Race and Racism Discourse in U.S. Nursing

Challenging the Silence

Kechinyere C. Iheduru-Anderson, DNP, RN, CNE, CWCN; Monika M. Wahi, MPH, CPH


Online J Issues Nurs. 2022;27(1) 

In This Article

Abstract and Introduction


Racism has historically been entrenched in both nursing and nursing education in the United States, despite deliberate efforts to raise awareness about how racism can cause health disparities in ethnic minority patients. To date, approaches to racism in nursing have followed Leininger's Theory of Nursing, and have focused on teaching cultural competence skills. This has had the unintended consequence of discouraging discourse about racism in nursing through white silence, and whiteness and colorblindness ideology. This article considers nursing in the United States and aims to deconstruct how language to address racism in nursing has been used historically; explain why using this language has not been successful; and describe innovative approaches to racial discourse to directly address racism in healthcare and nursing education. We offer implications for practice and education, proposing instead to teach skills in norm-critical thinking and discourse to nurse faculty and nursing students, eventually empowering the entire profession of nursing with skills to identify institutionalized racism, engage in discourse about it, and dismantle it.


Like many Western countries, the United States (U.S.) struggles with both overt and structural racism embedded throughout its governmental, business, and social systems (Iheduru-Anderson & Wahi, 2020). The profession of nursing in the United States is not spared from racism, largely due to its historical entanglement with colonialism, and enslavement of Africans who were brought against their will to the country (Esenwa et al., 2018; Waite & Nardi, 2019). Ethnic minority (EM) nurses, especially those who are indigenous peoples or immigrants from predominantly black African countries, face racism in U.S. practice settings, and EM nursing students and faculty experience racism in academia (Ezeonwu, 2019; Iheduru-Anderson & Wahi, 2018; Jose, 2011; Scherer et al., 2019; Waite & Nardi, 2019; White, 2018).