More than 4 in 10 nurses said they experienced racism or discrimination while in nursing school, with nearly 8 in 10 nurses calling for more diversity, equity, and inclusion (DEI) training in nursing education.
That’s according to survey data and interviews from nearly 1,000 nurses released May 31 by the Robert Wood Johnson Foundation. In light of the findings, foundation leaders called for self-reflection from the nursing community.
“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, the foundation’s director of program communications.
A combined 44% of respondents reported that racism or discrimination was part of their nursing school’s culture to a slight, moderate, or great extent. At 60%, Black and African-American nurses were nearly twice as likely to report racism or discrimination as their white counterparts.
More than half of nurses reported that microaggressions — generally defined as unintentional, subtle, or indirect expressions of discrimination or hostility — were part of their nursing school’s culture. Asian American, Black, and Latino/a or Hispanic professionals were more likely than white nurses to experience those behaviors.
A large majority, 79%, of nurses said more DEI training is needed in nursing education. While 58% of respondents said they received adequate training in racially and ethnically sensitive care, less than a third said they received sufficient instruction on unconscious bias and systemic racism in healthcare.
“More than half of interviewees say their workplace has not discussed the impact of systemic racism on health, and many say they had minimal discussion of racism/discrimination/disparities when in nursing school,” the study authors wrote. “Younger nurses are more likely to say equity issues are discussed in school, though some say this training reinforced stereotypes. About 2 in 3 interviewees say education on inequities would be helpful.”
Nearly all — 91% — of Black and African-American nurses said they saw a need for more DEI training in nursing school, with 84% of Asian American, 76% of Latino/a and Hispanic, and 66% of white nurses expressing the same preference.
While many healthcare and higher education institutions have systems in place for reporting discrimination or racism, nurses surveyed for the report took a dim view of such measures, preferring to speak to their own nursing colleagues instead.
“When discrimination occurs in the workplace, interviewees say they don’t have many avenues to handle it or don’t trust the formal channels,” the study authors wrote. “Many say that human resources and administration — and sometimes their unions — are of little help. Instead, they avoid traditional channels and turn to trusted colleagues or nurse managers to share frustrations, or they say nothing to others at work.”
The study, titled “Insights Into Nurses’ Experiences and Perceptions of Discrimination,” examined nurses’ experiences with racism and discrimination throughout the health care system. Overall, 79% of nurses surveyed said they witnessed or experienced racism or discrimination from patients, while 59% said the same about racism or discrimination from colleagues.