Content area
Full Text
Abstract
Purpose: To advocate for strategic actions by U.S. nursing leadership that denote the presence, customs, and implications of racism that has been institutionalized within the structures of U.S. nursing leadership and the profession.
Organizing Constructs: A racial equity framework is used to examine the barriers to quality health care and equitable health outcomes and to present evidence-based actions to dismantle structural inequities embedded in the nursing profession.
Methods: This article was developed through a comprehensive literature review and synthesis of relevant research, data, peer-reviewed literature, government reports, and organizational guidelines.
Findings: A commitment by U.S. nursing leadership to eradicate structural racism in nursing must be made in order to effect sustainable transformative change toward more equitable systems of health care.
Conclusions: This article presents recommendations for nursing leadership in the United States to renew its commitment to quality health care through dismantling structural racism at all levels of direct and systems nursing practice and education, at the bedside, and in the boardrooms.
Clinical Relevance: Structural racism in nursing and health care also persists globally as a key social determinant of health. Its elimination aligns with international health care and nursing's policy priorities, yet change can only occur when senior leaders clearly understand it as a key barrier to health, and commit to transformative change in how their "systems" work. These recommendations can also be culturally adapted by global nursing for use in antiracism work.
Key words
Health disparities, health inequities, racism in nursing, social determinants of health, structural racism
Motivating health equity is requisite given starkly disparate health outcomes among black and brown racialized populations compared to white populations in the United States. Racial justice and improving health equity take on a significant role in the work of racial minority nurses (Beard & Julion, 2016). Representation of racial minority populations in nursing remains disproportionate when compared to the representation of white populations in nursing O'Connor and colleagues (2019) reported that 85% of nursing faculty nationally are white, and the landscape in which nurses operate requires them to have constructive and bold conversations and self-reflection on racism given that nursing academia strives to not only embody an inclusive educational space but to prepare professional nurses who can deliver equitable care for a diverse population....