Learning from our lived experiences

acism isn’t something that happens “somewhere else.” It happens right here, every day, in the halls of our hospitals and clinics, within the confines of our academic departments and throughout the research enterprise. It is sometimes inflicted by strangers, but more often by well-intentioned colleagues.

Scenario #1: A bedside nurse’s experience of racism

I left with a knot in my gut

I walked in the door and greeted my patient; she returned my smile. I introduced myself as her nurse for the day shift. Her smile quickly shifted. She asked me, “You’re an RN? How much experience do you have? Where did you go to school?” I felt awkward but answered her barrage of questions and tried to reassure her of my qualifications and intentions to provide her the care she deserves. After completing my tasks, I left her room with a knot in my gut. Did she question me because I am a Black woman? Did she question me because I look young? But there are many nurses that are younger than I am on this unit. At mid-shift, the charge nurse informed me that she is reassigning another nurse to this patient; the family had made the request stating that it just wasn’t a good fit. I felt sick to my stomach. I started to wonder if I even belong in this profession.

The pain feels so raw right now

This wasn’t the first time I’d experienced something like this, and I’ve just blown it off. This time, however, it stuck with me. I couldn’t sleep for the next few days because I could not stop thinking about it: I don’t want to stay silent anymore. I can’t after the murders of George Floyd, Breonna Taylor and Ahmaud Arbery and so many others. Who do I tell? I’m not sure my supervisor would understand. My colleagues that I usually work with are also White, and I don’t know where people stand. And what can they do about it? The culture of our hospital is patients come first. This feels so raw right now; I don’t want to get upset in front of them and be seen as the angry Black woman. I really don’t want this to happen to someone else, so I decided to say something.

The floodgates open

I scheduled an appointment with my supervisor and tried to report the incident as rationally as I could, but I could not stop the tears. It was like the flood gates opened from all those years of repressing these types of incidents from patients and colleagues. My supervisor expressed that she was there to support me. But then she said I wasn’t alone, that White nurses also get dismissed by their patients. She said that patients usually do not have malicious intentions; they are stressed and fearful and take it out on the nurses. Unfortunately, this is part of our job.   

Scenario #2: Her supervisor’s response

I didn’t know what to say

One of my staff came to me today. I work hard to be available for staff to express their concerns. I’m not aware of anything for this nurse, other than a patient’s family requesting a different nurse over her. That happens a lot. Patients get connected to different caregivers for all kinds of reasons. I welcomed her in, and she began crying. She told me she hadn’t slept. She said she couldn’t help but feel that the patient had asked for the change because she was Black. I felt my stomach flip. I didn’t know what to say. She is clearly upset. She is usually even-keel, not very emotional. There is a part of me that accepts that what she is saying is true because I have experienced similar discrimination as a woman working in health care, but I’m anxious to go down that path.

Sometimes patients are just difficult

There is so much going on already with COVID-19. I don’t have the bandwidth to tackle racism too. I told her I am here for her, that she can always talk to me. I told her she is a good nurse and this patient doesn’t change the way we see her performance, that this happens to everyone. Sometimes patients are just difficult. It’s our job to help them feel comfortable when we give them care. I said I was sorry this woman took it out on her.

Common dynamics

Many BIPOC experience the painful impact of microaggressions and other forms of racial trauma and receive limited systemic support. They often also carry the burden of proving and solving their own case. If they share it with White colleagues and supervisors, they might be met with the following responses, that despite good intentions, leave the wound uncared for:

How to respond with compassion

We have adapted the three elements of self-compassionDeveloped by psychologists and researchers Drs. Kristen Neff and Christopher Germer.: mindfulness, common humanity, and self-kindness, as a framework for fostering compassionate intention and response. Adapt this practice for yourself to care for your own feelings, whether they be anxiety, insecurity, resistance, anger, or shame. Though the threat varies significantly, racism impacts all of us. When you can meet your own suffering with care, you are better able to show up for the suffering of others. Then adapt these same steps to respond to your staff with compassion when they’re sharing about racism. 

1. Mindfulness

2. Common humanity

3. Kindness and compassion

Compassion means a desire to alleviate suffering

Often well-meaning intentions have a negative impact. Responding with compassion means identifying how you can appropriately support your colleague or supervisee. What is within your role and how can you use your privilege and power? Protect the individual’s confidentiality and seek resources as needed. If it is within your role to gather more information and problem solve, how can you do this in a way that centers the people most impacted, that doesn’t easily dismiss racism and protect the status quo?

By investing time and other resources to offer continued support, advocacy and education, you can support healing and prevent future incidents. 

Originally published August 2020