94% of Nurses Say There's Racism in Healthcare: Survey

Aine Cryts

January 25, 2022

Ninety-four percent of nurses report that there's either "a lot" or "some" racism in their profession, according to a new survey.

The primary area where racism is experienced by nurses is in their career paths. Incivility and bullying and interactions with colleagues are other acts associated with racism, reports the survey of more than 5600 nurses.

Ernest Grant, PhD, RN, president of the American Nurses Association (ANA), said in a statement that he and his colleagues are "disturbed, triggered, and unsettled by the glaring data and heartbroken by the personal accounts of nurses." Grant is co-lead of the National Commission to Address Racism in Nursing, which released the survey.

Martha Dawson, DNP

"From the bedside to the boardroom, I have been in many different places...in hospitals as well as in academia as faculty, and I've worked as a nurse consultant. In every space, I have seen [racism] show up," Martha Dawson, DNP, RN, president of the National Black Nurses Association (NBNA), told Medscape Medical News.

Other organizations participating in the National Commission to Address Racism in Nursing include the National Coalition of Ethnic Minority Nurse Associations and the National Association of Hispanic Nurses.

Nurses of Different Races Experience Racism Differently

Sixty-three percent of nurses reported personally experiencing racism in the workplace, but nurses of different races experience racism differently. While 92% of Black nurses said they personally experience racism in the workplace, 73% of Asian-American nurses, 69% of Latinx nurses, and only 28% of White nurses reported having this experience; 74% of nurses who consider themselves multiethnic or of other race said they experience racism.

Other findings from the survey include the following:

  • Sixty-six percent of respondents experience racism where the transgressor is a peer and 60% where it's a manager or supervisor.

  • Among nurses who witnessed an act of racism at work, 81% reported that it was directed toward a peer.

  • Almost 60% (57%) of nurses said that they have challenged racism in the workplace, but 64% said no change came about as a result of their efforts.

In the midst of racial justice protests in June 2020, the ANA described racism as "a public health crisis that impacts the mental, spiritual, and physical health of all people." At the time, the ANA made a variety of commitments, including the following:

  • Championing the Code of Ethics for Nurses, which recognizes "human dignity regardless of race, culture, creed, sexual orientation, ethnicity, gender, age, experience, or any aspect of identity";

  • Collaborating with nurses to end systemic racism, especially in the nursing profession, while advocating for the need to address community- and healthcare system–based health inequities that result from racism;

  • Promoting dialogue, effective listening, and commitment to improve the health of all communities.

In 2021, the National Commission to Address Racism in Nursing defined racism as "assaults on the human spirit in the form of actions, biases, prejudices, and an ideology of superiority based on race that persistently cause moral suffering and physical harm of individuals and perpetuate systemic injustices and inequities."

Racism can also be coupled with colorism, which is another challenge in healthcare settings, Daniela Vargas, MPH, RN, a clinical nurse and DNP student at the University of San Francisco, told Medscape Medical News. Her advice for nurses: Be willing to have uncomfortable conversations with colleagues and embrace these situations as "teachable moments."

Colorism is a type of discrimination that's typically based on skin color where a lighter skin color is often favored over a dark skin color within a racial or ethnic group, per the Pew Research Center. A November Pew poll found that a majority (62%) of Latino adults reported that having a darker skin color negatively impacts their career advancement.

Healthcare Leaders Must "Set the Tone"

Dawson encourages healthcare leaders to "look at the data" revealed in the report and then act on that data. "Like it or not, [you] have to own the climate and the environment within [your] organizations, because [you] set the tone," she told Medscape Medical News.

To address racism, she recommends that healthcare leaders look to best practices on ending workplace bullying. A 2018 book on the topic recommends a variety of options, which can include the following:

  • Changes in policies and procedures, training for staff and managers, and monitoring of bullying behaviors;

  • Requiring that the bullied employee receive an apology from their colleague;

  • Providing compensation to the bullied employee; and

  • Disciplinary action, which may include dismissal but also includes training, coaching, and/or counseling.

Dawson also champions increasing the number of Black, Asian-American, Latinx, American Indian, and Alaskan Native nurses. According to NBNA, Blacks make up only 7.8% of the country's approximately 4 million registered nurses, while non-White nurses account for a total of 26.7% of registered nurses. Increasing Blacks in the nursing profession to 15.6% is the organization's long-term goal.

She points to the NBNA Mini Nurse Academy, which was launched in 2018 to expose students from traditionally underrepresented communities in grades 3 through 6 to the nursing profession as one effort to increase diversity. The program also partners students with role models and mentors as they continue to middle and high school. Currently, nine cities and states host the program.

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