October 22, 2020

Episode 37: Making your unit safe for nurses of color

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Podcast

Description

2020 has been a pivotal year for discussions about race and many of these important conversations have spilled over into healthcare, forcing those of us who work in this industry to reckon with how we care for patients and how we treat our coworkers of color. 

Our guest for this episode is Ashley Sayles, a pediatric nurse practitioner living and working in Baltimore. Ashley has been very open about her brushes with racism and her experience being the only Black nurse on her unit.

In this conversation, she shares invaluable insights and advice to nurse leaders on how to create more equitable and inclusive workplaces and guidance to nurses who want to be allies for the nurses of color on their units. Ashley also shares how 2020 has been a turning point for her and other Black nurses and the changes she’s witnessed as a result of the growing Black Lives Matter movement.

Links to recommended reading: 

Podcast

Transcript

Dan:
Ashley, welcome to the show.

Ashley:
Thank you so much for having me. I'm so excited to be here.

Dan:
So Ashley, what are you up to right now? What's the project you're working on that's keeping you busy.

Ashley:
I've been working on trying to create a mentorship program online for minority nurses through my business, The ReNegade Resume.

Dan:
What does that look like? Are you using a platform that is in existence, like the Facebook mentoring stuff, or are you building your own? How's that working?

Ashley:
I have no idea. I am currently in the Googling how to mentor people online phase.

Dan:
I love it. No, that's great. I think there's a lot of that needed and there's definitely not a great platform that I know of out there. And so that's awesome, I'm excited to see what you do with that. Have you seen a big need in the market for minority mentoring?

Ashley:
To be honest, I've seen quite the opposite, which is really interesting. I have a lot of, I guess IG colleagues that I have mentoring organizations specifically targeted to Black nurses, but for some reason I have people reaching out to me on Instagram DM asking me to mentor them. And I'm like, "Hey, there's this person and that person who already have a mentorship platform, why don't you use that?" And they're like, "No, we really want to be mentored by you." So I'm like, "Well, let me figure out what it is I can offer you."

Dan:
Well, you must've had a lot of experience in your career, just dealing with different things that you can help coach people through. Specifically, let's go into the content that you wrote for us recently around being the only Black nurse on a unit. How has that shaped experience, and then what tips can you offer to other nurses in this similar situation?

Ashley:
You're definitely right about that. I do think I have a lot to say about that for sure. I know so many other Black nurses that are going through the same thing and it kind of just felt like it was a right of passage. My mom is a nurse and she's been through these things, when I talked to her, she was kind of like, "Yeah, that's how it is." And I'm just like, "Well, that's how it is." And I guess this year with... I'm pretty sure the history textbooks are going to call this a Civil Rights Movement of 2020.

Dan:
Yeah.

Ashley:
I think this year, it just became so much more in the limelight or it became a really big thing where I was just like, "You know what? All of these things that we've kind of accepted as a part of life as a Black person or as a black nurse, it really doesn't have to be this way." And I think it's because we suffer in silence and amongst ourselves so much that we kind of just are like, "Well, that's just the way the world is." And I felt really empowered, yet nervous to write about that because it was something that I went through that I think about all the time and it definitely shaped who I was as a nurse. It really wasn't until this year, and as I said, what's been going on that made me really think this is not cool.

Ashley:
I made it through barely, but there's probably a nurse somewhere who was really struggling and thinks that she's the only one or doesn't have someone to turn to, or they're also may be a non-Black or non-person of color nurse who may see some things like this going on in her unit and just doesn't even know, or doesn't feel empowered to speak up on behalf of someone she calls a friend who's a minority. I felt that given I do have a little platform and Trusted gave me an even bigger platform to speak on, I figured I might as well use it and use it to be real real.

Dan:
Yeah, yeah. Right. Yeah, be real about it and bring it up there. What are some of the experiences that you had that really impacted you and kind of lit that fire for you, that call to action to do something about it?

Ashley:
There's so many. There's so many. When I really kind of got into the social media thing and kind of telling everybody my business online as my mom calls it. I realized that as I shared stories, I got so much feedback from people who are just like, "Oh my gosh, that's happening to me. Or that happens to me. And I didn't even know, or you'd never know looking at you. And you're an NP now and all that, that you would have struggled." I had to take my nurse practitioner boards twice, I failed the first time. I talked about that and I'm like, "Look, it sucks. It happens. I went to the number one nursing school in the country and I still failed the first time."

