Nurses not Nursing: Insensible Violence and Institutional Inertia

Jess Dillard-Wright

The nursing organizations that purport to represent the entire profession repeatedly and resolutely refuse to sharpen their political analysis, refuse to walk what they so readily talk, and I am furious. Furious about the death of colleague and comrade Alex Pretti. I am furious that substantive responses from my discipline to the Trump administration’s terrorism are predicated on objective violence against a nurse, particularly when the quotidian violence has escalated continuously. In this, I recognize a historical pattern in the professionalized discipline of nursing: like Alex Pretti, nurses have shown up for the people, while nursing shows up too late, inert and ineffective.^[1] This is not accidental. Instead, by choosing late engagement and a politics of neutrality, nursing shores up proximity to white, patriarchal power while mobilizing the moral cache of gendered carework.

As I think through the issues at hand, I want to draw a distinction between how I am using nursing and what I mean by nurses. When I use “nurse,” I refer to individual nurses. When I say “nursing,” I mean the assemblage of professionalized nursing organizations that govern and regulate the discipline and profession, like the American Nurses Association (ANA) and the American Academy of Nursing, as well as other institutions that comprise the healthcare-industrial complex. This assemblage of systems, structures, and institutions seems impossible to change, a convenient imaginary that stops radical transformation before it starts. In the following discussion, I reflect on how nurses show up and how, both historically and in the present, nursing lets us down.

When I say nurses show up, I am talking about Marie Branch. In 1972, Branch reported in Nursing Forum on her trip to the People’s Republic of China as part of the Black Panther Party delegation, connecting health practices observed there to critical needs of the American people.^[2] By the time she traveled to China, Branch had already launched a Panther-led community clinic in Southern California and was leading antiracist nursing education research.^[3] Branch’s influence reached ANA by way of its Cabinet for Human Rights. In a 1975 report on Affirmative Action in nursing, Branch offered a critique of the organization’s progress toward racial equity, noting “serious concerns about the status of affirmative action with ANA today” and citing a record of inaction.^[4] In 1978, led by efforts from the Cabinet, ANA adopted a justice-oriented “Position Statement on Nursing and Health Needs for Ethnic People of Color,” which advocated for a “multifaceted approach […] to correct the injustices that exist in the health care system,” reflecting terminology introduced to nursing by Branch.^[5] Though the organization adopted progressive positions in the 1970s, reflecting broader social and political attitudes, particularly in the Cabinet for Human Rights, ANA shifted toward a more corporate structure and politics in the 1980s. While the Cabinet for Human Rights was a generative space for progressive thinking in the 1970s, that eroded in the 1980s, and its mission was folded together with ANA ethics initiatives to form the Center for Ethics and Human Rights in the 1990s.

By the 2020s, ANA had lost Branch’s influence, reverting to or maintaining the practices she critiqued. This is reflected in ANA’s “Our Racial Reckoning Statement” issued in June 2022, which aimed to serve as an acknowledgment and apology to nurses of color for the racist harm done by the organization, as well as a “starting point of a new journey toward the future.”^[6] Speaking about the statement on the Reverend Al Sharpton’s MSNBC talk show PoliticsNation in July 2022, then ANA Vice President of Nursing Practice and Policy Cheryl Peterson invoked history as both explanatory and exculpatory. She insisted that ANA “needed to look at ourselves as a professional organization that is 126 years old. We needed to repair our relationship with the nurses of color and the organizations that stepped into that breach when we failed to represent the interests of their members and the needs of communities of color.”^[7] In so doing, Peterson offered a sanitized version of ANA’s history, a passive vessel for, rather than an active producer of, racism in nursing. In the same interview, Peterson went on: “we’re choosing to address it because we know that racist views, policies, and behaviors have, over many years, been unchallenged and unchanged by those in power.”^[8] This narrative is patently false: nurses have, in fact, challenged ANA’s racism, as Branch’s work shows.

When I say nurses show up, I am talking about Carolyn Innes. Innes found her way to gay liberation after attending a talk delivered by iconic gay rights leader Barbara Gittings in Philadelphia in 1971.^[9] Gittings was already an established activist and, following her talk, shared details about unfolding plans for a 1972 Pride march in Philly.^[10] Innes immediately jumped in, joining the planning committee even as she was apprehensive about being outed in her professional life.^[11] Gittings became Innes’ formal mentor, and this firsthand view of Gittings’s work with Frank Kameny and others to depathologize homosexuality in psychiatry inspired Innes to launch a “gay caucus” for nursing.^[12] Innes and coworker David Waldron started the Gay Nurses Alliance (GNA) shortly thereafter. The organization debuted with a screening of The Invisible Minority: The Homosexual in Our Society at the 1973 Pennsylvania Nurses Association conference.^[13] By 1974, GNA boasted local caucuses in Massachusetts, New York, and California.^[14] GNA co-organized a 1975 women’s health conference with Judy Norsigian in Boston and the National Gay Health Conference in Washington, D.C. in 1978.

