Rhode Island Nurse August 2022

Volume 11 | No. 4
The Official Publication of the American Nurses Association Rhode Island
Aug., Sept., Oct. 2022
The Rhode Island Nurse
Quarterly publication sent to 7,000 Registered Nurses and LPNs in Rhode Island
Message from the President
Inside
Excellence in Nursing Awards
Page 3
I am a Nursing
Conference Junkie
Page 4
Annual Meeting Summary
Page 5
Leigh Hubbard, MS, RN
President, ANA-RI
As fall draws near, I tend
to reflect on the precious,
limited time we have over the
summer months, the official
time of vacations, laughter,
togetherness, 5K runs, cookouts,
and camps. Many of
us count the days until the
weather turns and the tee
shirts come out, when the
school buses disappear, and
the stickiness of melting icecream
and salt and sand are endless.
In this profession, many of us have limited time
to enjoy this weather and these moments with our
people due to the ever-present work of healthcare
that must be done. My hope for all of you is that
you did have slivers of time this season to unplug,
to breathe, to enjoy moments of summer fun,
despite the tasks at hand, namely ongoing (now
baseline) COVID-19 patients, the monkeypox
threat, staffing shortages, gun violence, heat
related trauma and illness, to name a few.
More importantly, I hope that, even during the
work times, you were able to name at least one
great moment each day. Perhaps a colleague
acknowledged what an amazing feat it was to
change the complicated dressing, or a family
member provided you with a sincere thank you.
Perhaps you witnessed a kid skip out of the
hospital when discharged or caught an elderly
couple in a loving embrace. Maybe the wind hit
you in the perfect way as you walked to your car
one morning after a long shift, or you were able
to see the lightbulb go off over your mentee’s
head as they learned the critical ‘why’ behind the
task-oriented ‘what.’ These moments don’t need
the summer heat to be found. They can be found
year-round, every day, if we open our eyes and
hearts to see them and to let the sparkle find its
way into our lives.
It’s understandable why we crave calm, and
we are currently tripping over contact hours
about resilience, mindfulness, and work-life
balance, which is so difficult at times to gain
and maintain. A quick review of our history as
a species reveals, however, that we have never
been in a world where calm and peace is the
baseline. As a species we are born screaming,
and we have always lived in a world with virtually
constant threats. Thousands of years ago, it was
the threat of being eaten, starving, or freezing
to death. The threats have changed, but our
genetically coded response to those threats has
not. Our ability to withstand threat, to be resilient
despite danger and uncertainty, comes from our
ability to feel safe and cared for, and from our
ability to recognize and nurture the humanity
and community that surrounds us. It does not
come from one week off, a 90-minute massage,
or always leaving on time, or even getting eight
hours of sleep every night. It does come from
being certain of our place in the world, of our
acceptance by those that surround us, and it
comes from us providing that to others.
What an easy thing to write or to say. It is
much harder to do when we live and work in
places where people are constantly hearing bad
news, coping with medical nightmares, managing
uncertainty, carrying the weight of oppression or
childhood trauma, navigating addiction or chronic
or acute illness, or unsure of where they will sleep
or what they will eat tomorrow. Still, the ANA Code
of Ethics Provision 1 demands that we …practice
with compassion and respect for the inherent
dignity, worth, and unique attributes of every
person. In other words, we make our fellow
humans feel welcomed, included, and like they are
people worthy of our time and care.
As we enter the fall and the manic holiday
season, I challenge you to make it a habit to
consciously identify at least one instance of
humanity and/or inclusion a day (note examples
above) and tell someone about it. AND I
encourage you to provide the world with an
example of humanity for others to witness. This
could be looking a stranger in the eye, smiling,
and saying hello. It could be acknowledging a
new co-worker who seems to be struggling, or it
could be telling your kid or dear friend that you
accept them unconditionally, no matter what. It
could be giving your leftovers to the person sitting
on the corner or letting the minivan turn left at a
busy intersection. It may be acknowledging how
crappy it is to wait to be seen by the provider or
for an important test result. These moments
matter because they validate all involved as
human beings, living in this time, as being worthy
of this effort. For onlookers, these acts of
humanity provide hope that the world, despite the
ever-present, ever-changing stressors and threats,
isn’t all bad and that in you, their RN (or friend,
neighbor, or family member), they can find safety
and trust.
Each season brings with it a flavor that each
may experience differently, depending on our
history. I urge you to consider what unites us and
to invite others into whatever calm or chaos you
call life. Opportunities to connect may not quiet
the storm but in community we find strength and
support to rise to any challenge.

Page 2 • Rhode Island Nurse August, September, October 2022
Welcome Back
It is with pleasure that RISNA (ANA-RI) renews their relationship with ALD Publishing
to present you with our first quarterly digital newsletter. The newsletter will be
published quarterly and will update you on local and national issues that are of
concern to nurses and the nursing profession.
Please let us know what would be of interest to you in upcoming editions.
