If a patient or a coworker makes a racist comment to a Black person working as a nurse in Oregon, that nurse may have no one who looks like them to turn to for commiseration and understanding. Nurses of color in Oregon work in predominantly white spaces, which can be very isolating on top of a job that is already emotionally and physically draining. A new podcast, Black Care Matters, focuses on the challenges and successes of Black nurses in Oregon. We talk to Erica Bailey, president of the Alliance of Black Nurses Association of Oregon, Violet Larry, vice president of ABNAO, and Rashida Quinn, host of the podcast, about their work.
The following transcript was created by a computer and edited by a volunteer:
Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. If a patient or a coworker makes a racist comment to a Black person working as a nurse in Oregon, it’s likely that the nurse may have no one who looks like them to turn to for commiseration or for understanding. Black nurses in Oregon work in predominantly white spaces, which can add isolation on top of a job that is already emotionally and physically draining. A new podcast, Black Care Matters focuses on all of this. It launched yesterday. It was created by the Alliance of Black Nurses Association of Oregon or ABNAO. Rashida Quinn is the host of the new podcast. She is the program director for ABNAO. Erica Bailey is a registered nurse and a nurse educator. She is the president of ABNAO and Violet Larry is a retired nurse and the vice president of the Alliance. They all join me now. It’s great to have all three of you on the show.
Rashida Quinn: Thank you.
Erica Bailey: Thank you.
Violet Larry: Thank you.
Miller: I want to start with a clip from one of the episodes of the new podcast. It’s from the interview with an amazing person named Ron Harris who I’ve never met, but I feel like I have because I’ve listened to him. Here he is talking about the challenges that he faced in recent years, both because he is often the only Black nurse or Black health care giver, in some ways, in his workplace, and because of the pandemic. Let’s have a listen.
Ron Harris [podcast recording] “I don’t want to have to sacrifice my own life for people that’s not deserving of it. Not just for having to deal with my Black experiences, but also being a nurse during this time. I just kept on crying and I was just like, I don’t know what I’m gonna do because I cannot go back to this job anymore. I’m constantly being attacked in one way or another. Being a Black nurse, you have to be able to see the perspectives of everybody that you come in contact with - the managers, your coworkers, your patients - and try to do what’s right by everyone, but you sacrifice a little bit of yourself. And it’s just like when I’m looking in the mirror and I don’t see myself, I don’t see the person that I thought I would be as a nurse. I feel like the last three years was just a huge dark time frame.”
Miller: Erica Bailey, what’s it like for you to hear that?
Bailey: It’s hard. I listened to it yesterday, but I’m tearing up now listening to it, because it’s difficult to hear that anyone would experience something like that, but it’s also, I can relate to the experience. The piece that stands out the most to me is sacrificing a part of yourself. I feel like that’s pretty true just moving through the world as a Black person in predominantly white spaces, particularly as a Black nurse. We were just talking in the hall about code switching, the ways in which you sort of leave parts of yourself or hide parts of yourself to navigate the spaces that you’re in, particularly professionally.
Miller: Can I ask you, I mean, code switching…it’s an enormous thing. There is an entire show about their entire lives that experience it in various ways. But what does it mean specifically in the context of your profession? As a nurse, what does it mean to not be able to be your full self when you’re doing your job?
Bailey: It’s interesting because nursing requires you to use so much of your humanity, but you’re also kind of supposed to be neutral.
Miller: Like a helpful robot.
Bailey: Kind of, right? Like it’s not about you. It’s about the other person. It digs deep into who you are as a human. But yeah, you’re supposed to be sort of neutral, objective. I don’t know if you can relate to that, Violet, but it’s just sort of like the ways in which you sort of are expected, I think to leave those things aside. But when you’re talking about something that’s so central to who you are as a person, it gets complicated when you’re talking about your identity as a Black person, right?
My only experience as a nurse is here in the State of Oregon. So I’ve only had the experience of working with definitely a vast majority of white patients. And so it’s just not something I lead with. I don’t know how to say…I obviously can’t hide it. I mean, it’s something that’s visible, but it’s not something that I get to carry with me in my tool belt per se, because people, it’s about their experience, they want to see themselves reflected. We’re talking about their experience, their perspective. So it just gets really kind of complicated.
Quinn: I think of a moment when one of another guests on our show, Marneesha, talks about helping a man out of the bed and noticing a large swastika on his back. And in that moment, amongst Black peers, there would probably be a very different conversation being had about what it feels like to have that experience. But amongst white peers and the white man that she’s caring for, as the only Black person in that room experiencing that, she talks about on the show the emotional response in her body, her heart pumping faster. Also thinking, OK, what do I say next as this person is trying to explain why they have that tattoo?
