Abstract
To advocate for strategic actions by U.S. nursing leadership that denote the presence, customs, and implications of racism that has been institutionalized within the structures of U.S. nursing leadership and the profession. A racial equity framework is used to examine the barriers to quality health care and equitable health outcomes and to present evidence-based actions to dismantle structural inequities embedded in the nursing profession. This article was developed through a comprehensive literature review and synthesis of relevant research, data, peer-reviewed literature, government reports, and organizational guidelines. A commitment by U.S. nursing leadership to eradicate structural racism in nursing must be made in order to effect sustainable transformative change toward more equitable systems of health care. This article presents recommendations for nursing leadership in the United States to renew its commitment to quality health care through dismantling structural racism at all levels of direct and systems nursing practice and education, at the bedside, and in the boardrooms. Structural racism in nursing and health care also persists globally as a key social determinant of health. Its elimination aligns with international health care and nursing's policy priorities, yet change can only occur when senior leaders clearly understand it as a key barrier to health, and commit to transformative change in how their "systems" work. These recommendations can also be culturally adapted by global nursing for use in antiracism work.
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