Truth,Trust,and Selective Solidarity in Nursing

Abstract

Racism remains deep-seated in nursing culture, education, and practice, and within professional organizations, despite widespread declarations of commitment to address racism. This commentary examines two legal cases—one involving a Black nurse, the other white—both fired, yet met with contrasting responses and selective advocacy. This case study in systemic racism reveals how race shapes professional solidarity and engagement of leaders and organizations. Nurses, particularly white nurses, must confront uncomfortable truths, reckon with distrust, demand accountability, and move beyond statements to sustained, anti-racist action. Trust in nursing depends not on reputation alone but on the willingness of nurses to uphold justice.

In nursing journals, more articles on racism have been published in the last 5 years than ever before. Similarly, professional organizations have disseminated numerous position statements and convened a national initiative to combat racism in nursing.^1–4 These documents often reflect the same obligations contained in mission and value statements of organizations and institutions, like commitments to equity, integrity, courage, and a safe, ethical work environment. Such attributes are required to meet the diversity, equity, and inclusion (DEI) mandate for Magnet certification and recertification (a program seen as a marker of institutional nursing excellence). ⁵

Despite growing literature on racism, DEI requirements in Magnet certification, and stated commitments to fight racism, very little seems to have translated into actions that actually fight racism. On the contrary, DEI initiatives may mask racism with a virtuous “veil” instead of confronting it. ⁶ There is a critical need to address racism in nursing and move beyond stated proclamations to actively embody and implement these commitments. Racism continues to cause serious, lasting harm in nursing, with racial trauma stemming from the collective impact of repeated assaults, microaggressions, and traumatic experiences at the individual, institutional, and systemic levels.^7,8 Those harmed by institutional racial trauma can feel abandoned and unsupported by peers and supervisors, experience deleterious effects on mental and physical health, and suffer long-term negative impacts on their social and economic lives. ⁹

Bigotry and discrimination persist, despite an increase in awareness, even in certified institutions and professional organizations with expressed commitments to DEI.^6,10 This not only contributes to the degradation of individual well-being, but persistent racial trauma inflicted by members of the “most trusted profession” is contrary to its expressed values.^10,11 An analysis of two legal cases involving nurses highlights the inconsistencies and shortcomings of how nursing organizations address breaches of trust and perpetuate systemic racism. One such case involves the American Nurses Association’s (ANA) unqualified support of a white former nurse defendant, RaDonda Vaught, including a formal request for leniency from the court in the setting of sentencing for criminally negligent homicide and gross neglect of an impaired adult. ¹² The other case involves the absence of any nursing organization’s support in the ongoing Civil rights lawsuit involving a Black nurse as plaintiff, DonQuenick Joppy, alleging workplace discrimination and wrongful termination. ¹³

State of Tennessee v. RaDonda L. Vaught

A jury determined that former nurse RaDonda Vaught took a substantial and unjustifiable risk when she administered a paralyzing agent instead of an anxiolytic to Mrs. Charlene Murphey in 2017, who died as a result. Court documents and interviews with Ms. Vaught cite holiday staffing, time constraints, and hospital-wide technical issues as contributing factors. Ms. Vaught admitted her error, but the jury found that in overlooking vial labels and leaving Mrs. Murphey unattended, she employed practices that even a layperson would not have taken.

As Ms. Vaught’s case progressed, nursing organizations raised concerns about the potential criminalization of errors.^12,14 As an example, the ANA and Tennessee Nurses Association expressed concern, stating “We are deeply distressed by this verdict and the harmful ramifications of criminalizing the honest reporting of mistakes.” ¹⁵ Framing the event as a mistake and highlighting honest reporting is a misrepresentation and obscures the truth: Competent nursing practice would have prevented Mrs. Murphey’s death. The actual focus of the legal proceedings was whether Ms. Vaught’s actions met the threshold for criminal negligence. During and after the trial and verdict, despite losing her license, Ms. Vaught continued to enjoy support from nursing organizations. The hashtag #IStandWithRadonda was shared thousands of times and over $200,000 was raised to support her. ¹⁶ As recently as November 2024, she was the keynote speaker at an ANA conference. ¹⁷

DonQuenick Joppy v. HCA-HealthOne

Nurse DonQuenick Joppy faced criminal charges, later dismissed, after following an order to cease aggressive treatment and support a peaceful death for a patient at end-of-life. The ordeal caused significant financial and emotional strain. ¹⁸ Nurse Joppy maintains her license and an impressive professional record, including three DAISY award nominations. The silence from professional nursing organizations on this case is deafening, especially when compared with Vaught’s case. There were no organizational statements, and crowdfunding has raised less than $7000 in over 2 years. ¹⁹

Nurse Joppy takes The Medical Center of Aurora (TMCA) to trial this August in a federal Civil rights lawsuit. TCMA must defend against claims that Ms. Joppy was subjected to persistent workplace discrimination. Ms. Joppy experienced escalating levels of marginalization, harassment, denial of professional opportunities, and retaliation after reporting discrimination. ²⁰ TCMA must also defend against claims that Ms. Joppy was terminated because of her race, and because she engaged in protected activity. Such practices are antithetical to nursing’s professional code of ethics (e.g., provisions 1, 5, and 9) ²¹ Ms. Joppy, her attorney, and supporters have reached out repeatedly to the ANA, other organizations, and prominent individuals without receiving support or even an opportunity to discuss her case.

