Study: 40% Of Nurses Experienced Racism Or Discrimination In Nursing School

More than 40% of nurses said they experienced racism or discrimination during nursing school, and nearly 80% called for more diversity, equity, and inclusion (DEI) training in nursing education. The findings come from survey data and interviews with nearly 1,000 nurses released May 31 by the Robert Wood Johnson Foundation, which used the results to call for hard self-reflection across the profession.

"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.