Diverse Perspectives & Advocacy

Being the Only Black Nurse on the Unit

Ashley Sayles, MSN, RN, CPNP-PC
July 29, 2020
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True Life: I’m The Only Black Nurse on the Unit

We’re no stranger to being the token black person — us Black nurses. We’re often one of few in our nursing school classes and clinical rotations, so it isn't usually surprising to us that we may be one of few on our inpatient nursing units. After all, Black people are 13.4% of the population, so it's to be expected, statistically, that we will often be in situations where we are not the majority.  

I had a great time in nursing school, to be honest. I only have a couple memories of racial situations that made me uncomfortable, and one was a clinical instructor that was fired, and another with a patient. For the most part, my nursing school was pretty receptive to any feedback regarding how they could improve their cultural competency, and I took advantage of every opportunity to correct or adjust. 

I was sure my nursing career would be the same.

At least that was my thought process when I realized I was one of seven Black nurses on a unit with a nursing staff of 165. 

“This is how it was in school- it won’t be much different”

One aspect of nursing school I did not pay enough attention to was how I felt providing care as the only Black person on the unit. I was so focused on not making a mistake, I didn’t really check in with my emotions.  

But as days, weeks, and months passed by in my first nursing position out of school, I realized being part of the 4% of Black nurses on my unit affected me EVERY DAY.

black chess piece in the middle of white chess pieces black nurse

Being a Black Nurse, the Truth

So, you’re a Black new graduate critical care nurse in an inner-city, urban setting at a huge, world-renowned, educational medical campus smack dab in the middle of a low-income, predominantly Black neighborhood. 

You’re excited to start your new nursing position at an amazing hospital taking care of the sickest patients in the region, yet you’re nervous as a new graduate and worried about making mistakes. You are excited to meet your new coworkers and hope you get along well with them.  

As you get into the first few weeks on the job, you are learning the lay of the land: which nurses are nice to new hires, and which ones aren’t; which nurses seem to socialize with everyone, and which ones don’t; you’ve found a few people that you feel comfortable asking questions and chatting with.  

You’ve definitely identified who you DON’T feel comfortable around, too. They seem to find an issue with everything you do. They are passive aggressive toward you. They help others but never you. They welcome white new graduate nurses but not you.

In simple terms, they don’t like you. For some reason this particular person or group of people that don’t like you are ALWAYS someone with the power to make your life miserable at work. Maybe they’re in charge of the schedule, or they determine which nurses advance the clinical ladder and who doesn’t. So, you try to make them like you. You come in earlier than everyone else, you never make mistakes, you stay late to help others, the patients and families love you, you restock supplies, you offer to work extra weekends. You’re an asset to your unit in every way. 

Guess what? They still don’t like you.  

And if you’re like me, they hate you even more for it. After 6 to 12 months of brown-nosing and trying to make nice to no avail, you finally come to the conclusion that it’s a race issue. You’ve been trying to convince yourself otherwise for a long time. 

But two months after your white coworker went out drinking and overslept for work, she was promoted to charge nurse. You, a Black nurse, who has never been late, made a med error, upset a patient or family, and has been employed six months longer than Oversleeping Olivia, are still in an entry level position. 

Ok fine, they don’t want you to advance in your career here, got it.  After all, you’re here to take care of patients, and that’s what you’re doing — even if you are capable of more complex nursing responsibilities now.

Once you find contentment in that, you notice your patient assignments becoming unsafe: “Why am I taking care of double the load than the shift before me? Why am I always getting and giving reports to two nurses but am expected to take care of the load myself?” 

You handle it well, of course, because you’re a great nurse, but why is this only happening to you? You notice the Black patients don’t do as well or receive as tender care as the white patients do on the unit. You’re in the break room eating lunch alone, and the group of “popular” nurses are talking about the “ghetto” family in room 8 or the patient with “ridiculous” hair in room 10. It was an afro, by the way (as was my hair).

Fed up, you schedule a meeting with your nurse manager and spill all of the pent up frustration you’ve harbored onto her desk. She explains away all of your real feelings with ridiculous claims, and the conversation look like this:  

Your manager: “You haven’t advanced the clinical ladder because you’re in grad school; we thought you were leaving.”

You: Six other nurses in grad school have advanced…

Your manager: “Staffing has been so rough lately. I know the assignments can be involved, but you’re handling them well!”

You: There were three nurses called off the night I took care of three vented patients alone…

Your manager: “You know how the break room is, they talk about everyone.”

You: They were talking about a patient’s hairstyle that was identical to mine…

After getting nowhere with your manager, you decide to focus on your grad program and look forward to your graduation and the opportunity to find new employment. I tried going above her and reaching out to the “diversity and inclusion” office in the facility.

I’m still waiting for a reply to those emails sent five years ago.

This was their goal — to break my spirit and drive me out.

And I’ll admit they won, because that is exactly what I did. For me, I needed to protect my sanity, and I felt my disdain for my job affecting my care for my patients. I hated going to work, and I hated being assigned the worst assignments EVERY SHIFT. I was tired of being overlooked for opportunities and working 4x harder to receive a quarter of what my white peers were inherently gifted.

single lonely flower on white background black nurse

What have I learned since this experience?

Above all else, it’s of the utmost importance to protect your mental space and your patients as a nurse. You are responsible for their care, and if the social, political, or racial climate of your unit does not allow you to perform at your best physically, psychologically, and emotionally, it’s in your patients’ best interest for you to leave.  

This does not mean that we never fight for change within these units. It's very important to speak up when you notice inequitable practices and then pursue the necessary steps to bring about change. I definitely believe I could have done more (sent more emails, publicly called out the behavior, hired a lawyer, etc.).

But it' s also important to know when you’ve personally had enough and to respect that limit for yourself.  

To non-Black and person of color (POC) readers, I hope this has offered perspective of the experience of the lonely Black nurse on your unit. Many of the aggressions I described could have been prevented if my white “friends” on the unit stood up for what’s right and addressed how I was being treated. 

You can be the difference that keeps an awesome Black nurse on your unit that may otherwise feel they have no hope. Be a true ally, even if it means you may suffer a loss.

Looking to Learn More?

Check out our event series Shift[ing] Forward, that we hosted last July to educate, inspire, and connect nurses. From nursing careers beyond the bedside to tools for anti-racist allyship in healthcare, Shift[ing] Forward is all about bringing the nursing profession forward, together.

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