Aug 13, 2020, By: Michelle Danda
This article is among the first on Canadian Nurse to focus on the issue of racism — particularly anti-Black racism — in nursing and health care. Our aim is to give a voice to those who have experienced racism or want to speak out against it.
- Racism is not just a problem in the U.S. It is deeply embedded in Canada as well.
- Nurses must start conversations about the overt and systemic racism in Canadian health care because it impacts the health of everyone, especially racialized people and populations.
- Structural and institutional racism is much more insidious than overt discrimination because individual intent is not necessary.
My mother has brown skin; she is from the Philippines. My father had white skin; he was from Czechoslovakia. I look racially ambiguous.
I grew up in Canada in the 1980s and 1990s. I have personal experiences of overt racism, like the kids on the playground calling me racial slurs, and covert racism, like people openly asking me, “where are you really from?” When I responded that I was from Ontario, some people assumed my mom was my nanny, others complimented me on my “great tan” in the middle of winter.
My experiences of racism are ongoing. I continue to be openly asked intrusive questions as if they are the norm, like “are you native?” (to query my ethnicity) or “do they all have the same dad?” (when people learn I have four kids).
I have been a nurse for 12 years and have experienced and witnessed overt racism — of patients toward clinicians, but also clinicians towards patients. I have felt the systemic racism permeating through our health-care system. The recent public outcry and protests related to the Black Lives Matter movement has gained momentum following the brutal killing of Black American George Floyd by a police officer. This has sparked global conversations about the state of racism. While some Canadians breathed a sigh of relief that this blatant racism towards Black people was contained to the United States, many Canadians are pointing out the racism that is embedded deep within Canada.
The process, the policies and the structure of the health-care system itself are deeply rooted in racial bias.
As nurses, we are obliged to start a conversation about the overt and systemic racism in Canada because it impacts the health of everyone, especially racialized people and populations. We must call for a common understanding of systemic racism, the policies and practices entrenched and firmly established within the health-care institution that results in exclusion of some and preference for others. As nurses, we are obliged to call out this structural and institutional racism, which is much more insidious than overt discrimination, because individual intent is not necessary; the process, the policies and the structure of the health-care system itself are deeply rooted in racial bias.
As nurses, we learn about and understand the social determinants of health. The determinants encompass a broad range of personal, social, economic and environmental factors that determine individual and population health. One of the determinants of health is race/racism. As nurses, we need to be brave and start conversations about racism and racial bias, highlighting issues like the effects of historical trauma, and the disproportionate representation of Black and Indigenous people in Canadian prisons. Nurses must push forward agendas that uncover inequitable access to health care, like that experienced by refugees and people who do not speak English. We need to speak up loudly about the conscious and unconscious bias that is impacting the care that people in racialized communities receive, especially the injustice of racialized populations having the least amount of health-care services in their neighbourhoods. We must recognize and examine why racialized groups are over-represented in certain diseases, like the levels of HIV infection rates in Indigenous populations.
As nurses, we need to be brave and start conversations about racism and racial bias.
It is time for nurses to challenge statements like “I don’t even see colour” or “I’m colour-blind.” Such statements erase the importance of understanding the individual’s context as they navigate through life, where the world is not colour-blind, within a racialized body. In effect, these statements de-value the overt and covert racism that they have experienced in their life.
It is time to call out the systems we work within and to explore our personal implicit biases. These are uncomfortable conversations to have with coworkers, and with ourselves, because we may see that, in fact, we are not as “colour-blind” as we believed, but that we have individual racial biases and stereotypes that influence our practice.
Michelle Danda, RN, MN, MPN, CPMHN(C), graduated from the Bachelor of Nursing Accelerated Track program at the University of Calgary in 2008. She currently lives and practises mental health nursing at Lion’s Gate Hospital in North Vancouver, BC. She has four beautiful children with her partner, who is also a mental health nurse. She is also a fulltime doctoral student in the PhD Nursing program at the University of Alberta.