Could Promises Create More Inclusive Teams?

Jen Hamilton, a labor and delivery nurse in North Carolina who speaks widely on how to be a better ally to your patients, shared a story about the moment her nursing changed. One day, a few years into her work, she noticed that one of her patients was shaking. The patient wasn’t in labor, she was in for an induction, and as of yet, no procedure had started. So she stopped what she was working on, pulled up a seat, and asked if she was ok. The patient's response, “I am just afraid that you are going to kill me.” Jen was confused, the girl was in a hospital, the place that should make you feel the most safe, with a nurse who was there to help her, and yet, she was fearful. And that women, shared with Jen the history of gynecology, a history that is not shared when you are studying it. James Marion Sims, who is considered the father of gynecology, experimented on black enslaved women without any anesthesia. A lot of what modern gynecology is built on is born from the suffering of enslaved black women. This moment changed everything for her. She started learning about the history and paying close attention to the experience of black women in the hospital where she worked. This experience of learning and noticing changed how she shows up for all of her patients, especially black women. She realized that her coming in wearing scrubs and a badge does not inherently make her a safe person. She is a stranger, coming in, and expecting women to answer very personal questions and to be examined. 

And I think that is a really important realization for all of us. Just because you were put into a position of power, be it by working your way up to a management role or starting a company, it does not make you an inherently safe or trustworthy person - especially when you are working with marginalized groups who have dealt with decades of conscious and unconscious discrimination and trauma.

So she changed her practice. The first thing she does is pull up a seat next to them. Not over them, but beside them. Before she asks them any questions, she tells them about herself. She realized she must give of herself before she expects anyone to give of themselves. And from there she makes promises. What she calls her “Sit in Solidarity” promises. They are:

• I promise to be your advocate. 

• I promise to listen and believe you.

• I promise to prioritize your safety and security. (And talks about how she will do this)

• I promise to explain things so that you can make decisions you feel good about.

• I promise to protect your bodily and decision-making autonomy.

• I promise to never keep secrets from you. 

She believes that the field of obstetrics would change if doctors and nurses could make these promises to their patients and keep them. 

While having a baby is different than being a manager, being aware of someone's historical distrust in your position is still extremely important. Doctors are considered authority figures that we are expected to trust. Yet study after study shows that women, especially women of color, are consistently gaslit by downplaying their symptoms, in many cases, delaying life-saving care or creating situations that result in PTSD. A study on heart disease found that women who went to the doctors with chest pain and other stereotypical symptoms of a heart attack were twice as likely as men to be diagnosed with mental illness. Recently a horrifying story came to light that dozens of women who underwent an egg retrieval at Yale Medical Center were doing this incredibly painful procedure without any drugs since a nurse had been stealing the fetynol that should have been in their IV and instead replaced it with saline. And while the theft is horrifying, the reality was that these women were telling everyone during and after that they were in excruciating pain and no one believed them. 

When you have experiences like this your whole life, as many women, people of color and disabled people do, you start to equate people in positions of authority with people who you don’t expect to believe or trust you. And frankly, they have good reason to believe that. A national survey found that people with disabilities are at a heightened risk of workplace discrimination, including being fired or never being promoted. Focus group interviews by Keller and Galgay (2010) found that disabled people feel like they are treated like “second-class citizens” and often feel like their intelligence and skills are underestimated.

Now you can’t change the past or other people’s actions. You can’t right the experiences that have happened for disabled people, but you can sit beside them, and make promises, just like Jen does with her patients. 

So what kind of promises make sense for the workplace? Ideally, these will be commitments that you come to together, either individually or as a team. They should also be promises that you are kept accountable to. For example, if you make a promise to give every employee the benefit of the doubt, and it appears that you are giving it only to certain employees, then your team should be able to have an open and safe conversation with you about it. 

Here are some example promises a manager might make:

• I promise to believe that you are doing your best work

• I promise to not make assumptions without talking to you directly

• I promise to evaluate if my decisions are equitable and unbiased before making them

• I promise to listen without retribution if you want to discuss your experience with me as your manager

• I promise to divide the work equitably and to create a formal process for evaluating each team member for promotions

• I promise to support your requests for accommodations without judgement

• I promise to continuously evaluate how I am showing up for every member of my team and strive to do better when I make mistakes

So what promises are you willing to make?