In the introduction of The History of Racism in Nursing: a Review of the Historical Scholarship, authors Dominique Tobbell, PhD, and Patricia D’Andontio, PhD, RN, FAAN, note that history, or rather the stories we tell about our history, frames how we think about ourselves. These stories are not without bias and the author’s positionality, where one stands vis-à-vis backgrounds, assigned, roles, social constructs, political capital, and sheer ambition, play key roles in the makeup of history.

The positionality of the 2 authors, who are White, was called into question at a recent public forum on racism in nursing held by DNPs of Color. The forum was held to brainstorm responses to the call for public comment on the 2022 National Commission to Address Racism in Nursing Foundational Report issued by the American Nurses Association. Although the 2 authors are White, the committee that commissioned the work was diverse and included G. Rumay Alexander, EdD, RN, Katie Boston-Leary, MBA, MHA, RN, NEA-BC, who are both Black, and Cheryl Peterson, MSN, RN.

In discussion of the report, many attendees of the DNPs of Color forum acknowledged the frustration of people of color in this arena. “Although the authors say it, the first thing that stood out to me is that the authors are White. I question, even though you have the context of history of nursing, we’re talking about the history of racism in nursing. Were there any barriers to having Black authors?” said Yvette Conyers DNP, MS, RN, FNP-C.

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“Dr Patricia D’Antonio and Dr Dominique Tobell are both notable and respected historians. History can be troubling to the soul. If you write a history of someone you don’t personally identify with, you would bring in someone who can identify. For example, if I were to write about transgender health, I would bring in someone [who identifies as transgender] who can truly supplement the data, as I myself do not identify as transgender.” said Ashley Graham-Perel, EdD, RN, NPD-BC, MEDSURG-BC, CNE, who is a nurse historian and Black historian.

Yvette Lowery, DNP, MSN/Ed, FNP-C, also commented that “to try to improve this, we need to be more intentional about being involved in this as we are tonight. Involved in health policy and these organizations.”

Long History of Racism in Nursing

The history of racism in nursing goes back to the antebellum south and slavery. Although the report is an exhaustive view of the dehumanization of Black midwives and healers in colonial America. The modern history of Black nurses in America is a struggle for recognition, education, job opportunities, and parity.

Dr Conyers pointed out the origin story of the history of nursing in the report starts off with the mention of Florence Nightingale. “That has been the lens that many of us have been taught [about this history of nursing], I think that narrative needs to change,” she said.  “We need to be intentional about whom we mention in our history so that those who learn have representation.”

Mary Seacole, a British-Jamaican “doctress,” is introduced as a counterpart to Florence Nightingale in the report. Nightingale reportedly rejected Seacole’s offer of help, leading Seacole to establish her own “hotel” to take care of British soldiers during the Crimean war. 

The rich history of Black midwives is given coverage in the report, which also includes the push by White physicians to move birthing from the home and into hospitals. The report notes that after that transition, birth-related complications and infant mortality rates were often higher in births attended by White clinicians compared with Black midwives at the time.

This is the reason why “when we look at the number of Black midwives that the number is so low. There was a push to decrease Blacks from midwifery,” said Dr Conyers. The legacy of that policy can still be seen today in the higher rate of infant mortality among people of color.

“Black midwives helped slaves and their masters deliver babies. Once birth was put in the hospital, Black midwives were locked out the midwifery,” agreed Janet Williams, DNP, MSM, CNM. There are signs of hope. “I was on a call with 95 doulas and midwife students of color [currently in training]. The push is definitely there. More Black nurses are trying to go into midwifery to help address the high maternal and infant mortality rates,” Dr Williams said.

Notable Black Nurses in History

Two publications mentioned in the report that helped to shine a light on the role of Black nurses include Mary Elizabeth Carnegie’s The Path We Tread: Blacks in Nursing 1854-1984 and Darlene Clark Hine’s Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890-1950. Hine writes of the phenomenon of racism that structured the American health care experience—including separate hospitals and medical and nursing schools for people of color.

Madeline Feliciano-Weiser, MSN, RN, emphasized the need to be intentional on who is mentioned “in our histories so those who are learning have representation to identify with.” Joanna Seltzer Uribe, MSN, RN, and an EdD Student, has profiled over 100 past and present-day nurses in the project Nurses You Should Know.

There was much discussion about nurses of color who were omitted from the report. A few names that were mentioned include:

  • Mary Elizabeth Mahoney, who was the first African American to study and work as a professionally trained nurse in the US. In 1879, Mahoney was the first African American to graduate from an American school of nursing.
  • Adah Belle Samuels Thoms was the first graduate of the Lincoln Training School for Black Nurses in 1905 and was a cofounder with Martha Minerva Franklin of the National Association of Colored Graduate Nurses in 1908. The association’s goal was to integrate Black nurses into nursing schools, nursing jobs, and nursing organizations.
  • Ildaura Murillo-Rohde is a Panamanian-born nurse who started the National Association of Hispanic nurses in 1975. She specialized in psychiatric nursing and held academic appointments at severe universities. 
  • Maude E. Callen is a nurse-midwife who was born in Florida and worked in South Carolina for over 60 years. She cared for families in a 400-mile radius and trained many women to be midwives. Her work was brought to national attention in W. Eugene Smith’s photo essay Nurse Midwife, published in Life in 1951.