In honor of this month's Juneteenth holiday and in recognition of the challenges facing the African American community that we’re seeing highlighted through the Black Lives Matter protests, Fast Layne Solutions CEO Christopher Hughey connected with a hospice administrator and nurse this past week to talk about what it means to be a healthcare leader of color. This blog article is based on that conversation.
Due to the contentious nature of these topics, our interviewee, whom we will call Pam, has asked to remain anonymous. She is a middle-aged African American healthcare leader based in the South.
Pam is many things: nurse, healthcare leader and administrator, mother.
She is also African American.
What went through your mind when I added that last fact and how do you think it impacts those other labels that describe Pam? Many people these days want us to ignore race. They tell us it shouldn’t matter, so we should simply disregard it. For them, that is how we will end racism: just pretend race isn’t even a thing and all will be well! So let’s examine how being Black in America in 2020 changes how Pam has to manage her life and then re-ask that question at the end.
Being a nurse v being a Black nurse:
One day, in her role as a nurse, Pam (a highly qualified medical professional) and her colleague (her White assistant) arrived at a home to visit an ailing, elderly patient in hospice care. The patient’s wife answered the door in a panic as her husband had just lost control of his bowels and the result was a very unpleasant mess. The wife was also quite distressed as she was uncertain how to administer her husband’s anti-anxiety medication and needed a nurse to help her with it. Upon seeing a Black woman and a White woman at her door, she immediately handed towels and a bath basin to Pam and the medication to her White assistant.
Does 'White privilege' mean that that White assistant has never had struggles in her own life? That becoming a nurse's assistant was easy for her? That she faces no personal challenges of her own? No. Of course not. All people face struggles in life. But what White privilege does mean is that her skin color doesn’t add to those struggles. And it means people don’t draw on centuries of stereotypes and oppression and shove cleaning supplies in her hands when she walks in the room based on the automatic assumption that she must be the ‘help’.
Being a healthcare leader and administrator v being a Black healthcare leader and administrator:
Being a healthcare administrator and leading a team of providers and staff are two challenging responsibilities for anyone. But when you add in the African American experience, it can become more than just challenging. At times, it can become next to impossible, especially in an age when we are seeing dog-whistled approval of racist attitudes coming from the highest levels of our country’s leadership. This has impacted Pam’s life directly. She supervises a staff of almost four dozen people in an area of the country already not known for its racial tolerance. Of late, the climate of tension has made her job even more difficult, with some staff openly disrespecting her. And it is impossible to gloss over the impact America’s political toxicity is having on this aspect of her life: she has noticed, for example, that such behavior is measurably worse the day after a televised ‘Make America Great Again’ rally. But as a business leader, she can’t mandate people’s politics or attitudes, and she also faces the constant stress of walking the line between maintaining control of her organization and being cast as the ‘angry Black woman.’
None of these are challenges faced by White healthcare leaders and administrators.
Being a mother v being a Black mother:
One day recently, Pam, a Black mother of biracial adult children, noticed that her son’s car had a malfunctioning taillight as he was pulling out of her driveway. She had a moment of panic and stopped him before he could leave, insisting he take her car instead. When she recounted this story to her White friend, whom she has known for decades and who has an adult son roughly the same age as Pam’s, her friend was puzzled that Pam would be so adamant about her son switching cars. After all, a non-working taillight isn’t such a danger to vehicle safety, and even if he got a ticket for it, it would be a minor offense. Pam had to explain to her friend that none of those everyday considerations was going through her mind when she panicked and made her son change cars. This wasn’t about such mundane factors as vehicle maintenance or insurance costs or ticket court dates. No, when Pam saw that darkened taillight, what she had to picture was her gentle giant of a son being shot to death because a nervous cop approaching a car occupied by a large, dark-skinned male panicked when he saw that man reach for his license. She had to picture herself identifying his body while listening to the police explain how her son’s death was his own fault for acting ‘suspiciously,’ how a wallet can look like a gun in the heat of the moment. She had to imagine White social media explaining to her that none of this would have happened had he simply maintained his car properly (because apparently we have capital punishment for burnt-out bulbs if you’re Black). Her White friend was aghast at all this. It had never occurred to her to fear such outcomes from something so trivial as a broken taillight.
