Racism is harming nurses, and it’s an ongoing problem. January results from a survey of over 5,600 nurses found that almost half of nurses say there’s a great deal of racism in nursing. Sixty-three percent of nurses surveyed have personally experienced an act of racism in the workplace, with the wrongdoers being either a peer (66%), a patient (63%), or a manager or supervisor (60%). What Is racism and who experiences it?
Racism includes any attitude, action or inaction which subordinates a person or group because of their race or ethnicity. It is the systemic mistreatment experienced by Black, Indigenous, and people of color (BIPOC). Racism hurts everyone and is a patient safety issue. It has negative consequences for both patients and healthcare workers, leading to higher risks of illness and, in some cases, lower standards of care for BIPOC individuals.
According to the survey, 92% of Black nurses experienced racism at work. But nurses of other races and ethnicities experienced racism as well, including Asian (73%), Hispanic (69%) and white (23%) nurses.
The National Commission to Address Racism in Nursing (the Commission) conducted the survey, and it continues to examine the issue of racism within nursing. The Commission consists of leading nursing organizations, including the American Nurses Association (ANA).
In recent years, society is placing more emphasis on the issue of racism in the workplace. Many processes, grants, resources, and events are dedicated to ending discrimination among and toward nurses. But there is still so much more progress we can make.
What Can Individuals Do to End Racism in the Workplace?
Racism is a massive, important issue, but every action you take to combat it, no matter how small, is a move in the right direction. Here are some steps you can take to promote antiracism at your organization:
One of the best ways to fight racism is to learn more about where it stems from and how it affects others. Try:
- Reading books about those who have experienced racism and ways to stop it: Reading about this issue can help you understand the pain and trauma that results from it. Consider reading books such as White Fragility by Robin DiAngelo, How to Be an Antiracist by Abram X. Kendi, or So You Want to Talk About Race? by Ijeoma Oluo.
- Seeking out media about stopping racism and how it affects others: Listen to people sharing their experiences of racism through podcasts, TED Talks or social media.
- Taking an unconscious bias quiz: Unconscious bias refers to the automatic and unintentional feelings against particular groups of people. We all have some inherent biases that we may not even realize. Learning about these types of biases can help bring awareness to them. Take this quiz to understand if you may have unintentionally disrespected another because of race or other stereotypes.
- .Participate in programs like the Commission’s ECHO on Racism Series. Registration is FREE.
Understand the impact of racism within healthcare
Racism permeates many areas of our society, including health care. Understanding how racism negatively affects our patients’ health outcomes can inspire us to combat racism for our patients and our BIPOC colleagues. Here are just a few examples:
- Non-Hispanic Black women in the U.S. are more than three times as likely as white women to die during childbirth, according to a review presented by the American Diabetes Association.
- COVID-19 disproportionately affected people of racial and ethnic minorities, including Black, Native American, and Hispanic communities.
- The physician workforce fails to represent the U.S. population demographics. A 15-year study of medical school admissions found that proportions of Black, Hispanic, and American Indian or Alaskan Native medical students increased slower than students of other races and ethnicities, including white students.
Be an ally
Allies are people who speak out or challenge the status quo to support people who have been marginalized. Once you’ve educated yourself and understand the impacts of racism, you can be an ally by standing up against discrimination and racism.
Become an ally by:
- Listening and learning from people of different races and ethnicities
- Standing up when witnessing racism and injustice
- Recognizing privilege and white fragility (feelings of discomfort a white person may experience when discussing racial inequality) and how it may impact your perspective
Continue to be an ally by:
- Becoming an antiracism ambassador: If yourorganization hasaDiversity, Equity, and Inclusion (DEI) task force or support group, consider joining it.
- Raise funds to fight racism: Many organizations have fun runs or walks that involve raising money for causes that support fighting racism.
- Share your truth: Capturing both good and bad perspectives and experiences regarding racism is crucial for sparking change in the nursing profession. The Commission encourages nurses to share their stories and continue making their voices heard.
Create an inclusive work environment
Help make colleagues of all ethnicities and nationalities feel welcome and included.
