African born black nurses' perception of their U.S. work environment: Race matters

Internationally Educated Nursing Staff Caring for Older Adults: A Scoping Study

INTRODUCTION

Internationally Educated Nursing staff (IENs) are born and obtained their initial educational preparation in their home country before relocating to work in high-income countries (e.g., United States). Older adults are recipients of IENs' care. The study purpose was to synthesize relevant findings on IENs' experiences caring for older adults in various settings.

METHOD

Arksey and O'Malley's framework approach to Scoping studies was employed. The PubMed, CINAHL, PsycINFO, Web of Science, and Google Scholar databases were searched. A labor and employment relations researcher and a health science librarian were consulted.

RESULTS

Three main themes (transitional challenges; IENs' experiences working with older adults; factors affecting IEN service delivery) and seven subthemes emerged.

DISCUSSION

Cultural beliefs and communication barriers posed particular challenges to IENs as they worked with Western peers, older adults, and families. Facilitating factors revealed can inform administrative leaders of practice initiatives. Research gaps and limitations identified can guide future study approaches.

The Vitruvian nurse and burnout: New materialist approaches to impossible ideals

The Vitruvian Man is a metaphor for the "ideal man" by feminist posthuman philosopher Rosi Braidotti (2013) as a proxy for eurocentric humanist ideals. The first half of this paper extends Braidotti's concept by thinking about the metaphor of the "ideal nurse" (Vitruvian nurse) and how this metaphor contributes to racism, oppression, and burnout in nursing and might restrict the professionalization of nursing. The Vitruvian nurse is an idealized and perfected form of a nurse with self-sacrificial language (re)producing self-sacrificing expectations. The second half of this paper looks at how regulatory frameworks (using the example of UK's Nursing and Midwifery Council Code of Conduct) institutionalize the conditions of possibility through collective imaginations. The domineering expectations found within the Vitruvian nurse metaphor and further codified by regulatory frameworks give rise to boredom and burnout. The paper ends by suggesting possible ways to diffract regulatory frameworks to practice with affirmative ethics and reduce feelings of self-sacrifice and exhaustion among nurses.

Factors affecting the advancement of Black nurses into leadership roles: A scoping review

BACKGROUND

The profession of nursing has recognized the lack of diversity in nursing leadership. Nurses of color represent fewer than 20% of leadership roles in nursing administration, education, and professional organizations. Efforts are needed to identify and implement strategies to increase the representation of nurses of color in positions of high influence.

PURPOSE

To review the literature to uncover the factors that may impact Black nurses in their pursuit of leadership roles in nursing administration, education, and professional organizations.

METHODS

The authors conducted a scoping review, searching CINAHL and PubMed databases in November 2022 for peer-reviewed English-language studies of leadership among U.S. nurses. They excluded studies that did not include a research method, did not have participants, a minimum of baccalaureate preparation as an inclusion criterion for participants, or were published before January 1, 2012.

DISCUSSION

Of 331 articles identified, a total of 12 met the inclusion criteria. Evaluation of the studies revealed three concepts related to mentorship, racism, and hiring practices. Of the 12 studies, 9 addressed issues related to mentorship, 5 addressed issues related to racism, and 2 addressed issues related to hiring practices. Some studies address more than one of the concepts. Ten were qualitative studies, and two were quantitative studies.

CONCLUSION

Findings suggest that Black nurse leaders are faced with obstacles and challenges when considering entering and/or staying in leadership roles. The limited amount of research on Black nurses in leadership roles remains inadequate.

What does person-centred care mean, if you weren't considered a person anyway: An engagement with person-centred care and Black, queer, feminist, and posthuman approaches

Despite the prominence of person-centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values  We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised from healthcare than others. We point to the colonial, homo- and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self-determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*-cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. ^* We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). ^** Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. ^*** With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the 'dominant minorities' of white-cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people.

Race-induced trauma, antiracism, and radical self-care

Being racialized as Black in the United States has contributed to this population having to operate with a level of race-induced trauma, especially those who are darkly melanated. Historically, Black persons have been terrorized into colonization, and the cultural psychology of anti-Blackness has been entrenched in our society. Through the practice of racialization, the historical, social, and political processes of constructing racial identities and meanings have impacted the formation of understanding of the body and the rationalization of hierarchy. In addition, the internalization of these ideas of hierarchy and difference within power/knowledge relations that they (re)produce is pervasive among people in the United States. This article aims to explicitly highlight racism as trauma, address the relevance of radical self-care when disrupting anti-Black racism, and consider steps to promote trauma responsiveness when incorporating these practices.

Diversity and Inclusion or Tokens? A Qualitative Study of Black Women Academic Nurse Leaders in the United States

Severe under-representation of Black women academic nurse leaders persists in United States higher education, and a major research gap still exists regarding experiences of these leaders, and facilitators of and barriers to their success. Our objective was to examine how race and gender influence how Black women academic nurse leaders’ function in their leadership positions, how they are perceived by their peers, and how their perception of race, gender, class, and power influences diversity, equity, and inclusion initiatives in the workplace. Critical race theory was used as a guiding theory, and the study design involved narrative inquiry followed by thematic analysis. Four overarching themes with four sub-themes were revealed: (a) Paying a personal price for authenticity, (b) Being the only one is hard even when you are in charge, (c) The illusion of diversity and inclusion while trying to survive, and (d) Focusing on building and sustaining diversity, equity, and inclusion. Implications for nursing education including instituting training for faculty in anti-racist pedagogy and requiring nursing programs to meet inclusivity metrics for approval and accreditation.

Rejecting the myth of equal opportunity: an agenda to eliminate racism in nursing education in the United States

BACKGROUND

Unfortunately, racism and discrimination against Ethnic minority (EM) has been globalized, universally infecting industries worldwide, and the field of nursing has not been spared. In the United States (US), overt and institutionalized racism (IR) still permeates the fields of nursing, nursing leadership, and nursing education. Programs to address these disparities, and efforts by nursing professional societies and nursing education policymaking bodies to address racism in the nursing field, specifically with nursing leadership and education, have met with little success.

OBJECTIVE

The purpose of this paper is to illustrate the existence and magnitude of racism and its impact on the fields of nursing, nursing leadership, and nursing education, and to make evidence-based recommendations for an agenda for reforming nursing education in the US.

METHODS

A narrative literature review was conducted with a focus on pulling together the strongest evidence on which to base policy recommendations.

RESULTS

Based on the available literature, we put forth five recommendations aimed at modifying nursing education in the US as a strategy to counter IR in the US in the nursing field.

CONCLUSIONS

Recommendations to address IR in nursing focus on nursing education, and involve implementing programs to address the lack of opportunity for both EM students and faculty in nursing, developing an anti-discriminatory pedagogy, and incorporating diversity initiatives as key performance indicators (KPIs) in the process of approval and accreditation of nursing programs.