Intentionality in reducing health disparities: Caring as connection.

Objective: Inadequate health care quality may contribute to Native American health disparities through racial/ethnic discrimination by health care professionals. Nursing approaches to relationships and caring offer a means to understand health disparities through an unconventional lens. The study objective was to examine health disparities within the context of patient/nurse relationships.

Design: A descriptive-qualitative method guided data collection and analysis. Eleven nurses who serve Native Americans were interviewed. They described attitudes, meaningful relationships, and nurse leadership.

Results: Nurses discussed their perceptions of and experiences with Native American patients. Four themes emerged: shared patient/nurse values, patient-centered care, external forces, and stereotype-driven care.

Conclusions: Are we ready for the challenge to advocate for, build, and sustain organizational structures that support caring relationships? Implications for public health nursing include being intentional about recognizing implicit biases and ethnocentrism; examining nurses' complicit roles in perpetuating racism; and developing mechanisms to collectively advocate for improved Native American health.