WHITING-OUT DIFFERENCE - WHY UNITED-STATES NURSING RESEARCH FAILS BLACK-FAMILIES

The health needs of black families have not been substantively addressed in the intellectual tradition of nursing in the United States. This tradition is permeated by white middle-class and female ideological perspectives, a bias unrecognized by the majority of nurses, including those in academia. It is an ideology that labels, stigmatizes, and blames victims of racial, sexual, and class discrimination. Approaches that explicate health concerns from the viewpoint of the client, illuminate the experience of discrimination, and expose its influences on health have been excluded from the discipline. The dominant perspective driving research conducted by health providers, of which nursing is but one example, is marked by approaches to problems that maximize the importance of the role of the individual provider and propose solutions for people without consideration of the social context and group membership. As a result, socioeconomic, cultural, and environmental factors that contribute to the chasm between the health of black and white Americans have been ignored. Conformity to white middle-class standards for feminine thought and behavior in the training of nurses entrenches the covert ideological underpinnings of the culture of nursing and maintains the dominant research perspective derived from it. This article argues that the conformity required of both students and faculty in nursing has systematically excluded black people, thus preventing their insights from challenging covert ideology and from shaping the core paradigm of nursing. The conformity is maintained through self-regulation by faculty members and students, a self-correcting process describe here and labeled ''whiting-out difference.''