DENVER - A recent article by Susan Bonini, Ed.D., MSN, RN at the University of Colorado Anschutz College of Nursing and published in the Journal of Professional Nursing, discusses the manifestations of whiteness and its effect on the profession of nursing. The authors say racism and white supremacy have created a nursing profession of mostly White females that discriminates against People of Color in education, practice and finance. Until nursing confronts its “whiteness,” Dr. Bonini states that the disparities will continue and vulnerable populations will have limited access to quality health care.

The authors say People of Color in nursing faced and continue to face “insidious and invisible barriers” or “whiteness”. The authors define whiteness as a form of unconscious bias that anyone who isn’t White is a deviation from the norm, or not normal.

“Turning a blind eye to how whiteness operates, or feeling too ashamed to address whiteness itself, will not only maintain the field as White, it forces People of Color to suffer from the effects of limited access to quality healthcare,” said Dr. Bonini. “Thus, nursing’s unwillingness to change becomes a direct violation of one’s social contract with the public.”

Diversity is key to closing the gaps in health inequities, according to the piece. The United States Census Bureau predicts People of Color will be the new majority by 2043. The authors ask, “Shouldn’t the profession of nursing reflect the diversity of the population?” Other studies have shown race, ethnicity, and language commonalities are associated with better patient outcomes and willingness to accept medical care.

While the profession has taken steps to make nursing inclusive, an American Association of Colleges of Nursing survey found today’s workforce is 90% female and 81% White. People of Color still have difficulty gaining admission, paying for education, learning by traditional European methods of instruction, and rising in the ranks.

The authors say whiteness offers special privileges by allowing White people to create and follow rules that work best for them. The study cites a case where nurses learn to recognize signs of well-being only on skin the color of White and don’t account for ethnic or cultural differences.

“To access good oxygenation and circulation to the extremities, one is taught to assess for the skin color to be pink, which assumes the patient’s skin color is White,” wrote Dr. Bonini. “What are students taught if the patient’s skin color contains more melanin?”

To create equity in the healthcare system, the authors argue for major changes from new methods of teaching to grading that accounts for life experience.

Among other changes, the article recommends the nursing profession offer:

• A multicontextual learning environment that supports students of every ethnicity
• Courses that teach the history of racism in the profession
• More budgeting, childcare and other services to meet the real-world needs of People of Color
• Modification of recruitment, admission and retention strategies to acknowledge multilingual abilities and life experience
• More access to scholarships and tuition relief for low-income students

While many programs strive to increase diversity in nursing today, the article concludes those programs won’t work until the profession addresses its “pervasiveness of whiteness” and meets the needs of people of all races, perspectives and socioeconomic backgrounds.

**Note: In 1946, Zipporah Parks Hammond became the first Black woman to graduate with a bachelor of science degree from the University of Colorado School of Nursing. You can help induct Zipporah into the Colorado Women’s Hall of Fame today by signing her petition.