses from minority backgrounds make up almost 20% of registered nurses, according to the American Association of Colleges of Nursing. Sadly, their representation among the nursing community compared to the population of BIPOC Americans remains small.
Many nurses of color feel discouraged in their workplace if their fellow nurses don’t look like them, so it’s no surprise that they can leave their jobs faster if they don’t receive support when they’re overworked.
Julia Barcott, the chair of economic and general welfare at the Washington State Nursing Association (WSNA), has seen this happen in her workplace. Barcott is an ICU nurse at the Astria Toppenish Hospital in Toppinish, Washington, an area with a large population of Hispanic, Filipino, and Indigenous tribes. She adds how she mentored four Hispanic and Indigenous bilingual nurses who experienced understaffing during the COVID-19 pandemic.
Julia Barcott is the chair of economic and general welfare at the Washington State Nursing Association
“They went to college together, got their nursing degrees, and all wanted to serve their communities. They stuck it through the pandemic,” says Barcott. “Then, when things didn’t get better after the pandemic slowed, they realized that the hospital wouldn’t address the staffing issues. They were continuing to go on as if the pandemic was still here.”
Barcott explained that these nurses eventually left their jobs, despite receiving sign-on bonuses.
“You want to have racial equity and have people that look like yourself if you’re a patient that understands your customs and beliefs,” says Barcott. “These four young women were like that. They were a huge asset.”
Chronic workplace conditions such as these are some of the reasons why nurses of color join unions. However, systemic racism has also factored into why BIPOC nurses can be disillusioned with the profession. Dealing with discrimination as a nurse in the early 90s is why Triunfo-Cortez, a Filipina, decided to become involved with unionizing.
“I was applying for a transfer and was bypassed because the manager told me she could not hire more Filipinos. And so, at that moment, I thought, why should you look at the person’s ethnicity? You have to be looking at the qualifications, right?” says Triunfo-Cortez. “And so I became involved thinking that nurses need to speak up because this is modern history, and there’s still apparent discrimination happening.”
When nurses of color get involved with unionizing, they provide unique views on chronic healthcare challenges that others may not have. BIPOC nurses can also gain more accurate representation in a healthcare system where white-dominated opinions can be at the center.
Nursing Shortages Don’t Exist
While nursing unions can help bring awareness to unfair nurse-to-patient ratios and workplace violence, they also bring light to long-held beliefs about the healthcare system–like nursing shortages don’t exist.
“What we have is not a staffing shortage, but a shortage of nurses who do not want to work under unsafe working conditions because we do not want to be blamed for bad outcomes of our nursing care,” says Triunfo-Cortez.
Barcott mentions that some people with nurse licenses aren’t practicing as a nurse at all because of understaffing.
“There’s like 150,000 nurses in Washington. Less than half of those are working right now, but many of them are the ones that have active licenses. They are not willing to work in the conditions that are occurring now,” Barcott says. “They would rather not work as a nurse or take time off because they’re burned out, or they go do something different.”
Hospital executives and management often think of profits and business expenses more than the harmful conditions nurses experience daily. Some employers believe that to solve this retention problem. Then they need to direct more funds toward hiring new nurses.
For example, Barcott explains that it costs around $100,000 to orient a new nurse over six months. However, when hospital management and financial officers don’t address chronic workplace issues, these nurses leave faster, causing this cycle to repeat.
Nursing unions see this issue, which is why many lobby for legislation for fair staffing and safe workplace practices.
In Washington, the WSNA pushes for state laws to be passed supporting safe staffing standards, enforced rest breaks, and functional staff committees. Like the WSNA and the NNU, the New York State Nurses Association (NYSNA) educates union nurses on worker rights. It helps them bargain for health benefits, higher wages, and paid holidays.
Using Unions to Make a Difference
When nurses of all demographics sit at the table to discuss fair workplace conditions, everyone, including patients, benefits from a better quality of care.
“It’s uplifting to know that most of our nurses are real and true patient advocates, not just by word, but in action as well,” says Triunfo-Cortez. “When you think alike and know that your goal and your mission are the same, then you will do everything in your power to achieve those goals because we know that if we all work together towards a common goal, it would be for the betterment of everyone.”
After the pandemic, more people now see that nurse unions exist and are here to stay. People not working in healthcare are picking up protest signs, while hospital management sees that there’s strength in numbers.
“I think that’s why membership is starting to go up in a lot of areas where essential workers were put in that position because that was the only that’s the only way we can collectively band together and express the needs of our patients. And it was only a matter of time,” says Barcott.
See Our Champions of Nursing Diversity
Sign up now to get your free digital subscription to Minority Nurse