Like Branch, Innes, and Waldron – through the GNA – would make their presence known to ANA; Waldron was ultimately appointed to the Cabinet for Human Rights. Through that work, Waldron elicited the support of the Cabinet in endorsing the civil and human rights for people of all “sexual and affectional preference” in 1978.^[15] Getting there required concerted organizing and asking critical questions about queer representation in ANA and the spaces it sponsored. ANA retains an ostensibly supportive LGBTQ+ stance in a recently reaffirmed ANA Ethics and Human Rights Advisory Board (EAB) position statement titled “Nursing Advocacy for LGBGQ+ Populations,” published in 2025.^[16] The position statement, however, retains a whiff of deficit framing, positioning LGBTQ+ folks as “high-risk” for some health considerations while reinforcing a decidedly binary orientation to LGBTQ+ advocacy in which nurses do the advocating, and the people who need advocacy are patients.

When I say nurses show up, I am talking about Alex Pretti. Pretti, a Veteran’s Administration Intensive Care Unit nurse, “wanted to make a difference in the world,” according to his parents, Michael and Susan Pretti.^[17] For Pretti, that looked like providing compassionate nursing care while also showing up to advocate for his community and assisting fellow Minnesotans when physically confronted by federal agents. As he helped a neighbor, Pretti was pepper-sprayed, held down, and shot multiple times after being disarmed by federal agents.^[18] His murder was captured from multiple angles on video taken in real time. No one should face this kind of extrajudicial violence. Not Pretti. Not Renee Good. Not Keith Porter, Jr., not one of the thirty-two confirmed deaths in ICE facilities in 2025, nor any of those already registered in 2026.^[19] Families should not live in terror, irrespective of immigration status.

Not until Alex Pretti was murdered did we see outcry from nursing organizations – “we are Alex Pretti.” Of course, not all nursing organizations are so resolute in their political ambivalence as ANA; groups like National Nurses United consistently articulate a politics of care that attends to the realities of the moment. And yet, because ANA positions itself as the voice of the profession, the organization assumes some accountability and responsibility for how it represents us. Why did it take ICE murdering one of our own before ANA showed up? Where is the outcry for all the others harmed, humiliated, hurt, and annihilated by the actions of this abject regime? Even in honoring Pretti, ANA falls short: “Deeply disturbed and saddened to learn of the death of Alex Pretti, a registered nurse,” ANA characterized Pretti’s death as an act of workplace violence, citing “concern[…] for the safety of nurses, both on the job and in the communities they serve.” The sole call to action is “a full, unencumbered investigation,” condemning violence in US communities.^[20] This lands as opportunistic, failing to interrogate the circumstances of Pretti’s death, never mind the reality that it took a white, male nurse dying at the hands of federal law enforcement for ANA to condemn this violence – even though it has been ongoing in the US since the very birth of the nation. It again fails to meet the sociopolitical realities of the moment, echoing its past failures, reflecting a sordid and disappointing institutional inertia that leaves much wanting.

None of the individual nurses named here were doing the political, activist, and community work that they were doing because they were nurses. In fact, I rather think that Innes and Branch, like Pretti, were nurses because they wanted to care for their communities, of which they themselves were and are a part. Nearly 99% of people born in the United States meet a nurse on their first day earthside. Because of this, as a nurse, I feel compelled to think on global, planetary, universal, and holistic scales about how the profession moves and acts.^[21] It matters what we do, what we say, and how we move as a profession. The work we do is intimate, touching us all at some point or another. We all have a stake in making nursing the best it can be. This demands accounting for histories of harm while also working to repair them. It also means cultivating an imaginative and capacious politics, recognizing that nursing needs this if it is really about wellbeing and care. What we don’t need? More empty words and co-opted victimhood. The people deserve better. Nursing can build a better future using the foundations laid by nurses like Innes, Branch, and Pretti (as well as others not discussed here) through critical engagement with our collective histories, using this moment, this political reality, as an impetus. Rather than shying away from political snarls, nursing could actualize the ideals it professes and do the work of building a more just, equitable future.

Featured image courtesy kaboompics.

Jess Dillard-Wright

Jess Dillard-Wright, PhD, MA, RN, FAAN is an associate professor at University of Massachusetts Amherst Elaine Marieb College of Nursing. Jess’ research occupies the intersection where nursing, philosophy, history, and activism meet, informed by feminist science and technology studies. Jess is currently co-editor-in-chief for the journal Nursing Philosophy and a developmental associate editor for Witness.

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