In a survey, 75% of Black respondents said that racism had impacted their mental health in the workplace.
According to a nationwide survey published by the American Nurses Association (ANA), racism is a problem in professional nursing. In fact, nearly half of the 5,623 nurses who responded said that there is “a lot” of racism in nursing.1,2
The survey also revealed that 63% of nurses have personally experienced racism in the workplace; and that 56% of nurses say that racism has impacted their mental health in the workplace. Specifically, 75% of Black nurses said that racism has negatively impacted their professional well-being.
Moreover, although 3 out of 4 nurses have witnessed racism in the workplace, 64% of those who actively challenged racism or stood up for their colleagues said their actions effected no change.
Racial background impacted how individuals perceived racism; 92% of black respondents shared that racism is a problem, compared with 73% of Asian nurses, 69% of Hispanic nurses, and 28% of White nurses.
Behind the Numbers
Quanna Batiste-Brown, DNP, RN, NEA-BC, is chief nursing officer at UCLA Health, as well as a recent inductee as a fellow in the American Academy of Nursing. Batiste-Brown has had a remarkable career—starting out as an LPN before pursing her BSN, MSN, and ultimately her DNP. She has worked in home health, as an oncology nurse navigator, and has spent the past 10 or so years working in ambulatory care. In her current role, as a leader in the UCLA health system, she helps oversee more than 300 clinics spread across 5 counties. In total, the system cares for a very diverse patient group that included more than 2 million individuals annually.
And yet, throughout her own career, she has been impacted by racism.
“As a Black woman of color, I have experienced racism [at work],” she said. “Those experiences have really created the advocacy that that you see now.”
Batiste-Brown was part of the focus group with California ANA that ultimately led to the larger work on racism. She told Oncology Nursing News that, as a Black woman working in health care during the pandemic, it was like all her separate lived experiences were coming together.
“It really hit home,” she said. “The opportunity to be an advocate for change. It was an opportunity for me to bridge [my] passion for advocacy and to speak up for social justice.”
California ANA is a subsidiary of the National ANA. California ANA had come together to start the work on racism before the national group came together. The work in California came off the heels of the death of George Floyd. Nurses across the state were feeling upset and tired. They wanted to do something to document their lived experiences, as well as the experiences of their patients, and discuss ways in which nurses could create change in health equity. A focus group was born, which ultimately led to a much larger focus group on the national level.
According to Batiste-Brown, as a leader, it was shocking how different respondents had different perceptions on racism based on their background.
“What surprised me about the survey results was the level of awareness based on ethnicity,” she said. “There are very different perceptions of about racism based on the folks who responded. I think that there are opportunities for education and self-awareness, and I think there are opportunities for everyone to come together to have honest conversations about how we move change forward.”
According to Batiste-Brown, these findings need to be considered at an administrative level. For instance, at her own institution, there is Chief Nurse Executive Council. The council met to discuss the results and design a Diversity, Equity, and Inclusion Strategic Plan.
As part of their plan, nurses completed a survey at the institution-level. Both nurses and managers completed the assessments, because these 2 groups can often have different perceptions of racism. The institutional survey helped inform the leadership plan.
“It is important for us, as leaders, to understand the perceptions of nurses,” she said. “Having that information together, bringing it together, and then using that information to develop a strategic plan for improving experiences of racism was really eye opening.”
She added that there are many opportunities for management to implement diversity, equity, and inclusion in their organization, from hiring practice to degree assistance programs. She also pointed out that there are instances when the harm comes from outside the staff. Sometimes, the patient is the one abusing the staff. In these instances, organizations must be firm and protect their employees.
“Organizations have policies related to behavior that is not acceptable. That information is usually provided to patients at admission, [and] some organizations have posters that are posted in public areas,” she said.
“Employees also have the right to be protected from patients, just as patients have the right to be protected from employees,” she said. “No one should experience racism within health care. There needs to be safeguards in place to be sure that those things are managed.”
Showing Support for Colleagues
Being on the receiving end of a racist encounter hurts an individual’s well-being. Although it is important that administration address the issue at a high-level, oncology nurses must show support for their colleagues who have been harmed and help create a safe space for them to amplify their voices.
“You need someone that will be your advocate, or [at least] be your sounding board,” Batiste-Brown said.“When you are experiencing something that feels uncomfortable, you need validation.”
People of other races have said to her that they often “don’t know what to say” when other colleagues have experienced racism. The first step, she says, is to listen and show compassion to the person who is hurting.
“Be mindful of someone's mental health,” she concluded. “Be sure that they are not keeping that information inside of them because it can be detrimental to your health, to be going through something as severe as racism and not tell anyone about it.”