2024/01/01 by Dominique A. Tobbell, Patricia D’Antonio · 1 voice
Nursing · Social Sciences · #Nursing Education, Practice, and Leadership #Race, History, and American Society #Racial and Ethnic Identity Research
paper · doi:10.5325/nursinghistory.32.0010
openalex publication_date 2024/01/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/15
History matters. Beyond George Santayana’s oft-repeated cliche that “those who cannot remember the past are condemned to repeat it,” history—or more correctly, the stories we tell about our history—frames how we think about ourselves now and the possibilities we can imagine for our future.1 These stories have their own power. They create a shared sense of identity. They can remain essential yet change over time in small but powerful ways to incorporate new questions and new issues. And they can construct meanings that sometimes bridge—even if they cannot destroy—divides based on what scholars have described as “positionality”: where one stands vis-a-vis backgrounds, assigned roles, social constructs, political capital, and sheer ambition.We acknowledge our own positionality. We are both White women. We are also, respectively, the director of the Eleanor Bjoring Center for Nursing Historical Inquiry at the University of Virginia and the director of the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania. As such, we are experts in broad areas of the history of nursing and healthcare as well as in the narrower areas of our own expertise. We believe deeply in the power of history and historical analysis; we believe both give scholars and readers the distance of time to step back and reflect upon difficult and contentious issues. Historical concepts and methods reflect the complexity and interconnectedness of critical political, social, and cultural issues that cannot be reduced to single variables. They attend to the importance of context and causality. They link ideas and actors in interpretive narratives of meaning; as such, there can be no overarching “story” but, rather, different ones that privilege different perspectives.2 And, most important, they encourage formulation of judgments and assessments of significance.3G. Rumay Alexander, Katie Boston-Leary, and Cheryl Peterson, representing the National Commission to Address Racism in Nursing, commissioned this essay. The timeline they presented that would best enable this essay to move the Commission’s work forward precluded original research. We have thus constructed what we call an historiographical essay. This established form of essay reviews relevant published historical research that addresses issues central to examining the issue of racism in nursing. The research we review focuses primarily on issues of structural and systemic racism that have affected nursing: “forms of racism that are pervasively and deeply embedded in and throughout systems, laws, written or unwritten policies, entrenched practices, and established beliefs and attitudes that produce, condone, and perpetuate widespread and unfair treatment of people of color.”4 This scholarship centers on the experiences of nurses who identified as Black, Asian, Native American, or Latino—populations that have been historically racialized in the United States. That is, they have been treated as distinct racial groups (regardless of ethnicity), constructed in structural opposition to the category of “White,” even as the meanings ascribed to these categories as well as the culturally determined parameters of these categories have shifted over time and across place.5 Because of this racialization, Black, Asian, Native American, and Latino nurses have faced structural and systemic racism that influenced their access to educational and professional opportunities and to institutional power in nursing and healthcare. They have also been approached as monolithic populations and actors, with too often insufficient attention to how the intersections of class, religion, place, access, and ambition differentially shaped individual experiences.6We acknowledge the importance of topics and themes raised during the public comment period: the role of historically Black colleges and universities in nursing education and practice; the global histories of nursing, particularly those in Asia, the Middle East, and Africa; the experiences of Alaska Native nurses as well as Asian and Pacific Islander nurses in the United States; and the role of leadership and missions for nurses of color in those organizations that have emerged since the 1970s. Regrettably, these are topics for which richly contextualized historical studies do not yet exist. Most histories of nursing and healthcare published by 2021 cover events and actors up to the 1960s. The changes are attendant upon what historians now call “the long Civil Rights era” and acknowledge the groundwork laid by Black professionals in the 1950s is only now the subject of sustained historical analysis.Our essay acknowledges these limitations. It moves forward in historical time to explain the evolution of relevant questions and issues. At times, it segues into earlier periods and other areas of significant historical research to explicate important themes. And it ends with suggestions for further areas of research that might help nurses understand the complex and complicated dimensions of racism in nursing. But we must begin with nursing’s own origin story.Florence Nightingale lies at the heart of Western nursing’s historical story. We begin here not to reify but rather to critique the central place that Nightingale—and Whiteness—have occupied in the history of American nursing. That story can be summarized as follows: The educated daughter of Britain’s elite struggles against the conventions of her mid-nineteenth-century time and place and achieves fame for her skilled care of her countrymen fighting in the Crimea. The epidemiological and sanitary that her ideas about nursing care her public the that to the of the for in American for as it for the care of the and during own Civil the and for institutional in her on And American most of White and class, to the of on Nursing as to their own to of these origin the deeply ideas about the importance of social embedded in ideas about nursing, her on Nursing for the the and to to their who on The of nursing in the United for the at which one for and for those who to their their the for the of to nursing and the of and into the of most other who to by embedded in these stories it no for This to change in the and 1970s. 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