A national survey revealed racism remains a challenge across the nursing profession. Two members of the American Association of Nurse Anesthesiology (AANA) who were appointed to working groups for the study said that their participation in the survey was vital since, “at the end of the day, patient outcomes are impacted.”
Edwin N. Aroke, PhD, CRNA, a tenured associate professor at the University of Alabama at Birmingham School of Nursing, serves as a subject matter expert on the research working group, and Monica Rose, PhD, CRNA, adjunct faculty at Wake Forest University School of Medicine, Nurse Anesthesia Program, and anesthesia independent contractor, serves as a subject matter expert on the education work group. Both work groups are part of the American Nurses Association (ANA) National Commission to Address Racism in Nursing.
“It is important for the AANA and Certified Registered Nurse Anesthetists (CRNAs) to be involved in the work of the Commission because ethnic minorities have historically been underrepresented in the profession of nurse anesthesia, “said Dr. Rose. “We, CRNAs of color, have unique clinical and professional experiences. We need to have conversations about those differences and hopefully dismantle structural and systemic racial practices.”
The commission recently released results from a survey of more than 5,600 nurses showing significant problems with racism within the profession. According to the report, 63% of nurses surveyed say that they have personally experienced an act of racism in the workplace. Additionally, three out of four nurses surveyed said they have witnessed racism in the workplace.
Dr. Aroke offered his perspective on racism and nursing research: “The work of this commission is essential as it acknowledges the negative impact of racism on all nurses, be it RNs, CRNAs, students, those in clinical education and research settings. At the end of the day patient outcomes are also impacted by racism. For example, we have seen patients do much better when they are taken care of by people they trust and who come from a similar background. In addition, understanding racism in nursing and healthcare overall could positively impact research: increasing diversity among researchers, bringing more funds to diseases that predominantly impact people of color, as well as validating research findings for all people.”
The survey results are in line with the commission’s new definition of racism: “Assaults on the human spirit in the form of actions, biases, prejudices, and an ideology of superiority based on race that persistently cause moral suffering and physical harm of individuals and perpetuate systemic injustices and inequities.”
According to Dr. Rose, evidence shows Black patients are undertreated for pain relative to White patients. She believes this is an important topic for the nurse anesthesia profession. “Racial bias against Black patients has led to undertreatment of pain and pain syndromes. This additional layer of structural racism leads to health care disparities and inequalities. For example, comparing pain assessments of Black patients to a ‘control’ group could perpetuate some practitioners’ perception that Black people have ‘tougher’ skin and therefore require reduced analgesics. This stigma impacts patient care and is misaligned with the fundamentals of nursing practice. Clarifying these concepts is critical because if we can just change one person’s thoughts about racial bias and pain management, we will have made a difference. I also believe minority faculty experience unique challenges, such as being scrutinized more harshly by students when compared to White faculty and being denied tenured faculty positions despite evidence of being qualified. Historically, minority faculty are less likely to be recruited and retained when compared to other demographic groups. I do believe there have been recent shifts in these hiring and retention practices favoring hiring qualified minority faculty. There’s still work to be done on this topic.”
“We know that funding and funding priorities impact virtually every aspect of research and outcomes,” said Dr. Aroke. “Studies have shown that sickle cell disease affects three times more people in the United States than cystic fibrosis. Yet, cystic fibrosis receives as much as 11 times more research funding than sickle cell disease from the federal government and foundations. Such disparities can directly affect evidence-based care and subsequent patient outcomes.”
Statements obtained from Dr. Aroke and Dr. Rose are representative of their individual experiences and opinions and are not issued on behalf of their university affiliations