Challenges Faced By Black Nurses: Q&A With An Advocate

Black nurses have shaped American nursing for well over a century. The abolitionist Sojourner Truth was a persistent advocate for nursing education and training, though most people only remember her as the woman who escaped slavery. The country's first Black licensed nurse, Mary Eliza Mahoney, earned her credentials in 1879 after years working as a janitor and cook at a New England hospital.

Those trailblazers opened the path, but the work is not finished. Minority nurses make up only 19.2% of the registered nurse workforce, and Black nurses account for 6.2%, even though Black Americans were 12.7% of the population in 2017, according to the 2017 National Nursing Workforce Survey. Education can narrow that gap, but it carries its own barriers. A 2018-19 report from the American Association of Colleges of Nursing found only about 34.2% of students in baccalaureate programs came from minority backgrounds.

Faculty representation lags too. Betty Smith Williams became the first Black person to teach nursing at the college level in California in the 1950s, and nursing faculty of color still have low retention today, according to a study in Nursing Outlook.

Jamil Norman, PhD, RN, CNE, an RN and advocate for diversity in nursing and nursing education, talked through these issues: the challenges Black nurses face, and the role education plays in changing them.

Q&A with Jamil Norman, PhD, RN, CNE

The main challenge Black nurses face is racism. Workplace discrimination and abuse from patients still happen. Black nurses struggle to move into leadership, and that is tied directly to racism.

There is a long history of mistrust between the Black community and the healthcare system. Repairing it takes better representation of Black and other minority professionals. Patients tend to prefer providers they can identify and communicate with easily.

Increasing diversity in nursing has to be intentional. Health systems and universities need to actively seek out minority candidates, and recruiting from historically Black colleges and universities is a clear way to do it. Targeted programs help too, like postdoctoral fellowships that give recent doctoral graduates from underrepresented backgrounds mentoring, teaching experience, and a path into faculty roles.

As Black nurses, we have to encourage others into the profession and guide them toward higher education. We need to become educators, clinicians, and practitioners so young Black nursing students see role models who look like them.

When I think about the Black nurses who came before, I think of perseverance, persistence, and purpose. They fought to be recognized and educated so they could care for their community, and they stayed the course when the odds were against them. Sojourner Truth promoted nursing education and training. Betty Smith Williams advocated for it and became the first Black nurse hired as a college educator in California. Their work forged the path that let me become a nurse educator. There is still much to do, and like our pioneers, we have to keep striving toward diversity, equity, and inclusion.