Ashley:
Don't feel like you're the only one or that you're going to be a bad provider because I definitely did. I shared, and it was in sharing that I realized that there's a community out there of people who looking for someone to kind of help validate their feelings or help them, I guess, see the light at the end of the tunnel because of that. That's really what lit the fire in me to start talking about just anything, any of the adversities we go through in life or adversities I have personally been through.

Ashley:
But as I said with this year, with how everything's been going with race relations and things like that, I really felt that people need to know that we're suffering as Black nurses. And we need our colleagues, especially as I saw a lot more non-people of color talking about it. I'm like, "Well, let me tell you guys what you guys are doing, and you don't even realize you're doing it." There were people who I still follow for my job that were posting all this Black Lives Matter, and this is ridiculous. And I'm like, "You are literally making my life a living hell [inaudible 00:06:51] working, and you are number one activist right now. It's the craziest thing to me." I'm calling everyone out. I'm calling you out because you need to realize that being on social media and posting a black square is not being an ally. And you need to know exactly how you were not an ally so that you can fix this behavior in real life and not just on social media.

Dan:
Yeah, no, that's exactly right. And I think bringing light to the actions that people don't even know they're doing is key.

Ashley:
Yeah.

Dan:
And to have someone, like you said, give it to them real.

Ashley:
Yeah.

Dan:
We almost called this podcast, Give it to me Straight. So I was like [crosstalk 00:07:28].

Ashley:
Yeah, seriously.

Dan:
Don't sugar coat this stuff-

Ashley:
Yeah.

Dan:
... because the more awareness we have about it, the better.

Ashley:
Absolutely.

Dan:
What advice would you give nurse leaders to make sure that they're not letting a unit struggle with these types of issues between racial relations and equity and inclusion? Are there certain tactics that a nurse leader could take to have better team cohesion?

Ashley:
I definitely do. There were a lot of times that I felt like my management and leadership on that unit really, really failed me. First of all, acknowledging that what someone says to you is real, that's the first thing. Don't explain away their concerns, emotions, or even stories of things that have happened, because you're just so appalled at the idea that racism can be happening on your unit. You just got to throw that out the window. You got to throw that feeling of, "Oh my gosh, this can't possibly be happening here." You got to just throw it out and hear what someone's telling you. I definitely went to my nurse manager and said, "Hey, I'm being targeted. I need you to understand that I'm being targeted."

Ashley:
And I came with examples. I came with emails. I felt like I had a case and everything that I had to say there was some, "Oh, well, that's not because," and, "Oh..." And I'm like, "Look, lady, you know how much balls it took for me to come to you with all of this, knowing that it's probably going to get around the whole, it's probably going to make my assignments even worse than they already are. People going to think I'm telling on them, whatever. And I mustered up the courage to talk about it with you, just for you to completely just ignore everything I said and just negated it." And that sucks. And I think that's just the number one first step is acknowledging that this can be happening on your unit and someone can really be feeling this way on your unit.

Dan:
And the courage that it takes to go talk to... If it gets to a point where you have to go talk to them-

Ashley:
Yeah.

Dan:
... and bring this to light, there's a level of courage-

Ashley:
Exactly.

Dan:
... and fear and anxiety and all the other emotions that come with that stress get you in that place, there's something that needs to be addressed. Whether it's a tangible thing and as bad as people say or not, it's worth digging into.

Ashley:
It's definitely worth digging into, definitely. Don't just chalk it up to, "Oh, she's just sensitive or whatever." It's no, this is real. And aside from that is not waiting for that to even happen. I think that's the next thing. Making a conscious effort to make sure that cultural competency is really discussed on your unit. Not just a module You have to click through online in order to qualify for vacation the next year or whatever your facility's role is. It needs to be something that we're constantly talking about. It's coming up in every meeting, there should be specific meetings for it. There should be a diversity committee, just like there's a vacation committee and a events committee and whatever. There should be someone who's really focused or a group of people who are focused on making sure that this stays at the forefront of our minds.

