Practice Expectation Spotlight: Confronting Racism

Do you have unconscious bias? The truth is we all have unconscious bias; in fact we all have thoughts that we are not aware of which may lead to unintended consequences for our client. Stereotyping is hard to recognize at first glance; it is invasive and can linger in the very place you work. We have zero-tolerance policies for violence, but who has a zero-tolerance policy for racial profiling?

The Code of Ethics for Registered Nurses holds the value to honour dignity though recognition and respect of the intrinsic worth of each person. All RNs, RN(AP)s and RN(NP)s are expected to practise according to this value.

Have you ever had a feeling arise that caused judgement toward an obese patient, malodorous patient, a sullen teenager or a frail elder? Now add descriptors of race or gender identity in front of any of the previous posed questions.

Just sit with any discomfort for a moment and have compassion for yourself and others.

Entry-level competencies for RNs call on us to identify the influence of personal values, beliefs, and positional power. This includes acting to reduce bias. Furthermore the RN(NP) entry-level competencies expect RN(NP)s to demonstrate “leadership by using the nurse practitioner role to improve client care and facilitate system change.”

In an article written by Phillips-Beck et al. (2020), eight Indigenous communities in Manitoba describe how racism exists in our health care system. The article addresses these questions:

1. What is the root cause of racism in health care for First Nations people?
2. What perpetuates racism?
3. What is the impact of racism? and
4. What needs to be done to eradicate racism and create equitable health care?

This article unpacks how primary care providers perpetuate racism and how this is received by First Nations communities. The article powerfully demonstrates that with the current social and political climates, it is now time to address systemic racism in Manitoba’s health care system.

Taking a moment to finding compassion in a stressful environment is not always easy and there is no better time to pause and reflect. Health care contributed to unconscious bias through the treatment of the marginalized, impoverished and vulnerable. Lack of connection due to someone’s culture, gender, looks, finances, work or other characteristics contributes to “othering.” To be discriminated against is to be judged prematurely, harshly and unjustly. To really see our role in the healing process of discrimination in the health care system, we first must acknowledge that it exists and then meet it with a compassionate approach.

References and Resources

Phillips-Beck, Wanda, Rachel Eni, Josée G. Lavoie, Kathi Avery Kinew, Grace Kyoon Achan, and Alan Katz. 2020. “Confronting Racism within the Canadian Healthcare System: Systemic Exclusion of First Nations from Quality and Consistent Care” International Journal of Environmental Research and Public Health 17, no. 22: 8343. https://doi.org/10.3390/ijerph17228343

Canadian Nurses Association, 2017. “Code of Ethics for Registered Nurses.”

College of Registered Nurses of Manitoba. 2018. “Entry-level Comptencies for RNs”

College of Registered Nurses of Manitoba. 2016. “Entry-level Competencies for RN(NP)s.”

College of Registered Nurses of Manitoba. 2018. “Practice Expectations for RNs”