The White/Black Hierarchy Institutionalizes White Supremacy in Nursing and Nursing Leadership in the United States.

Abstract<b>Background</b>: Black/African American nurses (BAANs) in the United States (US) experience barriers to career advancement.<br><b>Aim:</b> The specific aims of this study were to a) explore how the perception of racism or racial bias affects the motivation of Black/African American nurses (BAANs) in the United States (US) to seek and apply for nursing leadership and faculty positions, and b) to characterize the racism-related barriers that BAANs perceive that prevent them from moving forward with their careers in academia and nursing leadership.<br><b>Method</b>: As part of a qualitative focused ethnographic study, 30 nurses who self-identified as BAAN, had a bachelor’s degree or higher, and had at least five years of nursing experience were interviewed. Qualitative data underwent thematic analysis.<br><b>Result</b>: Although five themes were identified, four were established in the literature, and one – Nursing Leadership Dynamics (NLD) – was novel. A complex network of NLDs that served to both prevent the success of BAANs as well as threaten their job security and health was identified.<br><b>Conclusion</b>: This study identified a multi-faceted, tightly-woven system of NLDs that serves to continually institutionalize and enforce a white/black hierarchy and white supremacy in nursing at all levels in the US, including education.<br><b>Key words</b>: Nursing; Economics, Nursing; Education, Nursing; History of Nursing; Leadership; Racism; United States