Ashley:
There should be an anonymous Dropbox or someone can say, "Hey, I think we should talk about blah, blah, blah in our meeting or whatever," where there's no pressure on anyone that feels like they're being singled out or anything. And just kind of make sure you it's out there. There's an arena for you to speak. I think just like it's not an accident when a unit has zero falls or zero CLABSI's or whatever the case is. That's not a secret because there's a whole committee, there's research, we're doing all kinds of stuff to make sure.

Ashley:
We have checklists to make sure we're doing everything we can to keep a central line safe. We need to have that same energy when it comes to making sure that your unit is a safe place for Black people or people of color, it takes effort. And the idea of, oh, if we just don't acknowledge race, it's just not going to be a thing is like saying, "Oh, we don't acknowledge bacteria, and then it won't cause infection."

Dan:
Right. Just because you don't believe it doesn't mean it's not there.

Ashley:
Right. It's, "No, we don't even think... It's not there, so no". It doesn't work that way. It has to be acknowledged in order for us to figure out how to keep it at bay, just like anything else.

Dan:
I think that's great advice. And you have to be on the lookout for it. And from a leadership perspective, it's looking for those behaviors, those cues, the way people react to different things, the unspoken, nonverbal indications and things. And I think lot of times leaders don't jump into that stuff. They want to go to the hard data or the outcomes that are like, "Oh, the unit seems fine," but you kind of got to go that layer deeper.

Ashley:
Absolutely, definitely do. I always wanted the nurse manager that I felt completely comfortable coming and talking to. I didn't want to be attacked for feeling the way I feel. When I say that things are happening, it's not even that I attack those individual people. It's just that systems are in place that allowed these people to kind of make me feel crappy. And I think it's important for the leader to listen and say, "Hey, this charge nurse, every time I'm on, she's giving me unsafe assignments. It's unsafe." Aside from it being annoying or whatever the case is, I literally cannot manage this. And I personally feel like I'm getting these assignments so that I am more inclined to fail and give me an option... More ammo behind getting me out of there-

Dan:
Yeah.

Ashley:
... and that's really what it felt like sometimes. And it's like, I'm sorry, but you think of any other possible explanation of why certain things can be happening. You're just like, "No, I'm sorry. I'm looking at everyone else, this doesn't happen to anyone else. It literally only happens to me. And it's only with this charge nurse." What I would want a leader to do is really, I'm not saying storm down there and be like Ashley said... It should be, let me really look at this. I'm going to look at the past assignments sheets and see what kind of assignments Ashley was getting. I'm going to really look into this and see what's going on because that's not cool. And I'm going to have a meeting with all of the charge nurses to say, "Hey, we've noticed patterns in the way that you guys are assigning."

Ashley:
And whether it be is there going to have to be some new process on how we're making assignments or whatever the case is, but there needs to be some system in place to check people who don't even realize, or maybe are 100% doing it on purpose. And I think it just needs to be taken very seriously and taken seriously from the beginning, as soon as you hear it.

Dan:
There's no question about that. As far as... The kind of the last kind of area that we can do some reform in is also in the educational nursing school area. What do you think we could do better in nursing schools to bring light to the stresses that you just talked about and actually kind of build a better cohesive culture of nursing in general?

Ashley:
I think honestly, having these conversations. One thing that they don't really talk about in nursing school is working on a unit or a team with other nurses. It doesn't really come up that often, only when you're doing maybe mock codes or something where you have to deal with multiple people and people are taking roles and things, but we don't really talk about what it is to be a nurse on a unit. Things like burnout, turnover, I didn't hear about those terms until I was working. And I think it's important to talk about that when they... There's always a class about professional role or something, and they're telling you how you can go lobby on the Hill for health care reform and things. I'm like, "That's all great, but let's talk about how we lobby in our units for fair treatment."

Dan:
Yeah, yeah, yeah. Right. And how do we deal with the leader that's horrible and I go home stressed out and crying every day?

Ashley:
Yeah, exactly. And it's not even just about race. There's all kinds of other things, how to make sure you're being treated fairly. How do you know if you're a patient assignment is safe or not? Things like that. As a new nurse, you never really come in wanting to ruffle any feathers, so you kind of just go with the flow and sometimes you learn a lot of really awful habits or tendencies to take care of seven patients when that really shouldn't be or whatever the case.