- Recognize a wide variety of holidays and traditions as a staff: Ask fellow nurses who celebrate specific holidays, such as Juneteenth, Diwali, or Eid al-Fitr, how you can celebrate in a small way at work to educate others about one another’s traditions.
- Add a religious holiday observance policy: Allow nurses to request days off or changes in their schedule to accommodate religious holidays.
- Put fighting racism at the forefront: Print our infographic on the Top Ten Ways to be an Antiracist in Nursing and post it at the nurses’ station as a reminder to fight racism.
Advocate for Change
If there’s one thing you should remember when combatting racism in the workplace, it’s this: Be unrelenting in speaking the truth about racism. Many nurses are already doing that — 57% of nurses said they’ve challenged racism in the workplace. But more than half of those nurses also said their efforts resulted in no change. That points to a problem that needs to be addressed at higher level — among leadership.
What Leadership Can Do
“This issue requires top-down change for everything else to fall into place,” says Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, Director of Nursing Programs & Healthy Nurse, Healthy Nation.
Here are some ways leadership can support fighting racism from the top down:
Hire nurses from communities that have been marginalized
When a nursing team is made up of individuals from a variety of cultures and backgrounds, they can provide different perspectives and approaches. And a diverse, vibrant staff creates a more inclusive environment for other health care workers and patients.
Some steps hiring managers can take to promote diversity include:
- Assessing the current hiring and promotion processes for unconscious bias and making adjustments
- Offering targeted internships to nurses or nursing students from groups who have been marginalized
- Highlighting diversity on your health care organization’s career site and throughout the hiring process (One caveat: Do not mislead candidates by making them think that an organization is more diverse than it really is)
Support BIPOC nurses in career advancement
Once nurses from communities that have been marginalized are part of the organization, it’s important to nurture them in their career goals and help them achieve leadership positions. “We have to start with diversifying nursing leadership at higher levels — the people who have the power to enforce change,” says Katie.
Hospital leadership can help nurses from marginalized communities by:
- Devoting time to talk about a commitment to diversity during new hire orientations
- Having the Chief Diversity Officer (CDO) to talk to nurses about diversity awards within the organization
- Asking nurses to share personal or professional growth goals or for ways to support DEI initiatives within the health care system
- Developing and deploying a diversity plan for the organization
Ask “what if” questions
Leadership is often defined by the questions it asks or fails to ask. By framing questions with “what if,” leaders are forced to imagine or explore more options and solutions.
Some questions to consider:
- New hire interviews are blinded to ensure racism or unconscious bias doesn’t affect our hiring processes?
- A third party, outside of HR, conducts the organization’s exit interviews?
- Senior nurses from communities that have been marginalized mentor newly hired BIPOC nurses?
Take reports of racism seriously
Nurse leadership needs to take action against racism in the workplace, especially when it’s reported by staff nurses. It can feel defeating for nurses when their reports lead nowhere, making their efforts seem futile. Staff nurses can speak up as often as possible, but it’s up to those in leadership positions to implement positive change.
Create an antiracism task force
Some hospitals and health systems have created a Diversity, Equity, and Inclusion Officer position to lead DEI efforts across the organization. Elevate nurses to positions on DEI task forces or teams, so they can share issues nurses face and help be part of the solution. Nurses on the task force can also bring these insights back to their teams.
Update language in internal communications
The Associated Press (AP) made changes to its style guide in 2021 to help combat racism and create more inclusive language standards. Ensure internal communications are updated to reflect those changes. For instance, Black is a more accepted term than African American, and the word “brown” should be avoided, instead use specific racial identities when available.
Take a look at images on educational materials and communications for nurses and make sure people of various racial identities and communities are included in photos and visuals.
Provide training opportunities
Nursing leadership can bring in speakers and offer training opportunities to the staff on unconscious bias, racism, and other DEI issues. Make this education part of the job and pay nurses to learn about these issues.
Fight Racism One Step at a Time — And Keep Going
“We can’t fall into a trap of complacency,” says Katie. “We need to keep our collective feet on the gas pedal to continue advocating for better – better practice environments and better outcomes.”