"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.
The numbers break down sharply by race. A combined 44% of respondents said racism or discrimination was part of their nursing school's culture to a slight, moderate, or great extent. Among Black and African American nurses, 60% reported it, nearly twice the rate of their white counterparts. More than half of all nurses said microaggressions, the subtle or indirect expressions of bias, were part of their school's culture, and Asian American, Black, and Latino/a or Hispanic nurses reported them more often than white nurses.
The appetite for change is wide. 79% of nurses said nursing education needs more DEI training. While 58% said they received adequate training in racially and ethnically sensitive care, fewer than a third said they got enough 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, and 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."
Demand for training tracked closely with who bears the brunt of discrimination: 91% of Black and African American nurses saw a need for more DEI training in school, along with 84% of Asian American, 76% of Latino/a and Hispanic, and 66% of white nurses.
The reporting systems meant to address discrimination are not earning nurses' trust. Most respondents said they would rather talk to a colleague than use formal channels. "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 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."
The study, "Insights Into Nurses' Experiences and Perceptions of Discrimination," looked at discrimination across the whole healthcare system. Overall, 79% of nurses said they witnessed or experienced racism or discrimination from patients, and 59% said the same about colleagues.
Frequently Asked Questions
How many nurses experienced racism or discrimination in nursing school?
A combined 44% of nurses said racism or discrimination was part of their nursing school's culture to a slight, moderate, or great extent. Among Black and African American nurses the figure was 60%, nearly twice the rate reported by their white counterparts.
Who conducted the study?
The Robert Wood Johnson Foundation and NORC at the University of Chicago surveyed 980 nurses nationwide between March and April 2022 and released the findings, titled "Insights Into Nurses' Experiences and Perceptions of Discrimination," on May 31, 2023.
Do nurses experience discrimination beyond nursing school?
Yes. Across the healthcare system, 79% of nurses said they witnessed or experienced racism or discrimination from patients, and 59% said the same about colleagues. More than half reported that microaggressions were part of their school's culture.
Do nurses want more DEI training?
Yes. 79% of nurses said nursing education needs more diversity, equity, and inclusion training. Demand was highest among the nurses most affected: 91% of Black and African American nurses, 84% of Asian American nurses, 76% of Latino/a and Hispanic nurses, and 66% of white nurses.
Why don't more nurses report discrimination?
Most respondents said they would rather talk to a trusted colleague or nurse manager than use formal channels. Many reported that human resources, administration, and sometimes their unions were of little help, so they avoid traditional reporting systems.