Email your suggestions and articles of interest to dpolicastro@risna.org.
The Rhode
Island Nurse
The American Nurses Association - Rhode Island
(ANA-RI), a constituent member of the American
Nurses Association (ANA), is the authority on
matters concerning the profession of nursing and
nursing practice in the State of Rhode Island.
Updates from the Executive Director
Executive Director
Donna Policastro, RNP, ED
Donna M. Policastro, RN
Executive Director
After over two years of
isolation and multiple “ZOOM”
meetings; it now seems that
we have returned to some
kind of normalcy. However, we
must still remain vigilant.
So, what has RISNA
(ANA-RI) been up to for
the last two years. Many
members volunteered at
COVID immunization clinics,
volunteered at RIDOH and
staffed our hospitals Covid units and ER’s. Many
nurses took a pause and reprioritized their career
goals and left the profession entirely.
The 2020/21 licensing cycle in RI revealed that
5500 registered nurses did not renew their license.
What will the future look like for nursing care as we
figure out how to replace the nurses that we have lost.
On a positive note, two new baccalaureate
programs have applied to the Board of Nursing
for approval. Providence College will welcome 50
students as will Johnson & Wales University in 2023.
RISNA”s board has been engaged in increasing
networking and education activities for our
members and to attract new members. Please visit
our website at www.risna.org for updates on events.
The board of directors election will occur in late
Fall. Please consider running for a board seat. This
year, we will elect a President, Treasurer, Secretary
and two Directors.
The Legislative session will begin in January 2023.
A Legislative Commission to study the benefits of reentering
the Nurse License Compact will commence in
October 2022. RISNA has a “seat” on the commission
and will provide an update in our next edition.
Until then, enjoy the end of your summer.
Respectfully submitted:
Donna M. Policastro, RN
Executive Director
President
Leigh Hubbard, MS, RN, ONC
Vice-President
Donna McDonald, RN, BSN
Treasurer
Annette Fonteneau, MSN, APRN,
DCNP
Secretary
Julie Ann Greenhalgh
Board of Directors
Joanne Borademos, RN
Jacqueline Insana, MSN, RN,
PMH-BC, NPD-BC
Ara Millette
Sylvia Weber, MSN, RN
Publisher
Rhode Island Nurse is published quarterly every
February, May, August and November by Arthur
L. Davis Publishing Agency, Inc.
For advertising rates and information, please
contact Arthur L. Davis Publishing Agency,
Inc., PO Box 216, Cedar Falls, Iowa 50613,
(800) 626-4081, sales@aldpub.com. ANA-RI
and the Arthur L. Davis Publishing Agency, Inc.
reserve the right to reject any advertisement.
Responsibility for errors in advertising is limited
to corrections in the next issue or refund of price
of advertisement.
Acceptance of advertising does not imply
endorsement or approval by the ANA-RI of
products advertised, the advertisers, or the
claims made. Rejection of an advertisement
does not imply a product offered for advertising
is without merit, or that the manufacturer lacks
integrity, or that this association disapproves of
the product or its use. ANA-RI and the Arthur
L. Davis Publishing Agency, Inc. shall not be
held liable for any consequences resulting from
purchase or use of an advertiser’s product.
Articles appearing in this publication express the
opinions of the authors; they do not necessarily
reflect views of the staff, board, or membership
of ANA-RI or those of the national or local
associations.
American Nurses Association - Rhode Island
1800D Mineral Spring Avenue, PO Box 299
North Providence, Rhode Island 02904
Tel: 401-331-5644 • Fax: 401-331-5646

August, September, October 2022 Rhode Island Nurse • Page 3
RISNA News
Sylvia Weber, RN, MSN, PCNS
Since early childhood I
was always sensitive to my
surroundings and would be
the one who would intervene
when peers would be
aggressive or cruel towards
any living being. This, and
my mothers favorite saying,
“it’s a great life if you don’t
weaken,” was the foundation
for the path I followed and
committed to.
A defining experience occurred when I was six
years old when relatives from Europe, who were
survivors of the Holocaust, came to the United
States and stayed with family until they were able
to create a life here. After I went to bed I would
pretend I was sleeping. I stayed awake because I
wanted to hear them share their experiences. It was
this experience that led me to make a commitment
that as long as I lived I would so something every
day to make this a better world for all, no matter
how small or large it was, a smile, a greeting, a chat,
support, etc. As I followed this path I learned about
many principles/concepts. One is the concept of
innocence, the ability to approach each situation
with “new eyes” while taking into account lessons
previously learned. I also learned that in Western
thought we tend to believe in a beginning and
an end instead of eternity which allows us to be
near sighted rather than look at our impact on all
generations, all of life, present and future.
When the time came for me to explore the
career path I wanted to follow, these and other
experiences, led me to look at professions that
brought compassion, healing and knowledge into
the world to help others. I was drawn to nursing as it
is based on these principles/concepts.
