Nursing report calls to end anti-Black racism and discrimination within the profession

In a groundbreaking report released today, the Registered Nurses’ Association of Ontario’s (RNAO) Black Nurses Task Force (BNTF) unveiled recommendations to tackle structural racism within nursing organizations, regulatory bodies, associations and the broader health system.

“For years, Black nurses have been afraid to speak out about the microaggressions, discrimination and racism they face within academic and workplace settings for fear of reprisal and the suppressive behaviours of managers,” says BNTF co-chair and RNAO Past-President Dr. Angela Cooper Brathwaite. “Today, during Black History Month, we’re proud to release a report that sheds a light on the challenges and barriers Black nurses face and the solutions that will help us eliminate anti-Black racism and discrimination within the nursing profession.”

The BNTF is made up of 17 Black nurses and nursing students working in various sectors of the health system with a mandate to tackle systemic racism and discrimination within nursing.

The report, Acknowledging, Addressing and Tackling Anti-Black Racism and Discrimination Within the Nursing Profession, features 19 recommendations. The BNTF was guided in its work by four main pillars: education and awareness building; research; advocacy at all levels; and partnership with allies and stakeholders. The report also includes information from a scoping review of the literature and results from an online survey of 205 Black nurses across Ontario.

The report’s recommendations are:

• Include racism and discrimination as a topic in nursing and interprofessional curriculums.
• Provide equitable and fair placements for Black nurses in all practice settings.
• Provide mentoring programs for nursing students to enhance academic achievements, reduce stress, anxiety and dropout rates and to empower Black students.
• Create educational and research grants/financial incentives/scholarships targeted specifically for Black applicants.
• Develop and implement anti-racism, anti-oppression, cultural safety, and diversity, equity and inclusion training and orientation for staff at all levels in all workplace and academic settings.
• Include diversity, equity and inclusion committees in all workplaces and academic settings to address racism and discrimination.
• Hold all staff (professors, managers, health-care providers) accountable for addressing racial discrimination and develop specific strategies to combat it.
• Acknowledge systemic racism and discrimination exists at individual, organization and policy levels. Non-Black nurses must self-identify and address their individual biases. They must be encouraged by their organization to continually engage in reflective practice and delve into their perceptions and experiences to assess inherent biases and values.
• Create safe spaces for Black nurses to open up about the discrimination and oppression they face in professional settings.
• Embed mentorship programs in workplaces for Black nurses to facilitate professional growth and development, and to improve retention and recruitment of Black employees.
• Provide tools and resources to support Black nurses as they navigate difficult challenges when dealing with residents, patients or families who display racism.
• Advocate for diversity in leadership, senior and/or administrative, education roles in the nursing profession as well as health sectors.
• Increase access to mental health supports in the workplace and academic settings to address traumas related to racism.
• Develop and enforce policies on anti-racism, such as zero tolerance of racism from staff, nursing leaders, patients and families.
• Collect and disseminate race-based data.
• Provide mandatory courses or workshops that include topics of cultural humility, anti-oppressive behaviors, anti-racism and trauma-informed care in orientation and continuing education programs.
• Stand in solidarity through partnership with health-care associations and organizations; advocate to diversify their senior team and provide equitable opportunities for Black individuals at the senior executive/management level.
• Advocate for the federal and provincial governments to address racism against Black Canadians and include Black History within the educational curriculum in Canada.
• Advocate for the establishment of a commission similar to the Truth and Reconciliation Commission to investigate and address racism against Black Canadians.

“The recommendations outlined in this report speak to the dire need to address and ultimately expunge racism from our profession. The report highlights the devastating impact systemic racism is having on the lived experiences and mental health of Black nurses in academic and workplace settings,” says BNTF co-chair and nurse practitioner Corsita Garraway. “All health-care and academic organizations must immediately take action and acknowledge that anti-Black racism is deeply entrenched in the history of nursing in Ontario and Canada.”

“RNAO is calling for an end to anti-Black racism within the profession and the dismantling of systemic racism in Ontario. Racism is a determinant of health that plays a key role in generating and reinforcing social inequities,” says RNAO CEO Dr. Doris Grinspun, who launched the task force in June 2020 after the murder of George Floyd sent chills across the world and those who have experienced anti-Black racism and violence. Grinspun says “no sector, profession or organization is immune to the ingrained effects of systemic racism, including nursing and health care. We are determined to leave no stone unturned until we end systemic racism within our profession and beyond.”

“RNAO will continue to use its platform to call for decisive action from national and provincial nursing organizations and institutions to enact meaningful change to overcome the systemic racism that exists in our profession. Racism is a public health crisis that cannot be ignored. It threatens the health and well-being of racialized nurses, it limits their contributions to the health system and it interferes with their ability to provide safe, compassionate and ethical care to Ontarians,” says RNAO President Morgan Hoffarth.

In addition to these 19 recommendations, RNAO developed specific actions to grow allyship and solidarity with Black nurses within its own organization. This includes a plan to integrate anti-racism and discrimination training for all staff during the onboarding process, develop a human resources framework that promotes equitable hiring practices and stand in solidarity with organizations that are instituting advisory committees for marginalized nurses and encourage organizations in Ontario to have such committees.

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system, and influenced decisions that affect nurses and the public we serve. For more information about RNAO, visit RNAO.ca or follow us on Twitter, Facebook and Instagram.

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