Miller: As if there could ever be any explanation.
Quinn: Right. And the quality of her care. So I’m trying to get him to the bathroom. That’s my job right now and I’m experiencing something that no one else is in the room. So I think that’s a good example of how code switching in a more extreme moment like that becomes a survival tactic and not just a way to participate in the lexicon that makes everyone feel comfortable. It’s also a way to make sure that you are protected.
Bailey: Well said.
Miller: I want to hear another clip from that same interview with Ron Harris because it really illustrates, in a chilling way, just another version of this. Let’s have a listen. And then I’d love to get your thoughts on this.
Harris [podcast recording]: “I remember the first time I was called the N word by a patient. I was like consoling them while they had a lumbar puncture. I was so taken back. And I remember I told one of the charge nurses who they end up telling my manager and she was saying like, ‘You can’t change the behavior of a racist.’ I still focus on the quality of my care. But like that compassionate aspect, I feel so disrespected that I have to cut off a certain level of emotion that I have towards you to protect myself.”
Miller: Violet, how do you care for somebody effectively, meaningfully, if you know that they don’t respect you as a person?
Larry: For me, sometimes I would just step away and say I am not the person that needs to be taking care of this person right now.
Miller: Did you have the ability to do that? I mean, the management that would say yes, we have your back. We’ll put somebody else in there. We understand.
Larry: Well, my line of nursing for the majority, for my 35 years of it, was in community health. So I had one-on-one autonomy with my patients. And it’s like, I don’t feel safe, I could step away and I’m going to turn you over to somebody else. While working in the hospital at the beginning of my career, I would do the same thing, for my own. I just had that innate ability to say, this is not helpful to me. I don’t feel safe right now and you need somebody else to take care of you. And so I was afforded that opportunity.
Everybody doesn’t have that. And so that’s when it becomes very stressful. And, “I got to still take care of this patient, even though they think this way about me.” And it’s so difficult to go into those situations day after day after day and not have any supports around you. And that’s what these podcasts are about. It’s like not having anyone to talk to about what you’re going through. I mean, I can recall going to meetings about just a variety of things and looking in the room…is there gonna be somebody who I can identify with, who I can give that wink to, give that nod to, to know they have my back and I have my back? And oftentimes, that didn’t happen. I had a white nurse that said, you really do that? When you go into a room, you really kind of scout it out to see if there is another Black person in that room? And it’s like, yes.
Miller: She was so used to being a member of dominant culture that it didn’t make sense to her that if you were the only person who looked like you in the room, that you would seek out the commonality and seek out the nonverbal understanding of potentially shared experiences. She literally couldn’t understand that.
Larry: She couldn’t understand that, could not understand that. But that’s something it’s like, yeah, and if you do do that and find and make a connection, then the white dominant culture is like, “you must have known them before.”
Miller: You all know each other.
Larry: You all know each other. It’s like “no, we just met.”
Bailey: But there’s context. There’s a commonality. There’s understanding.
Larry: For sure.
Quinn: That’s wild, especially because what is missed in that moment is that’s exactly what they’re doing, walking into this space with a nod and a commonality and a comfort that is afforded them by the fact that they’re amongst each other, because if the inverse was true, and they walked into a room - especially in Oregon, which happens maybe never - of all Black people as the only white person, that experience would be assaulting their daily lives. And it would be a moment of like, oh, this is what it feels like. Where’s my wink? Where’s my nod? So, I mean, just when you just inverse it, you can kind of feel into how being a part of the dominant culture really does afford you more privileges than you realized.
Miller: Erica, one of the themes that stood out to me from more than one interview of this podcast is - I hope I can put this the right way - even if you were to say, I don’t care about the experience of Black nurses, just suck it up, do the job, even if you had a vile mentality like that, one of the themes that comes out is that the provision of health care is worse because if people are not being respected or listened to or validated or can bring their full selves to their workplace, they’re not going to do their best work.
Bailey: Right.
Miller: How does that actually happen? I mean, I guess what I was wondering is in the context of a clinic or a hospital or a community center, what could potentially suffer in terms of care if the people who are doing the jobs are not fully valued?
Bailey: That’s a really good question. It makes me think about…I had some students a while back talk to me about this idea that they felt like they were taught to maintain unconditional positive regard for their patients. And I thought, that’s interesting. I don’t know that I had that language. But it’s true. You sort of come out of nursing school with this understanding that you’re just supposed to receive whatever you’re given. And so it kind of goes back to what I think I was trying to say earlier was just this idea that you’re not exactly sure what you’re going to receive when you walk into that room. There might be some sort of markers or triggers that may have you on guard thinking that you’re going to experience something. But when you are continuously disrespected or there are parts of you that you can’t bring to the space or that you’re not understood in the space by your coworkers, your managers, etcetera, I mean, it just erodes your compassion I think.
