Real Nurses looks at racism in the nursing profession

Professor Tania Das Gupta didn’t intend to study racism in nursing, but since she was often called as an expert witness in racial discrimination cases involving nurses, she thought she’d take a closer look. The culmination of her research is her recent book, Real Nurses and Others: Racism in Nursing, because what she found surprised her.

Das Gupta, chair of York’s School of Social Sciences in the Faculty of Liberal Arts & Professional Studies, thought most of the racism toward nurses would come from their patients or maybe their managers, but in fact the majority came from other nurses (27.3 per cent). “It raises the whole issue of co-worker racism in a union environment,” she says. The patients were the next most likely group to express racism (23.8 per cent), followed by doctors (14.3 per cent) and nursing managers (12.8 per cent).

Left: Tania Das Gupta

“It’s very systemic. It’s very difficult to put your finger on it,” says Das Gupta. “I would call it a new racism. It didn’t have the mark of the kind of racism we’re used to. It doesn’t use the language of racism. This new racism is very subtle.”

And, she adds, “It’s difficult to prove in the court system.” Still, a group of nurses alleging racial harassment for having been fired did win their case in 1994. It was the first case in which Das Gupta was called to be an expert witness. “This was a landmark case in Ontario and Canada. It was the first time the Human Rights Commission took up these complaints as a systemic case,” she says.

After that, Das Gupta continued to be called. Eventually, she decided to study racism in nursing. She used a multi-level approach to the study. A survey was sent out to all nurses from the Ontario Nurses’ Association (ONA); 593 responded out of some 40,000, what Das Gupta calls the largest single sample of Ontario nurses that she is aware of. She conducted 18 in-depth interviews and looked through other arbitration cases. The study uses a developed theoretical framework that can be applied to other situations or occupations and takes a race, gender and class approach to looking at how racism takes place in an occupation where it is mostly women.

In Real Nurses and Others: Racism in Nursing (Fernwood Publishing, 2009), Das Gupta looks at the importance of studying racism in nursing, gender and class concepts, the political economy of health care, what the nurses say, race and racism at work and the way ahead, along with the findings of the study.

“There were some striking findings that you go ‘Oh my God is that right?’” says Das Gupta, acting chair of the new Department of Equity Studies at York. The nurses were asked if they had ever been made to feel uncomfortable because of their race, colour or ethnicity and 82 per cent of black/African Canadian nurses, 80 per cent of Asian nurses, 50 per cent of South Asian nurses and 57 per cent of Central/South American nurses said yes. So too did 25 per cent of white/European nurses.

“When the racism is coming from a patient, it raises the interesting question of how does one fight back in that situation,” says Das Gupta. “If a person is ill, does that make it all right for a perpetrator to be racist? I think not.”

Das Gupta was also surprised to learn that most nurses who experience racism don’t take the issue to their union. Most tend to try and handle it on their own.

Real Nurses looks at how fear, lack of support, management collaboration, co-worker harassment and ineffective institutional responses make it difficult for victims of racism to fight back.

Over 14 per cent of nurses reported that any action they took had no effect on the harassment. Yet 58.1 per cent of black/African nurses and 48.3 per cent of Asian nurses perceived that their race, ethnicity or colour affected their relationship with their colleagues, while 54.8 per cent of black/African nurses, 46.7 per cent of Asian and 44.4 per cent of South Asian nurses said it affected their relationship with their manager.

Both those relationships can affect job promotion. “There’s a pattern of differential of treatment,” says Das Gupta. Over 40 per cent of black/African nurses and over 30 per cent of South Asian nurses reported their race, ethnicity or colour affected their access to training opportunities in the workplace. Somewhat fewer, indicated their performance reviews were also affected. Das Gupta wonders why the ONA hasn’t done more.

“There’s no one institution that’s not affected by systemic racism. I think there’s a role for government, unions, employers and even community groups to play.”

But one of the first places it should start, says Das Gupta, is in the schools of nursing, where racism can be dealt with head on. In fact, she says, it may be a good idea for them to read Real Nurses, the title of which came from the experience of one black nurse who was always asked if she was a “real” nurse. Her response was always the same, to say yes she was a “real” nurse; that RN (registered nurse) stood for “real” nurse.

By Sandra McLean, YFile writer