During my career I continued to have
experiences that broadened and expanded my
knowledge of the underlying principles/concepts
that enhanced my life and work. As Dolores
Krieger, RN, PhD said, “think deeply and care
deeply.” This occurred at Pumpkin Hollow Retreat
Center in New York State. It was also there that I
learned a wonderful metaphor that’s an underlying
principle for me, that of the brook: The brook is
always changing and its path is not always smooth.
It comes to rocks and other obstacles to eventually
find a way around or over the obstacle, and it
keeps on flowing.
Equally true is the principle of consciousness.
As James O’Dea stated in an Institute of Noetic
Science publication in the winter of 2008-2009,
“consciousness can be limited and divisive or can
lead to a new humanity, the capacity to heal, to
forgive, to deepen the bonds of friendship and love
and become an integrated whole/oneness.”
My experiences as a nurse also expanded my
view of spirituality. There are many ways people
express their spirituality, organized religion being
one. It includes our relationship with and within the
universe. It’s also our sense of purpose, direction
and why we believe we are here. It’s our feelings
of connectedness with our selves, with others,
with all of life. When we have a clear sense of our
spiritual path, our sense of purpose, and are true
to it, our possibilities are limitless. We understand
that when one door closes, another opens. We
understand that opportunities are not better or
worse, they are different. We understand that we
are more comfortable with the concept of surrender
as not giving up but rather of turning it over from
the physical plane to the spiritual plane while
still doing what’s in our control on the physical
plane. We understand that surrender is letting go
of our attachment to the outcome. It is true that
we may not get what we want and we understand
that we are starting a process of change and of
transformation. The process of our experiences are
as important as the outcome.
As a result, to me, nursing is more than a
profession, it is who we are and how we live and
walk in this world.
have thousands
We
nursing jobs!
of
Find your dream job now.

Page 4 • Rhode Island Nurse August, September, October 2022
I am a Nursing Conference Junkie
Leigh Hubbard, MS, RN
President, ANA-RI
I remember my Nursing
Research course in my
Bachelor’s program at
UMass Dartmouth. It
was a mandatory course
within the curriculum, but
I remember thinking, this
is silly – I want to care for
people, not do research!
I tucked the info from
that course into a corner
of my brain and got to
work. For the first few years I busied myself with
getting into the practice of nursing, refining my
assessment skills, trying not to do harm, learning
how to be a good colleague, and teaching
those coming on after me. As I became more
comfortable with the basics, I felt a tug toward
improving the systems and workplaces that I
was a part of. I remember thinking, what would
happen if we changed this a bit, or refined this
process, or asked nurses about this scenario?
There was a desire to learn what other similar
institutions were doing – how were they handling
staffing deficits and medication errors? How
were they coping with the unexpected death of
a patient? How were other institutions reducing
post-surgical complications or admission rates?
I began using my institution’s library (Because
back then there was an actual place where
nursing journals were sitting on shelves) and
looking for information. It was in the front and
back of those journals I discovered invitations
to attend conferences. Then I remembered my
research class.
I attended my first conference in Boston in
2008. It was an adolescent health conference,
with a track in sexual health, which was the
area of nursing I was practicing at that time. I
paid a few hundred dollars, requested the time
off of work, and took the train from Providence
to Boston. I heard incredible speakers and met
incredible people. I learned of alternative ways to
ask questions in a way that carried less judgment
and would help put my youthful patients at
ease. I learned about assessment tools I hadn’t
seen before, and I learned of up-and-coming
technology and medications that were going to
be emerging in the near future. It was an injection
East Bay Community Action Program (EBCAP) is seeking experienced
Registered Nurses, Nurse Practitioners, and Physician Assistants
to join our agency at various locations. All positions are offering sign-on
bonuses of up to $2,500 for select positions!
We are seeking highly professional and motivated individuals who enjoy
working with clients in a community health setting. Come join our expanding
dynamic multidisciplinary team and provide comprehensive patient care
using a care team model. To learn more about career opportunities,
visit www.ebcap.org/careers or email careers@ebcap.org.
For Full Time Employees Working 30 – 40 hours per week, EBCAP provides
a comprehensive compensation and benefits package that includes heavily
subsidized medical and dental insurance plans (BCBSRI), supplemental
vision insurance, voluntary medical and dependent care flexible spending
accounts, up to 3% company matching 403(b) retirement plan, employer-paid
life insurance & long term disability, generous paid time off that includes
vacation/holidays/personal days/sick time, mileage reimbursement, tuition
reimbursement, opportunities for center-paid training/CEUs, employee
assistance programs, and more!
EBCAP is an equal opportunity/affirmative action employer committed to providing a diverse work environment.
of professionalism, innovation, and inspiration.
