By Brianna Patt
Racism within the healthcare system can not only impact patients, but even traumatize the Black women that work within it.
Black Womens Healthcare Trauma
To understand Black women’s complicated relationship within the healthcare system, we have to unpack the history of trauma and indifference linked to it.
The most notable example of medical trauma and indifference is the case of three enslaved women who lived in Alabama: Anarcha, Lucy and Betsey. Father of Modern Gynecology Dr. Marion Sims experimented on them without anesthesia (despite it being available at the time) under the belief that Black people felt less pain than white people. A racist idea that was so prevalent that it remained in the nursing textbook “Nursing: A Concept-Based Approach to Learning,” until 2017 when it was pulled by its publisher Pearson and remains throughout the modern healthcare system. Lucy was the first to be operated on, in a surgery that took an hour and was described as agonizing for Lucy. Due to Dr. Sims using a sponge to watch away urine from her bladder, Lucy developed blood poisoning that it took two to three months for her to recover from. Anarcha, who was 17 at the time the surgeries began, was operated on 30 times over the course of four years.
Black women’s experience navigating this discrimination in healthcare from a treatment perspective inevitably has an effect on them as they enter it as a professional.
How Trauma Impacts Nurse Burnout
In a 2023 study conducted by Penn state, it was found that Black nurse practitioners tend to spot health inequities that their patients encounter and make an effort to confront those issues. Importantly, it is also noted that Black nurses felt that it was their duty to point out these inequities, so much so that the free time they weren’t spending helping patients find apt resources, they allocated to expressing their concerns to administrators.
While administrators would agree with the concerns raised by nurse practitioners, they would often only offer lip service, This inaction can feed further into the clinician burnout that already hails prevalent in the field.
“Participants consistently noted that while administrators often agreed verbally with the need to address health inequities, few systemic changes occurred. This “lip service” contributed to feelings of increasing burnout especially among participants who had themselves experienced instances of racism or microaggressions in the workplace. Taking on this labor in addition to their clinical roles, also while navigating workplace discrimination, led to an overwhelming sense of burnout and emotional exhaustion.”
The loss of a diverse pool of nurses is detrimental, as Penn state’s study believes nurse practitioners from diverse backgrounds can play a key role in improving health equity.
How Burnout is Killing Black Healthcare Workers and Patients
In a study on structural racism in the healthcare field, it was found that while Black women are “overrepresented,” in the healthcare field but are concentrated in the lowest wage jobs, particularly in direct care jobs. Jobs that also come with higher risk in a field where workers are already more susceptible to work related injuries.
Despite the role Black women play in the healthcare field, the chances to move up from Direct Care roles is limited, per the American Nurses Association. This lack of inclusion in healthcare as well as healthcare education has concerning effects on Black patients.
For instance, Black, Brown and Native women are two to three times more likely than White women to die from pregnancy related complications that are mostly preventable. Overall, the American Nurses Association found that this also leads to worse treatment outcomes.
Given that Black nurses tend to advocate for patients and Black patients are also more likely to be open with Black Doctors (per an 2021 Stanford research study), ensuring their inclusion and comfort is arguably essential to helping prevent these health inequities. Being more responsive to feedback can also lead to nurses being less burnt out and offer better care overall.
Conclusion
So, what can we do to create a better environment for Black nurses to succeed? Health affairs suggest increasing the wage of direct care workers to match up with the risk they are taking. Offering more chances for mobility through the healthcare field (ex. offering career mobility to direct care workers), This will offer a pathway for a diverse stream of nurses. To truly respond to the suggestions of Black nurses, it’s also crucial to offer a far more inclusive education, ensuring that the textbooks and in turn the lessons that nursing students follow leaves no suggestion that Black pain is less significant.