Being a mother is hard for every woman. And being a mom isn’t made easy by being White. But it also isn’t made harder, either. And it doesn’t include the grim task of teaching your children how to behave ‘just so’ to avoid ending up dead after even minor encounters with law enforcement, encounters that would be at most a mild annoyance to the majority of White people.
The purpose of this article isn’t to solve racism. We don’t have those answers for you.
So we’ll just close by first asking that same question again:
How do you think race impacts Pam’s roles in life?
And we’ll add another on which to end:
After reading about Pam's experiences, do you think America can solve racism by simply ignoring the role of race in our society?
Postscript: Another thing to consider when asking if race matters is this: we were originally going to use Pam's real name and the name of her town. But after reading the draft, she asked that we make her contribution anonymous, and understandably so. If racism is 'over' in America, why does an African American healthcare administrator have to fear for her job (and potentially even her safety) for simply discussing actual events from her life with the CEO of a small company? Again, we don't have the answers. But we do feel it's time for everyone of every race in America to start asking themselves these questions.
February is Black History Month, and to celebrate, Fast Layne Solutions would like to pay tribute to some of the key African-American pioneers in the field of medicine.
Dr. James McCune Smith (1813 – 1865) was the very first African American to hold a medical degree. He was the valedictorian of his graduating class in medical school at the University of Glasgow in Scotland. After completing his degree and then an internship in Paris, he returned to the US, where he had a long and successful career that included being the first Black man to run a pharmacy in the United States; publishing articles in respected medical journals; and conducting extensive research, especially in the area of refuting racist theories about the connections between race and intelligence. He accomplished all this despite the many obstacles 19th-century America put in his path: he was refused admission to medical schools in the US due to his race, and was never accepted by the American Medical Association or even local medical groups. He was even once refused passage on a ship to return to America due to his race. Smith was an ardent abolitionist, and died just before the ratification of the 13th Amendment abolishing slavery.
Dr. Helen Octavia Dickens (1909 – 2001) was the first African-American woman to be admitted to the American College of Surgeons. She completed her medical degree at the University of Illinois College of Medicine in 1934. In 1942, she passed the boards to become the first Black woman to become a board-certified Ob/gyn in Philadelphia. She served as Director of Obstetrics and Gynecology at the Mercy Douglass Hospital in Philadelphia for almost 20 years, and did extensive research into the areas of teen pregnancy and sexually transmitted diseases, using the results to educate young women. As a doctor who faced the double challenge of overcoming both racism and sexism in her personal and professional lives, she was a true pioneer in both medicine and the fight for equality.
Dr. Robert Fulton Boyd (1855 – 1912) was the first president of the National Medical Association, an organization he and others founded in response to the racial segregation of medical facilities and schools and of other medical associations. Born into slavery, he went on to become a superlatively qualified healer, earning a degree not only in medicine but dentistry, on top of a Master of Arts degree. In 1893, he was appointed professor of gynecology and clinical medicine at Meharry College in Nashville.
Mary Mahoney (1845 – 1926) was the first African American woman to be awarded a nursing degree in 1879. She was also among the first Black women to be admitted to the American Nurses Association (ANA). She was a co-founder of the National Association of Colored Graduate Nurses (NACGN), which made significant contributions in the area of ending racial discrimination policies in their field. (The NACGN later merged with the ANA.) She was a civil rights pioneer in other ways, too: she was among the first Black women to register to vote in Boston after Suffrage. She was honored with induction into both the ANA’s and the National Women’s Hall of Fame.
Despite the great strides made by these and other brave African American pioneers in the field of medicine, to this day, Black medical professionals face challenges unknown to their white counterparts. Sociologist Adia Harvey Wingfield of Washington University has studied this subject extensively and her work shows we still have a long way to go. That’s doubly true for African American women working in medicine. Wingfield reported cases of Black female doctors regularly being called “miss” by people who assumed they must be nurses or orderlies. And the “new economy,” with its emphasis on contract work, has presented even more challenges, as Black medical professionals are disproportionately pushed into such arrangements, limiting both job security and upward mobility.
Every February, Black History Month provides us with myriad inspirational stories telling us how far we have come as a society, along with new milestones showing that we continue to make incremental improvements. But it also a sobering reminder that we still have miles to travel before we arrive at that “not too distant tomorrow [when] the radiant stars of love and brotherhood will shine over our great nation with all their scintillating beauty.” But we will get there. Dr. Martin Luther King never doubted that vision of his, and he never abandoned hope. Nor should we.
