Rutgers Nursing Magazine - Summer 2021

I “Fetch the Nurse” It was 1970, and Charlotte Thomas- Hawkins (PhD, RN, FAAN) was at the beginning of her career. She had earned her nursing diploma at Temple Univer- sity Hospital School of Nursing that spring and was starting her first RN job at the Hospital of the University of Pennsylvania. So, when she walked into a patient’s room and was asked to “fetch the nurse,” she felt a sense of deflation she remembers to this day. Thomas-Hawkins is Black, and even now, minority nurses are still facing racism, both subtle and overt, includ- ing the assumption that, because of their color, they couldn’t possibly be “the nurse.” That experience set Thomas- Hawkins to asking questions about the effects of bias that would one day im- pel her to become a researcher. And one of her research topics would be nurses’ experience of racism and how it impacts their emotional health. She completed a phase of that research in fall 2021, as the U.S. was starting to emerge from the COVID-19 pandemic lockdown. In fact, it was the pandemic, and nurses’ experience of it, that origi- nally inspired this study. In the spring of 2020, New Jersey was grappling with the third highest num- ber of COVID cases in the Northeast, and Thomas-Hawkins—associate professor and interim associate dean of Nurs- ing Science at Rutgers School of Nurs- ing—began to wonder how nurses were handling the effects of a uniquely grueling year. “I was interested in the level of worry that nurses had regarding COVID,” she says. But the past year had been marked by yet another consequential event— the killing of George Floyd, an African American, at the hands of white Min- neapolis police officers. “My experience as a minority nurse is that we constantly live with this subtle level of interperson- al racism,” says Thomas-Hawkins. She wondered how the entwined stresses of COVID and workplace racism affected nurses, particularly nurses of color. She surveyed 778 nurses in New Jer- sey hospitals who worked closely with patients. It was a diverse sample—60 percent white and the remainder non- white or multiracial. The results re- vealed a high level of what Thomas- Hawkins called “emotional burnout,” which was reported by 68 percent of the nurses overall, though minority nurses reported a higher level of emotional distress compared to their white coun- terparts. More than half of respondents overall felt that work was hardening them emotionally; 43 percent were de- pressed; and a third reported dissatisfac- tion with work/life balance. A majority worried about COVID; almost half were dissatisfied with their jobs; and nearly 20 percent planned to leave their jobs. It was her questions about racial climate and racial microaggressions—small-scale comments or actions, intentional or un- intentional, conveying racial bias, hostil- ity, or disrespect—on which respondents were clearly divided by race. Black nurses experienced more negative workplace ra- cial climates and a higher number of mi- croaggressions, especially from coworkers and patients. “To my knowledge,” says Thomas-Hawkins, “the quantifiable and harmful experiences of workplace racism by nurses is a new finding, and it’s not something that can be ignored.” She’d never set out to do groundbreak- ing research—in fact, she’d never set out to do research of any sort. That changed back when she got her master’s degree in nursing from the University of Penn- sylvania School of Nursing and moved from an inpatient floor to the outpa- tient dialysis unit at the Hospital of the University of Pennsylvania. There, she was struck by the fact that nurses did the lion’s share of the work, and there never seemed to be enough of them. She began to wonder how that low lev- el of nurse staffing affected patient out- R E S E A R C H E X C E L L E N C E One Faculty Researcher Studies the Impact of Racism and Microaggressions on Nurses