Policy Statement: Racism
The Registered Nurses Association of Ontario (RNAO) values diversity and recognizes that discrimination of any kind threatens the health of individuals, communities and nations as well as the provision of quality health care. It is only by working to eliminate this injustice that we, as registered nurses, are achieving our goal of speaking out for health and for nursing.
Racism is systemic in our society and endemic in our institutions. Racism has the effect of excluding groups of people (based on their race, colour, nationality, ethnic or ethno-religious origin) from decision- making processes and leadership and economic opportunities. Racism is both an attitude as well as the specific actions resulting from that attitude. The effect is to marginalize and oppress some people and to sustain advantages for people of certain social groups.
While individual racism manifests itself in an individual's attitudes and behaviours, systemic racism appears in the policies and practices of organizations. Cultural racism forms the basis of both individual and systemic racism. It is the value system, embedded in society, that supports and allows discriminatory actions based on perceptions of racial difference, cultural superiority and inferiority (Henry, Tator, Mattis & Rees, 1995).
Racism has a negative impact on the health of individuals (Hagey et al., 2001) and the nursing profession (Duffin, 2002). Nurses may encounter racism from multiple sources including clients and their families, colleagues (nursing and others), and systems and structures within the workplace. There is no single answer for dealing with all incidents of racism. Instead, responses must consider the immediate needs of the nurse and the patient/client, as well as the systemic issues that need to be addressed to minimize reoccurrence of similar incidents.
Since racism is both institutional and attitudinal, effective strategies need to focus on the examination, analysis, and unlearning of patterns, attitudes, and beliefs. This includes understanding the difficulties that individuals or groups have in dealing with racism without blaming those who have had misinformation or those who identify that racism is happening. Failure to respond to racism deprives individuals of opportunities for personal and professional growth. Further, overtly racist comments or actions often mask underlying issues and/or fears that need attention. Simply reacting to the overt racism may prevent purposeful resolution of significant individual, organizational, or societal problems. The focus needs to be developing a broader understanding of the situation and the behaviour that needs to be exhibited in the practice setting.
Effective solutions to racism must respect a client's and a nurse's right to voice concerns and address problems in a way that will facilitate the provision of safe and effective care in an atmosphere conducive to mutual trust and respect. The goal is to establish a consistent way to deal with this behaviour and to prevent or resolve problems.
RNAO recognizes these are difficult conversations that require an informed, supportive professional team within a supportive organization. The results can be beneficial; creating an environment that is inclusive and able to achieve excellence through diversity. Effective policy requires not just the stated goal but the structures to support and promote policy implementation. We therefore encourage all nurses and other health-care professionals to:
- Model appropriate behaviour and promote a climate of inclusivity and mutual respect;
- Identify and challenge systemic issues and barriers that exclude some groups from decision-making and opportunities for leadership and professional advancement;
- Recognize and acknowledge that racism/discriminatory behaviour can have a tremendous impact on the individual;
- Validate perceptions/feelings and provide support. Do not attempt to justify the behaviour or minimize the impact;
- Determine if immediate intervention is needed. The decision should be based on the needs of the client, the needs of the nurse, and should recognize that the nurse-client relationship is critical to effective care;
- Explore options for clarification/mediation;
- Provide opportunities for the nurse and other team members to review an incident and discuss its impact;
- Develop agency specific guidelines for nurses to assist in recognizing and naming the problem;
- Develop protocols and resources to assist nurses in dealing with acts of racism related to client-specific and provider-specific situations as well as institutional issues. (When resolving an issue, a personal or individual resolution may appear to be adequate. However, unless some systemic change can be initiated, the personal racism is likely to be repeated).
RNAO is committed to an environment where all nurses and clients are treated with dignity and respect and where diversity is valued. We are committed to achieving an environment where all members of the profession have equal opportunities to participate fully in the nursing profession to their maximum potential and where clients receive care that is respectful of cultural needs. RNAO endorses initiatives undertaken by agencies and organizations to eliminate discrimination and racism in any form, any workplace, and in the profession.
The absence of discrimination alone does not go far enough toward achieving a healthy environment within which to practice professional nursing. Conscientious efforts to understand diversity are necessary to strengthen professional relationships and ensure that care received by clients is congruent with their needs. Discriminatory behaviour threatens the quality of the health-care system as well as the health of individual clients and caregivers.
Please see the PDF version of this document for footnotes and references.