At a point in my career, a devastating event deeply affected me. One of my former nursing students, a vibrant young Black woman, tragically lost her life and the life of her newborn during childbirth. Despite access to healthcare, she fell victim to maternal complications that ended in her untimely death. This loss was not an isolated incident but rather indicative of a more significant crisis facing Black mothers in the United States – one that is not just a healthcare issue but rather a matter of social justice and equity.
In recognition of National Nurses Week, it’s crucial to reflect on nurses’ profound impact on healthcare, particularly in addressing health disparities. This year’s theme, “Nurses Make the Difference,” resonates deeply with me, as I have dedicated my career to advocating for improved maternal health outcomes for Black women and preparing nurses for careers in healthcare aimed at advancing health equity.
Every maternal death is a devastating tragedy that leaves a hole in families – representing a forever-altered dynamic. Perhaps even worse, statistics from the Centers for Disease Control and Prevention show that most maternal deaths are preventable.
This staggering data also demonstrates that Black women are nearly three times more likely to die from pregnancy-related complications than white women. Morbid racial disparities such as these do not have a place in the 21st century. Still, they are exacerbated by socioeconomic factors, a shortage of providers, and a lack of access to quality healthcare.
Central to this work is the recognition of the lived experiences of Black women. Factors such as poverty, barriers to healthcare access, and lifestyle choices are frequently used to explain the disparity in Black maternal health; however, these factors alone are inadequate to explain the problem. Healthcare providers often fail to see their patients as individuals with unique needs and concerns. Implicit bias and cultural incompetence compound these disparities, leading to substandard care and poor outcomes.
To effect meaningful change, we must address these root causes head-on. This includes increasing access to quality healthcare, fostering diversity and inclusivity in healthcare practices, and educating healthcare workers to be culturally competent and understand the social determinants of health.
Increasing access to quality healthcare is essential, and addressing the nursing shortage is a top priority when it comes to Black maternal health. By creating new programs and expanding existing ones that reach future healthcare workers, we can help prepare the next generation of diverse nurses who can reduce the burden on the current population of healthcare workers and meet the evolving needs of society – especially Black women.
As a nurse educator with over 18 years of experience in higher education, I believe education is integral to creating positive, sustainable change. At Walden University, where I serve as the associate dean for the BSN program, our online curriculum emphasizes the social determinants of health and the role of nurses in addressing health disparities. I am particularly excited about a new course we launched this spring, “Advocating for Diversity, Equity, and Inclusion in Healthcare.” This course, among others at institutions like Columbia and Frontier Universities, challenges students to confront their biases and privilege while equipping them with the tools to advocate for inclusive and equitable care. Our focus areas include implicit bias, systemic racism, microaggressions, health disparities, the healthcare ecosystem, and advocacy strategies to improve healthcare outcomes. These programs, which establish a better understanding of the unique experiences of our diverse population, are just a part of the solution. Patient outcomes can also be significantly improved by changing the face of those who deliver it. With minority populations experiencing disproportionate rates of disease and death, it is clear we need to create pathways to the nursing profession for all, regardless of ethnic, religious, or financial factors.
One way to do this is by providing educational access to those who may not yet have had the opportunity, which can mean emphasizing online education programs. This approach enables students to earn their degrees from where they live and encourages the development of nurses who practice within their communities, reflecting the communities they serve. This is a proven way to improve the healthcare outcomes of minorities, and it has the additional benefit of combatting the nursing shortage, particularly in rural areas.
Nurses, educators, policymakers, and advocates must join forces to dismantle the systemic barriers perpetuating healthcare inequality. Our industry has a unique opportunity to drive change and promote health equity by elevating the voices of marginalized communities, challenging implicit biases, and advocating for policies that prioritize equity and justice.
As we celebrate National Nurses Week, let us recommit ourselves to compassion, advocacy, and equity principles. Together, we can make a difference in the lives of Black mothers and ensure that every woman receives the quality care she deserves with the understanding she needs.
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.
To learn more about Daniels and her memoir, visit her website, or connect with her on Instagram or Twitter.
At its core, nursing is an inherently humanitarian career path: The job can’t be done without compassion and a willingness to advocate for patients, by any means necessary. As a nursing professional, you’re also likely to be unwittingly thrust into the political arena, treating both injured protesters and law enforcement officials following a violent clash.
Nursing Professionals on the Front Lines of Social Justice
As such, for modern nursing professionals, the lines between individual health care and politics often collide. Along with treating injured protestors at medical facilities and hospitals, many nursing professionals are volunteering their time on the front lines. In many cases, nurses at protests simply show their support to the cause.
But, if a nonviolent protest escalates into a dangerous situation, having a nursing professional on the scene is vital. You may be able to provide emergency care, of course, but even more importantly, nurses on the front lines of protests have a unique insight into police brutality. This sort of information is an invaluable tool for fueling the conversation about systemic racism in the health care industry as well as everyday life.
So, once you’re aware of the current landscape of protests and the tactics used by police, however, what will your next steps be? There are various ways that you can get involved and take a stand against police violence, on both a professional and social level. Here’s what you need to know about the consequences of police violence and how you can help protesters, no matter if you’re on the front lines or working in the ER.
Racism, Police Brutality, and Public Health
The COVID-19 pandemic had already altered daily life around the world long before May 25, 2020. That night, George Floyd lost his life in the hands of law enforcement officials, and U.S. citizens flooded city streets in response. These widespread protests didn’t dissipate overnight — in fact, they only grew larger, and the violence that escalated in several cities left health care workers in a dire situation.
Already under the threat of the pandemic, nurses from all walks of life suddenly found themselves working to balance public health considerations with the reality of police violence. As a patient advocate in these politically charged times, you should thus be aware of the unique needs of your patients. Victims of police violence and brutality, for example, may fear for their safety.
Discretion is a key factor in situations involving institutional racism and police brutality. Further, the provider-patient confidentiality agreement is especially vital if a protestor in your care wishes to pursue legal action against a law enforcement official or organization.
Patient Privacy in the Modern Health Care Landscape
Privacy is an important consideration in 2021, as so much of our everyday lives can be easily found on the internet. Protesters further put themselves on display, and the plethora of camera phones, as well as professional cameras wielded by the media, make anonymity nearly impossible. If you participate in a protest, whether as a curious observer, an active participant, or in a care-related capacity, it should be expected that your image will be captured on camera.
For example, even masks and costumes couldn’t hide the identities of countless right-wing protestors who stormed the U.S. Capitol on January 6. Thanks to the internet and social media, identifying the Capitol rioters was a simple endeavor. While this sort of facial recognition may represent a slippery slope scenario, at least where personal privacy is concerned, the tech proved crucial to holding the rioters responsible.
In the age of telehealth, patients should be afforded more privacy considerations than the protesters, yet various challenges exist when it comes to protecting patient information. To ensure that you’re properly adhering to patient privacy laws, as well as protecting vulnerable patients such as victims of police violence, you must take every possible precaution when collecting, accessing, and storing patient data. You may also want to stay up-to-date on relevant laws and HIPAA regulations, which can change without warning.
There’s No Place for Violence in a Caring Society
As long as police violence remains prevalent, the minority nurses of the future are likely to face unprecedented challenges while on the job. Whether you find yourself in a position of mentor or you’re working directly with patients injured during a protest, your voice is powerful. In the wake of a global pandemic and continued racial disparity, nurses may be inspired to stand up for their patients and actively address police violence, for the sake of both public health and social justice.
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