Black and Asian nurses overlooked for promotion due to structural racism Royal College of Nursing research reveals

Racism is endemic in health and care with White nurses twice as likely to get promoted as Black and Asian staff, an RCN survey unveiled at its annual Congress shows.

A UK wide survey of nursing staff with nearly 10,000 respondents found that White nursing staff and those of mixed ethnic background across all age groups were more likely than Black and Asian colleagues to have received at least one promotion since starting their nursing career.

The difference appears most stark among those aged 35 to 44 years old. While 65.9% of White and 64% of respondents from mixed ethnic backgrounds within this age group stated they had been promoted, this dropped to just 38.3% of Asian and 35.2% of Black respondents.
The RCN is calling on the UK Government to seize the opportunity of its planned reform of human rights legislation so that health and care organisations, regulatory bodies and inspectorates be required to tackle racism, including in the workplace. This could include a legal requirement to eliminate disparities in recruitment, retention, and career progression or a greater responsibility for employers to protect minority ethnic groups from racism in all its forms. It also must address inequalities in relation to healthcare access, experience and outcomes for patients, as well as for the health and care workforce.

The RCN says structural racism is having a devastating impact on minority ethnic staff. For example, the survey also found that Black respondents working in both hospital (38.9%) and community (31.6%) settings are more likely to face the need to report having experienced physical abuse than respondents of other ethnic backgrounds.

The RCN also wants the COVID-19 inquiry to address why a high number of ethnic minority nurses died during pandemic, including any structural reasons.

Its call comes as delegates at the RCN’s annual Congress in Glasgow hears accounts from nursing staff of racism they’ve experienced at work during the pandemic.

Speaking about being sent to high-risk areas during the pandemic, agency nurse Roseline Sanni-Ajose said, “Covid-19 was a terrible situation for Black  and ethnic minority nurses in the country. Due to the shortage of PPE, we were not given adequate masks and were told to reuse our protective clothing and wear a gown all day, even if we’d been exposed to COVID-19 patients.”

Bruno Daniel, the RCN’s Diversity and Equalities Co-ordinator said,
“These examples of racism experienced by nursing staff in the workplace are deeply shocking. The pandemic has shone a spotlight on structural racism in health and care services and we must seize this opportunity to stamp out this vile behaviour once and for all.

“The UK Government and devolved administrations must properly acknowledge and address this problem and the devastating impact it has on Black and ethnic minority staff and patients.”

The RCN’s Employment Survey took place in October 2021. The survey received 9,577 responses from registered nurses, health care support workers, students and nursing associates working across all areas of health and social care.

Key Research findings:

• Black and Asian respondents across all age groups are less likely than white respondents and those of mixed ethnic background to state they had received at least one promotion since starting their nursing career.
• The difference appears most stark among those aged 35 to 44. While 65.9% of white and 64% of respondents from mixed ethnic backgrounds within this age group stated they had been promoted, this dropped to just 38.3% of Asian and 35.2% of Black respondents.
• Black respondents working in both hospital (38.9%) and community (31.6%) settings are most likely to report having experienced physical abuse than any other ethnicity. Among white respondents the proportion of people who reported having experienced physical abuse drops to 32.3% for those working in hospital and to 19.9% for those working in community settings, and to 26.7% (hospitals) and 29.6% (community) for Asian respondents and to 34.2% (hospital) and 19.3% (community) for those of mixed ethnic background.

On Monday 6 June 2022 the RCN published a seprarate report on the pressures nursing staff are facing based on a survey carried out in March 2022. The findings of the report, called Nursing Under Unsustainable Pressure: Staffing for Safe and Effective Care included:

• Respondents from Asian (84%), Black (85%) and White Other (80%) backgrounds were more likely to be unpaid for their additional work than respondents from a mixed ethnic (77%) or White British background (76%).
• Overall, 73% of respondents from a white British background reported the ability to raise their concerns compared with only 63% of Asian respondents and 68% of Black respondents.