Racism in Nursing: Results from RWJF Survey

Racism in Nursing: Results from RWJF Survey

A recent survey from the Robert Wood Johnson Foundation found that nurses experience or see exceptionally high instances of discrimination and racism in the workplace and while in nursing school.

The Insights Into Nurses’ Experiences and Perceptions of Discrimination survey was conducted to uncover what and how much intentional and unintentional discrimination nurses experience or see across their careers. Beginning even in nursing school, the survey found that nurses are seeing or experiencing discriminatory events and attitudes from both their patients and their colleagues, despite most respondents (90%) reporting that organizations are making diversity, equity, and inclusion a priority in the workplace.

The survey sample of 980 respondents were 24 percent Asian, 24 percent Black/African American, 23 percent Latino/Hispanic, 11 percent Other, and 32 percent White/Caucasian. Males accounted for 16 percent of respondents, 82 percent were women, and 2 percent were nonbinary or preferred not to answer.

While the incidence of discrimination from colleagues was less than that from patients, the respondents reported high numbers of each (59% vs. 79%). The survey asked nurses about racism or discrimination in nursing school environments and found that while the majority reported that nursing curriculum did provide information about culturally competent and racially sensitive bedside care, only about one-third reported a curriculum that included topics like racial bias or systemic racism in healthcare settings or the healthcare industry.

And while workplaces are making DEI a priority, more than 3 out of 4 nurses who experience racism, discrimination, and microaggressions are not formally reporting those to their workplace. A higher number (40%) say they will discuss either seeing or experiencing discriminatory incidents with a supervisor and 57 percent say they talk about it with their fellow nurses.

The survey also looked at microaggressions which can have a significant impact on a working environment and nurses’ personal well-being. Nurses who were Asian, Black/African American, and Latino/Hispanic were more likely to report they experienced microaggressions from others. Patients were the source of microaggressions most of the time with sixty-six percent of nurses reporting some kind of microaggression based on race or ethnicity. And the working location made a difference in the survey results. Nurses in a nursing/residential care facility or home health care role reported the greatest number of incidents (88%) compared to 78 percent in a private practice/doctor’s office/outpatient clinic setting.

But close to half of the respondents reported the same kind of behavior from their colleagues with the highest percentages (65%) reported in a hospital health system setting or “other” setting. Nursing supervisors, human resources staff, and senior management were also identified as being the cause of discriminatory incidents, particularly for Black/African American respondents. Incidents included being threatened, insulted, called by a slur, or unfairly humiliated in front of colleagues.

The impact on nurses is considerable. Ninety percent of those who experienced or saw discrimination in the workplace say it affected their personal mental health and well-being. And about half said it had a negative impact on their relationships with those in more senior roles and with their nursing colleagues.

Nurses say improvements including more focused hiring practices, more DEI training and education, clear paths for reporting, a zero-tolerance policy for discrimination, consequences for incidents, and encouraging all nurses to report seeing or experiencing incidents (including an option to remain anonymous) would help the nursing workplace and industry.

The survey offers plenty of information for nurses and nurse leadership to discuss and begin implementing changes to improve conditions for nurses.

Study Reports Diabetes Is Top Concern for Latinos

Study Reports Diabetes Is Top Concern for Latinos

Latinos Lives and Health, a poll released last month by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health, found diabetes is the top health concern of Latinos.

With 19 percent of Latinos reporting diabetes as the foremost health concern facing their families, it far outranks the next most reported health issue, cancer, which ranked number one by 5 percent of Latinos. The results of the survey show the significant differences among diverse populations in this country and can help nurses address the specific needs and concerns of their Latino and Hispanic patients.

As is always the case, healthcare tensions involve much more than just physical ailments. The poll also reported significant amounts of stress around healthcare costs and employment issues. More than one in two Latinos are concerned that if a major illness struck, they wouldn’t have the funds or health insurance to cover the resulting bills. And in many Latino and Hispanic cultures, family comes first which can have significant impact on treatment adherence. There could be a very real reluctance among patients to take money from the family funds to pay for their own healthcare or to set aside time to care for themselves, even if it can improve their health.

According to the Office of Minority Health, rates of diabetes in Hispanic and Latino populations are high, so families have a right to be concerned. Hispanics and Latinos over the age of 18 are diagnosed at a rate of 13.2 percent compared to 7.6 percent of non-Hispanic whites. They also die of diabetes complications at a higher rate than non-Hispanic whites, so clear health information about diabetes management is essential.

As a nurse, one of the most important things is to make patients aware of diabetes as a serious disease with potentially life-threatening, and certainly life-altering, complications. Follow through on medications and lifestyle changes are essential, but when you are talking about changes and treatment, you must take cultural expectations into account, too. Various traditions around family dynamics, food, and celebrations can wreak havoc on trying to control diabetes, so making yourself familiar with some patient expectations can lead to positive treatment and care outcomes.

The Agency for Healthcare Research and Quality listed a few suggestions in their Diabetes Disparities Among Racial and Ethnic Minorities report. Involving the family in new approaches to diabetes management with medication, eating, and exercising helps. Show patients how to read labels and what to watch for. Exercise can be a family walk after dinner.

Above all else, listen to the patient and the family to see what approaches they might have and then try to work within that framework.