Racism isn't something that happens "somewhere else." Mindfulness educators and social workers Trinh Mai and Jean Whitlock facilitated an interracial dialogue on talking about race and racism to learn from local lived experiences. Here they share a scenario reflecting common dynamics and give recommendations for a compassionate and constructive response.
Trinh Mai and Jean Whitlock
Aug. 27, 2020
Article Advisors
Special thanks to the following advisors who participated in the dialogue and contributed to this article:
Mary-Jean (Gigi) Austria, Nurse Manager, HCI Clinical Staff Education
Kino Hurtado, Graduate Research Assistant, Educational Research and Policy
Dawnyle Kelley, Informatics Pharmicist, IT Services
Katie Stiel, Graduate Medical Education Wellness Coordinator
Learning from our lived experiences
Racism isn't something that happens "somewhere else." It happens right here, every day, in the halls of our hospitals and clinics, within the confines of our academic departments and throughout the research enterprise. It is sometimes inflicted by strangers, but more often by well-intentioned colleagues.
Scenario #1: A bedside nurse's experience of racism
I left with a knot in my gut
I walked in the door and greeted my patient; she returned my smile. I introduced myself as her nurse for the day shift. Her smile quickly shifted. She asked me, "You're an RN? How much experience do you have? Where did you go to school?" I felt awkward but answered her barrage of questions and tried to reassure her of my qualifications and intentions to provide her the care she deserves. After completing my tasks, I left her room with a knot in my gut. Did she question me because I am a Black woman? Did she question me because I look young? But there are many nurses that are younger than I am on this unit. At mid-shift, the charge nurse informed me that she is reassigning another nurse to this patient; the family had made the request stating that it just wasn't a good fit. I felt sick to my stomach. I started to wonder if I even belong in this profession.
The pain feels so raw right now
This wasn't the first time I'd experienced something like this, and I've just blown it off. This time, however, it stuck with me. I couldn't sleep for the next few days because I could not stop thinking about it: I don't want to stay silent anymore. I can't after the murders of George Floyd, Breonna Taylor and Ahmaud Arbery and so many others. Who do I tell? I'm not sure my supervisor would understand. My colleagues that I usually work with are also White, and I don't know where people stand. And what can they do about it? The culture of our hospital is patients come first. This feels so raw right now; I don't want to get upset in front of them and be seen as the angry Black woman. I really don't want this to happen to someone else, so I decided to say something.
Further Reading
"3 Steps to Healing and Resistance in the Face of Racism"
By Trinh Mai
"How to Practice Self-compassion for Resilience and Well-being"
By Jean Whitlock, Trinh Mai, Megan Call, and Jake Van Epps
The floodgates open
I scheduled an appointment with my supervisor and tried to report the incident as rationally as I could, but I could not stop the tears. It was like the flood gates opened from all those years of repressing these types of incidents from patients and colleagues. My supervisor expressed that she was there to support me. But then she said I wasn't alone, that White nurses also get dismissed by their patients. She said that patients usually do not have malicious intentions; they are stressed and fearful and take it out on the nurses. Unfortunately, this is part of our job.
Scenario #2: Her supervisor's response
I didn't know what to say
One of my staff came to me today. I work hard to be available for staff to express their concerns. I'm not aware of anything for this nurse, other than a patient's family requesting a different nurse over her. That happens a lot. Patients get connected to different caregivers for all kinds of reasons. I welcomed her in, and she began crying. She told me she hadn't slept. She said she couldn't help but feel that the patient had asked for the change because she was Black. I felt my stomach flip. I didn't know what to say. She is clearly upset. She is usually even-keel, not very emotional. There is a part of me that accepts that what she is saying is true because I have experienced similar discrimination as a woman working in health care, but I'm anxious to go down that path.
Sometimes patients are just difficult
There is so much going on already with COVID-19. I don't have the bandwidth to tackle racism too. I told her I am here for her, that she can always talk to me. I told her she is a good nurse and this patient doesn't change the way we see her performance, that this happens to everyone. Sometimes patients are just difficult. It's our job to help them feel comfortable when we give them care. I said I was sorry this woman took it out on her.
