Segregation in Nursing: Effects Are Still Felt Today

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Segregation in Nursing: Discrimination Was Common in the Past, and Its Effects Are Still Felt Today

Segregation in Nursing: Effects Are Still Felt Today

In 1954 the Supreme Court ruled that racially segregating children in public schools was unconstitutional, overturning the long-held notion that “separate but equal” was, in fact, far from it. While Brown v. Board of Education of Topeka was a landmark decision and a huge win for the civil rights movement, it was a case of winning the battle for equality, but not necessarily the war. The “new Jim Crow” — referring to laws that enforced racial segregation — is said to continue to this day, particularly in the criminal justice system.

Nursing is another field where segregation is no stranger, however. In the years leading to the Civil War, African Americans often weren’t allowed to receive an education. There were more opportunities in the Northern states, but slaves were forbidden from learning to read and write in the South. Reading and writing lessons still happened covertly but at significant risk to students and teachers alike.

To meet a need for healers, generations of black women became midwives. Doing far more than helping deliver babies, they frequently assumed the local doctor’s role in the communities in which they lived.

To Practice My Profession Faithfully

In times of war, women have served, both on the front lines and behind the scenes.

Florence Nightingale gained fame for tending to the wounded and dying during the Crimean War of the 1850s. Her ideas and practices in turn are seen as a forerunner of modern nursing education — though schools and hospitals remained segregated into the mid-20th century. Clara Barton nursed soldiers during the American Civil War, eventually founding the American Red Cross.

They’re far from the only women who’ve helped heal in 19th-century wars. Many African-American women have tended to Union soldiers, including Harriet Tubman. However, she is perhaps better known for being a “conductor” on the Underground Railroad and a Union spy and supporter of women’s suffrage.

Wartime needs tended to loosen restrictions somewhat, creating a space for Tubman and other black Americans to heal the ill and injured. In World War I, the Army and Navy nurse corps initially refused to allow black nurses to join. When the 1918 flu pandemic struck, leading to severe staff shortages in hospitals, the rules were finally relaxed. It wasn’t a lasting change, however.

The same happened during the early years of World War II. Thousands of black nurses applied to serve but were rejected. Mabel Staupers, executive secretary of the National Association of Colored Graduate Nurses, lobbied for the American Nurse Corps to change its policies. In 1941 some restrictions were loosened, but a limited number of black nurses were allowed to join.

Three years later, that quota was lifted, spurred by the skyrocketing demand for nurses. However, most African-American nurses were relegated to serving segregated hospital wards in the U.S. or tending to German prisoners of war both on the homefront and abroad. Adding insult to injury, nurses assigned to posts in the South and Southwest were barred from social functions and officer meetings, forced to dine in segregated dining halls, and frequently refused service at businesses located off-base.

The fight to end segregation and discrimination in the U.S. Armed Forces continued after the war. In 1948 President Truman signed an order to integrate the military. Many black collegiate nursing schools opened around the time as well. It was another battle won, but the war on segregation wasn’t over.

The Modern Era

Health care seems an odd place to encounter segregation, at least to the modern mindset.

We are all born. Most of us will fall in love and have babies. We get sick. Most of us grow old. Eventually, we die. So our experiences as human beings are very similar — but segregated facilities were common, and nurses were no strangers to the practice, whether in securing an education or making the rounds while on the job.

Those restrictions and reduced opportunities have left lasting harm to the black community.

Nevertheless, nurses have long stepped in to help and heal where they could. Could perhaps be the operative word. All of society has not always welcomed women to mend the sick. Black nurses, in particular, have faced obstacles. Jim Crow Laws may have been formally struck down in the 1950s, but segregation continued into the 1960s and discrimination beyond that.

Some progress continued to be made: Black patients were no longer relegated to hospitals’ basement level, for example. Civil rights groups fought to break down barriers further, but some remain to this day. Non-white nurses (and doctors) still experience racism from patients. The ugliness of racism doesn’t just leave an immediate sting, but its effects can be long-lasting, particularly mental health. It can lead to post-traumatic stress disorder, depression, and a host of other issues. In worst-case scenarios, victims may resort to substance abuse to cope.

While the profession is predominantly white, the ranks of nurses are slowly growing more diverse. According to a 2018 National Sample Survey of Registered Nurses, as of 2018, nearly 4 million licensed registered nurses were working in the U.S., and out of that group, 26.7% were of racial or ethnic minorities. Specifically:

  • 2% were Hispanic
  • 8% were non-Hispanic black
  • 2% were Asian
  • 7% were multiracial

Considering that the American Nurses Association says the need for registered nurses will outpace that of any other profession for the foreseeable future, it shouldn’t matter what a nurse’s race or ethnicity may be. Just that they are qualified and willing.

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