As my nursing career evolved, I sought
out conferences and ways to physically
connect with others instead of just reading
a paper and doing a continuing education
quiz. When I met my mentor, the Director of
one of my programs, they shared this tidbit:
“Submit abstracts. You have things that you
are doing that other institutions should know
about. And don’t submit alone – always include
a colleague. We never do anything alone in
nursing.” I thought, no… everyone knows this
stuff. Everyone is doing this. What I’m doing
isn’t special. And also, Writing an abstract is
hard! What if it gets rejected? Ultimately, she
encouraged me to submit a 250 word abstract
about our program’s successful perioperative
transfusion reduction initiative. I logged onto
the website, followed the instructions, wrote
our story, found a few trusted colleagues to
edit and then incorporated their feedback. I hit
the ‘submit’ button and waited two months. I
remember receiving the email informing me that
our abstract was accepted! I was so excited and
also validated in the work we were doing for our
patients – now we would be able to share with
others and potentially positively impact care on a
larger scale!
My institution offered a professional
development benefit, so had I attended, the
conference would have been paid for but the
hotel and flight would have been on me, and I
would have had to take PTO to attend. Because
I had an accepted abstract, however, my
institution was willing to pay for the conference,
hotel, and flight. I was sold. With this
conference I not only got a dose of innovation
and inspiration but I also had the financial
support of my institution. I was tasked with
being an ambassador for our organization and
presenting this great information, but I wasn’t
left to do this on my own. I received help
organizing my presentation, working on timing,
and considering and preparing for questions
the audience may ask. The conference itself
was thrilling, as was presenting to a group of
supportive peers.
I now submit abstracts regularly. Some don’t
get accepted and some do. Some are related to
outcomes and data, and others are related to
nursing collaboration with other disciplines, or
how to manage angry patients, or care for people
who use drugs. More recently I worked with a
systems designer and researcher and submitted
an abstract to the Design Research Society
International conference. It was an entirely
different experience attending a conference
as one of the only healthcare professionals in a
huge room with creatives and designers, many of
whom were designing tech, systems, and policy
for healthcare. I met people who worked for
the United Nations, aiming to reduce antibiotic
resistance in rural India in females with urinary
symptoms, people designing adaptive equipment
Founded in 1971, CODAC is RI’s oldest and largest non-profit, outpatient provider of
treatment for Opioid Use Disorder. With 7 community-based locations, as well as 3
correctional facilities, CODAC is well-positioned to deliver services wherever they are
needed across the state.
CODAC is Hiring for Medication Nurses (LPNs)
We are looking for dedicated nurses who are looking to make a difference in a patient’s
life. Our medication nurses are responsible for dosing patients who are struggling with
opioid addiction, as well as providing support and guidance as they journey to recovery.
We offer a competitive salary, comprehensive benefits and a generous time off package.
Hours are 5am to 2pm, Monday -Friday, and occasional weekends. Flexibility to float
between sites is required. Applicants must have a valid RI Nursing license and be fully
vaccinated against Covid-19.
Check us out at: www.codacinc.org
Interested candidates can contact Jessica Perry at 401-461-5056 or
jperry@codacinc.org
for people who had suffered a stroke, people
designing for wellness and aiming to end stigma
surrounding mental health disorders through a
redesign of algorithms associated with stock
imagery. Fascinating!
I have never been to a conference that I
felt wasn’t worth going to, and the network
of people that I have met have come in handy
long after the closing keynote speaker. From
those relationships, I have hosted nurses from
other hospitals who want to see what we are
doing, and I have visited hospitals and spoken
with nurses who have extended the offer. I’ve
emailed simple questions and received examples
of policies that I’ve used when developing new
programs or researching alternative ways of
doing. I’ve connected my colleagues with my
connections and fostered interstate institutional
collaborations. This, to me, is how great ideas
are spread, when we remove the silo and have
opportunities to connect and learn outside of our
usual four walls.
If you say to yourself, “I don’t have time,
and I don’t have anything to add….,” it’s likely
not true, but that’s okay – just attend. Attend a
regional conference and use that professional
development stipend which is a benefit likely
offered by your employer. Or think about the
things you do, the workarounds or the gaps in
care or practice that you have solved. Talk with
your manager or nurse educator about what it
would take to measure the effects of an action
or to write up the improvement. You may think,
“I don’t know what conference to attend…”
If you subscribe to a journal, seek out their
annual conference or check the ANA website
for upcoming conferences. Google it! Specialty
organizations usually have, at minimum, annual
offerings, but many have local or regional miniconferences
that may be available.
If you think, “I can’t take the time off…” when
planned for (and many of these are scheduled
up to a year in advance), it’s easier to request
the time, and if you let your manager know how
your attendance will improve your practice or the
practice on your unit, then they are likely to work
to support you if possible.
If you are scared to go alone, know that nurses
are pretty good at talking to people and making
others feel welcomed. By getting slightly outside
of your comfort zone, by stretching, you will
grow. Through this personal growth, learning,
and networking, we find common ground,
solutions to problems, and return to our daily
work professionally revitalized. **
Have you been to a conference you found
particularly exciting/valuable?
