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Understanding Racism As a Historical Trauma That Remains Today Creative Nursing, Volume 27, Issue 1, 2021 Understanding Racism as a Historical Trauma That Remains Today: Implications for the Nursing Profession Roberta Waite, EdD, PMHCNS, ANEF, FAAN Deena Nardi, PhD, PMHCNS-BC, FAAN In order to promote health equity and support the human rights mandate contained in the American Nurses Association’s Code of Ethics for Nurses with Interpretive Statements, the nursing profession must understand historically the creation of race, white supremacy in the United States, and entrenched racial terror and brutality toward black and brown racialized populations. Considering the limited racial diversity in the nursing profession despite its stated mission to increase diversity, the profession must build a path to understanding antiblack racism as a historical trauma that remains to this day, a path that encompasses antiracist ideology. Antiracism education is critically needed at the pre-professional and professional levels, for nursing students, providers, educators, administrators, and researchers to inform our own understanding of bias within the contexts of our educational and health-care systems. Dismantling racism requires an enduring commitment to the ultimate goal of social justice for ourselves, our patients, and our communities. This article presents antiracism actions that nurses should employ to dismantle racism, focusing primarily on personal-level initiatives, with self-work as the starting point. Keywords: nursing; antiblack racism; historical trauma; ally; accomplice; co-conspirator "My genuine fear is that they don’t remember . [W]e haven’t created a culture, a nation that requires people to remember the damage we have done to one another as a result of this history of racial inequality." Bryan Stevenson, the Equal Justice Initiative (2019, p. 5) acism is a structured social system in which DEFINITIONS Rthe governing racial group, founded on a belief system of superiority and inferiority, classifies and Whiteness ranks individuals into social groups (e.g., races) and Whiteness entails the historical and social construction applies its power to degrade, disempower, and dis- of being white, including social status, privilege, and parately assign fewer societal resources and oppor- power linked with being white (Beckles-Raymond, tunities to groups described as inferior. Racism has 2020). Whiteness in America is inherently associated been rooted in the United States over centuries (Harde- with the enslavement of African people (chattel slav- man et al., 2016). Its formation is rooted in white- ery) and ongoing oppressive practices, from European ness and white supremacy culture, and it must be colonization of Indigenous lands in North America truthfully examined if dismantling racism is to be to Jim Crow laws, lynching, red-lining, and the con- realized. This article will operationally define white- tinuous racial domination and discrimination of the ness, white supremacy, racialization, antiblack racism, present. Importantly, white group-level self-interest white privilege, and historical trauma, then describe engenders and sustains white ignorance regarding intentional, persistent antiracism actions that address universal whiteness (Beckles-Raymond, 2020). This what nurses need to do; how to build knowledge ignorance is not solely from not knowing, but rather and understanding through education; and what soci- the social construction of whiteness as superior; this ety needs to do to assure health equity for indi- seriously skewed optic justifies domination. It also viduals, populations, and communities we aim to enables individuals to believe that racism no longer serve. Pdf_Folio:19 exists and assures them that society is an equal © 2021 Creative Health Care Management 19 http://dx.doi.org/10.1891/CRNR-D-20-00067 of whiteness also reveals the ideology of neutrality in Racial images influence the world and communication. produce character assumptions; however, Antiblack Racism racialization is rarely applied equitably to all humans. Given the historical antiblack racist sentiments and actions reflected in operations of day-to-day life in the United States, the nursing profession must crit- playing field for all individuals. Ultimately, white ically examine how such sentiments penetrate their ignorance rationalizes the preservation and repro- behaviors, values, beliefs, and practices. Highly vir- duction of white supremacy (Beckles-Raymond, ulent antiblack racism is pervasive in our society 2020). (Hardeman et al., 2016). This form of racism entails prejudices, attitudes, behaviors, beliefs, practices, White Supremacy stereotyping, discrimination, and/or policies that explicitly or implicitly racialize black people as infe- White supremacy, a