Becoming an Accomplice in Decolonizing Nursing Knowledge

Notable Works

The recent attention that has emerged related to disparities in health and healthcare, along with acknowledgement of systemic racism, has been known and acknowledged in the nursing literature long before the surge that happened after the murder of George Floyd on May 25, 2020. Long before this happened, there were many voices calling for nursing and health care to wake up and address these issues, but they were regretfully ignored or given performative attention only. One notable example of a call to action was published in January 2019, authored by Dr. Roberta Waite and Dr. Deena Nardi.

Waite, Roberta, & Nardi, Deena. (2019). Nursing colonialism in America: Implications for nursing leadership. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing, 35(1), 18–25.

In this article, Drs. Waite and Nardi focus on the historic roots of colonialism in shaping the nursing profession, and offer insights that lead to action challenging and decolonizing nursing. They specifically address the need to:

  • change hiring and promotion practices,
  • confront the complicity of white silence,
  • critique the design and dissemination of nursing knowledge development, and
  • urgently pursue widespread change in nursing education.
Posted by permission of the publisher

Now, almost 5 years since the publication of this article, nurses, nurse leaders, and nursing organizations, have only begun to take these insights seriously and to put the recommended actions in place. This notable work must not now be discounted and ignored under the misguided application of the “5 to 10 year rule” that all too often diminishes the evolution of informed perspectives grounded in the wisdom of the past . Waite and Nardi identify essential “first steps” needed to take meaningful action, which include: examining and understanding the underlying dynamics that sustain institutionalized racism, recognizing the ways in which nursing education shapes racist attitudes and practices, and assuming leadership in decolonizing nursing. They urge nursing leaders to become accomplices in creating real change.

Becoming an accomplice to deconstruct white supremacy is key. When nursing leaders fight back or forward, together, with persons working to decolonize and mobilize anti-oppressive and anti-racist practices and policies, they become complicit in a struggle and movement towards liberation—we are then accomplices. The goal for nurse leaders is not to simply unlearn oppression. Rather the goal is to understand the importance of securing resources and material support to promote liberation efforts and to act on this understanding.

Waite & Nardi, 2019, p. 21

Waite and Nardi identified five important actions that nurses can take, as accomplices, to create solutions to the persistent conditions that lead to disadvantage for people of color, including nurses and other healthcare professionals of color, and patients who carry disproportionate risk of harm, illness and death in the context of being cared for. The five actions, notably, includes the action to examine the process of knowledge development. Nursing research and the theories that form the basis for nursing research are at the heart of “evidence based practice”. These activities and the scientific processes on which they are based are regulated and conceptualized by dominant discourses that originate in colonial, Euro-centric thought. Decolonization calls for a complete re-orientation to perspectives and practices that give priority to an anti-racist lens.

In describing what a nurse leader accomplice does to acquire an antiracist lens, Waite and Naardi state:

A nurse leader accomplice strategizes with, not for, to help or support others and engages intentionally in difficult, disturbing, and challenging discussions. Nurse leaders who are accomplices recognize that no one has a responsibility to provide them information to promote their understanding of American colonialism. Accomplices seek to learn and understand the enduring effects of American colonialism because they are accountable and responsible for confronting these issues. 

Waite & Nardi, 2019, p. 22

They list the following actions that an antiracist lens calls forth:

  • Ensure inclusion of diverse viewpoints and forms of evidence in addition to clinical research when gathering evidence to support change
  • Ensure that the policy writing group, task force, or research team includes members from diverse heritages who can bring different perspectives and understandings and histories to the table
  • Examine what research questions or critical inquiry processes are used to formulate policies and proposals; what populations or interests stand to benefit, and what populations are left out? (p. 24)

As Waite and Nardi noted, it is vitally important to become well versed in and reflect on human rights history broadly, and the ways in which colonialism and its core of racism have shaped our discipline. But it is now time to move beyond reflection and to take active steps to change the status quo. Wherever you are on this journey, I highly recommend this article. It is informative, clear, and inspiring! Pass it along to your friends and colleagues – together we can make significant change!

Resources for antiracism reflection and action

2 thoughts on “Becoming an Accomplice in Decolonizing Nursing Knowledge

  1. “Keep on keeping on.” There is a largely silent, passive aggressive White resistance to decolonization of racism in our profession. It is like an invisible wall, an organizational and institutional barrier. Based on my observations, this wall is upheld/enforced willingly by those who lead such organizations and institutions even as they deny such resistance exists or give lip service to anti-racism. Dx: Anti-racism resistance. Intervention: “Resist the resistance.” One “resist the resistance” path: There must be some sort of economic or reputational cost to be averted or benefit to be gained for organizations/institutions to change. Anti-racist rankings may help us resist the resistance. It must be a relatively easy ranking to understand without compromising the complexity and subtleties involved. And, the rankings must be validated and evidence-based. Best to partner with agencies that rank healthcare institutions. Since high ranking anti-racist hospital/long-term care outcomes are likely to be better than low anti-racist hospital/long-term care outcomes, I recommend partnering with CMS since it is against EEOC law to discriminate in the workplace. Anyone interested in developing and validating a a pilot ranking and approaching CMS with a pilot implementation and testing plan?

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