We would love to hear from you ! Use THIS
LINK and in the Subject: “Conference Junkie”
Happy Conferencing!
Leigh Hubbard’s nursing work includes
Managing a LGBTQ and sexual health clinic,
surgical services, program development
and management, regulatory readiness, and
ambulatory care and management. She has
worked in surgical intensive care, neurosurgery,
oncology, and women’s health. She finds great
joy in smoothing transitions within healthcare
through process improvement and helping to
guide RNs and other healthcare staff members
through unsure, challenging circumstances.
She feels that “professional growth spurts”
abound when a person or team innovate and find
connection.
Leigh Hubbard is also the President of the
American Nurses Association in Rhode Island
and the Strategic Design Fellow at RISD Center
for Complexity. She is a founding member of
Mainstay RI, a small think tank dedicated to
opioid overdose care redesign. She is an active
member of Grace Episcopal Church in Downtown
Providence, where she sings soprano in the choir
with her two children.

August, September, October 2022 Rhode Island Nurse • Page 5
ANA-RI Annual Meeting Summary

Page 6 • Rhode Island Nurse August, September, October 2022
GOVERNANCE Column
Inspiring Words from RISNA Governance Chair,
Joanne Borodemos, RN
Nursing Politics 101: Public Opinion is On Our Side
Current Professional Nursing Issues are more
complex than just “staffing ratios” and we need
local Legislative and policy solutions immediately to
correct them. Our role as a patient advocate and our
ethical code demand that public policy formulation
is part of our work. Nurses must produce and lobby
for these laws and policies as the role of nursing has
been compromised in every setting and our patients
need us. No knight in shining armor is coming to
save us from the evil profiteers.
“Health Care Delivery systems are held together,
and enabled to function by the nurses”
– Lewis Thomas
“America’s Nurses are the beating heart of our
medical system “ – Barack Obama
“Nurses are ranked the most trusted profession 20
years in a row” – Gallup poll
Once upon a time, nurses simply went wherever
we were needed without interference – the
battlefield, the homes, the schools, the factories.
The hospitals were staffed exclusively by nurses and
physicians. We were highly regarded, respected and
appreciated. The need for nursing care, comfort and
support, teaching, and patient advocacy has not
waivered. Our social contract with our patients and
communities still stands!!
What has changed, is that somehow the
corporate world we live in now has had the
audacity to move nurses to the “cost side” of
the equation and corporate CEOs and insurance
companies have an incentive to cut back on nursing
services everywhere to save money for them, even
though there would be no revenues for hospitals
at all without us. At the same time they hold us
hostage to corporate priorities based on surveys
and consumerism and more aggravation. They
constantly interfere with our responsibilities, but we
do our job in spite of them. We know this cannot go
on.
Nurses, for example, once served an important
role in physician offices. The nurse triaged patient
phone calls and concerns. The nurse was a second
pair of eyes and ears, did the much needed patient
teaching, provided support and comfort to the
patient and families, made follow-up phone calls
to check on the patient, provided referral to other
services when needed, and as always watched
and advocated for the patients. Everyone working
in the physician office now is there for billing
purposes. They will schedule you the “first available”
appointment in two months or send you to the ER to
sit and wait for seven hours or three days…
Healthcare has become chaotic, fragmented,
inadequate and increasingly unsafe, and people
are dying because of these unchecked changes
imposed on nurses and healthcare. It is a miracle
that some survive this obstacle course.
No longer protected or empowered by Common
Law and tradition, we require legislation now to
codify and protect the role of nurses in healthcare.
The law must guarantee our independence,
authority, autonomy and self-direction as a
profession. We must be able to practice at our full
potential.
Our political voice in our state must become
louder. We must increase our solidarity and our
visibility or nothing will change. RISNA represents
all nurses in our state. Unions cannot address all the
complexities of our profession, and not all nurses
belong to a union. We are in the process of writing
critical legislation for the next session of the general
assembly.
We also have our own RISNA Political Action
Committee for local politics. Let’s fire it up! The PAC
can donate to local political candidates who support
nurses. We can also use the PAC as our collective
voice to issue opinions and speak out publicly,
endorse candidates and support causes that nurses
believe in, or oppose those we strongly do not
support. We can have a powerful voice because the
people trust us and need us to take care of them.
Public opinion is behind us.
Ideally we encourage membership to ANA-RI, if
you cannot do that, please at least join our RISNA
PAC. A donation of 10 dollars or more to the PAC
will also connect you to the RISNA PAC newsletter
which will focus on state candidates, issues and
legislation pertaining to Nursing and Healthcare
in our state. We will also update you on our critical
upcoming legislative projects regarding nurse
practice through this newsletter.
I would love to speak to any RI Nurses who have
ideas, questions or would like to be more involved.
Please email JoanneBorodmos@gmail.com so we
can connect. Nursing is a team sport!
Please consider joining your professional association
and donating to our PAC; just go to www.risna.org!