Today’s guest blogger is a Registered Nurse and hospice administrator who shares with us her personal experiences and observations of a life in healthcare from her front-line perspective. We welcome guest bloggers who can share insights regarding the many facets and aspects of healthcare: tech, administration, policy, and patient outcomes, among others. Interested in contributing? Please send your credentials and a brief content pitch to us at firstname.lastname@example.org, using GUEST BLOGGER in the subject line.
What Do Nurses Eat?
What do nurses eat? Well, the old adage is that “nurses eat their young.” Not literally of course; I’m not talking about a nurse cannibalizing their biological children. I’m talking about the abuse a new nurse sometimes faces when he or she enters the workplace. It’s a surprising hurdle that a lot of nurses must deal with: bullying, hazing, and conflict in the workplace. The types of bullying can manifest in different types of forms, such as unwillingness to help a coworker, verbal abuse, mocking, gossip, exclusion, and, in extreme cases, even physical abuse.
I find it so unusual that even though nursing is a profession that is committed to helping, caring, healing, and loving others, it's also very consistent with such bullying tactics like hazing. Nursing is regarded as one of the most trusted professions; however, in this career we are subjected to high pressure, stress, and extreme emotions, which could lead to a boiling point that may precipitate aggression towards each other.
Does that still stand as true today as when I started out? Unfortunately, I believe it does, and I see it happen often in my own career. It often happens when new nurses are insecure and unable to defend themselves. Suddenly, they find themselves in this new, big, scary world and in a new role straight out of nursing school.
Believe me, we all know that nursing school is no joke, and some nursing school instructors can be vicious. I wonder if such experiences make new nurses accustomed to this treatment as a result of nursing school and clinicals. Is it possible that being bullied, humiliated, and harassed is familiar and it just carries on into the workplace with them? Is this a rite of passage, akin to hazing in sororities and fraternities?
The bigger questions are why it is necessary and when does this end? Does it end when a person has been a nurse a certain number of years? Does it start over and over when a person goes into a new job, regardless of how many years s/he has actually been a nurse?
I witnessed one of the first instances of bullying of nurses while attending nursing school. There was in our class one student who was particularly bright, beautiful, and organized (let’s just say she was perfect). Honestly, she rather intimidated the rest of us and would consistently stand to speak anytime she had a question or to answer a question. She was the kind of girl that we all detest: her always perfect notes were pristine, she always made A’s. When it was her turn to speak, she would stand, poised as Princess Diana, and in the most articulate voice you can imagine, would answer or ask a question.
One day after a very grueling test, we were all literally in tears because we were sure that we had failed it. Suddenly, this young lady stood up to ask a question. That’s when it happened: another student blurted out to her, “would you please just sit your ass down?!”
The entire room burst into laughter. Even the instructor laughed out loud and openly. Very slowly she sat down. I saw tears run down her face. That was the very first instance that I can recall that I witnessed nurse bullying and this poor girl wasn’t even officially a nurse yet. It was so blatant that I was actually shocked. The instructor did nothing, giving absolutely no reprimand to the student who blurted out. Through the instructor’s silence, the bullying student’s behavior was condoned and somewhat rewarded. For the remainder of the term, the bullying student was regarded as the leader of the class.
I often wonder about that young lady today. I wonder what her nursing career has been like since we graduated. I wonder: does she still display her intelligence boldly? Does she still stand while being extremely poised in all her interactions with people, or did she shrink and become quiet and reserved? I think and wonder about her frequently, and I feel very sad that on that day when everybody burst into laughter, I joined in the chorus. I succumbed to the peer pressure to laugh and ridicule a fellow future nurse who was just trying to make her way, just as I was.
For years, this culture of bullying has been widely tolerated among nurses; however, there has been increased public attention brought to this problem. As a nurse leader, I am very watchful of bullying behavior by senior nurses towards new staff, making it clear to them that it is not accepted as part of the culture of our workplace. I think about the new employees and especially the nurses that come under my leadership and strive to cultivate a new adage: “nurses protect and treasure their young.”
My name is Freda Beaty. I’m originally from Winston-Salem, NC, but currently live in Greenville, SC. I am a Registered Nurse and I am the Administrator for a hospice company. During my free time, I am a jewelry designer and self-proclaimed photographer. You can reach me at email@example.com.