By Carol Davis
Nearly eight out of 10 nurses have seen or experienced racism/discrimination from patients, and almost six out of 10 nurses said the same about racism/discrimination from colleagues, says a new report from the Robert Wood Johnson Foundation (RWJF).
RWJF examined nurses’ experiences and perceptions of racism and discrimination in both healthcare settings and nursing schools through a nationwide survey of nearly 1,000 nurses from March 2022 through April 2022 conducted by research organization NORC at the University of Chicago.
Although diversity, equity, and inclusion (DEI) efforts became primary focal points for the nation in the wake of the 2020 murder of George Floyd and the resulting racial justice movement, there has been little research on nurses’ experience and witnessing of discrimination, according to RWJF.
The survey explored the extent and severity of racism and discrimination happening around nurses, how often it’s reported, and the culture of the institutions where it occurs.
Among the key findings were:
- Asian, Black, and Hispanic nurses are significantly more likely than white nurses to have seen or experienced microaggressions. Two-thirds of nurses have seen or experienced microaggressions due to race/ethnicity from patients, and nearly half (47%) of nurses said the same about microaggressions from colleagues.
- Fewer than one in four nurses formally reported racism or discrimination they saw or experienced to workplace management. Although 40% of nurses discuss observing or experiencing discrimination because of race/ethnicity with their supervisors, only 23% formally report or document incidents.
- Nurses say their organizations are prioritizing diversity, equity, and inclusion (DEI) initiatives, but more education and training is necessary. Nine in 10 nurses say equitable patient outcomes are a stated organizational priority at their current workplace.
- Nurses say there was a culture of racism/discrimination in their nursing school and that more training/education is needed. More than half of nurses say that their nursing school taught about racially/ethnically sensitive bedside manner while with 60% of Black/African American respondents reporting racism/discrimination. Less than one-third said they were taught about racial bias/stereotypes or systemic racism in healthcare.
While most survey respondents say their organizations are prioritizing DEI initiatives, very little formal reporting occurs when nurses or their patients experience racism, the report notes.
Fewer than one in four (16%) nurses report discrimination they saw or experienced to human resources; instead, most nurses (57%) speak with their fellow nurses, nursing directors/supervisors/managers (40%), or other staff (37%). Black nurses are most likely (64%) to have discussed with other nurses discrimination or racism they’ve observed.
Among nurses who reported such observances or experiences, more than 50% say their relationship with supervisors, senior leaders, and fellow nurses was negatively affected, the report says.
Additional training and educational programs would be beneficial to addressing this problem, including at nursing schools where respondents reported a culture of racism exists, respondents suggest. More than half of nurses say their nursing school taught about racial sensitivity in caring for patients, but less than one-third were taught about structural racism in healthcare, a topic that could benefit patients and employees alike.
Most nurses (91%) say diversity and inclusion at the staff level is an organizational priority; 78% say that about having an ethnically and racially diverse leadership team.
Most of those surveyed (85%) say hiring ethnically and racially diverse nurses is an organizational priority, and most agree hiring practices would improve the ability to recruit and retain racially and ethnically diverse nurses.
Zero-tolerance workplace discrimination policies, clear consequences, and reporting anonymity would improve nurses’ workplaces’ ability to retain racially and ethnically diverse nurses, eight in 10 nurses say.
“If we are to truly provide just and equitable care to our patients, we as nurses must hold ourselves accountable for our own behavior and work to change the systems that perpetuate racism and other forms of discrimination,” said Beth Toner, RN, director of program communications at RWJF.
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.