2022 ANA Membership Assembly
Thundermist Health Center is a federally qualified
community health center in Rhode Island. The health center
serves three communities with locations in Woonsocket,
West Warwick, and South County. Thundermist has been
improving the health of patients and communities for more
than 50 years.
We are accepting applications for the following
nursing positions:
• Nurse Manager
• Registered Nurse
• Nurse Care Manager
Learn more about these positions at https://us62e2.
dayforcehcm.com/CandidatePortal/en-US/THUNDERMIST
Thundermist is dedicated to the goal of building and maintaining a
diverse and inclusive workforce committed to caring for patients in a
manner that is respectful of cultural difference.
Donna McDonald, Vice President of ANA-RI
with Senator Jack Reed (D)

August, September, October 2022 Rhode Island Nurse • Page 7
Opening
This is a journey.
Throughout our history, the American Nurses
Association (ANA) has sought to lead nursing
into the future. Through acts of omission, when
we failed to act, and commission, when ANA’s
actions negatively impacted nurses of color, we
have caused harm and perpetuated systemic
racism. This statement serves as a starting
point for a journey during which we seek to
acknowledge past actions that continue to impact
the profession today and as a starting point of a
new journey toward the future.
ANA begins this journey in conjunction with the
efforts undertaken by the National Commission
to Address Racism in Nursing (the Commission).
This statement focuses on ANA’s own actions,
while the Commission seeks to address racism
in nursing within the broader profession.
We recognize that as a leader, ANA holds
accountabilities at both the organizational and the
broader professional level. Through both efforts,
we are striving for a more inclusive, diverse, and
equitable professional organization and a nursing
profession that meets the needs of all people.
Our intention with this statement is to publicly
identify and acknowledge our past actions
while addressing the harms that continue today.
The section on ANA Reckoning is not meant
to be a complete listing of all ANA actions that
have caused harm. Historical exclusions of
and transgressions against Black nurses will
be discussed in this document. This harm has
undoubtedly extended to all nurses of color. In
addition, there is much debate about labels and
terms to identify racialized minorities. We have
chosen to use the term “nurses of color” to reflect
all nurses representing race and ethnic groups. It
is our intention to be fully inclusive in the use of
this language.
In the end, it is our actions that will truly reflect
the sincerity of this apology and serve as the
underpinning for forgiveness. For it is forgiveness
that we seek — forgiveness from nurses of color,
the nursing profession and the communities that
have been harmed by our actions. We fervently
hope that this statement, its subsequent work
and the efforts of the Commission will contribute
to healing — individual healing for nurses,
reconciliation with the ethnic-minority nurse
associations and healing of the profession.
ANA wants this statement to reflect genuine
reconciliation and acknowledgment and hopes
that it is a step toward forgiveness. Ultimately, we
seek to contribute to the healing of nursing.
ANA Reckoning
There is much that can be said about ANA’s
history and failure to include and represent
the views and needs of nurses of color. The
examples below are not to be considered as a
complete reckoning of ANA’s past, but they are
representative of times and actions when ANA
failed.
To begin, we must acknowledge that from
1916 until 1964, ANA purposefully, systemically
and systematically excluded Black nurses.
ANA’s predecessor organization, the Nurses’
Associated Alumnae of the United States and
Canada, was open to alumnae associations of
schools of nursing, including Black hospitals and
nurse training schools (Hine, 1989). The Nurses’
Associated Alumnae became the American
Nurses Association, and in 1916, the membership
rules shifted away from an alumnae-based
membership to that of a state- and districtbased
membership. This resulted in Black nurses
being denied membership in some state nurses
associations. Despite significant advocacy and
pressure from the National Association of Colored
Graduate Nurses (NACGN), this discrimination
persisted. In 1946, the ANA House of Delegates
voted to adopt a statement that urged the
“removal, as rapidly as possible, of barriers that
prevent the full employment and professional
development of nurses belonging to minority
racial groups” (Carnegie, 1991, p. 76). And in
1948, the ANA House of Delegates established
ANA’s Racial Reckoning Statement
an “Individual Membership Category” that was
open to all nurses who were not accepted through
a state or district association. However, it was
not until 1964 that a final district in Louisiana
dropped its discriminatory rule for membership
(Carnegie, 1991). This timeline reflects the failure
of ANA leaders to aggressively pursue changes
in its discriminatory membership rules and allow
for full membership regardless of race. While
membership within ANA was hard fought by
NACGN, the full inclusion of Black nurses within
ANA leadership and decision-making remains
unrealized and elusive for all nurses of color.
One representative incident from 1939 involved
Estelle Massey Riddle Osborne, president of
NACGN from 1934-1939. In 1939, President
Osborne was invited by ANA President Julia C.
Stimson to meet with ANA’s Advisory Council
to discuss the status of Black nurses in the
profession. The site of the meeting was the St.
