Reflections from an ally in training.
Similar to an acute exacerbation of a chronic disease, the racial injustices of the past year stalled our progress towards health equity. During my 3-year hiatus from bedside nursing, I have made time to reflect on my position as a White nurse. Recently I returned to bedside care and while caring for patients in the medical ICU during COVID-19, I could feel our world was on high alert. From instances of microaggressions to blatant discrimination, the volatility of the current landscape of our world affected our care. For example, while working a shift in the medical ICU, I cared for a patient suffering from severe seizures who was intubated, sedated, and chemically paralyzed. At the start of my shift, I met this patient’s brother who notified me that their father, Mr. Parks*, was coming to visit and was “tough” and would probably “put me through it” when he arrived. He was a protective and a fierce advocate for his son, explained the brother, but he felt confident I could handle his father’s questions and skepticism after getting to know me throughout the day.
When Mr. Parks arrived, he asked me for updates and gauged my handle on the situation. Mr. Parks, who is Black, expressed anxiety due to our restricted visitation policy, a result of an overwhelming wave of COVID-19 cases in the previous weeks. “I’m terrified to leave my son’s side. I’ve always stayed overnight with him due to our experiences with racism and discrimination throughout the years.” He graciously shared his excruciating experiences of racism and discrimination during his son’s many years of complex care for a seizure disorder, including healthcare providers who assumed his son’s disorder resulted from drug abuse or non-compliance with medication. What began as a conversation about his son’s condition evolved into an intense schooling on racial injustices in the healthcare system. Mr. Parks asked, “look to your left and your right: what do you see?” I answered, “Well, I see an empty hallway with a few nurses running around in PPE.” “And how would you describe these nurses, Lyndsay?” Mr. Parks asked. “Resilient. Tired. Busy. Compassionate” I said. He raised an eyebrow, “Ok and what else?” “They are primarily White,” I timidly replied. “Exactly” he said. I knew where he was going with his original question when he asked me to observe our unit from the doorway; and I wished I had a different answer.
During a rare moment to be fully present with Mr. Parks, a luxury rarely granted while caring for patients during COVID-19, I engaged in one of the most sincere, raw conversations I’ve ever had about race and health equity. He asked me if I knew the beginnings of racism in American history (and to go home and look it up if I didn’t). He reflected on the mistrust of the COVID-19 vaccine and its’ inequitable distribution in communities of color After thanking him for entrusting me with this part of his story, I asked, “so where do I go from here? How do I move forward from awareness to action?”
He said, “you need a guide. Someone to help you navigate the cultures, stories, experiences, and histories you can never fully understand due to your own culture, story, experience, and history as a White person.” I was afraid, but I asked, “how do I find a guide when voices on social media resoundingly scream, ‘do your own work. Don’t ask us to teach you.’ ‘Why don’t you at least try to understand our experiences?!’ ‘You will never understand.’
Unphased, he replied, “You do it like this,” motioning to our current conversation.
You do it in relationships built on trust, mutual respect, humility, and kindness. By pulling up a chair and opening your heart and ears in whatever sphere of influence you inhabit, no matter how big or small. For me that day, that sphere was the bedside. In my future career as a nurse scientist and educator, that sphere includes thoughtfully, intentionally, and humbly consulting guides to help me conduct research and educate future nurses in a manner that promotes health equity.
So I’m here, an ally-in-training, typing this reflection to share within my tiny sphere of influence. After my experience with Mr. Parks and his son, I am motivated to continue pursuing intentional mentorship from expert guides, namely the incredible patients, healthcare providers, friends, and nursing faculty collaborating with me on this journey. My goal is to continue learning what it means to pursue health equity in my life and work.
I hope this post provides an impetus for any allies-in-training to reflect: What is our sphere of influence and how can we be active advocates and allies in that space, no matter how large or small? Who are the guides in this space that can help point us in the right direction and provide feedback along the way?
Take a moment to reflect on your sphere(s) of influence and guides in your particular life spaces. Start with a small step to intentionally engage with these guides and experts to continue training towards allyship. For me, my small step is writing this post alongside my mentors to reflect on the space I am starting from as I pursue this next chapter of training. Mr. Park’s reminded me that each individual’s story, context, and experience is important. I’m examining who I follow on social media and intentionally following key voices in the health equity conversation, actively participating in a faith community deeply committed to diversity and inclusion, pursuing opportunities to be mentored by leaders in health equity research, and volunteering with community organizations in my neighborhood. When these steps feel insignificant and small, I remember my conversation with Mr. Parks that day and recommit to pulling up a chair and opening my ears right where I am.
Lyndsay DeGroot is a 4th year PhD Candidate in Nursing at the Johns Hopkins School of Nursing. Her experience as an ICU nurse inspires her current research focused on palliative care for people with advanced heart failure.