‘The Only One’—But Not Alone: Black Nurses on Overcoming Bias, Finding Support & Growth
Nursing is a profession grounded in compassion, trust, and human connection. But while the field serves diverse communities, its workforce does not always reflect that same diversity. Today, over 80% of registered nurses identify as White, making nursing a profession where many nurses of color often find themselves as “the only one”—the only non-White individual in their nursing program, cohort, on their unit, or sometimes even in their entire organization.
In a recent episode of the Nurse Converse podcast, four accomplished Black nurses—ranging from bedside RNs and CRNAs to doctoral-prepared leaders and influencers—came together to share their personal and professional journeys. Their conversation shed light on the challenges they’ve faced navigating systemic bias and racial disparities within the nursing profession.
But their stories are not just about obstacles—they're about resilience. Through mentorship, peer support, and strong community ties, these nurses have found ways to thrive in environments that weren’t always built with them in mind. Their experiences underscore the importance of representation, connection, and creating inclusive spaces where all nurses can grow and succeed.
Thank you to our podcast hosts and panel for coming together to share your personal experiences. We deeply appreciate your courage, vulnerability, and willingness to engage in such an important—and often difficult—conversation. Your voices are powerful, and your openness helps move the nursing profession forward.
- Ama Mathewos, MPA, BSN, RN, NEA-BC, CTACC
- Everett Moss II, DNP, APRN, CRNA, NRP
- Casey Green, MSN, RN, CCRN-CMC, CTRN, CFRN, CEN, TCRN, CPEN, CNRN, NRP
- Travius Keandric Richardson, BSN, RN
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Representation in Nursing: Building Trust and Connection
When we talk about representation in nursing, it’s not just about fairness—it’s about better care. Who patients see at their bedside matters. It can build trust, create comfort, and even improve health outcomes. But the reality is, nursing still doesn’t reflect the diversity of the communities it serves.
Nursing remains a predominantly White profession. Here’s how racial groups are represented in the nursing profession, according to AACN:
- About 80% of registered nurses identify as White
- 6.3% are Black or African American
- 7.4% are Asian
- 6.9% identify as Hispanic
- Native American, Alaska Native, Native Hawaiian, and Pacific Islander nurses each make up less than half a percent.
That means many nurses of color often find themselves as “the only one” on their unit—which can feel isolating and exhausting.
This lack of representation becomes even more complicated when caring for patients from diverse backgrounds. Without someone who shares (or even understands) their lived experience, patients may feel less seen, less heard—and less likely to trust their care.
We can’t ignore these numbers or what they mean in real life. Increasing diversity in nursing isn’t just a box to check—it’s a step toward equity, connection, and truly patient-centered care.
“The Only One”
Casey Green, an experienced ICU nurse now pursuing a career in nurse anesthesia, shared her experiences working in Baltimore, where she was often the only Black nurse in a predominantly Black patient population. She described moments when patients, unfamiliar with seeing Black professionals in such roles, would mistake her for a member of the environmental services (EVS) team, rather than recognizing her as their nurse.
“People asking if I was EVS or like other support staff, not being able to comprehend that I was the nurse taking care of them. Because I was Black, how could I be a nurse taking care of them?"
Casey also reflected on the powerful moment that inspired her to become a certified registered nurse anesthetist (CRNA). When her father underwent surgery, she saw a Black CRNA for the first time, an experience that profoundly shaped her career path.
"Up until that point, I had never seen a Black CRNA. My mom is a worrywart, and she was like, 'After she talked to me, I feel so calm. He’s gonna be taken care of.' And when I saw that, I was like, 'That’s it. That’s what I want to do."
These experiences highlight the profound effect that representation can have, both in terms of patient comfort and as a source of inspiration for the next generation of Black healthcare professionals.
Everett Moss II, a CRNA, also spoke about the comfort that comes from receiving care from someone who looks like you. He recalled working in pediatric settings where young patients, nervous around unfamiliar faces, would calm down immediately in his presence.
“You’ve got a small child who may not have been around any other races, and they're scared to interact with all of the other providers. Then I pick her up, and she lays her head on my chest. It's calm. Like it just does something to my soul."
He also described the deep trust that can form in these moments, recalling an interaction with an elderly patient.
“You have an 80-something-year-old lady looking at everybody else in the room and she looks at you and says, 'Baby, please keep me safe.' Those are the experiences that speak to me,” he said, adding that for many patients, seeing a familiar face can be a powerful source of comfort and reassurance. "There’s a population of people who just simply feel a little bit more comfortable, have a little bit more trust and belief in healthcare because of seeing individuals who resemble them."
These stories capture the profound emotional impact that representation can have, not just for the patients, but for the healthcare professionals who care for them, reminding us why diverse voices are so essential in the nursing profession.
Navigating Bias and Microaggressions
Navigating bias and microaggressions is a significant challenge for Black nurses, who often face assumptions about their roles and abilities based on their race.
Ama Mathewos shared her own experiences of being mistaken for support staff rather than a nurse, a common and frustrating reality for many nurses of color. She described the exhaustion of repeatedly having her role questioned, even after providing high-quality, hands-on patient care.
"I would get on an everyday basis, like when I was clinical bedside, after giving great care, interacting with meds, dressing changes — I was on the surgical floor, all of that. And I would hear the patient be like, 'Well, I’m not sure who my nurse was.' And I’m like, 'Well, who did you think I was these past 12 hours?'"
