A case for anti-racist nursing education
July 26, 2024
Blythe Bell (she/they) is a white settler nurse and nurse educator who was born and raised on Treaty 7 Territory outside of Calgary, AB. She and her daughter have now settled in the land of the lək̓ʷəŋən, Esquimalt and Songhees Nations. Blythe has just completed her PhD in Leadership Studies through the Department of Educational Psychology and Leadership Studies, supervised by Dr. Catherine McGregor. Her research examined the factors influencing anti-racism in nursing education. In May 2024, she received an Outstanding Graduate Student Research Award from the UVic Faculty of Education.
From nurse to teacher
In 2003, Blythe completed her nursing school in Calgary and then moved to Victoria. Over the next ten years, she worked as a nurse in Victoria and across the world, from Portland, Oregon to Austin, Texas, and Australia. After specializing as a perinatal nurse, she began taking on students as their clinical instructor and realized she enjoyed teaching. “I love the teaching part of nursing. Healthcare is a lot of knowledge exchange and empowering people with the education they need to make their own informed decisions.”
She was tasked with teaching practical nursing courses that included cultural safety content. She quickly realized that to be a teacher, she needed to advance her education and develop teaching skills. Without it, she’d just be repeating what she knew from her own school experience. She began taking online courses in the Master of Education program offered by Thompson Rivers University, then decided to switch to UVic’s in-person Master of Education in Leadership Studies program.
Peeling back the layers
Blythe was deeply influenced by broader cultural movements like Black Lives Matter that exposed her to different voices and stories. She undertook a process of self-reflection and began to wonder how she’d gotten through four years of nursing school and ten years of nursing practice without reflecting on her world and questioning the systems around her.
UVic instructors Darlene Clover and Willow Allen both encouraged her to “dig where she is standing” and focus her studies on racism in nursing and nursing education. “I wanted to talk to other nurse educators broadly about the experience of teaching anti-racism, and the challenges of facing racism in nursing education.”
“Winding my way through my own ignorance motivated me to do work in the education system. It's really disappointing when your intention is not to harm anybody. Then you dig into it more and find the implicit racism and layers of judgment that we’ve been socialized to adopt as white people in this country.”
Research within the nursing community
Blythe started her master’s research with a literature review, at which point her supervisor presented her with the opportunity to fast-track her master’s research into a PhD program. “I feel grateful to Catherine [McGregor] for presenting me with the opportunity to move into a PhD program. As a single parent, it’s a very big opportunity to get through the terminal degree without having to carve out time and money to come back to grad school.”
Blythe created an anonymous survey for nurse educators that she designed with open-ended questions to elicit robust, contextual responses. It asked about factors that might prevent nurse educators from being anti-racist, maintaining an anti-racist environment and teaching anti-racism in health care. Of the approximately 100 survey respondents, 17 opted to further participate in the study through focus group discussions. Of those, several said they didn't have other places where they could have explicit conversations about racism in nursing education.
She says there is a strong undercurrent of prejudice in nursing and nursing education and a quiet socialization that makes it hard to call out. It’s also difficult for a lot of people to get past initial feelings of guilt when they realize they may have caused harm. Most people will get uncomfortable and shy away when talking about their own complicity. Educators worry about backlash from students. It’s especially tricky when educators are often amidst their own anti-racism learning when they’re expected to teach the concepts and model good practice.
“It's a yucky experience to realize that you've been harmful and that you have intrinsic beliefs about people that you didn't really think you did. But it doesn’t help anybody to hang out in guilt and shame. It’s not about ignoring or denying those feelings, but there's no sense in hanging out there because it’s not productive.”
Making space for conversations about racism
There are many reports of harm in the field of nursing, and the environment continues to be harmful for people with marginalized identities. Nursing in Canada has historically been very white-centered and heteronormative, with deep ties to Christianity. Many of these norms are still implicitly entrenched and enforced. Blythe says the Canadian healthcare system has been reluctant to prioritize collecting race-based data on nursing students. Nurses have only recently received tools and resources for how to assess non-white skin regarding wounds and healing. “It’s so deeply entrenched that all of our resources need to be audited and redone to make sure that we're not perpetuating a white-centric lens.”
She says there are people who want to do anti-racism work in nursing education, but more supports are needed to do it. Those who are trying to change the culture and curriculum are completely overburdened and often unsupported, and there's still no structured approach to bringing in anti-racist pedagogy. Even when organizational plans exist, there must be an accountability element to ensure the work is happening.
“Whatever perspective that has kept some of this critical content out of the early years of nursing education is problematic. From my perspective, nursing curriculum should include anti-racist and anti-oppressive training across the four years, starting from day one. Normalizing having uncomfortable conversations, not knowing the answer, potentially feeling bad and being able to work through that in a professional way as a student or as an educator would be so beneficial.”
What's next
Blythe currently works as a research coordinator on a project with Dr. Lisa Bourque Bearskin, an Associate Professor at the UVic School of Nursing and the BC Chair for Indigenous Health Nursing Research. The project is a collaborative effort across five institutions and aims to build Indigenous nurse leadership by creating a program designed for and highly accessible to Indigenous nurses and grad students. After this contract, Blythe is hoping to secure a tenure-track position and continue advocating for anti-racist nurse education.
She says the most important takeaway is the need for resources and structural accountability. In the meantime, this work will continue to rest on the shoulders of those most passionate. “It goes way beyond our professional responsibilities, it’s our human responsibility.”