By Geona Barrow
While attending a bias workshop, a fellow nurse assumed she was a white woman. An emergency room patient saw her and immediately felt safer than she had with other Black nurses charged with her care. One elderly white patient flatout asked, “are you a nigger?”
Her outward appearance has led to some interesting interactions, but make no mistake, Dr. Kupiri Ackerman-Barger is comfortable in the skin she’s in. As Dean of Diversity Equity and Inclusion at UC Davis’ Betty Irene Moore School of Nursing, Dr. Ackerman-Barger works to ensure that others feel the same in the spaces they occupy as healthcare providers.
Dr. Ackerman-Barger, 51, was born to a White mother and Black father. Her parents separated when she was fairly young, her father eventually returning to the Bay Area and she remained in rural Humboldt County, where she was usually one of only a few Blacks there. Long before there was a term for it, she learned how to “code switch.”
“I lived the Black experience when I was with my dad and I lived the white experience when I was with my mom,” Dr. Ackerman-Barger shared. “It was all about how the world interacted with me, less about how I felt.”
For her, becoming a nurse stemmed from a natural curiosity about people. That, and the steady income.
“Nursing was just a really great way to do something that I loved, which was interacting with other people and it was a really good livable wage,” she shared. “I wanted to have something that was reliable, the idea of serving my community and being in service to others was deeply fulfilling.”
Nursing has long been seen by African Americans as a noble profession, one of the “good jobs” that were available to them.
Dr. Ackerman-Barger graduated from Humboldt State’s nursing school at age 26. She worked in critical care and as an emergency room charge nurse, before rising to the position of nursing administrative supervisor. She earned a Master of Science in Nursing Education from Sacramento State and a Doctor of Philosophy in Nursing Education from the University of Northern Colorado.
“The highlights of being a nurse are definitely those times when you get to connect with families, at those pivotal moments, like when somebody is born, the birthing experience, watching somebody come into the world and seeing a family welcome a child, it feels like, that’s when we are connected with whatever higher power there is,” she said.
There’s a similar feeling at the other end of the spectrum, she says.
“I was an ICU nurse for a long time and being with families while their loved one transitioned out of this world, you just feel so deeply connected to the people, the family, your work, and to your own family.”
Dr. Ackerman-Barger no longer works in a hospital setting and today contributes to the advancement of the field in academia. She educates on the intricacies of bias and creates initiatives aimed at making the school’s learning environments, workforce, programs, and services more diverse and inclusive.
Diversity for Black students at the Betty Irene Moore School of Nursing, matches local and statewide demographics, she said.
“Twelve to 15%, that’s kind of been our rate. We get kudos for our diversity, but here’s the thing, if we’re going to change the overall workforce diversity, if we recognize that historically people of color have been hugely underrepresented in nursing and health professions, just matching that demographic right now, that’s not going to be significant in changing the needle. We’re already in this big deficit, so we really need to be shooting for having more students overrepresented for a while to make up for that deficit,” Dr. Ackerman-Barger said.
At the current rate, it would take some 50 years to achieve true racial match in health professions and patient demographics.
“That, of course, is far too slow,” Dr. Ackerman-Barger said.
In nursing, there is a lot of discussion these days about culturally-competent care.
“At the School of Nursing, we do have some courses where we spend specific time working on social determinants of health, and also the notion of health equity. Those are the big, sort of overarching topics and by understanding social determinants of health and health equity, we hope that we can help our individual care providers see how their role is important in mitigating health disparities,” Dr. Ackerman-Barger shared.
“A lot of people think, ‘I don’t have anything to do with that. I’m not racist. I would never do this. This is a bigger problem.’ Yes, there are multiple things that contribute to our health disparities, but some of it is that communities don’t trust us as a health care institution.”
She points to historic mistrust of the health care system in the Black community and how other people have experiences of being talked down to and belittled when it comes to their own health.
