Illustrative quotes for institutions of care
| Theme | Subtheme | Illustrative quote |
|---|---|---|
| “Black tax” in nursing | Nursing as a service: the blending of art and science | I think sometimes people have to remember that we’re there to care for the patient. So any of our own personal feelings need to be left at home. (R#18) I mean it’s a good profession. It pays well. But you’ve got to be in it because you love it. And sometimes you can even say to staff members — “Well, why are you even in nursing if you hate it so much?” (R#12) Then it would come to, “Is [participant] on today? I don’t want you. I want [participant] to come in.” It is because I would take the time, right. Then you would have family members say, “Oh, my gosh, [participant], you stand out above everybody else. It doesn’t matter if they need to use the bathroom. You’re only supposed to be doing medication. But you have no issue taking them to the bathroom or changing them.” And I would tell them, well, I’m here to care for them so it really doesn’t matter what they need, that’s what I’m here for … I’m treating them like humans. (R#8) |
| Nursing politics: navigating intraprofessional tensions | I felt like I was never going to fit in. I felt like I would get common ground in a conversation where like I had children, and a lot of these nurses had children. So, I would say, “Oh, how are your kids? Where do your kids go to school?” But I very much felt left out in those conversations … I thought maybe it was me, maybe I was aggressive, maybe I came off too harshly. But I don’t think so because I always knew what I wanted to be taught. So I can’t really say that there’s a nurse that sticks out in my mind as someone who took me under their wing and mentored me. And I think that’s what led me to always strive to make sure that that never happened to somebody else. And that’s why I have such a strong sense of mentorship today with the nurses. (R#4) They should be helping me out. But these were older people that have been doing this for 5 million years. They’re jaded. They’re on their way out the door. They’re ready to retire. They’re sick of the place. They’re sick of the politics. They’re like in their 70s. Which not all of them are like that. It just so happens that people that unfortunately I was around, that’s how they were acting. (R#16) I mean it’s sad to say that because there aren’t enough of us … I feel I always have a different experience than somebody else. I always feel like I have to do things 100% right because if I don’t then the next nurse will come on, and the patient will be like, “Well, it was the Black one,” and everybody knows who it is. So I found that it kind of made me work harder and want to be better for myself and for my patients. Always keeping my head high and owning up to everything that I do as a nurse, making sure that my assessments are good, and just being a great leader for the patient and for the interdisciplinary team. (R#7) | |
| Nursing education: primer for praxis | In my nursing class, it was me and another Black girl in our whole like class of like 180 or 160 students. So as a student, when I would go in our clinical group, I always felt like I stood out. (R#7) We’re like taught from a white perspective, a European perspective. I found that in classes they would teach things that weren’t true. We did the Tina simulation where you talked to Tina on the computer. You had to like interact with her and try to give her. … You had to be good at asking questions so you could get the actual answer. So they were saying that there were all these things wrong with Tina. And some of them were true. But there was 1 thing that they commented on, which was the darkness around her neck and how that was a health issue. And it can be, but lots of people who are darker complexion just naturally have that discolouration around their neck. But they were putting it in all my classmates’ head that that’s just automatically wrong. So I’m like, you’re going to go into the workplace and you’re going to offend someone who’s Black. And guess what, you’ve just ruined that relationship. So I felt like they were just giving false information. Also when they would cover a topic of anyone who wasn’t white, they would just be like, “Oh, you’ll see something different.” But they never told you what you would see that was different. They’d be like, “Oh, you’re looking at oral mucosa. And for someone who is white, it will be pink. And for someone who is like black, it’ll be a different colour.” But then the next topic just starts. And you’re like, well, what colour is it going to be? Like how am I going to save lives if I don’t even know what’s going on? (R#14) There were some heated topics. I remember it was just me and 1 other ANS student in this class because we always tried to stay in the same classes together just for support. … And I remember there were some heated topics about employment equity and affirmative action. And, of course being a predominantly white class, there were some people who would say “I don’t believe in affirmative action.” And I was like, wait a minute, like, no, no, no … I hate to bring up history, and the social determinants of health, and how we have systemically been oppressed. And I hate to bring up the Black card, as people say. But … we are in the condition we are based on systemic issues, historical issues. Like there’s nothing we can do change that. But I feel that white people just don’t understand that. And I felt like at that point, from a leadership perspective, I was advocating for my population and my community. That was big in a nursing school from a nursing student perspective. (R#10) | |
