“Gatekeeping” is defined as the activity of controlling, and usually limiting, general access to something. A “gatekeeper” decides what information should move past them, or who’s in and who’s out.
When I first thought of pursuing a nursing career, I decided to accept a job at a university medical center. I wanted to make sure I could handle being around bodily fluids, death, and the stimulation of an intensive care unit (ICU).
The university was large and well-known and was in a fairly diverse city that had multiple historically black colleges and universities (also known as HBCUs). Right away, I was amazed and quite perplexed that despite having more than 100 nurses comprising the total nursing staff, the unit I was assigned to had only ONE black registered nurse! I felt that something was seriously wrong with that percentage. I immediately started wondering why there wasn’t more representation. I soon discovered that many black and Hispanic nurses were applying, but none had received offers for employment. Furthermore, I learned that minority nurses who applied were scrutinized more heavily during the interview process. If anyone on the interviewing panel disliked the way a minority candidate answered a question, it was grounds for immediate rejection. Meanwhile, I watched how several white nurses struggled through basic nursing functions and were handled with “kid gloves” whenever mistakes were made. Meanwhile, the black nurse, who was clinically proficient, wasn’t allowed to act as a charge or resource nurse or gain additional experience in the areas where the sickest admissions were sent. Charge nurses consistently placed her in the isolation area where the patients had “code browns” around the clock. This wasn’t a nurse who struggled with any assignment given. This nurse was excellent and everyone in our unit knew it, but those who were in charge refused to change. It was clear that they didn’t want her to advance or outshine her white counterparts Despite the prejudicial treatment and lack of support she received, the lone black nurse didn’t leave the unit. I didn’t blame her because she’d worked hard to earn her spot and leaving wouldn’t change how the next minority nurse was treated.
Upon graduating, my supervisor assumed that I’d transition into a nursing position within the same ICU. Luckily, I ended up in another ICU due to the facility’s residency program regulations.
Although the newer ICU was a little more diverse, the same gatekeeping tactics were in place. White nurses who had certified registered nurse anesthetist (CRNA) aspirations were always allowed to have the sickest admissions. Black nurses still weren’t allowed to act as charge or resource nurses and we were given the remainder assignments that nobody wanted. I did my best to get to know the other black nurses and learn their experiences, which often paralleled my own. That’s not surprising. However, I remember one Saturday night where all the black nurses were on shift together. That one night was different because I felt like I had a little more support in the unit. Strangely, it never happened again. I wonder why? #RhetoricalQuestion
Like many nurses, I had a PRN job at another hospital to help pay off my student loans. This position was also in the ICU but at a county hospital. This unit was full of black nurses, and they were floored when they learned where I worked full time:
“They’re letting black nurses in over there now?”
“They don’t hire many black nurses; how are they treating you?”
There was an abundance of qualified black nurses who had the desire to work in my full-time unit. The academic medical center ICUs are known for having sick patients, which prepare nurses for any and everything. Black nurses have always had the desire for advanced practice/CRNA positions. Unfortunately, many black nurses are systematically kept out of specialty areas, especially the ICU, to limit their advancement. It needs to stop. For someone living in one of the metropolitan areas, such as Atlanta or Houston, where black nurses are more in abundance, it’s a little harder to spot the gatekeeping tactics at the staff level. However, when I worked as a travel nurse in these same areas, I noticed that gatekeeping is still prevalent at the leadership and executive levels.
I want more nurses and those working at the nurse management level to address gatekeeping, which is a byproduct of racism within the profession. According to the American Nurses Association (ANA), seven out of 10 black nurses have experienced racism within the profession. This shouldn’t shock anyone. As I stated to ANA president Ernest Grant on Twitter, “WE BEEN KNEW!” Grant is a black man who started his nursing career as an LPN and then rose through the ranks after obtaining advanced degrees and experience. Of course, he deleted the tweet. I’m disappointed that Grant chose to skip an opportunity to address the public and engage in sincere dialogue with those who’re most impacted by the ANA’s study results.
When are more nurses going to stop talking and start acting? If your area’s patient population is diverse, but your nursing staff isn’t, that’s a problem. I guarantee gatekeeping is occurring and those who’re in power are playing in your face and choosing to ignore the obvious. It’s not true that “minority nurses aren’t interested in applying” because they are. There’re approximately 80% white nurses in the profession. For those who’re reading this, I’d like to know what you’re committed to doing to stop gatekeeping and other systematic tactics from occurring? I recommend watching Melody Hobson’s Ted Talk. It’ll certainly stir you to take initiative and do something! I’m seriously over the talking. We need ACTION. This isn’t an that BIPOC nurses can achieve alone. We don’t have the numbers or the power, but many of you reading this do!
Let me know what you’re committed to doing in the comments.
“Of course, he deleted the tweet.”
Yeah these are the kinds of conversations that upset #ColonialNurses and they can’t tolerate having them in the open
Gatekeeping takes many forms but the goal is consistent – control who gets in and what gets said
I am committed to doing all I can to stop gatekeeping and other systematic tactics from occurring. I will protect and lift up Black women especially in the nursing profession. I will listen, read, and reach out to those who have been doing the work. I acknowledge my own privilege and the life I lead is supported by systemically racist institutions. I promise to speak out, disrupt, reimagine and take action to change it all. Love you Corporate Nurse Lexi J! Thank you for sharing these stories and making sure we stay committed.
Damn Lexi,
A big topic of study in my Masters program is “equity in healthcare”. A main theme I have encountered in my readings is the need for nurses, nurse leaders, APN’s etc. to acknowledge and talk about the organizational hierarchy. Talking about it starts with bold people having the balls to address the issue. In my small, most recent OR, we had 1 black nurse and 1 black surgical tech. Wilmington, NC is very diverse. I worked with 1 black CRNA at this hospital, she was fucking phenomenal, and Nigerian and a travel nurse.
I don’t really know what I am trying to say, or what my point is, but basically it pisses me off too. I hate going to the bigger OR across town and all I see is perky, young, white CRNA’s who think “their shit don’t stink”. I hate it. We are nurses, here to do a very serious job, not wear cute scrub hats to match our eyes.
Knowledge is power, I hadn’t thought about the gatekeeper definition before. I will notice it from now on.
Thanks for being you.