Luckily, I haven’t gotten to that space but I could imagine that the job does become rote, you do become a robot because your emotional body is tender. It’s damaged. And how on earth are you supposed to dip from that pool to extend compassion or grace or empathy to another human when you’re just continually degraded? It’s really counterintuitive, I think, to the job. But also it’s kind of what’s expected of nurses in general. I mean, this isn’t unique to Black nurses. It’s just maybe more, it’s like icing on a bad cake. Trying to think of the radio version of what I was about to say. [Laughter]
Miller: I appreciate that. We were saying that the flip side of this, another way to ask that question that I asked before is, how does care suffer if patients don’t see themselves reflected in the people who are healing them?
Violet, what has this alliance, which is now not that old, meant in terms of a convenor or a provider of community that was maybe absent at the workplace itself?
Larry: Oh, my goodness. This alliance has been amazing. Like I said before, I’ve been a community health nurse for 35 years. The majority of the time, the only one who looked like me, nobody else to talk to about what a client might have said that day. Being able to come into this space with like-minded folks just renews your purpose and the why you’re doing what you’re doing.
I didn’t have all and don’t have all of the experiences that most of the nurses do because I’ve been fortunate for the last 15 years to work with an African American culturally-responsive home visiting program. But I was always telling my nursing staff that this is special. When you step outside of this group, you’re in the real world. Don’t take these moments for granted, the ability to talk amongst each other. So coming to the alliance, I was like, “you all, I’m here for you, anybody want to come work for me, because you will have the experience that you need.” It really is awesome to work with qualified, skilled, educated Black nurses, and just talk about our experiences.
Miller: I want to play one more clip from the new podcast. The first episodes were just released yesterday. This is from the episode with a nurse named Tanisha Jarvis.
Tarnisha Jarvis [podcast recording]: “I was expecting to come in and learn how to take care of all kinds of people. And I feel like I didn’t get that in nursing school. One of our members said it really well once that she felt like she went to nursing school and she learned how to take care of white bodies and not bodies of color, right? Like that was kind of frustrating a lot because I’m gonna be taking care of all sorts of people and I want to benefit everybody but it specifically like my community and how can I take care of them if I’m not learning that?”
Miller: Erica, I saw you nodding there. Tanisha, I assume she’s not talking about the correct dosage of an IV medication or how you read liver numbers for liver function or something. She’s not talking about universals of human bodies. What is she talking about?
Bailey: Well, I can give you some examples. We were just at a career day event at McDaniels High School last week and we have these incredible mannequins, they are Black-bodied. Most of what’s exciting about these mannequins is their internal organs, but what is visible of their skin is Black. And I shared with the students how unique this is because when you look at nursing textbooks, medical textbooks, across health care, the pictures that you see are white bodies. When they talk about assessing things that you might see with the skin, they don’t talk about how do you do that when somebody’s skin is dark? You also learn different things like, oh, Black folks have high blood pressure, but they don’t talk about why. There’s no physiological reason why Black folks are prone to high blood pressure. We’re talking about things like intergenerational violence and oppression and racism that have resulted in that.
I can tell you that we still have modern textbooks today, when you’re talking about racial and ethnic diversity, you get chapters or paragraphs that give you really kind of gross and disgusting generalizations about a particular group of people as if you can just make an assumption that, oh, if you’re caring for Black people, their family might come in large numbers and be really loud or this is how they cry when they’re grieving. These are things that they extend to Native Americans and people of Asian Pacific Islanders, all sorts of things, none of which are particularly helpful because you can’t apply those generalizations. But you don’t have those chapters or passages about people of European descent.
Miller: Rashida, we just have a minute left. Has working on this podcast changed the way you think about being a patient?
Quinn: Absolutely. I think it changes the way that I think about receiving care, in that I can enter a space in which someone’s providing care, and if they look like me, know that we are supporting each other a little differently than it would be if they didn’t. It also has made me…
Miller: You’re supporting them. But in some ways they’re taking care of you.
Quinn: Exactly.
Miller: You also feel like you’re supporting them.
Quinn: Exactly. Yeah. And I think one of the most powerful things that we’re learning is that this is not just our work. It’s everyone’s work.
Miller: Rashida Quinn, Violet Larry, and Erica Bailey, thanks very much.
All: Thank you.
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