Black and Asian nurses in the NHS report harassmentBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7015.1247 (Published 11 November 1995) Cite this as: BMJ 1995;311:1247
Many black and Asian nurses in the NHS suffer racial harassment from patients and colleagues and many feel that they are discriminated against, according to a report from the independent Policy Studies Institute. Eight per cent of NHS nursing and midwifery staff are from ethnic minority groups, and although the report, Nursing in a Multi-ethnic NHS, found that most NHS employers had formal equal opportunities in place, they were not fully implemented.
The book is based on case studies of six NHS employers and 150 interviews and a nationally representative postal survey of over 14000 staff. Nurses said that they did not think that managers were doing enough to deal with harassment and discrimination. When interviewed many of the nurses spoke of occasions when they had been ignored, talked about, or racially abused.
The study found that most incidents of racial abuse were not reported because there was a perception among ethnic minority victims that the complaint would not be supported. The authors of the report say that written policies and procedures need to be accompanied by widespread communication, formally through team briefings and informally through general comments and conversations. They point out that “racial harassment will not disappear simply because nursing staff and management refuse to recognise it for fear that it will somehow detract from their ‘professionalism.'
Black nurses are less likely than white nurses of similar age, experience, and qualifications to be in the higher grades of F and G. The study found that they can expect to reach these grades as many as five years after their white peers. Because of the lack of written criteria and a systematic identification of training needs, many ethnic minority as well as white nurses reported a general feeling of unfairness in the allocation of opportunities for training and promotion. According to the report, only one employer had completed an audit monitoring the ethnic composition of its workforce. None had monitored opportunities for promotion or training even when there was a commitment to do so in their policy documents. “Equal opportunities policies will be ineffective without a training programme that seeks to communicate the policy, raise awareness of equal opportunities issues in the workplace and help staff to work in anti-racist ways.”
The Policy Studies Institute recommends three actions for all NHS employers: they should ensure that their equal opportunities policy is implemented and produce information to show how effective it has been; they should undertake a case by case review of the development and promotion prospects of individual nurses, especially black nurses near the boundary between grades E and F; and they should initiate a campaign to make every employee feel responsible for supporting ethnic minority groups and preventing racial harassment.
The junior health minister, Baroness Cumberlege, said that it was unacceptable that some nurses thought that they were unfairly treated. She emphasised that the NHS was committed to equal opportunities and reported that the service would be running a series of workshops to disseminate good employment practice, with the emphasis on ethnic minority issues.
Ms Christine Hancock, general secretary of the Royal College of Nursing, said, “Black nurses should not have to put up with racist abuse as part of the job. Ward sisters and managers must make it clear to patients that illness is not an excuse for bad behaviour.”