What If I Experience Racism as a Nursing Student?

Do nursing students experience racism?

Before we answer that question, let’s bring it back and explore the term racism itself.

Racism is defined as assaults on the human spirit in the form of actions, biases, prejudices, and an ideology of superiority based on race, which persistently causes moral suffering and physical harm of individuals and perpetuates a system that continually oppresses ‘other groups’ and perpetuates the dominant social group in society.

There is plenty of research that points to the presence of widespread racial inequality and prejudice across healthcare services and even in our nursing programs.

• Ethnic minority staff experience racism from both patients and other colleagues; and lack the organizational support and space to discuss racism openly; resulting in psychological trauma, emotional depletion, and even physical health impacts
• Reports show over 30% of nursing students from minority backgrounds experience racial discrimination in their nursing programs
• A survey conducted in 2021 found that 40% of minority nursing students witnessed racially insensitive comments being unaddressed by faculty

So, yes unfortunately nursing students do experience racism.

What does racism look like as a nursing student?

Racism in the context of nursing school can include individual acts, but it is also built into the academic institutions’ policies, culture, practices, and procedures.

Here are some examples:

• Faculty grading bias
• Inequitable treatment following an error
• A casual comment or racialized jokes/slurs
• Questioning a student’s competence based on their accent
• An intentional statement of othering (‘they’re not one of us’)
• Unfair assignment of workload in class or clinical placement
• Being singled out or blamed for mistakes that everyone makes
• Exclusion from social interactions (i.e. leaving an individual out during breaks)
• Giving preferential treatment to schools with a mostly white student population
• Institutional rules or standards that systematically advantage some and exclude others
• Implicit assumptions in the curriculum ( the normativity of whiteness among patients)
• Celebrating the accomplishments of some students and not acknowledging the contributions of racialized students
• Implicit assumptions in the curriculum (assuming that the patient being care for is white)

It is critical that nursing students from all social, cultural, ethnic, and religious backgrounds experience a racially safe and inclusive educational environment. Fortunately, there has already been national discussion and a call for “open dialogue” within the profession urging nurses to convey their commitment to creating sustainable changes.

So, do nursing students have a role in this too? Of course, you do!

We simply can’t keep silent or wait on the sidelines for someone else to fix this problem.
Responding to racism with silence and inaction is a form of complicity, which continues to foster systemic racism, and simultaneously conveys to racialized students and nurses their lack of value.

So, what if I experience racism?

As a nursing student, if you won’t (and don’t) learn how to deal with racism within your own backyard (e.g., classrooms, laboratories, and clinical learning environments), how will you tackle the racial issues and challenges in the ‘real world’ as you provide care for individuals and families of various religions, cultures, and backgrounds?

Here are a few things you can do:

1. Know Your Rights

What is your institution’s stance on racism and discrimination? How does the institution manage individuals who face racial discrimination or prejudice? You may need to review your organization’s policies and procedures on harassment, discrimination, and/or racism. Being clued up on your school’s policies can empower you with the knowledge you need and help you navigate the next course of action.

2. Step Back and Reflect on Yourself and Others

Racism is a multifaceted problem. Because its roots run deep, breaking it down requires a thorough understanding of its complexity. Instead of being reactive and allowing emotions to drive your next steps, take a moment (at least a day or two) and consider the context and societal backdrop of the situation. Acknowledge the experiences of those involved, and ask yourself:

• What has shaped their perspectives (culture, history, practices, upbringing)?
• What was their original intent vs the actual impact?

Then, consider your own action or inaction in the situation. Be honest and ask yourself:

• What did I do to confront racism where it was present?
• Why have I not done more or said more to address racism?

3. Unite With Others

Racism can often lead to feeling isolated or questioning your worth or value. Seek out individuals, allies, and/or groups who share your perspective on equality and inclusivity and can understand your unique experiences.

Allies are individuals in a position of privilege and power who seek to operate in solidarity with a marginalized group, by actively and consistently practicing the skill of unlearning and reevaluating. Allies could be student peers, instructors, nurse alumni, preceptors, and even other health professionals.

A united and collective voice on racism, specifically in nursing education, strengthens the need and urgency for change. Joining support groups, other allies, student organizations, or open forums, can provide support and foster a sense of shared community.

4. Leverage Leadership

Your professors, instructors, and administration can also be helpful allies in the fight against racism. Forge partnerships with them to explore proactive and realistic solutions. Sharing your student experiences with these leaders marks an opportunity to spark lasting change. Your insights may shed light on issues and ‘behind-the-scenes’ realities that are often untapped or overlooked. Bringing these issues to the forefront and working collaboratively with these leaders can help revitalize and strengthen nursing curricula and the teaching and learning environments that students interact with every day.

5. Seek Counseling

The effects of racism on mental and emotional health can be profound. Many academic institutions prioritize the health and well-being of students. Working with a professional Counselor offers a confidential and safe space for you to seek support, share your concerns, thoughts, and emotions, and identify ways to cope or take action. Tackling racism with mental health support can help you confront the individual ‘toll’ that racism can take and helps you regain or strengthen your sense of worth, value and confidence.

It’s not enough to simply talk about racism and expect things will change if complacency remains the status quo. Nursing students of all races, cultures, backgrounds, and ethnicities have a role to play. When we can create nursing schools and learning environments that value diversity, inclusion, and equity we are shaping our profession and the future of nursing.

REFERENCES:

American Academy of Nurses & American Nurses Association. (2020). Call for social justice to address racism and health equity in communities of colour.

American Nurses Association (2022). National Commission to address racism in nursing.

Beagan BL, Bizzeth SR, Etowa J. Interpersonal, institutional, and structural racism in Canadian nursing: A culture of silence. Canadian Journal of Nursing Research. 2023; 55(2):195-205.

Canadian Association of Schools of Nursing (2023). Promoting Anti-racism in Nursing Education in Canada.

Hantke, S., St. Denis, V. & Graham, H. (2022). Racism and antiracism in nursing education: confronting the problem of whiteness. BMC Nursing, 21, 146.

Moorley, C., Darbyshire, P., Serrant, L., Mohamed, J., Ali, P., & De Souza, R. (2020). Dismantling structural racism: Nursing must not be caught on the wrong side of history. Journal of Advanced Nursing, 76(10).

National Commission to Address Racism in Nursing. (2022). Report series: Racism in nursing.

Odzakovic, E., Huus, K., Ahlberg, B. M., Bradby, H., et al. (2023). Discussing racism in healthcare: A qualitative study of reflections by graduate nursing students. Nursing Open, DOI: 10.1002/nop2.1619

Author Bio

Justine Bailey is a Registered Nurse and passionate educator from Ontario, Canada. She has worked in nursing practice, education, and leadership for over 15 years. Apart from teaching, Justine works with the UWorld Nursing team to create content to educate and empower nurses and students from diverse backgrounds to lead meaningful lives and professional careers.