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How much has changed since Mary Seacole?

Mojibola Odusanya 2 Oct 2024

Black History Month - Has the issue of racial discrimination in nursing improved in the last 150 years?

A nurse and businesswoman who famously nursed sick British soldiers during the Crimean war in the 1850s, Mary Seacole was, in my opinion, the first black woman to really make her mark on British public life. A contemporary of Florence Nightingale, although 15 years older, she truly is an inspirational figure. 
 
Mary’s offer of help to the British War Office, asking to be sent as an army nurse to the Crimea, was declined despite her extensive knowledge and experience. Although other reasons were given for declining Mary’s application, she gives voice to her suspicions in her memoir: "Was it possible that American prejudices against colour had some root here? Did these ladies shrink from accepting my aid because my blood flowed beneath a somewhat duskier skin than theirs?”
 
There was no doubt that Mary met the eligibility criteria at that time for sponsorship to the Crimean war. She had practiced nursing wounded soldiers, having learnt from her mother. The lack of available information about the 14 nurses who were state sponsored, along with Florence Nightingale, hints that Mary may have had greater influence and would have been equally or more qualified to be sponsored.
 
On their return from the Crimean war, Mary was bankrupt and, in order to maintain a decent living, had no choice but to accept charitable fundraising organised by one of the soldiers. and was almost forgotten for almost a century after her death. Florence, in contrast, had tea with Queen Victoria and enjoyed limitless career progression, including the establishment of the first secular nursing school.
 
The denial of equal opportunity had an impact on Mary and as a nurse writing this, I’m almost certain it would have had an impact on the soldiers’ experiences of nursing care had Mary not self-sponsored. History has it that the denial of opportunity brought Mary to tears on the street. While the soldiers experienced Florence as the ‘Lady with the lamp’, they saw Mary as ‘Mother Seacole’. This highlights the value of diversity in nursing, in both age and approach. It shows that patient care is optimised by Equality, Diversity and Inclusion (EDI). 

The impact of Mary’s care was shown by the many military men, including top-ranking officers, who supported a fund-raising event organised for her benefit. Over 1,000 artists, including 11 military bands, entertained a crowd of 40,000 people. The words of The Times correspondent William Howard Russell sums up her contribution: "I have witnessed her devotion and her courage ... and I trust that England will never forget one who has nursed her sick, who sought out her wounded to aid and succour them and who performed the last offices for some of her illustrious dead”. His testimony teaches that every nurse’s place in nursing history should be determined by their contribution, not their skin colour. 
 
Many believe that nursing has progressed significantly since the 1850s. No doubt countless changes have taken place, but improvements in the eradication of discrimination and a levelling of the playing field in the offer of opportunities have not kept pace with the changes in nursing. Black minoritised ethnic nurses continue to be denied career progression opportunities. Reasons are too easily found for this, and for a lack of diversity in nursing leadership. Some organisations appear to be running in the opposite direction from the Equality Diversity and Inclusion statements they release to the public. Complaints about racism can become triggers for victimisation, rather than turning points.
 
Mary’s self-sponsorship to Crimea is akin to the self-sponsorship of minoritised staff. In comparison to white staff, they are more likely to self-sponsor for additional qualifications for leadership positions within the NHS. The NHS Workforce Race Equality Standard, (WRES, 2024) shows that BAME nurses are less likely to be offered career development opportunities. This is underscored by data on the ethnicity pay gap.
 
Mary’s career pathway was determined for her - stay behind in Britain and follow the usual path, regardless of career interests and experience. This is like minoritised nurses’ systemic restriction to band 5 Agenda for Change roles and the denial of opportunities for specialism. Mary’s commitment to service was undeniable. However, her famous words that “willingly had they accepted me, I would have worked for the wounded in return for bread and water” are not repeats of histories to leave behind in the twenty-first century. We hope the nursing profession of our generation will be one where no nursing staff will hope to sacrifice equal pay and promotion for acceptance.  

Racism, in nursing is both overt and covert, though frequently denied, ignored or renamed as interpersonal issues. It has, for too long, been the giant elephant in the room that many will do their best to avoid acknowledging. Ignoring any form of discrimination is not a harmless act. It is an encouragement to perpetrators and wind to their sails to propagate hate. It is like ignoring a ready to disperse dandelion seed head in a garden. It impacts directly on patient care, nursing as a profession and, at its most devastating, lives are lost too. If there is anything the recent reports have taught us, it is that racism has been ignored for far too long and has engulfed the very principles of nursing.  This is not something I am imagining. This is backed up by findings in a number of NHS and organisational reports including, most recently, the independent review into the NMC (2024) and the Carr Review into the culture of the RCN. In the face of such evidence, I cannot help but question, how much has really changed since Mary Seacole?  
 
Sadly, for almost two centuries, not much has changed except that the reported figures have significantly increased. Disadvantages remain for the minoritised, and much pain is endured by the victims of racism. Words are cheap in tackling racism, there is need for non-tokenistic actions if we are to free future generations from experiencing emotional resonance triggered by reading the harrowing reports of racism in our generation.
 
The recent defacing of Mary Seacole’s statue in the front of St Thomas on the anniversary of Florence Nightingale’s death is a reminder of the undercurrent polarisation in nursing and the enormity of the work that is needed to right this. The story of nursing does not have to be one where either Nightingale or Mary Seacole are celebrated alone. It can be one where we value everyone’s contribution and consciously play our parts knowing that history will judge our contributions. We can completely rewrite the story of nursing. We can stand together and courageously tackle injustice.  

Members in the North-West region have started a network for like-minded individuals to discuss and tackle such issues together.  The network is growing, and it is only by working together as a multi-cultural collective that we can challenge and stand up for civility, fairness, respect and dignity for all nurses in the workplace. These are standards we should be aspiring to within our profession and are no more than we all deserve.
Mojibola-Odusanya

Mojibola Odusanya

Chair, Greater Manchester Branch

Mojibola is a mental health nurse working for Pennine Care in the North West. She is the current Chair of the Greater Manchester branch. 

Page last updated - 02/10/2024