Nurses Need Not be Guilty Bystanders

Public health nurses face a variety of social challenges in the workplace.  As the healthcare environment becomes more multicultural and the perception of limited resources grows, racism and social class issues can arise.  Prejudice  impacts access and quality of healthcare.   As the Hispanic population continues to rise, more Latino/Latinas are seeking health care.  As a result, questions regarding the legal status of Latino/Latina patients, motives for seeking care, and raw prejudices may open up nurses to providing substandard or dehumanizing treatment.  Nurses can be caught up in racist conversations, even by listening and not acting.  Ethically, nurses are called to respond to acts of injustice, but what is the status of those nurses who remain silent?  Thomas Merton, a 20^th century monk and philosopher cautions that witnesses of unjust acts who remain silent become “guilty bystanders.”  Guilty bystanders, through their silence and inaction, do not act to right injustices.  What is called for is an ethical response to right the injustice through “quiet leadership.”  Quiet leaders believe they must act, persist, endure and be tenacious in their consistent response to racial prejudice.  Quiet leaders are nurses who learn about and help enact healthcare access policies, who reach out to affected populations, who learn about and become more culturally competent, and become active in legislative advocacy and lobbying for better access.  A variety of case studies are presented to demonstrate specific strategies nurses can use to respond to prejudice and injustices using Merton's prinicples.