Nursing’s Racial Reckoning Requires More Than Another Statement (Opinion)

This is an opinion piece; the views expressed are the author’s. Disclosure: Dr. Walker is the founder and CEO of SarAI, an artificial intelligence-powered maternal health platform. SarAI is not affiliated with Sigma Nursing and has no financial interest in the matters discussed in this article.

There is a plainspoken expression in Black communities for being repeatedly disrespected while expected to pretend otherwise: someone is “playing in your face.” It describes institutional bad faith, the performance of respect in public while exclusion or exploitation persists beneath the surface. For generations, nursing has engaged in this form of bad faith with Black nurses. The profession celebrates itself as the nation’s most trusted. Its schools teach caring, advocacy and social justice. Its organizations condemn racism and affirm diversity. Yet Black nurses continue to describe environments in which their competence is questioned, scholarship marginalized, leadership constrained and objections recast as personal deficiencies. This contradiction is historical and structural.

The controversy involving Sigma Nursing offers a troubling illustration. After private communications attributed to its chief executive circulated publicly, Sigma placed him on paid administrative leave and retained outside counsel. The organization said it had not authenticated the communications. The board subsequently announced a leadership change, effective immediately, and an interim CEO search. A leadership change does not answer how he was selected, how employee concerns were handled, or whether protecting reputation and membership revenue took precedence over protecting Black employees and members.

Additional claims about Sigma’s treatment of Black employees and members continue to circulate in videos and commentary online. Sigma has not released investigative findings, so claims drawn from unverified material must stay carefully attributed. Social media is not a substitute for independent investigation. Its risks, incomplete information and accelerated judgment, call for disciplined verification, not institutional indifference. The deeper problem is that so many nurses turn to public platforms before they trust internal processes to protect them.

The central issue is larger than one leader. It is whether nursing welcomes Black nurses as students, employees, dues payers and symbols of diversity without treating them as equal owners of the profession’s intellectual, organizational and moral authority.

Want to see more Nurse.org articles in your Google results? Add us as a preferred source.

I write as a Black woman, education policy scholar, former assistant dean within nursing education and equity strategist. From that vantage, racial inequity in nursing is not a series of insensitive encounters. It is sustained through decisions about who is admitted, whose conduct is scrutinized, whose scholarship counts, who advances, whose concerns receive a response and who absorbs harm quietly for the sake of stability.

Nursing’s dysfunction is not exclusively racial. Its culture of hierarchy, gatekeeping and exclusion burdens many nurses. But Black nurses encounter that broader institutional dysfunction alongside a distinct and disproportionate racial burden, a disparity the profession’s own data makes unmistakable.

Black women provided sophisticated care within families, communities, plantations and military settings. Yet the emerging profession built legitimacy around white, Eurocentric conceptions of education, womanhood, morality and scientific authority. Racism demanded separate hospitals and nursing schools, so Black communities built their own. Black nurses founded the National Association of Colored Graduate Nurses in 1908 because mainstream organizations would not fully receive them.

Standards framed as objective reproduce inequality when institutions begin from unequal positions. In 2022, the American Nurses Association acknowledged that its 1965 position paper, which recommended a baccalaureate as the minimum for professional practice, disenfranchised schools serving students of color and excluded their graduates. The question is not whether standards are necessary. It is whether they were designed and enforced with serious attention to the racial conditions that shaped institutions’ capacity to meet them.

Whiteness Remains Embedded in Nursing Education

In this context, whiteness does not refer to white individuals or personal prejudice. It describes the institutional treatment of white norms, histories and standards as nursing’s unmarked default: the presumed neutral standard against which other forms of knowledge, behavior and professional identity are measured.

Curricula routinely present white nurses as the profession’s principal architects and confine Black knowledge to diversity modules. Admissions processes described as meritocratic can rely on measures shaped by unequal educational opportunity. Clinical evaluations may reward conformity to white expectations of speech, demeanor and deference. Black faculty often carry disproportionate mentoring and diversity labor while remaining underrepresented in senior leadership. Scholars identify white dominance, not individual prejudice alone, as a barrier to antiracist change. Increasing enrollment without changing the environment diversifies who experiences harm without transforming what produces it.