| Invite only!: Gatekeepers, standards and structural design | It’s at the School of Nursing. When you go there and you fill out your application forms. She was showing me the papers. And I’m looking at the courses. I was like oh, I can’t wait to take this course, I can’t wait to take this class. And she’s like, “Well, you’ve got to make sure you get in first.” And I was like, oh, I’m pretty sure I’m going to get it … I’m like no, I know I’m going to get in. And she’s like, “Well, don’t start picking things now. You better get in first.” (R#16) If I had walked away upset and not spoke with anybody, that would have changed my whole life. It was potentially life changing… because I wasn’t accepted into any other program. I didn’t apply for any other programs. So that was my first experience with the School of Nursing. (R#3) I feel very much that if I was Caucasian, I would have been further ahead than what I am now … it feels like the old boys club or the old girls club. And, it sparked me into almost writing a book called “If only they could see me” or “If they could see me.” I’d write the story about my life and what it’s like. But I really do think that my race has a lot to play with the fact that I haven’t been in leadership positions. … And, I guess one has to sort of resign themselves to the fact that it is what it is. But I really do feel that if I was born a different colour, I would be a lot further ahead with the experience that I have. (R#4) | |
| Nova Scotia health care as an archaic institution | Who is at the table?: Inclusion beyond tokenism | I’m a big advocate for Black people in the health care field because I feel it’s needed and it’s important, especially in Nova Scotia, because we have such big Black communities. And like I said, for them to feel represented in the health care field. When they see you, it’s amazing. It’s a good feeling … I am a big advocate for nursing and trying to get more Black nurses in the hospitals because I know the way the Black community feels when they see a Black person. It’s like I’m the best thing in the world. It doesn’t matter who I am, any of that stuff. (R#7) Patients have stated how good it is when they come into this place and they see that there are Black nurses here that understand what they’re going through, who may have been in the same shoes that they’ve been, who have dealt with racism at the workplace, who have dealt with racism and classism, in Nova Scotia. They feel great about having someone that understands and that knows. They don’t have to explain everything because we understand. So that’s one reason why I think we need Black nurses — because we need to mirror our community … why shouldn’t we have Black nurses? Why shouldn’t we have Asian nurses? Why shouldn’t we have people that represent this community? But Black nurses are crucial, right. In this space where I’m working, we need to have Black nurses. (R#6) We should have a voice at the table. And any programs that they’re setting up should involve us. We should be involved. For example, I’m feeling really proud that yes, we have a person who is the ANS health consultant. However, for 10 or 15 years, we’ve had the gay, lesbians; we’ve had the Acadians. So why are we always just an add-on? … I think that it should be automatic when you’re setting up a program of any sort … you should cover everybody, not just be an add-on, and not be told that your numbers are small. (R#5) |
| Competency gaps: mistrust, discrimination and patient harm | We’ve been a marginalized population in Canada, let alone Nova Scotia. You have some patient advocates, like Aboriginal patient navigators. Do you have any Black patient navigators? You know, there’s nothing like that. So one of the things I see is we’ve certainly not done ourselves any favours with bringing up anything to do with Black people. (R#4) I had a patient from our community. And they were brushing her hair. And I said, ‘whoa, she needs oils in her hair, she needs grease.’ And they’re looking at me like I’m crazy. And I’m saying she needs lotion on her skin. Put some cream on her. … Our skin needs that daily. (R#8) Even as far as when Black newborn babies are born, they have Mongolian spots. Well, I think everybody knows what they are now, hopefully. But, I recall a woman who came to the Black health program, she said that they called community services on her when she brought her baby in for a check-up. Community services was called. She was put in one room, her baby was put in another room because her baby had bruises on his back. And it was Mongolian spots … I guess the other reason is so we can add to the knowledge about our race, about Black people, you know. … There just needs to be more information. Not only just understand things that are physical, like sickle cell anemia, like Mongolian spots, but also to understand the history. What has that person encountered in their life? What have they dealt with before they come into a clinic or before they can go into a hospital, and they’re upset and they’re angry because you said something? Can we just bring another perspective? Can you have somebody who understands, who can shed a little light on that situation? (R#6) | |
| Community-oriented care within a medical-based system: providing the best care | I think working in acute care and seeing the lack of representation from the ANS community accessing services. Not having that representation and not having that reflected within the workforce. Because I was the only Black nurse. There were some other allied health workers. But not having that representation … I think how important it is to have professionals that are representative of the patients you want to see in these programs … I know there are youth out there that could benefit from these programs and services. … The structure of how some services are set up create barriers to access. It’s how the programs are structured, the staff, and some of the expectations around the programs that don’t take into consideration aspects of how to best engage with people. (R#9) More Black people are staying home and being looked after at home. I find it’s rare to have an Indigenous or a Black person on our unit. They’re staying home longer, and being looked after at home. And it’s not usually the diagnosis of caregiver burnout either. A lot of times when it’s caregiver burnout, it’s like they’re just dropped off. “I had enough. It’s like I’ve had enough. I can’t do it anymore.” But you don’t see that so much with the Black population or the Indigenous population. (R#12) Which is why we’ve got to take care of ourselves, mentally and physically before you try to go through a system that isn’t designed for you to be taken care of. You can’t rely on that. You have to be the one that you rely on. Then when the time comes, let’s hope we have some diversity in the field. That’s the last boat you want to have. You want to take care of yourself is what I was trying to say. (R#15) |
Note: ANS = African Nova Scotian.