She noted that this type of bias didn’t stop when she moved into leadership roles.
"When I became a leader, often people would be like, 'Are you the case manager? Are you the social worker?' And I'm like, 'I've been here before. Nurse manager, you know.' But yeah, that's tiring and exhausting."
This kind of bias can undermine professional confidence and contribute to feelings of isolation, even in diverse healthcare settings.
The Pressure to Prove Oneself
The panel also discussed the unique pressures Black nurses face to prove their competence in predominantly White workplaces.
Travius Keandric, who was the only Black nursing student in his graduating class at the University of Alabama, reflected on his early career experiences navigating a predominantly White healthcare environment.
"I was forced to cut my dreads off in school," he said, highlighting the pressure to conform to a narrow standard of professionalism.
His first nursing role in Tuscaloosa was marked by overt racism and frequent microaggressions. He recalled a moment when a colleague was pressured to lie to upper management about him, an experience that easily could have broken his confidence if not for the support of a fellow nurse.
He said, “If I hadn't loved myself, I would have let myself go. And if it wasn't for this other nurse — like you say, Black, White, brown, or blue — to stand up for what's right versus what's wrong, I wouldn't be here."
Travius described feeling a constant pressure to outperform his peers in order to avoid negative judgment and prove his competence. This relentless need to excel, he noted, was both mentally exhausting and a contributing factor to burnout. His transition to a more diverse and inclusive healthcare setting in Atlanta brought a sense of relief and renewed professional fulfillment.
Casey described a similar experience, reflecting on the expectation to be "twice as good" as her non-Black colleagues just to be seen as equally competent. She shared how this pressure pushed her to pursue extensive certifications in her field.
"After becoming the alphabet soup queen, everything became a little bit easier," she said, referring to the long list of certifications she earned. "While I did it for personal growth, I also did it because a lot of my managers in the past were like, 'We’re not paying for you to do certification because we don’t think you’ll pass.' If I have to be five times better than you, then I'm going to get certified five times better than the next person, eight times better."
Casey also reflected on the frustration of seeing less experienced colleagues advance more quickly, a common struggle for many Black professionals. "It sucks because people will get into positions and you know that they’re less qualified than you," she said.
"I almost think that sometimes being Black in healthcare means you inherently have to be eight times better than somebody else to even be considered equal to them on a playing field."
This theme of needing to overachieve to overcome biases is a common thread among Black professionals in healthcare, adding an extra layer of stress to an already demanding profession.
Code-Switching and Authenticity in the Workplace
Another critical aspect of the conversation was the practice of code-switching, or altering one's behavior, speech, or even physical appearance to fit into predominantly White work environments. This can include changing hairstyles, modifying speech patterns, or adopting different mannerisms to avoid being stereotyped or judged. While code-switching can be a useful survival mechanism, it often comes at the cost of authenticity and mental well-being.
Nurse Travius in the panel mentioned the anxiety triggered by constantly having to adapt to different cultural expectations.
Ama highlighted the importance of staying true to oneself despite these pressures.
"I think sometimes people think code-switching is just about not using slang, but it’s more than that," she said. "It’s using your natural pace of language, your tone, your posture — telling a joke, whatever it is. It’s about not feeling the need to zip yourself into this ‘professional’ version that larger society expects, just to be taken seriously."
She compared this experience to a popular meme that captures the pressure many Black professionals feel to conform. "It’s like the meme where you’re a polar bear at work and a brown or black bear at home. It’s about taking on these behaviors, language, or attire that the larger society identifies as normal or professional, and then switching back when you're in a space where you know you won’t be judged negatively for being yourself." The consensus was clear: Black nurses should not have to change who they are to be considered professional or competent.
The Power of Community and Support
Despite these challenges, the nurses emphasized the importance of community, mentorship, and support in overcoming workplace isolation and bias. They encouraged each other and their listeners to seek out organizations like,
These organizations provide crucial networks, resources, and a sense of belonging.
Travius noted that moving to Atlanta, where the healthcare workforce is more diverse, made a significant difference in his professional satisfaction and overall well-being. This shift from isolation to inclusion highlights the critical need for healthcare systems to create environments where diversity is not just tolerated but celebrated.
Everett highlighted the importance of finding mentors and allies who understand the unique struggles faced by Black nurses. For him, mentorship is a way to give back and honor those who helped him succeed.
"I don't turn down a mentee," he said. "I don't take on traditional mentees in the sense that I'm going to be calling you, working on specific projects with you. You're going to have to ask me some questions. I'm going to give you some answers. But I don't charge for those things because I feel really blessed and fortunate that I have had people pouring into me since I stepped foot in the door. So it is impossible for me to charge what was given to me freely. I don't knock other people who do it, but I cannot do it. It's my way of paying back those people who I can never repay."
This kind of support can make a significant difference, providing not only professional guidance but also emotional reassurance in challenging work environments. For many nurses, finding mentors who truly understand their struggles can be a crucial part of building confidence and resilience in their careers.
Creating a Healthier, More Inclusive Future in Nursing
The experiences shared by these nurses serve as a powerful call to action for systemic change within the nursing profession. Representation matters not just for those working in healthcare but for the patients they serve. By fostering environments where all nurses can thrive, regardless of their race or background, the healthcare industry can improve patient outcomes, reduce health disparities, and ensure that all voices are heard and valued.
