Commentary

The Emergency Nurses Association Advances Anti-Racism “To Be a DEI Leader in Healthcare”

  • By Do No Harm Staff
  • April 22, 2023

The Emergency Nurses Association (ENA) is doing its part to align with the DEI and anti-racism narrative and is seeking the buy-in of its membership “to be a DEI leader in healthcare.”

Last fall, the ENA engaged Nonprofit HR’s “Equity, Diversity, Inclusion, and Justice” team to survey its members and staff to determine the current state of DEI at the organization. ENA sought to use that information “to outline a strong roadmap for the future.” What does that roadmap look like at the ENA?

The Diversity, Equity, and Inclusion in Action page lists three goals of the organization’s DEI initiatives. “Guide the profession to become better providers,” the first goal says, “through greater awareness and understanding of structural and social determinant [sic] of health, including racism and other forms of bias.” Anna Valdez, chair of the ENA DEI Committee, recommends one of her “favorite resources” for nurses: Overdue Reckoning on Racism in Nursing. This group’s Principles of Reckoning “take a bold anti-racist stand for nursing.” These principles include:

  • We commit to challenging, resisting, and ending the voices and actions that sustain white privilege.
  • We seek to nurture authentic anti-racist awareness.
  • We will inspire and nurture action, as we boldly claim an anti-racist identity for nursing.
Figure 1. From “ENA Connection,” Jan/Feb 2023 print edition.

Do these “principles” reflect the values of the ENA? More resources on its website demonstrate similar messaging. More “staff recommendations” include the American Medical Association’s (AMA) publication titled Advancing Health Equity: A Guide to Language, Narrative, and Concepts; the World Professional Association for Transgender Health (WPATH) version 8 standards of care; and the 1989 essay titled White Privilege: Unpacking the Invisible Knapsack. Multiple webinars on structural racism and DEI-related topics are available, and the Antiracism Resources for Nurses list recommends Ibram Kendi’s book “How to Be an Antiracist.” Kendi advises that “the only remedy to past discrimination is present discrimination. The only remedy to present discrimination is future discrimination.” How does that align with the “culture and climate of mutual respect” and “welcoming environment” the ENA’s DEI Vision Statement proclaims?

The DEI and anti-racism resources are plentiful on the ENA website. Glossaries borrowed from Harvard and the University of Missouri provide definitions for terms such as:

Additional DEI resources are available to members, but the ENA wants even more. “Wherever you are in your DEI journey,” ENA wants to know about additional content that nurses want to share.

Figure 2. ENA survey from the “Diversity, Equity, and Inclusion in Action” page.

What would the implementation of DEI look like in the emergency department (ED)? Suppose two patients come in at the same time: one with a broken arm and one with a heart attack. If the first patient has darker skin, will he or she be taken care of sooner, even though the second patient has a more serious condition? How did the ENA conclude that nursing must claim an “anti-racist identity?” Did ED nurses previously push black patients to the end of the line because of “white privilege,” creating disparities in their health outcomes? If there is a wait for an x-ray, will patients belonging to a particular racial group be moved to the head of the line? Who will be the arbitrator of such race-based approaches? A slippery slope indeed.

It’s disappointing to see the ENA taking this path, as it has traditionally been a reliable resource for emergency nurses who seek specialty certification and completion of vital courses in trauma and pediatric patient care. Division and identity politics have no place in this profession, and certainly not in the ED. Front-line nurses are taking care of patients who may be experiencing their worst day, and who may be frightened and vulnerable. They deserve to be addressed as individuals with unique needs instead of being seen as a member of a particular group.

We call on the ENA to continue its mission “to advance excellence in emergency nursing” and abandon the destructive DEI and anti-racism ideologies that have infiltrated other sectors of the healthcare industry.

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