Dismantling racist ideologies in nursing academia to enhance the success of students identifying as Black, Indigenous and students of colour.

Abstract

The University of Wisconsin-Milwaukee, where I worked when I shared these insights is located ‘On traditional Potawatomi, Ho-Chunk, and Menominee homeland along the southwest shores of Michigamme, north Americas largest systems of freshwater lakes where the Milwaukee, Menominee, and Kinnickinnic rivers meet and the people of Wisconsin's sovereign Anishinaabe, Ho-Chunk, Menominee, Oneida, and Mohican nations remain present’ (Electa Quinney Institute, 2023). I am now located at the Twin Cities campus of the University of Minnesota, which is built on the traditional homelands of the Dakota people. I grew up in a small African country called Malawi in southeast Africa that was colonised by the British. Where I am from, people apologise all the time for everything, and express gratitude even when they are experiencing oppression. Taking this into account – that oftentimes as Black, Indigenous, and people of colour, even when lands are being taken away, when we are told that we are less than everybody else, we still apologise or express gratitude, I will not express any appreciation or gratitude or apologise for any space that I take up to advance the cause for equity. I am committed to not expressing gratitude today or apologising for taking up space; space that should be taken every single day, taking into the account the injustices that have been noted by my colleagues; whether, for example, it is in relation to vaccine hesitancy as a result of mistrust in a healthcare system that centres Whiteness and a healthcare system that has engaged in harm towards Black, Indigenous, and people of colour for centuries. Taking up space every day, all the time, is important so that these injustices are discussed and so that we can work together to move forward and create a more just society where we can all succeed and where everyone can achieve better health and wellness. When I walk into a room and into a space as a Black woman, here in Wisconsin or wherever I might find myself, and it is a predominately White space (perhaps my colleagues are different from me), I do get the jitters. I feel uncomfortable, and I feel as though I am representing the entire African diaspora. If I mess up, I feel as though the entire population that identifies as Black, regardless of where they are, is also under a microscope or they are somehow under disdain because of how I have conducted myself. It is in this kind of environment, in nursing academia, or in academia more broadly, that we expect our young people who identify as Black, Indigenous, students of colour, to learn about a profession that is complex and involves caring, which is both an art and a science. We expect all of our students to succeed in this kind of environment. We also expect them to navigate an environment where Whiteness is constantly centred; where the curricula is focused on Eurocentric ideologies; where examples given in class are centred on Whiteness. It is in this environment that, we expect students who often are the only Black, Indigenous, Hispanic or Latinx student, often feeling isolated, to succeed. What makes the academic space more complex when it comes to racism and the resulting isolation and barriers to success experienced by students who identify as BIPOC is that institutions of higher learning are deemed as spaces that are woke, where the ignorance equated with racism and racist acts are supposedly obsolete (Christian, 2017). During these past couple of years, we have been in the midst of a global pandemic that was also complicated by key events marked by injustice, featuring the killing of unarmed Black people in the United States. The murder of George Floyd is just one example of an injustice against Black bodies that demonstrated anti-Blackness in the society in which we live. All of these intersecting events have contextualised the lives of our students. Yet every day, in the midst of a global pandemic and in the midst of harm rendered towards people in their own communities, our students were expected to be in class and to pretend that these activities were not happening or to at least attempt to dismiss them from their conscious minds to learn. Dr. Hatcher spoke about vaccine hesitancy. We saw particularly at the beginning of the pandemic, Black, Brown, Indigenous, people of colour dying at disproportionately higher rates from infection resulting from the SARS-CoV-2 virus (Sequist, 2020). Yet, the mistrust that has developed over centuries in Black and Brown community as a result of actual harm caused by the healthcare establishment, contributed significantly to the hesitancy in getting vaccinated and protecting communities from the more adverse effects of the infection. During this time, we expected our students to continue going to class when their communities were disproportionately affected in the pandemic. During this same time period, we witnessed massive media support of Gabby Petito, who died at the hands of her intimate partner. The support rendered to Gabby Petito, while commendable, is rarely rendered to the hundreds of Indigenous peoples including young girls who have gone missing in the same area where Gabby's remains were found (KTVB, 2021). We rarely know the names of the Indigenous people who go missing at an alarming rate in North America. Their experiences rarely garner any media attention. Our Indigenous students are thus expected to navigate an environment where every day that are told that they are less than; that their lives are of less value given the lack of media attention to the people who go missing in their communities, as Whiteness remains centred. It is within this context that I would like to suggest that our pedagogical approach