Charles Hotel in New Orleans, where Black guests
were required to use the service entrance and
freight elevator. President Osborne called on
ANA and President Stimson to adamantly protest
this discrimination. Instead of protesting the
discriminatory policy, President Stimson offered
to enter the hotel with President Osborne through
the service entrance. In the end, President
Osborne decided against attending and ANA
failed to step into a space of advocacy and
support (Hine, 1989).
President Osborne was the first Black nurse to
earn a master’s degree in the U.S. and became the
first Black nurse elected to the ANA board in 1948.
However, after her four- year term, there were no
Black nurses elected to the board again until 1970
(Carnegie, 1991). This lack of representation on the
policy level for 22 years concerned many Black
nurses, and when it was brought up at ANA’s 1972
convention, it was communicated that the only
obligation of ANA from the dissolution of NACGN
was the awarding of the Mary Mahoney Award.
In 1965, ANA approved a position paper on
nursing education that recommended the minimum
preparation for “beginning professional nursing
practice should be a baccalaureate degree” (ANA,
1976). The stated rationale for this change was
the increasing complexity of nursing activities and
patient care. One result of ANA taking this position
was the disenfranchisement of institutions and
schools of nursing that were available to students
of color and the exclusion of nurses who graduated
from those programs. ANA sought to advance
the educational level of nurses without ensuring
that all nurses would have the same access to
the education necessary to achieve the desired
educational level for entry into the profession.
There continues to be a need to examine how
this policy advances nursing today and to
examine strategies for ensuring that educational
opportunities are equally available to all students,
especially students of color.
In 1970, Dr. Lauranne Sams organized a meeting
with 200 Black nurses for the primary purpose of
organizing a Black nurse association. The group
reported the following concerns (Carnegie, 1991):
1. Concern over the absence of Black nurses in
leadership positions at ANA.
2. Limited opportunities for Black nurses to
support and shape ANA policies.
3. Persistent tokenism.
4. Limited recognition of Black nurses’
contributions to the profession.
5. Lack of significant increases in the number of
Black registered nurses.
6. No recognition of achievement with awards
(other than the Mary Mahoney Award).
7. Limited appointments of Black nurses to
committees and commissions.
In 1973, in her first address to the newly
created National Black Nurses Association
(NBNA), Dr. Sams considered the question of why
a Black Nurses Association was needed:
“No, I am speaking about all the past deficits
and discriminatory practice which have
continuously disgraced and limited the full
potential, the development, the selfhood,
and the self determination of Black folk. I am
speaking about today, Here and Now.”
In telling the history of the formation of the
NBNA, the article From Invisibility to Blackness:
The Story of the National Black Nurses’
Association by Gloria R. Smith notes that there
was a desire on the part of the Nurses’ Associated
Alumnae of the United States and Canada and
ANA for Black nurses to be members, but these
professional associations granted them few
privileges “other than paying dues” (1975, p. 225).
Although by 1964 there were no tangible rules
preventing membership for nurses of color, it
was evident that exclusionary practices and a
failure to represent all nurses remained. Similar
to the concerns raised by Black nurses, in 1974,
led by Dr. Ildaura Murillo- Rhode, a group of 12
Hispanic nurses who were also members of ANA
came together to consider establishing a Hispanic
Nurses Caucus within ANA because “ANA was not
being responsive to the needs of Hispanic nurses”
(National Association of Hispanic Nurses, 2022).
Ultimately, this core group and their organizing
efforts led to the establishment of the National
Association of Hispanic Nurses (NAHN). Today,
“NAHN members advocate, educate, volunteer,
seek partnerships, and conduct programming
in the Latino community to improve outcomes,
elevate literacy, heighten education, and influence
policy. We also work collaboratively with others
to improve health equity and to create a future in
which everyone regardless of race or ethnicity has
opportunities to be healthy.”
ANA recognizes that issues of racism persist
today and continue to harm nurses of color.
Findings from the Commission’s 2021 national
survey on racism in nursing (n = 5,600) noted
that racist acts are principally perpetrated by
colleagues and those in positions of power. Over
half of nurses surveyed (63%) said they had
personally experienced an act of racism in the
workplace with the transgressors being either
a peer (66%) or a manager or supervisor (60%).
Fifty-six percent of respondents also noted that
racism in the workplace has negatively impacted
their professional well-being. During listening
sessions with nurses of color convened by
ANA and the Commission, persistent themes of
stereotyping, prejudice, discrimination, exclusion,
oppression, tokenism, inequity, and insistence
on conformity and assimilation were found
(National Commission, 2021). The impact of these
experiences is demoralization, exhaustion, spirit
murder (murder of the soul), invisible workload,
silence, invisibility and self-doubt.
“The power in nursing is primarily held by middleage
to old-age white women who have just
recently begun to consider racism in nursing care.
There are racist principles that have been carried
down through history and never challenged.”
