Publication "Racial Discrimination in Nursing Education and Practice"

Racial discrimination continues to be a factor across economic, social and professional mediums, amongst others. My research aims to assess the presence and significance of racial discrimination against African American nursing students and its continuation into the nursing profession both in healthcare and academia. Systematic racism against African American nursing students burdens academic and social success, which continues with registered nurses and nursing school faculty indicated by tense work environments. Ultimately, these factors concerning discrimination and inconsistent treatment can contribute to the overall lack of diversity in the United States healthcare system.

Discrimination During Nursing School According to the National League for Nursing, the percentage of Black nursing students continues to decrease and has fallen below 12 percent as of 2012, down from 14.5 percent in 2003.

In the article, ‘Common Experiences of African American Nursing Students: An Integrative Review,’ interviewed students report that the lack of like-colored peers can create an uncomfortable environment and does not satisfy the desire to socialize. Socialization in this context includes the willingness and frequent one asks for help from peers, their inclusion in study groups, and general engagement beyond cordiality if any.

In many instances, an African American student can be the single African American in any class or even an entire nursing program. This can generate the feeling of loneliness, which would be amplified because they stood out, whether it be because of their hair, speech or other characteristics. Exclusion and seclusion are not limited to African American students amongst peers, it can include their instructors and administrators.

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Students in this study also report being closely watched for mistakes, being subject to unfair grading, and general mistreatment. Experiences range on a spectrum from feeling the faculty’s support to feeling ignored and devalued.

Students on the latter end of the spectrum often felt a disconnect with faculty members even while struggling, forcing them to lean more on support from family and friends and seek out other African American students. As minorities, there is pressure to be stand-out students, and without the inclusion from peers, it can become burdensome for them to succeed. It is important to have ‘academic and interpersonal support to help them persevere to graduation and the licensing exam’. Amongst African American students it becomes increasingly difficult to prioritize their education (seeking guidance, interacting during class, finding study groups, etc.) considering the isolation from and disconnection between them, faculty and their peers. Experiences of Black Nursing Faculty Nurse faculty members are not exempt from mistreatment by students, colleagues, and administrators. In schools of nursing, African Americans account for 5.6 percent of nursing faculty— a notable drop from 13 percent of African American students. Participants from the study, ‘The Lived Experience of Black Nursing Faculty in Predominantly White Schools of Nursing,’ report unfair treatments and disrespect on behalf of the aforementioned parties.

Five of the fifteen participants from the study recounted being addressed by their first names by students who address White faculty as ‘doctor’, although they possess the same credentials. Three participants shared the support they received from White colleagues, stating that those ‘relationships guided them… and allowed them to grow significantly in their careers’. Still, most participants’ accounts depict unfavorable relationships while experiencing dismissive responses during meetings and when seeking assistance. In addition, ten participants perceived discrimination from their administrators. Feelings of underappreciating were common amongst this group, some explicitly stating that their superiors did not want diversity in leadership positions. Racism in the Workplace Discrimination beyond the universities exposes itself in other facets, such as wages, and still through encounters with peers and supervisors.

African American registered nurses (RNs) have been recorded earning eight percent less than their White counterparts. In part, it can be contributed to factors such as educational background, but amongst RNs with the same qualifications, African Americans still earn less. This is a trend across many professions where African Americans with the same education, experience, and skill set as Whites are not compensated as such. It is not explicitly stated the individual reasons these RNs were paid less than others, but it is feasible to partially contribute it to racial discrimination. Other factors should be considered regarding minority wages: where minorities work (i.e. public hospitals v. private practice), patient demographics, hospital budget, and emphasis on job security. These factors, still, are correlated with race since it appears nurses of the majority race prefer working and are more likely to get hired at upscale medical facilities, creating an imbalance and resulting in wage disparity. Similarly, to nursing students, minority RNs have expressed a sense of loneliness in the workplace and can recall cases of subtle racism and stereotyping from both colleagues and patients.

Classified as microaggressions, these occurrences create tension in the work environment, which may only be perceived by the afflicted party, but have an impact nonetheless. In some cases, discrimination or stereotyping is accidental, but this does not change the effects microaggressions have on minority health care providers. Effects on Healthcare The dissonance in the healthcare and educational system, as it relates to minority students, registered nurses, and faculty is deeply rooted in racism and discrimination. Minorities are not strongly represented in the healthcare workforce. The lack of diversity has been recognized to positively correlate with health disparity among minorities, prompting healthcare organizations, such as the U.S. Department of Health and Human Services, to push diversifying personnel. Only 9.9 percent of nurses self-identify as African American according to the Minority Nurse report, compared to 13.2 percent of the United States population according to the 2012 Census Bureau.