to the education of nursing students must change, beginning with the unlearning of racist ideologies. Recently Ibram Kendi came to the University of Wisconsin-Milwaukee campus. He mentioned how oftentimes, we blame people who are underrepresented in academic institutions for being underrepresented. The people we are blaming are not even present, but we are blaming them for not being there. Dr. Canty spoke similarly of how we blame Black women for their own mortality as women during childbirth. We also blame Black women for the disproportionate rates of Black infant mortality. Such absurdity is rooted in racist ideologies that upholds and centres Whiteness, minimising the harm that has resulted from White supremacy, while blaming those on the receiving end of centuries of oppression, for realities that are outside of their control; realities that are rooted in structures and systems that have deliberately oppressed, harmed and murdered entire people groups for centuries. What we see when we do not see BIPOC peoples represented in various sectors of our society is a deliberate and racialized systematic exclusion (Hardeman et al., 2020). These are racist ideologies that must be unlearned by all of us if our students are to succeed. Some ways in which nursing academia is addressing the challenges we face with regard to the underrepresentation of BIPOC students within nursing academia is through holistic admission. This is to be commended. But we also need to address the climate in which nursing students come to class every day. The city of Milwaukee, for example, is considered one of the most segregated metropolitan areas in the United States (Rosenblatt, 2018). Many White students attending college in Milwaukee come from homogenous communities where they may not have interacted in a meaningful way with a person who identifies as BIPOC. Their interaction with BIPOC students is therefore an opportunity for learning. But this learning often happens on the backs of their colleagues who identify as BIPOC and who are also navigating and trying to survive and succeed in a predominately White academic space. They may have to hear untoward comments that their peers make. Sometimes they have to hear comments that faculty make that are also untoward. It is critical that we think about the climate that our students are navigating and how we can promote the success of all of our students. The success of our White students should not occur on the backs of our BIPOC students. We also need to stop engaging in White fragility. When BIPOC nurses in academic spaces point out racism, which is important to actually name and to point out when it occurs, we should not tone it down, dismiss it or pretend it did not occur. We need to hear one another, acknowledge one another and stop engaging in White fragility; calling a spade a spade, and not a big spoon. Additionally, we need to engage in being antiracist. We are either antiracist, or we are upholding structures and systems that continue to oppress our students and continue to oppress BIPOC peoples and the communities in which they exist. I agree with Dr. Canty – we are here but many times within the healthcare system we are not present. We are not present because of systems of oppression. And so, for example, vaccine hesitancy may occur because when people go for a vaccination, what they continue to see is systems of oppression where they engage with healthcare professionals, most of whom do not look like them. Oppression and marginalisation is cyclical. People living in communities that have been marginalised experience barriers that make it more difficult to succeed academically. Their resultant lack of representation in various spaces, including in healthcare, creates further marginalisation. The Whiteness of nursing academia specifically is a clear indicator of the health disparities that we see in Black and Brown communities in the United States. While we move towards achieving equity in nursing academia to facilitate equity for our students and address health disparities in our communities, we must make sure we support our students so they can be successful; so they can go into the healthcare workforce and be representative of our communities – that way, the healthcare workforce actually mirrors the communities served by the healthcare system; so that when people from various communities that disproportionately experience poor health outcomes access healthcare, that they can see themselves represented and they can build more trusting relationships and can comfortably follow through with recommended public health initiatives, for example. I will conclude by quoting Audre Lorde who said that ‘The master's tools will never dismantle the master's house’. We cannot continue to use the same strategies that we have been using in the past to dismantle a system of oppression that has been there for centuries. We must think about the ideologies that we embrace; how we can unlearn the various and specific racist ideologies; and how we can develop different structures, systems and environments, to create a more nurturing climate for our students. The academic environment was not meant to be nurturing because it was not meant for BIPOC peoples. A participant in Adeniyi-Ogunyankin et al. (2020) roundtable discussion of the tensions between Black feminist thought and the academic space specific to gender, women's and feminist studies, pointed out that academia was ‘built against my body – against my being there in the meta sense of feeling pushed out…’ (p. 13). If we are to all succeed in this academic environment and change the tide, we have to come up with different tools, for the master's own will not work in dismantling structures and systems that the master himself built to assure and uphold his supremacy. The author declares no conflict of interest.