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Although just five percent of the nation's 1.3 million nurses are African American, they have made notable strides in the profession: The number of African-American nurses increased 119 percent between 1980 and 2000, and almost half have at least a BSN degree.

When Joyce Newman Giger went back to her hometown in South Bend, Ind., after graduating from nursing school in the 1970s, she stopped at the city hospital and asked for a job application. She was told that the facility "didn't need anybody else to work in the kitchen."

Undaunted, she replied, "That's great, I don't want to work in the kitchen. I'm a nurse."

Giger, Ed.D., RN, FAAN, a professor of graduate studies at the University of Alabama at Birmingham School of Nursing, got the job. But, as one of five African-American nurses in a hospital with a staff of several hundred RNs, it would not be the last time she would run into prejudice.

One night, not long after she started working the 11 p.m.-to-7 a.m. shift at the same hospital, a patient on Giger's floor needed pain medication. He was Caucasian, and had been admitted that night after being severely beaten by several African Americans.

When Giger went into his room, the patient told her he didn't want to be treated by her. "I said, 'Fine,' knowing that the only other nurse on duty was also African American, as was the unit administrator," Giger recalled. "I went and got them, and said to the patient, 'It's either her, or her, or me or pain. What's your choice?' He said, 'OK, you.' "

Giger said she didn't take the patient's attitude personally. "It wasn't me, it was him," she said. "Racism is somewhere, everywhere. But you don't let it run you. You run it. You try to make a difference."

Giger succeeded that night. By the time her patient left the hospital, they were friends. "Every year at Christmas, we send cards. We have been doing that for over 30 years," she said. "That one experience that night changed his attitude. He told me he could have left that hospital not liking anyone who was African American."

Although working conditions and attitudes have improved in recent decades, lingering racism and discrimination present a continuing challenge-for nurses, patients and administrators of all backgrounds.

"When you go into the hospital, you're not going to have all black, all white, all Chinese. Cultural diversity, cultural sensitivity is the key," said Veronica Clarke-Tasker, Ph.D., MBA, MPH, RN, associate professor of nursing at Howard University in Washington, D.C.

African Americans have made significant strides in the nursing profession: The number of African-American nurses increased 119 percent between 1980 and 2000, and almost half have at least a BSN degree, according to the 2000 National Sample Survey of Registered Nurses.

The impressive growth rate is tempered, however, by the relatively small number of African-American nurses overall: Just 5 percent of the nation's 1.3 million nurses are African American-compared to 12 percent of the general population.

"We need more African-American nurses, more minority nurses period, since America is changing color," said Bettye Davis-Lewis, Ed.D., RN, FAAN, president of the National Black Nurses Association and CEO of Diversified Health Care in Houston.

African Americans have been involved in nursing in the United States for almost as long as the country has been independent from the British. In 1783, James Derham, a slave from New Orleans, bought his freedom while working as a nurse, and later became the first African-American physician in America, according to a history of African-American Nurses compiled by Aetna, a health insurance company.

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