Common dynamics
Many BIPOC experience the painful impact of microaggressions and other forms of racial trauma and receive limited systemic support. They often also carry the burden of proving and solving their own case. If they share it with White colleagues and supervisors, they might be met with the following responses, that despite good intentions, leave the wound uncared for:
|
Common Reactions |
Common Responses |
|
Invalidation and minimization of impact |
· "This happens to everyone. Don't let this ruin your day." · You're tough. I know you'll get through this. · Don't think about it anymore. |
|
Disbelief that it's racism; asking a lot of questions |
· "Do you really think it was about race?" · "I'm sure they were stressed, and you just happened to be there." · "How did you approach them?" · "Did you say something that could have been misinterpreted?" |
|
Highlighting of innocent intentions |
· "I'm sorry you feel that way; I don't think that was their intention." · "Remember, they're sick. They aren't at their best." · "He cares about his staff; I'm sure he is not intentionally ignoring you." |
|
Rush to problem solving |
· "You can always contact Human Resources or OEO if you feel like you are being discriminated against." · "What do you want me to do about it?" |
|
Defending the status quo |
· "They're just old. Sometimes those attitudes are generational." |
|
Personal defensiveness; need for reassurance from the fear of being seen as racist |
· "I just want to get different sides of the story, but I believe you; you know I'm on your side and I'm not a racist, right?" |
How to respond with compassion
We have adapted the three elements of self-compassion: mindfulness, common humanity, and self-kindness, as a framework for fostering compassionate intention and response. Adapt this practice for yourself to care for your own feelings, whether they be anxiety, insecurity, resistance, anger, or shame. Though the threat varies significantly, racism impacts all of us. When you can meet your own suffering with care, you are better able to show up for the suffering of others. Then adapt these same steps to respond to your staff with compassion when they're sharing about racism.
- Mindfulness
|
Intention |
Response |
|
Pause before you speak - take a moment to just breathe Think about what emotion you're feeling right now: anxiety, insecurity, resistance, anger, shame? |
· Make a mental note and name the emotion you are feeling before responding. · Ask yourself, what is needed now? |
|
Acknowledge and validate Use words that validate the hurt your colleague is experiencing. |
· "You are upset and have reason to be. I'm sorry you had to go through that." · "It sounds like implicit bias and racism." · "This is a hard issue to bring up. I appreciate you trusting me with your anger and sadness." |
|
Ask questions to learn more From a place of care and curiosity, rather than to disprove or contradict. · White people and BIPOC live different racial realities, thus it may be hard to believe something you have not experienced personally. · Notice if your first reaction is to rule out racism and ask why. |
· "This is the first time we're talking about it, but I'm betting you've had to deal with this before on your own." · "What was it about today that made you decide to talk about it?" · "Who do you normally turn to when something like this happens at work or otherwise?" · "If you are up for it now, could you please tell me more about what happened?" · "Can I ask you some questions to help me better understand the situation and know how to support you?" |
- Common humanity
|
Intention |
Response |
|
Let them know they are not alone This is an act of shared humanity. Express your ongoing support. |
· "I'm here to support you. We will explore how to respond together." · "You're not alone. I have heard this from other BIPOC nurses before." |
- Kindness and compassion
|
Intention |
Response |
|
Show your desire to help Offer appropriate and genuine words of affirmation and encouragement. Identify next steps or a plan of action. |
· "This does not change how I see your performance; you are an excellent nurse and a valuable member of this team." · "I'll protect your confidentiality and look into what resources are available to help." · " I will look into how we can better protect our staff from these racist incidents." |
Compassion means a desire to alleviate suffering
Often well-meaning intentions have a negative impact. Responding with compassion means identifying how you can appropriately support your colleague or supervisee. What is within your role and how can you use your privilege and power? Protect the individual's confidentiality and seek resources as needed. If it is within your role to gather more information and problem solve, how can you do this in a way that centers the people most impacted, that doesn't easily dismiss racism and protect the status quo?
By investing time and other resources to offer continued support, advocacy and education, you can support healing and prevent future incidents.
Resources
U of U Health Resiliency Center provides a host of general well-being resources, tailored individual and group services, as well as facilitates crisis response services.
- Individual Consults— receive support from allies and BIPOC therapists. Referrals to BIPOC therapists in the community also available.
- COVID-19 Well-being Resourceswebpage provides quick contact and a comprehensive list of resources available right now to U of U Health employees.
- BIPOC U of U Health Employee Resourceswebpage provides a comprehensive list of resources and support services for U of U employees who identify as Black, Indigenous, and People of Color.
- Anti-Racism Resources for U of U Healthwebpage provides anti-racism resources for individuals and teams to actively commit to eradicating bias and racism to promote the well-being of all people.
The U of U Health Office of Health Equity, Diversity and Inclusion provides programs and resources as well as ongoing activities and events that promote an inclusive climate.
The Office of Equal Opportunity, Affirmative Action and Title IX (OEO) exists to ensure a fair and equitable environment for all to pursue their academic and professional endeavors. OEO provides training for faculty, staff and students that can be customized to meet specific team needs. Contact OEO if you need to file a report of discrimination.
Learn more about mindfulness and compassion. Workshops offered by the Resiliency Center and Wellness and Integrative Health:
- Self-Compassion for BIPOC: Healing in Community, 9/10, 8:30am-12 pm
- Everyday Mindfulness Outside, begins 9/3
- Mindfulness in Medicine: Enhancing Quality of Care, Quality of Caring, and Resilience, first course begins 9/24
CONTRIBUTORS
Trinh Mai
LCSW, Mindfulness Educator & Social Worker with the Resiliency Center & Wellness & Integrative Health, University of Utah Health
Megan Jean Whitlock
Licensed Clinical Social Worker, Resiliency Center, University of Utah Health