Issue link: https://beckershealthcare.uberflip.com/i/1462389
44 NURSING SPOTLIGHT Start with awareness, follow up with structure: 11 ways hospitals can combat racism in nursing By Kelly Gooch W hen clinical leaders talk about nurses and their work during the COVID-19 pandemic, they are quick to point out their resilience and empathy. e country overall also has noticed the strengths of nurses. is year, Americans said nurses are the most honest and ethical profes- sionals for the 20th consecutive time, for example. But most clinical leaders also know nurses are still susceptible to racism and biases. "Racism exists in nursing and society. [Nursing is] a microcosm," said Karen Grimley, PhD, RN, chief nursing executive for Los Angeles-based UCLA Health. "It exists on a couple levels in the pro- fession and also in the business of healthcare. We see it with social inequities all the time. Because we've always been so busy looking outward, we might not have really paid attention to us as a profes- sion as it relates to the specifics of racism." A survey released Jan. 25 by the National Commission to Address Racism in Nursing also found racism to be a substantial problem within the profession, with more than half of nurses reporting they have personally experienced a racist act in the workplace. "Racism in nursing is an issue, and the number of studies published sharing reports of racism and perceptions of racism out there, we can't ignore those," said Deedra Zabokrtsky, DNP, RN, network chief nurse executive for Scottsdale, Ariz.-based HonorHealth. "e re- sults of the recent study were disappointing to read and heartbreak- ing to read. But there are a lot of efforts around this as well. I think we have to acknowledge that it exists and then we need to go about learning what it is and how best to confront that to correct it." Becker's spoke with Dr. Grimley and Dr. Zabokrtsky to understand what racism in nursing has looked like during the pandemic and how their health systems are working to combat it. How racism presents in nursing Racism can exist in various forms, according to the National Com- mission to Address Racism in Nursing. e commission's new definition of racism: "assaults on the human spirit in the form of actions, biases, prejudices and an ideology of supe- riority based on race that persistently cause moral suffering and physical harm of individuals and perpetuate systemic injustices and inequities." Dr. Grimley said nurses must be aware of these biases. She also advocat- ed for nurses being culturally humble and having situational awareness. Otherwise, "we may superimpose our beliefs or our attitudes onto someone, whether it's a colleague or a patient or a member of the community," she said. "So that inclusion you need to have can some- times be hard because some of this comes from systemic behaviors and attitudes in healthcare that have existed over the years. You read about it. You read about nurses eating their young. You read about nurses getting treated as subordinates by physicians. Even some of the stereotypical things you see on TV. It all predisposes any one of us to think in a biased manner that might not be accurate about the population or the person you're encountering." Combating racism in nursing Drs. Grimley and Zabokrtsky agreed that awareness is a key part to making strides to stamp out racism. Here are 11 strategies they identified to combat the issue. UCLA Health 1. Hiring a chief of health equity, diversity and inclusion. UCLA Health appointed Medell Briggs-Malonson, MD, to this position. She began in April 2021. 2. Establishing a council. Nurses at UCLA Health have established a council called Unity in Diversity, which meets monthly. Dr. Grimley said the council is tasked with identifying opportunities to enhance diversity and inclusion and ensure equity for staff and patients. Dr. Grimley said the council plans to continue working on under- standing social inequities and incorporating patient demographics including social determinants to provide more individualized care. "at group dovetails into the health system steering committee that's been created by our chief health, equity, diversity and inclu- sion officer," she said. "So, we've tried to put a system in place that's going to identify and begin to address cultural norms that may be contributing to systemic bias and racism. at systemic stuff that we haven't quite acknowledged yet." 3. Developing intervention teams focused on addressing concerns or complaints around sexual harassment and violence, discrim- ination and racism. Dr. Grimley said UCLA Health conducts detailed analyses of events to identify actions needed to resolve the issue, whether it's at an organizational level or an individual level. 4. Creating educational materials for staff around diversity, equity and inclusion. e health system's education includes mod- ules that introduce concepts of implicit bias, cultural humility and situational awareness. ese modules are "important in the overall architecture of how to understand and identify issues in a proactive way, but also to better prepare individuals to 'see something, say something,'" Dr. Grimley said. HonorHealth 5. Conducting annual staff engagement survey. Dr. Zabokrtsky said the survey presents questions about perceptions of diversity, equity and inclusion. e health system is transparent in sharing results widely. 6. Obtaining information from departing employees. Dr. Zabokrtsky said HonorHealth explores the reasons why employees le to identify opportunities for the health system to improve. "We're looking at that data and compiling any trends. We encourage employees to bring forth any concerns they have. We're doing a lot in terms of monitoring and asking for feedback, so that we keep the pulse of our teams and address concerns openly." 7. Using a "just culture" concept. Dr. Zabokrtsky said HonorHealth uses this concept to inform decisions it makes.