McDaniel, who is a devoted historian, says she became fascinated by the stories of the earliest Black nurses. “I feel a kinship with them,” she says. “And I didn’t even know they existed. When I was going to school, I didn’t see any professors that looked like me. I started researching and looking for people who look like me, and I was inspired to learn about them and chronicle their lives.”
For women who were such important pioneers, McDaniel says learning about Mahoney and other Black nurses in history was happenstance. “What’s troubling is that I didn’t learn about her in nursing school,” says McDaniel. With a scant two sentences devoted to Mahoney in the nursing textbook McDaniel’s classes used, she has no recollection of conversation about this woman who paved a path for generations of nurses to follow.
And while Mahoney is someone who gained formal experience, her journey was indirect. She worked in the New England Hospital for Women and Children doing jobs including laundress and cook. But that was typical, says McDaniel. “Many nurses in the past gained formal and informal training,” she says. “Many gained their knowledge experientially because they were not allowed entry into nursing school.”
And while many consider these nurses as unsung or hidden figures, McDaniel says they really have been erased from history. Their work was so essential–on the front lines of Civil War battlefields, for example–but not recognized.
While many people know about Louisa May Alcott’s work as a nurse and an author, few people have heard of Matilda Cleaver John, a Black nurse who fought to keep Alcott alive when she was sick with typhoid, says McDaniel. “No one hears about them,” she says.
With so many restrictions on Black nurses–where they could work, who they could care for, and what tasks they could perform–the women who took this career path were up against formidable challenges. Because of that, McDaniel wants others to know about the essential and transformative work performed by nurses who never got credit for the lives they saved, and the personal risk involved to do that work. It is, she says, a direct reason for the disparities and inequities that exist in nursing today.
“I am greatly influenced by Mary Eliza Mahoney not just because she was the first Black woman to graduate from a nursing school,” says McDaniel, “but also because of all she endured and the hurdles she had to cross to do what she did.”
With that in mind, McDaniel says her personal celebrations are especially poignant during National Nurses Week, and she particularly begins honoring the week on May 7 when she recognizes and remembers Mahoney.
Eventually, McDaniel would like to see a full history of nursing, once that reflects all nurses, included in nursing textbooks. “I want to bring them out of obscurity,” she says. “They had so much against them because of the color of their skin but they still did courageous things. I am inspired by their advocacy efforts.”
As technology continues to change healthcare practices, patient care simulation is transforming nursing education.
Vivienne Pierce McDaniel DNP, MSN, RN, works as the diversity equity, and inclusion consultant for Sentinel U® where she ensures that all simulation products create a lifelike healthcare environment that is sound and inclusive.
“Sentinel U® values nurses, and healthcare outcomes depend on how well prepared nurses are to address the social determinants of health and to provide equitable care across the continuum of care,” McDaniel says. “Sentinel U® is committed to healthcare equity through their products, and they are created to expose the learner to a diverse set of patients.”
As part of growing nursing advances and trends, simulations are used to help nurses experience various situations and individuals they could encounter during their nursing practice. Ensuring the products represent accurate and realistic diversity of all forms helps nurses gain essential skills. Whether a nurse practices in a highly diverse community or in a more homogeneous community, simulation provides needed guidance.
Because they can train with simulation products, nurses don’t have to learn on the fly when they are presented with a situation they have never encountered before. “It allows nursing students and novice nurses to increase their critical thinking and develop sound clinical judgment in an environment that is risk free,” says McDaniel. Because the simulations are realistic but tech-based, nurses can make mistakes without the risk of any harm.
For nurse educators, simulations that represent all kinds of diversity–from race and ethnicity to mobility or religious beliefs–offer a robust pedagogy for teaching diversity and inclusion concepts as they apply directly to nursing, she says. Nurses become aware of any implicit bias they may have–to an accent or condition a patient has. They also become aware of the subtle ways their implicit biases may impact the care they give inadvertently such as through terminology they use or an assumption they hold.
McDaniel’s commitment to ensuring equity in healthcare drives her to assess each simulation meticulously. Recently, she spent time reaching out to a leader of an indigenous tribe to make sure the simulation she was reviewing was accurate. She also wanted to learn more to understand how Sentinel U® could fine-tune it even more. Those details make a difference to nurses, patients, and residents of long-term care facilities. “People from underrepresented and underserved populations are going to be the first to notice that there’s bias and a lack of cultural competence and sensitivity,” she says.
When nurses train using all kinds of simulation scenarios, they help close a chasm that McDaniel sees in achieving health equity. Nurses who invest time in simulation will gain enough knowledge and practical experience to be positioned to achieve that with their patients. “To me it’s pivotal,” says McDaniel. “Simulation healthcare-based interventions help them achieve that. To achieve diversity, you must first foster an environment that’s inclusive and equitable.”
Vivienne McDaniel with the late US Representative John Lewis
McDaniel’s work as a nurse is her second career; she became a nurse in her 40s. A family-based commitment to civil rights runs throughout her work–she is family of Rev. Curtis Harris, civil rights activist who marched with Dr. Martin Luther King, Jr., in Selma, AL (her mother is a first cousin). “He put it in my head that we have to represent those who are underrepresented and serve those who are underserved,” she says. “That played a huge role in what I do.” And she knows that each nurse bring a set of lived experiences to their work.
Her own experiences are based in part on growing up in a rural setting. McDaniel recalls watching airplanes fly overhead and wanting to be on them one day. When she was able to travel, she used the opportunity to immerse herself into the communities and cultures around the globe to learn from them. “That all prepared me for what I was going to do later,” she says.
Each nurse, she says, brings a history that enriches patient care. “My favorite thing is diversity of thought,” she says. “What experience will that person bring to the bedside.” Simulation work adds to a nurse’s body of experience to broaden their understanding of inclusive patient care. “We must address all these topics because they might be encountered in a nursing practice,” she says. “Simulations are realistic and they will encounter characters and experience environments that some nursing students might never otherwise be exposed to.”
See Our Champions of Nursing Diversity
Sign up now to get your free digital subscription to Minority Nurse