Expand nursing’s role to achieve justice for everyone.

Inequities pervade the American healthcare system and prevent people from achieving their full potential. According to Deloitte, in addition to limiting self-actualization, these inequities generate unnecessary costs and financial waste—approximately $320 billion annually, which could increase to $1 trillion or more by 2040.

Ensuring that nurses deliver equitable care is more than satisfying a mandatory education requirement. Rather, it requires understanding and connecting with patients, whose backgrounds, families, environments, and experiences play a role in their medical histories and in their health and wellbeing when they return home.

The Black Lives Matter movement expanded worldwide after the deaths of several Black men, including the gruesome murder of George Floyd in May 2020. Floyd’s death came at a time when the country’s healthcare system was overwhelmed with patients suffering from COVID-19 and with the reality that more Black people were suffering and dying from this disease than any other ethnicity.

After Floyd’s murder, I stood with diverse groups of colleagues to raise awareness of racism and support our organization’s commitment to equitable care. The widespread pro­tests highlighted other factors that affect health, namely the social determinants of health (including poverty, lack of education, stig­ma, environmental constraints, and hun­ger), as well as the systemic inequalities faced by marginalized communities. Studies consistently demonstrate that racial and ethnic minorities experience poorer health outcomes, higher rates of chronic disease, and reduced access to quality healthcare compared to their White counterparts.

Personal experience

As a Black woman, I’ve experienced this inequity. When I was 21 years old, pregnant, and on Medicaid, I arrived at the hospital in labor. I was assessed, and my pain dismissed as unrelated to labor. I returned the next morning with increasing pain. The staff assessed me again and told me to walk outside and not return unless my water broke. I felt voiceless because of my medical and social circumstances. After about 10 minutes, my water broke and I returned to the hospital. The staff appeared disgusted, made inappropriate comments about my circumstances, and told me to shut up when I cried out in pain. They didn’t offer pain medication. Finally, a doctor I hadn’t met before held my hand and reassured me that she would take care of me and that I shouldn’t listen to the other uncompassionate team members.

Fast forward to today

On December 14, 2020, I made history as the first person in the United States to receive the COVID-19 vaccine outside of a clinical trial. I volunteered because I wanted to lead by example, instill public confidence in science, and protect myself so that I could care for my communities. In my current role as vice president of public health advocacy at Northwell Health, I lead the organization in expanding knowledge of issues that affect health and work with colleagues to implement initiatives that serve our diverse population.

Nurses should seek education on cultural competence, diversity, and anti-racism. We can advocate for anti-racist policies within our organizations and collaborate with other healthcare professionals to address racial disparities. We must expand beyond treating illness to advocacy and healthcare justice for all.

Sandra Lindsay is the vice president of public health advocacy at Northwell Health in New York.

American Nurse Journal. 2024; 19(2). Doi: 10.51256/ANJ022452

Reference

Davis A, Batra N, Dhar A, Bhat J. US health care can’t afford health inequities. Deloitte Insights. June 22, 2022. www2.deloitte.com/us/en/insights/industry/health-care/economic-cost-of-health-disparities.html