Active Allyship in the Healthcare Environment

by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

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    00:06 A 2022 survey from the National Commission to address racism in nursing in the workplace, found that 92% of black nurses have personally experienced racism, and three out of four nurses have witnessed racism.

    00:20 Now those statistics are quite alarming, especially for 2022.

    00:24 So I want you to imagine that you're working in a clinic and there's an obvious difference in treatment of employees based on any characteristic.

    00:33 So those statistics spoke specifically to race.

    00:35 But think about any characteristic of someone who was marginalized for whatever reason, usually, those are characteristics based on some, something to do with identity.

    00:46 And then the non-target employees get immediate approval of things like vacation or some type of sick leave, and there's no controversy about it, it just happens.

    00:56 So if you've been the target of that, or you've witnessed it, what would you do if you saw someone getting an extra workload or no compassion for real issues, and then someone else comes with something that may be a little less serious, like someone comes, let's say and want some sick time, or they need to have some type of surgery.

    01:17 And there's some pushback with when the schedule it based on the workload or the clinic load, but then someone else just wants to, let's say, go on a cruise.

    01:26 And they're allowed to do that and there's no pushback at all, how would you as a witness to that address it? And then what would you do if you experienced it? These are some of those subtle little things that oftentimes or discrimination, and we may not pay attention to it, but if it strikes you as that, what are you going to do about it.

    01:46 So this is where the concept of active allyship is important.

    01:50 And the key and that is the word active because allyship sometimes we can say to a person behind the scenes that we support them, we saw what's happening, but we don't do anything about it.

    02:01 Active allyship is what do you do in terms of supporting beyond just acknowledging the situation is that you want to be a part of the change so that it moves more into the activism piece.

    02:13 But allyship has to be more than just about words.

    02:17 So if you see a single event happen, it's important, or if there's a pattern of behaviors that happen, this is how we start the culture shifts.

    02:26 And when multiple people see and hear about these patterns, then that's even more of an important indicator that something needs to be done to shift those cultures.

    02:36 It means that something is happening and something needs to change.

    02:40 And so a good rule of thumb is if you see something, say something, do something.

    02:45 So how does the concept of allyship work? Well, this quote sums it up.

    02:51 Anyone has the potential to be an active ally.

    02:55 As an ally, you recognize that though you might not be a member of the under invested, or underrepresented or oppressed community that you support, you make a concerted effort.

    03:07 The key is that you make a concerted effort.

    03:09 That's that activism piece, again, to better understand the struggle every single day.

    03:15 And that understanding comes with listening and we'll talk more about that.

    03:19 So because of an active ally might have more privilege and recognizes that privilege, then they're more powerful, their voices are more powerful alongside the oppressed person.

    03:29 Because sometimes as the oppressed person, it may feel like people are just complaining.

    03:35 Oftentimes, the complaints or trivialized or the reports, I hate to call it complaints, but the experiences or trivialized and minimized whereas if you're a bystander, and you want to be an up-stander, bystander means you were there, you witnessed it, you don't want to just be a bystander, this is where the activism piece comes in, and you become an up-stander.

    03:55 Because you're gonna use your voice, to uplift and help to create those changes and transitions in the workplace.

    04:03 So you want to find that balance between allyship and you don't want to mute the voices of the person experiencing the issue, because that could translate into saviorism and we don't want to do that.

    04:14 We don't want to mute the voices.

    04:16 We also don't want to be necessarily louder than that voice.

    04:20 But how can you be supportive in a way that helps to move towards or advanced change.

    04:25 So allyship works best when every member of the team is invested in it.

    04:30 Again, I will say that culture shift a lot, because it doesn't shift if only some people or steering the ship in one way and other people are either maintaining status quo or steering it in an opposite direction, but the tone definitely has to be set.

    04:46 And this is basis is intended for every member of the team.

    04:51 But most importantly, leaders are in an ideal position to a role model what active allyship looks like and those are so many, there are so many key ways for leaders to do that.

    05:02 One is, you may not witness all these things but when other people on the team witness it, they need to feel like they can come to you and that they will be supported in terms of you being willing, because you're able by way of your position, but being willing to help be a part of that culture shift.

    05:20 And there's no one way to do it.

    05:22 We'll talk about that.

    05:23 With all of this work, everything we talk about is contextual, context matters, perception matters, perspective matters and whatever someone's perception is of a situation is their reality.

    05:36 So we have to be willing to respect that.

    05:39 Then you want to step back and ask the person how you can support them.

    05:43 It's not about what we think, you might want to share an offer what you think and some suggestions for it, but the best way to do it is to first ask people how you can support them in the situation.

    05:55 And then in some situations, you may have found yourself in that, in that space where you've witnessed something happen, but you didn't know if you should or shouldn't say it.

    06:04 Personally, I've witnessed it and I didn't know how to react to a situation when someone else was going through it because I watched their reaction and if they didn't have a reaction, I was like, well, maybe I perceived that differently.

