I’ve mentioned it many times that I am very lucky where I work. I have an exciting job that varies in daily tasks. And we have a team who is incredibly compassionate and forward thinking. With that, we are not exempt from internal and systematic bias. Because of this we are starting a program called Respectful Maternity Care. Ours will look a little bit different than this but will be similar.
We began last week with our management team, CNCs, Quality Specialist and educators viewing the movie Aftershock which documents the stories of two black women who died due to childbirth complications (that shouldn’t have happened). When the lights came back on at the end, several of our team was in tears. One of our team had seen the movie at a screening held by our hospital DEI committee and recommended it. Her comment was simple and profound, “I saw this movie and was moved by how I had always practiced, believing I treated every patient equally. But equal is not what we need to be doing, we need to be doing better. Ironically the very next patient I was assigned to was black. She was scared. I told her that I was here for her and if at any time she felt unsafe I wanted her to speak up. If at any time she felt unheard, to let me know.” This nurse said that she was really moved to look at how she has practiced for many years and where she might not have done as good of a job as she thought she had. This is a nurse who I would trust with my life if I needed. Her recognition of where she could be better is one of the reasons she is so good.
The movie is difficult to watch for many reasons. No one wants to think they could be part of a systematic problem and yet, it’s possible. Even probable in many situations. It is important to push ourselves and make ourselves just uncomfortable enough that we begin to have the conversations and think about what we can do differently.
I had another opportunity to attend a training on discrimination at the bedside. I didn’t realize until I got there that this was how to deal with patients who refuse care from, make racial or other slurs about, or otherwise discriminate against their care team. This too is a real issue and I found myself shocked at what some of my peers have been through as care providers due to their race, ethnicity, sexual orientation, or other.
Most of us don’t intend to overtly discriminate, but we may be guilty of microaggressions- everyday slights, insults, putdowns, invalidations, and offensive behaviors. When ICEA began the very small requirement of having diversity credits for certification and recertification, we had some push back. Mainly that it was too political. I validate those feelings and I also validate the need to grow and be better. We can call it by a lot of names; DEI, Equity, Cultural Competency, Respectful Maternity Care, etc. It all boils down to the need to expand our awareness of those around us, and look for ways we can grow and do better. This will mean something different in depending on where you live, the patients in your community, the type of education and care you are giving.
Each and every one of us is a unique and amazing person. We are so lucky to have the opportunity to work with individual families as they begin or expand their family. I hope we all continue to find ways to be our very best and push that care, compassion and kindness forward.
Elizabeth Kirts, MPH, ICCE, IBCLC, RLC