(Anonymous Quote, National Commission to
Address Racism in Nursing, 2021)
Seeking Forgiveness
As leaders of ANA, we apologize for the
named and the unaccounted-for harms. Our past
actions have caused irreparable physiological,
psychological and socioeconomic harm, not only
to nurses of color but to all patients, families and
communities that depend on ANA as the national
leader of the nursing profession. We failed to live
up to the professional values established through
the Code of Ethics for Nurses (ANA, 2015) and
our social contract that guides the relationship
between the nursing profession and society
and their reciprocal expectations (ANA, 2010).
In addition, as ANA sought to “professionalize”
nursing, we failed to support a robust education
approach that included the appropriate
preparation to care for ALL our patients,
especially patients of color.
More specifically, we apologize to all nurses
of color. Not only is the profession richer for your
Racial Reckoning Statement continued on page 8

Page 8 • Rhode Island Nurse August, September, October 2022
Racial Reckoning Statement continued from page 7
having persisted, but the people you cared for
and continue to care for today have been better
served. ANA failed to uphold your work and
support you as you advanced in nursing and
worked to improve the profession. Having failed
you, ANA also failed in supporting and caring
for communities of color and other marginalized
people.
We apologize to the ethnic-minority nurse
associations that have ably represented the
needs of their nurses and communities. Early
in the profession’s history, there was a stated
desire for one association to meet the needs of all
nurses. ANA only represented the needs of some
nurses and some patients. Nurse leaders of color
stepped into the breach. ANA’s failure to lead
resulted in a fragmentation of the profession that
contributed to a fragmentation in nursing care for
minoritized communities.
Moving Forward
As important as it is to reconcile ANA’s history,
our path points toward the future and actions
that should be taken as a means of holding ANA
accountable, continuing reconciliation to repair
the breach and becoming a restored association.
Each of the actions below will lead to additional
actions and efforts as ANA continues the journey.
Therefore, the ANA Board of Directors will:
• Continue to reckon with and apologize for
past harms that are made known to ANA.
• Engage in direct reconciliation with each of
the ethnic-minority nurse associations.
• Develop and implement a diversity, equity
and inclusion impact analysis that is
considered in all policies and positions of the
association.
• Initiate an oral history project dedicated to
amplifying the contributions by nurses of
color to ANA and the nursing professions.
Therefore, the American Nurses Association
will:
• Continue to serve as a partner in and
support the National Commission to
Address Racism in Nursing as it strives
to create antiracist practices and
environments.
• Advocate for and follow established
guidance on the reporting of race and
ethnicity in professional journals and
publications.
• Advocate for appropriate representation and
inclusion in textbooks and other educational
material.
• Actively engage in a program of diversity,
equity and inclusion within the association.
• Provide transparency into the race and
ethnic makeup of the ANA Board of
Directors, leadership and staff.
• Deliberately work to build diversity within
ANA’s volunteer and governance structure.
Conclusion
We, as ANA, are on a journey — a journey of
reckoning and reconciliation, forgiveness, and
healing. This journey will take some time, but it
is one that ANA is fully committed to. We invite
others to join us as ANA seeks to strengthen
who we are as a professional association and
the broader nursing profession through inclusion,
diversity and equity as we strive for antiracist
nursing practices and environments.
“As nurses we need to unlearn much of what
we thought we knew about racism — and get
comfortable being uncomfortable about our
profession and our own way of being — need
to see nursing through a new lens and be
open to what we might see versus stating that
racism does not exist.”
(Anonymous Quote, National Commission to
Address Racism in Nursing, 2021)
References
American Nurses Association. (2015). Code of ethics
for nurses with interpretive statements. American
Nurses Association.
American Nurses Association. (2010). Nursing’s social
policy statement: The essence of the profession.
American Nurses Association.
American Nurses Association. (1976). One strong
voice: The story of the American Nurses
Association. American Nurses Association.
Carnegie, M.E. (1991). The path we tread: Blacks in
nursing, 1854-1990. National League for Nursing
Press.
Hine, D.C. (1989). Black women in white: Racial
conflict and cooperation in the nursing
profession 1890–1950. Indiana University Press.
National Association of Hispanic Nurses. (2021).
History. https://www.nahnnet.org/history.
National Commission to Address Racism in Nursing.
(2021). Defining Racism. final-defining-racismjune-2021.pdf
(nursingworld.org).
National Commission to Address Racism in Nursing.
(2021). Summary Report: Listening Sessions
on Racism in Nursing. final-racism-in-nursinglistening-session-report-june-2021.pdf
(nursingworld.org).
National Commission to Address Racism in Nursing.
(2022). Survey Shows Substantial Racism in
Nursing. (nursingworld.org).
Sams, L. (1973, September). Presidential Address.
National Black Nurses Association. Cleveland;
Ohio.
Smith, G.R. (1975). From invisibility to blackness: The
story of the National Black Nurses Association.
Nursing Outlook, 23(4), 225-229.

August, September, October 2022 Rhode Island Nurse • Page 9