“What is the next step?”

That question is often asked in the midst of a crisis because it helps force the kind of myopia needed to deal with an urgent situation expediently and effectively. If the kitchen is on fire, no one should be talking about the plans for the refrigerator upgrade next month. If the fire is not dealt with, there will be no kitchen to put the new refrigerator in! Indeed, everyone’s attention needs to be focused on the very next step.

Racism in American has set the kitchen on fire. How will the profession of nursing respond?  Many large nursing organizations such as the ANA, the AACN and the NLN, have released statements decrying racism and recognizing the social upheaval we are currently steeped in. Statements such as these often point backward to prior calls to action and the aspirational but banal diversity and inclusion statements common to most organizations today. At the time of this writing, however, there are no clear calls to new action. No major nursing organization is saying with the clarity and authority necessary in a crisis, “This is the next step.”

Commendably, nursing has made broad calls to remedy the lack of diversity in its workforce with the most prominent one in the past decade coming from the Future of Nursing report released in 2010. Even in that report, however, increasing the diversity of the workforce did not rise to the top-level summary language used in the key recommendation. Similarly, the racism that contributes to the underrepresentation is never mentioned. While there is much good to be said for the historical stands of these nursing organizations and the minority leadership we see in some of our most respected national leadership positions today, most leaders in nursing will not deny that our progress has been too little and too slow. We find ourselves in a historic moment that begs for those who will issue clarion calls. 

The nursing workforce has long been marked by a level of racial homogeneity that does not reflect the diversity of the people and communities we care for. Depending on the sources you consider, the U.S. is approximately 60% non-Hispanic white while the nursing workforce is approximately 80% white. Undoubtedly, the groups of nurses who have the greatest impact on shaping the future workforce (national level leaders, academic deans, healthcare administrators, etc.), are an even more extreme picture of the incongruities that characterize the workforce at large. Our collective picture is one of disparity. 

So, what is the next step? Should we look to our large national-level organizations to lead in activism against racism, inequity, and disparity in nursing? Should we wait for someone else to take the next step? Do we minimize risk by avoiding the early adopter and laggard labels and stick to the safe middle?

Many of us have worked with students who are gripped with fear in a clinical setting. In that state, students can get locked into a kind of spiral. Some will try harder and harder without making any changes. Some will hide until the end of the shift. Others will give up entirely. If they are fortunate, some wise faculty person will come alongside and encourage the student by explaining that the next step, is to take another step. Simple questions and simple answers focused on addressing the situation at hand: 

“What needs to be done next?” 

“What can be done next?”

“Let’s do that then.”

In determining our profession’s response to our historical moment, perhaps the best action that can be taken is for every organization, no matter how small or large, to take another step. Instead of returning to old steps, which have not achieved the outcomes we hoped they would, instead of only issuing statements that help others to see our values (which is far better than saying nothing), determine what action your organization is capable of taking to directly impact the lack of diversity in the nursing workforce. Take another step.

In academia, our next step may be two-fold. First, step back from the programs and initiatives designed to improve the diversity numbers that have become badges of honor in the business of higher ed. Reallocate energy to step into relationships with the people those numbers represent. Authentic relationship will always be our best recruitment, retention, and success tool. It also happens to be the best tool for inciting change in ourselves and our colleagues. Second, work to immediately increase intelligent funding for disadvantaged students. The socioeconomic divide is one of the greatest deterrents to more people of color coming into nursing. Vigorously pursuing greater gifts and greater allocations are key to academic nursing’s response to the impact of racism in our country.

What’s the next step? It is to take another step. Another step that is defined by action that will, as directly and expediently as possible, impact the diversity of the nursing workforce. Thousands of small next steps taken by hundreds of ordinary organizations will move us further and faster along than any national-level initiative led by a major organization bound to the agendas and opinions of multitudes of stakeholders. We need not wait for someone else to make the next move. Embracing the current call for change in our nation and our society is too important to not be responsive to. At this moment, all we need do is take another step.