In a National Commission to Address Racism in Nursing survey of more than 5,600 nurses, 63 percent reported personally experiencing workplace racism. Among Black respondents, the figure rose to 92 percent. Black respondents reported racism from leaders (70 percent), patients (68 percent) and peers (66 percent). The disparity does not negate the difficulties nurses may experience across the profession; it demonstrates that Black nurses face an additional and disproportionately greater racial burden within that already difficult culture. These figures describe an occupational culture, not a handful of misunderstandings. Acknowledgment has value, but repeated study without enforceable action burdens the people already carrying the harm. The profession does not lack testimony. It lacks consistent accountability.

Predominantly white nursing organizations often point to Black members, officers, faculty or board representatives as evidence of progress. Presence does not establish power. Black nurses may hold titles without controlling budgets, policy, hiring, investigations, publication or executive accountability. Institutions can consume Black excellence while resisting Black power. Through dues, scholarship, leadership and mentoring, Black nurses create the prestige associations enjoy. The harder question is whether nursing values them as authorities who define knowledge, set standards, govern organizations and determine what accountability requires.

Sigma should release, to the extent legally possible, the scope, process and findings of its investigation, explain the governance failures surrounding the controversy, examine how earlier employee concerns were handled and disclose what reforms will follow. A leadership change without transparent institutional learning converts accountability into containment. Across nursing, organizations should commission independent examinations of culture, employment practices, board governance and complaint processes, then report findings and corrective actions publicly. Whistleblowers need meaningful protection.

Accountability must also be measurable. Organizations should publish goals, responsible leaders, timelines and evidence of progress. Boards should receive recurring reports on complaints, promotion patterns and turnover, with external review when senior leaders are implicated. Schools of nursing should examine admissions, progression, dismissal and promotion data by race. Accrediting bodies should assess racial equity as an outcome rather than accept aspirational language. Curricula should teach Black nurses and racialized professionalization as central history.

Professional organizations should identify who controls budgets, publications, honors, executive hiring and discipline. They should also reconsider governance models in which leaders of nursing institutions need not possess substantive grounding in nursing.

Nursing can preserve its self-conception as a caring profession occasionally disrupted by individual racism, or it can acknowledge that racism helped organize the profession itself. The first path offers reputational comfort. The second offers transformation. Black nurses have never been peripheral to nursing. They cared for communities white institutions abandoned, built schools and hospitals when barred from existing ones, created organizations when others rejected them, produced scholarship and educated generations of nurses. Nursing does not need to make room for Black nurses. Black nurses have always been here.

What nursing must decide is whether it will relinquish structures that treat whiteness as the unmarked standard and Blackness as a constituency to be managed, celebrated or contained. Enough becomes meaningful only when it changes who holds power, what conduct carries consequences, and whether Black nurses can expect protection without first generating public pressure. Anything less is not racial reckoning. It is another performance of concern by a profession that has asked Black nurses to wait long enough.

🤔 What would meaningful accountability from nursing’s institutions look like to you? Share your thoughts in the comments below.

Sources

• American Nurses Association. (2022). American Nurses Association racial reckoning statement.
• Bell, B. (2021). White dominance in nursing education: A target for anti-racist efforts. Nursing Inquiry, 28(1), e12379.
• Bonini, S. M., & Matias, C. E. (2021). The impact of Whiteness on the education of nurses. Journal of Professional Nursing, 37(3), 620-625. 
• Hine, D. C. (1989). Black women in white: Racial conflict and cooperation in the nursing profession, 1890-1950. Indiana University Press.
• Iheduru-Anderson, K. C. (2021). The White/Black hierarchy institutionalizes White supremacy in nursing and nursing leadership in the United States. Journal of Professional Nursing, 37(2), 411-421.
• National Commission to Address Racism in Nursing. (2022). Survey shows substantial racism in nursing. American Nurses Association.
• Soiland, A. (2026, September). Sigma Nursing board announces leadership change, begins interim CEO search. Nurse.org.
• Tobbell, D., & D’Antonio, P. (2022). The history of racism in nursing: A review of existing scholarship (Report 1 of 6). National Commission to Address Racism in Nursing.