Nurses face widespread bias, study finds

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The vast majority of nurses endure racism or some form of discrimination from patients, but a recent survey shows that bias and mistreatment also come from colleagues and supervisors.

Nearly 8 in 10 nurses say they have seen or experienced racism and discrimination from patients, according to the survey by the Robert Wood Johnson Foundation. Perhaps more disturbingly, almost 6 in 10 nurses say they’ve seen or suffered racism and discrimination from their colleagues.

The vast majority of nurses (89%) who have encountered or witnessed racism and discrimination say it has affected their well-being. The findings come at a time when many health care organizations are experiencing a shortage of nurses and many say they are losing their love for the profession.

Black and Asian nurses are the most likely to encounter racism, the survey found. Among Black and African-American nurses, 88% have dealt with discrimination from patients, and almost three-quarters (72%) have encountered discrimination from co-workers. Among Asian nurses, 86% have dealt with racism from patients and 65% have endured it from colleagues.

The survey found 77% of Hispanic or Latino nurses have encountered racism and bias from patients, and 57% have endured racism from co-workers.

Some nurses report they are suffering racism or bias from management.

Four in 10 respondents (41%) said they experienced or witnessed racism from supervisors or nursing directors, while a quarter (26%) suffered bias from senior leaders or executives. Black nurses were the most likely to suffer racism from management, the survey found.

While some nurses share their frustrations in experiencing bias and racism, few formally report it to their employer organization.

Four in 10 nurses (40%) discuss racial discrimination with supervisors, but less than a quarter (23%) will file a formal report with management. Most nurses (57%) are more likely to speak with their fellow nurses, while only 16% will go to human resources.

Nurses in hospitals are more likely to deal with racism than nurses working in physicians’ offices or outpatient clinics, according to the survey. It found that 84% of nurses in hospitals dealt with racism from patients, and 65% encountered racism from colleagues. By comparison, 74% of nurses in physicians’ offices or outpatient clinics dealt with racism from patients, and 54% had to deal with bias from co-workers.

The Robert Wood Johnson Foundation survey isn’t the first to indicate racism is a serious problem in nursing.

Last year, the National Commission to Address Racism in Nursing found that most Black, Latino and Asian nurses said they have personally experienced racism in the workplace.

Surgeon General Vivek Murthy said hospitals and healthcare organizations need to address racism and burnout, which is a factor creating more burnout.

Health systems can’t look the other way when it comes to bias from patients, Murthy said in his advisory. He pointed to the zero-tolerance policy at Massachusetts General Hospital, which calls for removing patients if they continually exhibit discriminatory behavior towards staff.

The American Nurses Association (ANA) released a “Racial Reckoning Statement” in July 2022 acknowledging the organization’s role in perpetuating systemic racism in the past. The ANA also outlined steps to promote equity and inclusion within the organization and in the nursing profession generally.