Betrayal and Critical Questions

Ms. Joppy’s workplace experience mirrors the challenges described by many Black nurses, further illustrating how racism manifests in nursing. During a recent discussion on the issue of racism in nursing, ANA Senior Vice President for Equity and Engagement Dr. Katie Boston-Leary stated, “Black nurses aren’t shown the same grace” as their white colleagues in matters of learning and practice. ²² Similarly, the lack of support for Nurse Joppy from professional organizations stands in stark contrast to their uncritical advocacy of Ms. Vaught. This absence of support is particularly troubling in the context of ANA’s proclaimed commitment to reckon with and address racism in nursing, and given assurance from the ANA’s Chief Nursing Officer, Dr. Debbie Hatmaker, that, “… when issues like this come to our (ANA’s) attention, we often have outreach with the individual or their representative or their attorney and we let them tell us what would be most helpful, particularly when it’s a legal issue.” ²³ Nurse Joppy’s case could have prompted action on organizational position statements, yet the only mention in an ANA publication initially mischaracterized it as an error. ¹⁴ A correction came following a reader’s letter. ¹⁸ Underscoring how even small exchanges can raise awareness, one of the original article’s authors is now a co-author of this articl.

Both hospitals in these cases are Magnet certified. Both cases highlight urgent concerns about trust and whether standardized systems can address racism, patient rights, and social justice in health care. Ms. Joppy finds herself unable to rely on nursing colleagues, or even the professional organization that claims to support the interests of all registered nurses, to stand with her in the pursuit of justice. Ms. Vaught’s case highlighted the fundamental issue of public trust in nurses to practice diligently. Both cases force nurses to confront an uncomfortable truth: what happens when the most trusted profession shows it is not trustworthy? What happens when the workplaces certified as most exceptional actually do not appear to be so, especially for Black nurses? How should nurses respond when egregious events occur in workplaces recognized for nursing excellence? Outside of seemingly performative antiracist words, are national nursing organizations accountable to nurses, or do they instead support institutional power? Who should nurses and professional organizations support?

Finding Truth and Building Trust

Reckoning with racism requires moving beyond discussions of history and abstract concepts and instead recognizing it as the lived, present-day reality of nurses like Ms. Joppy. Supporting nurses means acknowledging and addressing the many consequences of their racial violence and related trauma. Racism in nursing will persist as long as racist harm goes unacknowledged, and as long as perpetrators of racist acts are not held accountable—both are essential first steps toward truth and reconciliation. While some programs and organizations ²⁴ are meaningfully advancing justice and equity, the translation from position statements to tangible action remains inconsistent—if not absent altogether. The largest, most recognized, and most frequently called-upon nursing organizations appear to selectively apply their support, even in cases that directly violate their own mission and values.

We specifically call white nurses to actively engage in antiracist action, beyond performative statements—so, what might white nurses do with this information? Justice is not free, and contributing to Ms. Joppy’s legal fund ¹⁹ is one way to translate support into meaningful action. Learning about ²⁵ and telling a colleague about her case to ensure that present-day racism in nursing is not ignored or forgotten is a critical step in moving from racism as a concept in nursing to facilitating change. Calling on the ANA to account for the differing responses and act on antiracist claims may drive change. Nurse educators can expand legal education beyond loss-of-license cases to include the full scope of nurses’ roles as both plaintiffs and defendants, motivating students and continuing education participants to facilitate just and accountable work spaces. When Black nurses speak about unjust workplaces, believe and support them. Finally, hold professional organizations accountable—not only for what they say about racism in nursing but for what they do when racism is happening right in front of us.

Addendum

Subsequent to the submission and review of this article, the following occurred: On August 19, 2025, following a 5-day trial, a jury unanimously found that HCA HealthOne Aurora (formerly TMCA) violated nurse Joppy’s Civil Rights by discriminating against her based on race and retaliating against her after she reported discrimination. ¹³ The jury awarded Joppy $5 million for emotional distress and an additional $15 million in punitive damages, citing the hospital’s malicious or reckless disregard for her rights under Section 1981. ¹³ HCA HealthOne Aurora, member of a hospital network with 15 Magnet and 19 Pathways designations across facilities, ²⁶ plans to appeal. Despite ANA’s history of issuing same-day press releases in cases like RaDonda Vaught’s, ^12,15 it has remained silent on this verdict as of October 2, 2025.