Ashley:
And I think if you talk about it in nursing school, hey, in these settings, this is what you should expect. And if you don't see this, these are the offices you should look for. You should be looking for if you don't have an HR or nurse recruitment or whatever the case. There should be some type of education about this. Even have nurse leaders or something come and talk about maybe different programs or committees they've put in place on their units to combat certain things or something like that. But I think it definitely needs to be put into the curriculum just how to be a nurse on a unit and work on a team with other nurses.

Dan:
I think that's exactly right. I believe there's a lot of nursing school that doesn't address the realities and that's why new grads come out so... Knowledge wise they're prepared, but working wise, there's just so much nuance to the culture that isn't shared, and I think it leads to these weird behaviors.

Ashley:
Yep.

Dan:
What are some resources for nurses that are going through what you described? I know there's a few associations out there, but what other type of resources, besides your amazing mentorship program that you're building, could nurses use to deal with some of these things?

Ashley:
Honestly, I think social media has been so wonderful. I know for me, at least finding other Black nurses that are doing great things and just kind of reminding me that we don't deserve to be treated the way that we're treated. Sometimes when it's just you, you're just like, "Maybe I am doing something wrong or something." And it kind of reminds you that no, there's a lot of great Black nurses out there and they're all sharing their stories and especially now, it's been such an amazing time to follow Black people on Instagram.

Ashley:
I think that's really great. And as you mentioned, the organizations, I've been a member of the National Black Nurses Association since I was in nursing school. And they're so amazing and I'm so happy they're getting so much recognition now, because there were a ton of Black nurses that didn't even know that thing existed up until-

Dan:
Yeah.

Ashley:
... everything that's been going on and everyone's been donating to them and I'm sure they're like, "What is going on? Why are we getting all this heat?" But yeah, I think that's really great. There's also another page called Black Nurses Rock, that's really cool. They highlight a lot of online programs and mentorship or even little webinars and things that you can kind of listen to other Black nurses, either talk about this topic or any other topic. Honestly, social media has been such a blessing I think. And I think a lot of other Black nurses would agree just to help them realize that they're not in this alone.

Dan:
That's one of the first times I've heard social media being a blessing during the pandemic.

Ashley:
I know.

Dan:
That's positive. That's good. I think there's definitely a lot of negative stuff on social, but you've highlighted some really great places to kind of find people that are going through it and be able to address it, I think, and create that community.

Dan:
As we wrap up here, we like to do one last nugget of information that we share with our listeners called The Handoff. Ashley, what would you like to hand off to our listeners about you and diversity in nursing?

Ashley:
One nugget I think everyone should remember is speak up. Don't be afraid to speak up and no matter what your role in all of this is, if you see something, say something like they say and be teachable. Please, please, please be teachable. A lot of times people think they are experts in something or they know a ton about something and feel that they know too much to learn anything else about it. And anyone that does that is usually sorely mistaken. Please, please be teachable. Be open, be prepared to be bruised a little bit on your ego, but please just be teachable and speak up if you see something that needs to be addressed.

Dan:
Great advice. And I think that is a great handoff and nugget for people to remember, just speak up. It's your job to advocate for everyone on the care team, including your fellow nurses.

Ashley:
Yeah.

Dan:
Ashley, thank you so much for being on the show. We really appreciate it, and we'll post links to all of the awesome work you're up to, and those social groups that you connected with and Trusted is here to amplify the voice. So if we can do anything, please let us know, but really appreciate your time today.

Ashley:
Of course, thanks for having me. Trusted has definitely been awesome. And I didn't mention Trusted, check Trusted's blog out, there's a ton on there too.

Dan:
And written by you, which is great.

Ashley:
That's right.

Dan:
All right. Thanks Ashley.

Dan:
Thank you so much for tuning into The Handoff. If you liked what you heard today, please consider leaving us a review and subscribing on Apple Podcasts or wherever you listen to podcasts. And for more information about Trusted, please visit trustedhealth.com. This is Doctor Nurse Dan, see you next time.

Thank you and welcome to the Trusted Community!
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