CANTON, MA – As the nation celebrates the birthday of Martin Luther King, Jr. and contemplates its response to a white supremacist-led attack on the Capitol, and while the COVID-19 pandemic has made clear the disparities in health outcomes for communities of color, the Massachusetts Nurses Association has announced its organization-wide effort to educate and mobilize its membership to confront structural racism and its impact on the nursing/health professions, the health care workplace and in the broader society.
The MNA’s initiative is summarized in its recently approved Anti-Racism Position Statement, developed by its Diversity Committee. The group began work on the statement in response to the murders of George Floyd and Breonna Taylor last year, as protests occurred across the nation, and as the first wave of the pandemic wreaked disproportionate havoc on communities of color in Massachusetts. The statement, which provides a detailed rationale for the campaign as well as a series of recommendations to be undertaken to address the issue, was approved by the Board of Directors at the end of 2020.
“As an organization whose members work on the frontlines of the health care system, who every day confront the real life public health impacts of structural racism on our patients and members of color we feel it is imperative that the MNA is actively engaged in the work of shining a light on the issue and working for real change in our health care system,” said Samantha Joseph-Erskine, RN, a nurse at St. Lukes Hospital in New Bedford, member on the MNA Board of Directors and co-chair of the MNA’s Diversity Committee.
The statement makes clear the impact of racism on patients and communities:
As a professional association and union comprising nurses and healing professionals dedicated to the humanistic provision of socially essential care and the alleviation of suffering, we recognize institutional racism and the systematic oppression of poor, vulnerable communities and communities of color as both a crisis in public health and a pervasive obstacle to achieving the goals of our work in both our professional practice and in the labor movement (Causadias, 2019; Hahn, Truman, & Williams, 2018; Sidhu, 2008; Hines, 1989; Kaufman, 2018).
As nurses and health care professionals, we name racism as a determinant of health (Hahn, Truman, & Williams, 2018; Office of the Attorney General, 2020). We bear first-hand witness to the consequences of systemic racism and the inevitable policies which result in predictable, observable health disparities as well as the social, economic, institutional, physical, and psychological violence perpetrated against people of color, working-class people, and all members of society who are socially devalued and systemically assaulted. (Institute of Medicine, 2002; Causadias, 2019; Hahn, Truman, & Williams, 2018).
“As the pandemic has unfolded we have watched in painful despair as our community members of color and those from poor and disadvantaged communities filled the beds of our hospitals, again bearing the brunt of disparities created by deeply entrenched systems that foster unequal outcomes and treatment,” said Judith Laquerre, RN, a nurse at Cambridge Health Alliance and co-chair of the MNA’s Diversity Committee.
The statement also highlights the unique impact on minority populations and communities during the current COVID-19 pandemic, stating:
The global novel corona virus (Sars-CoV-2/COVID-19) pandemic has laid bare chronic health disparities which continue to plague our system of health care (Yancy, 2020; The Joint Commission, n.d.; Office of the Attorney General, 2020). As the pandemic evolved in the U.S. it revealed that African American, Black, Latino(a), and Native American communities were more likely to contract the COVID-19 virus and were also more likely to die from complications resulting from the virus (Yancy, 2020; The Joint Commission, n.d.; Office of the Attorney General, 2020). These health disparities, while shocking in the moment, are unfortunately not new. Research has consistently shown that minorities/people of color, indigenous people and individuals in vulnerable communities have greater difficulty accessing needed health care services, are more likely to be uninsured, and are overrepresented in publicly-funded health systems (Institute of Medicine, 2002; The Joint Commission, n.d.; Causadias, 2019; AHRQ, 2018; Office of the Attorney General, 2020). Research also confirms that health disparities in quality of care and outcomes appear to persist even after researchers control for education, income, access to insurance, and access to care (Institute of Medicine, 2002; The Joint Commission, n.d.; Heath, 2020).
The statement and the MNA campaign to address racism establishes the organization’s commitment to work internally and externally to address the crisis, including the impact of racism on nurses in the workplace, stating:
“The MNA is committed to lending our voice and actions to working in concert with all groups and individuals committed to and working for the dismantling of structures and polices that enable and support continued disparities in health outcomes. Disparities created by systems and structures that also present barriers to the professional growth and advancement of our members of color who continue to be systematically excluded and who experience barriers hindering their opportunities for professional advancement (Hines, 1989; Sidhu, 2008).
“We believe it is essential for the MNA use its platform to acknowledge and explicitly name Racism as being antithetical to our principles as healers and care providers and the mission of our Association,” said Marie Ritacco, MNA vice president who worked with the committee that drafted the statement.
The document concludes with a list of recommended actions to be undertaken over the coming years, including development of educational programs for nurses on these issues, the establishment of a process for nurses and union members to report and document instances of racial discrimination, along with mechanisms within the union to address these violations; creating an electronic library of resources for nurses and union members to access regarding these issues, and the establishment of relationships and participation with other groups and activists working on addressing these issues.
“As a predominantly white profession subject to biases that contribute to this problem, we believe it is vital that we do our part to educate and mobilize our members to both understand and begin to more aggressively address the crisis that is racism,” said Katie Murphy, president of the MNA.
Founded in 1903, the Massachusetts Nurses Association is the largest union and the professional association for the registered nurses in the Commonwealth of Massachusetts. Its 23,000 members work in 85 health care facilities across the state, including more than 70 percent of the state’s acute care hospitals. The organization’s mission is to advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.