Every February we celebrate the accomplishments and contributions of black Americans—including those of black nurses, who have been striving to improve, maintain, protect, and restore the health of Americans for more than a century.
In 1879 Mary Eliza Mahoney became the first black RN in the United States. She worked in health care institutions in low-level positions for more than a decade before finally entering a nursing program. Many other blacks have since taken the same path. In the past, our country's racist practices included restrictive admission to nursing schools. For years only historically black hospital- and university-based schools of nursing offered access to blacks who aspired to the profession. And once they graduated, black nurses were routinely denied opportunities to work in major hospitals and other care settings. So they created their own opportunities. Black nurses gravitated to the public hospital systems that generally provide care to the most vulnerable people in any community. Indeed, they were the backbone of the black hospitals (now closed) that provided care to black communities in the South.
Today there are few obvious signs that blacks aren't welcome in the nursing workforce. Black nurses have attained important positions in a variety of prestigious health care and academic institutions, serving as chief executive officers, chief nurses, presidents, and provosts. They have become legislators and policymakers at local, state, and even federal levels. But persistent barriers remain, including institutionalized policies that have limited access to and hindered movement within the profession.
The most recent National Sample Survey of Registered Nurses found that black RNs constituted only 4% of all RNs, even though blacks account for about 12% of the national population. And in 2008, Crain's New York Business cited a study by the Center for Health Workforce Studies at the State University of New York at Albany, which found that black nurses in New York City hospitals earned less than their white counterparts with the same experience and credentials. Black nurses interviewed by the newspaper indicated that they weren't surprised by the findings.
As we pay tribute this month to the accomplishments of black nurses and other black Americans, we must be willing to seek answers to some cogent questions. What, specifically, have academic and health care institutions done to ensure that black nurses are given access to educational programs and job opportunities at these institutions? Have their leaders reached out to those in professional nursing organizations with whom they might collaborate on projects to improve such access and ensure success for black nurses?
For those uncertain of how to proceed, there is guidance. Missing Persons: Minorities in the Health Professions, a 2004 report by the Sullivan Commission on Diversity in the Healthcare Workforce, gives detailed recommendations on how institutions can increase minority representation in the health care professions. These recommendations can be used by nursing programs and other health care facilities committed to changing the way they've conducted business in the past.
As this country contemplates health care reform, it's essential that the hard-won experiences and wisdom of black nurses be integrated into such plans. Data show that black nurses continue to work in communities that need culturally and linguistically competent practitioners. A reformed health care system must reward that commitment. Moreover, current laws prohibit discriminatory practices. Academic institutions must be held accountable if they fail to admit, retain, and graduate black nursing students. Health care institutions must continue to show their commitment to equity and parity for all within the system. After all, illness knows no color. We all stand to benefit from the active participation of black nurses in our communities and our lives.