Provision 9

To effectively promote and advocate for social justice, nurses and professional nursing organizations ought to and must first address the history of racism in nursing, take accountability for ongoing harms, and identify specific, measurable plans for creating more inclusive, diverse, and equitable professional organizations that meet the needs of all people. Dismantling structural racism includes understanding and mitigating the harmful impact of racism, recognizing the devastating challenges of structural racism and the resulting power imbalances, and building inclusive coalitions representative of the public.

Nurses ought to and must condemn all forms of oppression and demonstrate intentional efforts to reflect and act upon social justice issues that influence health outcomes and healthcare equity. Systems of oppression stem from governmental, educational, housing-related, judicial, carceral, and healthcare institutions, among others. These systems contribute to, reinforce, and perpetuate the oppression of socially constructed groups based on their ability, age, ancestry, citizenship, class, health status, housing status, marital status, national origin, primary language, race, religion, or sexual identity. Oppressive systems are often not mutually exclusive, and the concept of intersectionality provides a lens to understand the dynamics within discriminatory practices. Intersectionality underscores the necessity of comprehending the compounding and cumulative effects of these interconnected characteristics, promoting a more comprehensive understanding of the challenges faced by individuals and groups in society. Nurses ought to and must advocate for more inclusive and equitable approaches in healthcare.

Racism, a pernicious force that impacts how people receive and access healthcare, is a public health crisis. Nurses must recognize that racism can impact care through direct discrimination and bias in everyday interactions, as well as through institutional policies and laws that perpetuate systemic racism. To this end, it is imperative that nurses work toward becoming anti-racist. The nursing profession historically lacks an ethical analysis of racism, and moving forward must articulate and center anti-racism and equity as nursing values. Meaningful change requires nursing to recognize racism, not race, as the central force at the core of health disparity, inequity, and injustice.

Nursing ought to engage in ongoing self-reflection and critical self-analysis through a lens of anti-racism, equity, and intersectionality. Self-reflection and centering equity must lead to concrete practical changes in nursing organizations. These changes include the ongoing evaluation and transformation of organizational leadership structures, external checks and balances for organizations, the redistribution of power to reflect equity-centric organizational aims, and the consideration of organizational policies and statements that may unintentionally harm marginalized groups of people.