human-made and historically rior to other racial groups, and is rooted in the his- created culture, is “a political, economic, and cul- tory and experience of enslavement and its legacy tural system in which whites overwhelmingly con- (Noe, 2020). Antiblack racism manifests at interper- trol power and material resources, conscious and sonal, institutional, and systemic levels, and operates unconscious ideas of white superiority and enti- through white supremacy. tlement are widespread, and relations of white dominance and non-white subordination are daily White Privilege reenacted across a broad array of institutions and social settings” (Caswell, 2017, p. 224). White White privilege is the mostly unrecognized benefit of supremacy is a structural issue; therefore, individual being white. It is an unearned advantage, and it is choice is not a significant consequential factor. Racist everywhere in our society. structures exist, and racially white individuals profit Historical Trauma from these structures regardless of their personal choices and attitudes (Caswell, 2017). Thus racism, Historical trauma is the “cumulative emotional and whiteness, and white supremacy align as a historical psychological wounding over a lifespan and across trauma—a human-made system that has been perpet- generations, emanating from massive group experi- uated across generations since the birth of the United ences” (Williams-Washington & Mills, 2018, p, 247). States. This trauma can be passed down through gener- ations, enhancing physical and psychological ail- Racialization ments and other health disparities. Specifically, for Racialization is a process of constructing groups black people, historical trauma is “the collective spir- founded on physical characteristics that are socially itual, psychological, emotional, and cognitive distress described as significant; being racially white has perpetuated intergenerationally deriving from mul- always been rooted in a history of distinguishing self tiple denigrating experiences originating with slav- from others via symbolic construction or actual dom- ery and continuing with pattern forms of racism ination of others (Lewis, 2004). Racial images influ- and discrimination to the present day” (Williams- ence the world and produce character assumptions; Washington & Mills, 2018, p, 247). All individuals in however, racialization is rarely applied equitably to the United States, including nurses, must understand all humans. It is pointedly employed when describ- the influence of historical trauma, given its rooted- ing black and brown racial populations, rendering ness in white supremacy culture. To be formidable whiteness invisible, unnamed, and viewed as natural. accomplices for racialized black and brown popu- Implicit in understanding whiteness is the significance lations in the struggle for racial justice and health of racial beliefs as an organizing tenet of the contem- equity, nurses should understand historical trauma porary world that wields as deep an influence on nurs- and their role in sustaining oppressive structures via ing as it does on other facets of daily existence (Puzan, color-blind practices (not seeing race), along with 2003). Whiteness remains in nursing, even in spaces remaining neutral when met with social and politi- where black and brown racialized nurses predomi- cal platforms that fuel inequities. Historical trauma nate. Contending with whiteness, as a specific feature originates from the suppression of Black, Indige- of race, originates from the way an individual is situ- nous, and People of Color (BIPOC) by racially white populations. atedPdf_Folio:20 within it, bodily and geographically. The concept 20 Waite and Nardi WHAT NURSES MUST DO character and good heart, and being a good per- son. Frequently, color-blind ideology (i.e., claiming Race and Nursing not to see a person’s race or color) and polite Considering the limited racial diversity in nursing, interactions occur, yet nurses’ white supremacist with 80.8% of RNs White/Caucasian, 6.2% African discourse and behavior remain. The status quo American, 7.5% Asian, 5.3% Hispanic, 0.4% American precludes discomfort, conflict, and disruption, Indian/Alaskan Native, 0.5% Native Hawaiian/Pa- and establishes one’s moral, nonracist credentials cific Islander, 1.7% two or more races, and 2.9% other, (Dewhurst, 2019). Nurses may therefore avoid and its stated mission to increase diversity (Ameri- considering the ways they might be implicated in can Association of Colleges of Nursing, 2019), nurses sustaining white supremacy. We all swim in this must consider why the diversity of epidermal color stew of white supremacy and are affected by it, within the profession has not improved. It is impor- regardless of our racial color; those who can invoke tant
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