1. Pfeifer, Gail M. MA, RN
  2. Potera, Carol


Statements call for inclusiveness and action to prevent firearm injuries.


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The American Nurses Association (ANA) recently reiterated its long-standing position that nurses have an ethical obligation to help eliminate discrimination in health care settings.

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"All nurses must recognize the potential impact of unconscious bias and practices that contribute to discrimination and actively seek opportunities to promote inclusion of all people in the provision of quality health care, while eradicating disparities," the ANA said in a statement. The ANA took the position that "discrimination has no place in nursing practice, education, [and] research," according to the statement, and that all patients are equal and entitled to be treated with respect and civility. Moreover, organizational policies that foster discriminatory treatment should be flagged and stopped.


"The nursing profession is responsible for promoting an environment of inclusiveness and must be intolerant of discrimination," said Liz Stokes, director of the ANA's Center for Ethics and Human Rights. Stokes called on individual nurses to reflect on their values and resolve any personal conflicts that could adversely affect patients and monitor their organizations for evidence of bias.


Research shows that patients who think they've been discriminated against may experience impaired physical and psychological health, leading them to neglect treatment plans or delay seeking health care-actions that contribute to poor health outcomes. Health care workers can also be victims of racial bias when patients rebuff a clinician not of their race or ethnicity. Organizations and clinical leaders must be alert to such behavior and intervene as appropriate to support staff and educate patients.


The ANA also joined with the American Academy of Nursing (AAN), the National Association of School Nurses (NASN), the American Public Health Association (APHA) and six physician organizations in calling for government action on gun violence and more research into prevention of firearms deaths and injuries.


The ANA called on the U.S. Senate to pass the Bipartisan Background Checks Act of 2019, which prevents gun sales to people barred from owning them, and ANA president Ernest J. Grant urged nurses to take that message directly to their senators. The ANA also wants Congress to authorize $50 million for gun violence research.


The AAN called on Congress to create a bipartisan National Commission on Mass Shootings that would support universal background checks as a prerequisite for gun ownership and empower nurses and other health care professionals to prevent gun violence through screenings, patient counseling, and referrals to mental health services for people with dangerous behaviors. The NASN, meanwhile, registered its opposition to allowing teachers to carry firearms since no current research finds that doing so makes schools safer.


In addition to nursing organizations, six physician societies, including the American Academy of Family Physicians and the American Academy of Pediatrics, joined with the APHA to endorse universal background checks and oppose laws that prevent physicians from talking with patients about health risks associated with firearm ownership, among other gun violence prevention measures.-Carol Potera


Garran AM, et al AMA J Ethics 2019;21(6):E499-E504; Sigurdson K, et al. Pediatrics 2019;144(2); Cox K. Nurs Outlook 2018;66(3):219-20; McLean RM, et al. Ann Intern Med 2019 Aug 7 [Epub ahead of print].