“There are multiple ways that people bring in biases and say these things to patients,” Dr. Ackerman-Barger said. “So what are you going to do as a healthcare provider? Then we get into how do we provide quality care and part of that is looking at some of those scripts that you may have learned that may not align with your value system. And begin that process of using cultural humility to unpack that and to change that narrative.”
Deeply Committed
UC Davis’ “strong commitment to DEI” is what drew Dr. Ackerman-Barger in and what has kept her there.
“Keeping it 100% real, we have work to do. We have a lot of work to do, but we do have an amazing community of deeply committed individuals who have been spending their career trying to understand both the art and the science of moving, diversity, equity inclusion forward.”
She praises the work of colleagues like Dr. Ruth Shim, a national leader on social determinants in mental health and UC Davis Health’s Associate Dean of Diverse and Inclusive Education; and Dr. Jann Murray-Garcia, who heads the Betty Irene Moore School of Nursing.
“There is just this huge pocket of people, across identities, that are committed to the work and that makes me want to stay and do this work with them to learn to grow and to innovate,” Dr. Ackerman-Barger said.
“UC Davis is not perfect by any stretch of the imagination, but I do think that we have something that’s special and that is this collective group desire to move the needle forward.”
Dr. Murray-Garcia calls Dr. Ackerman-Barger her “sistah in good trouble.”
“She is an outstanding, well-published, well-funded scholar, nationally respected in both nursing and medicine,” Dr. Murray-Garcia said.
Both Black women are highly sought after for their expertise and perspectives.
In April, Dr. Ackerman-Barger was a featured speaker during the Western Institute of Nursing’s annual conference in Oregon. The topic was, “Justice, Equity, Diversity and Inclusion: Creating A Nursing Force For Change.” The event was a return to large in-person gatherings since the coronavirus pandemic shut things down in early 2020. COVID-19, she says, had major impacts on the work, good and bad. One of the good things was that technology like Zoom or Google Meet emerged and allowed her to reach more schools and organizations across the country.
“I’ve been able to have this sort of national platform without that difficulty of getting from one place to another,” she shared. “That’s been a positive thing. The negative part of that is a lot of the work around anti-racism, cultural humility, health equity, it’s about human interaction and man, it’s hard to talk about how to improve human interaction over the computer.”
A deep dive into racism requires people to be involved in dialogue. The absence of face-to-face meetings made things tricky and the country was about to find itself embroiled in what activists called a “double pandemic” — COVID and racial unrest following the killing of George Floyd.
“I was worried at the very beginning of the pandemic that a lot of my talks got cancelled, because we’re dealing with COVID, we can’t talk about racism and microaggressions. And a few months into the pandemic is when George Floyd was murdered and that all of a sudden became a national inflection point where so many people were reaching out.”
Dr. Ackerman-Barger went from doing two talks a month to two per day.
“There’s something happening that I haven’t seen in my lifetime, or my career, where people are no longer saying, ‘What’s the point of diversity?’ or ‘Oh, diversity would be nice, but it’s not a priority,’ to ‘We need to actively do something in our organization to make sure that we are not producing these disparate outcomes.’ I think that’s been a good thing too.”
Change is possible and Dr. Ackerman-Barger sees herself as a change agent.
“It sounds quaint or something, but I definitely feel called to it,” she said of her work.
“There was a while where I was like, ‘I don’t want to do diversity, equity and inclusion work, I don’t want to,’ but it almost felt like a split in my heart and soul. I just need to do this work. It’s so deeply ingrained in who I am as a person in terms of having been an activist since I was really young and growing up looking at these racial differences between the way that the world saw me depending on what family I was in.”
The work of iconic activists inspires her to push past the “dips and valleys.”
“I look at people like Martin Luther King Jr., who gave his life for this cause; Nelson Mandela, who spent 27 years in prison, for this cause, and when I start to feel tired or burnt out, I think, ‘Here are some of our heroes that gave up so much. I can deal with my racial battle fatigue; I’m going to get up in the next morning and keep doing it.’”