    06:16 But then when I had conversations with those people, one on one conversations, they did share with me that they experienced what I witnessed, but they didn't know how to say or respond to it.

    06:28 So that would be an ideal time to say, How can I support you in the future, if that happens, or I even in that instance, which takes me to the concept, one of the best practices for this is rapid response.

    06:40 So oftentimes we have the fight, flight, freeze, or appease in a situation when we witnessed something and so we don't know how we're gonna respond but rapid response is best, especially if it's egregious.

    06:53 So if you do have the confidence, the wherewithal, you're not shocked, and you can respond in the moment, it's good to do that.

    07:01 But that's not the only way again, to be an ally, rapid response could mean that you take some time to reflect, you take some time to have a conversation with the person or But that's not people who are experiencing it in the moment and then come up with a plan for how to address it.

    07:16 But it needs to happen.

    07:17 Even if it's not immediately, it might happen later on that day, it may happen the next day.

    07:22 One example of how to do that would be to say, You know what I noticed XYZ, so you stating what you observe, that subjective.

    07:31 And you say I want to take some time to think about it, but I would like to have a conversation about this.

    07:36 And so the person is aware, it gives them some time to reflect, it gives both parties or all parties time to think about it and then think of maybe some best ways to address it because communication and how you do it is important, especially if we're trying to promote change and not encourage more conflict by making someone more defensive about whatever the situation is.

    08:02 But you do have to address it because again, that's the only way the culture shifts.

    08:07 Why is allyship significant? In terms of health care professionals, we all operate by ethical codes of conduct.

    08:18 And when I think about healthcare, the two that come to mind quickly are non maleficence, so we don't want to do any harm and then to do good, beneficence.

    08:27 Those are two key ones.

    08:29 And then when we think about integrity, so those are things that you see a lot in healthcare organizations, and as well as academia, where people pride themselves on those things, especially with integrity, and we think about fidelity and veracity and all the things that probably separate us from some other professions.

    08:50 So in those healthcare environments, we need to make sure that we always prioritize the ethical codes of conduct and just ethical principles in general.

    08:59 Oftentimes, people see healthcare environments as altruistic places where racism and microaggressions either are rare or those things don't occur because we signed up to take care of human beings, right? Well, research shows that that's not necessarily true.

    09:17 The big picture is how does it impact outcomes, health outcomes, not only for people we see as patients but the people who work in our organizations.

    09:26 It impacts their health, it impacts our performance and impacts confidence and our ability to do our job and see ourselves growing in a space staying in that space and advancing in those spaces.

    09:39 And just thinking about all -isms, we mentioned racism, but all -isms have a negative impact.

    09:45 And not just on the people who are, for lack of a better word, the victim, but the person who is experiencing that whatever that oppression or marginalization or micro aggression is, it affects all humans and affects organizations.

    10:03 And I just gave an example when I talked about, you want to be able to see yourself in a space and grow and feel valued.

    10:09 Otherwise, there's a lot of turnover when we think about that when people go through or experience -isms.

    10:15 And sometimes when they witness -isms, when they're not in alignment with the person's personal philosophies, goals and values.

    10:24 So thinking about that, and there's a cost associated with it.

    10:28 When we think about how patients and families experienced those -isms and discrimination, and they don't feel like they're supported and have allies in a space, how does it impact them as human beings? And how does it impact their health? And how does that translate into more dollars.

    10:45 So there is research that has shown that.

    10:48 NIH reported something a while back about it cost healthcare organizations billions, not millions, billions of dollars, bias discrimination, stereotyping leads to acts of omission and acts of commission.

    11:04 So it's very, very important that we hold true to that ally ship, the active allyship and start the culture shifts.

    11:11 So when we talk about it, in terms of employees, morale decreases, there's increased stress, people start to feel isolated.

    11:22 There's burnout, physical burnout, mental burnout, especially when you don't feel supported.

    11:27 We'll all be humans, let me just throw that in there.

    11:30 So we're gonna make some mistakes, we're gonna have some days where we may not perform at ideal state, especially in leadership, sometimes I may not support people the way I intend to.

    11:42 But it's important that people feel like they can come to me as a leader, in terms of advocating for everybody in there and listening when someone comes to me either as the person who experienced it, or as the person who witnessed some type of discrimination, because there becomes this overall feeling that people don't belong in a situation and everyone wants to feel welcomed, which is what belonging is, and belonging is a feeling and no one wants to keep showing up in an environment where they don't feel that.

    12:13 So when we think about that, in terms of patients, people get sick when they don't feel like they're treated right.

    12:20 So physically and mentally, how does that impact a person.

    12:24 If I keep showing up in an organization, and I don't feel like I'm welcomed from the beginning to the end of that patient experience, whether I'm the patient or a family member, then I'm less likely to show up.

    12:37 And that all translates back into poor health outcomes.

    About the Lecture

    The lecture Active Allyship in the Healthcare Environment by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE is from the course Allyship.

    Author of lecture Active Allyship in the Healthcare Environment

     Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

    Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

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