- Introduction to Adult Nursing
Nursing is an important role to play, be it for the young ones or the adults or the elderly. For adult nurses, the role is ever more enhanced because they need to look after the needs and care of the young adults all the way to the elderly patients. The role of a nurse in such a situation cannot be underestimated because it is the job of the nurse (in adult nursing) to manage the patients and ease them. Thus, the nurses in adult nursing need to have strong inter-personal and communication skills. An adult nurse is required to work in varied conditions, be it in a hospital or a community centre. A nurse is required to work in conjunction with a team of personals such as the doctors, pharmacists, physiotherapists, radiographers, occupational therapists and other healthcare assistants.
An adult nurse is the one who works in close contact with the patient and his family. It is the nurse who has to evaluate the progress of the patient and hence keep the whole record of it. An adult nurse, therefore, needs to be compassionate, caring and vigilant. It may further suffice to say that the role of an adult nurse is nothing less than challenging what with the nurse being the one to deal with the ailing patients and their worried or confused attendants.
- Is it all Pride in Adult Nursing? Addressing Racial Bias in Nursing
In recent years, there have been several attempts by the government to attract more students of minority communities (BME) to join the field of nursing. The ever growing demands for the medical facilities and thereby nurses have further made the field of nursing, especially adult nursing, a really lucrative field. However, the point to ponder is that is it all worthwhile or are there some other issues that need to be looked upon?
While there are several aspects to the role and life of an adult nurse, it would be false to say that the life of an adult nurse is in any way easy. While the job itself is challenging, some outside forces too add to the woes of the nurses. While it may not be true in some cases, racial bias has been reported, recorded and seen within the working environment of the adult nurses. National Health Service (NHS) has itself made comments and recognised that racial discrimination poses as one of the major obstacles when it comes to "recruitment, retention and development of the BME employees in the organisation" (Elliot et. al., 2002).
According to a research study by Roger Kline (2013), there has been well documented "discrimination against the Black and Minority Ethnic (BME) staff in the UK in access to employment, in opportunities once employed, and treatment in employment." Despite the government initiating statutory and policy changes like Race Relations Amendment Act 2000, it has been a humungous task for the initiators to bring about equality by the NHS in the treatment and recruitment of BME staff. According to his report, the likelihood of the white applicants being appointed was 3.48 times greater than that of the BME applicants. Further studies establish the fact that there is a wider scale of racial discrimination in NHE when it comes to pay, grading, promotion and career advancement.
According to another recent report published by Sarah Calkin (2013), only 4% of the non-white nurses got into the NHS Leadership. Of these, only 2% were of the black origin, 1% of the Asian background and 1% were of the mixed origins. Compare this data with that of the data as presented by Nursing and Midwifery Council which claims that almost 20% of the registrants are of non-white background. She further adds that according to a study by International Journal of Nursing studies, it was more difficult for nurses belonging to the minority ethnic groups to receive job offers compared to the job prospects for white British nurses.
According to another report by Giga, Hoel & Lewis (2008), there has been seen a major difference in the hourly pay of the BME workers, when compared with the white counterparts.
While the reports and research studies mentioned above are simply a graze in the huge iceberg of literature that can be found online, the fact remains the same: is the picture for adult nurses all rosy? It is not just for the BME nurses that a racial discrimination prevails. It is also true that several organisations create a bias for the adult nurses based on their sex. According to the study by Giga, Hoel & Lewis (2008), the organisation with a typical male hierarchical type model often paid the female counterparts lesser. However, staying on track and discussing the problems of the BME nurses, we follow on.
The fact is that it is not just the employers who are biased towards the nurses from non-white background, rather a number of racial attacks origins from the patients being treated by the nurses.
In the paragraphs to follow, we will be providing with detailed proof of how racism is being an integral part of the NHS (National Health Service) in UK. According to a news report published on the website of BBC (2013), the figures of racial abuse are rising rapidly. From 420 in 2008-09, the figures rose to 694 in 2012-13. The facts and figures do not just stop here. It has been a widely known fact that the nurses often face racial prejudice from the patients themselves. According to a news report published in USA Today (February 18, 2013), an African-American nurse had pressed charges against the hospital because the hospital reportedly agreed to the request of a patient's attendant that his newborn child should not be handled by any non-white nurse.
In a similar case, the case was up against a south-African born nurse herself, where she was banned for a year from nursing by passing racial comments. According to the news report published on Kent Online, Helene Coetzee was recorded as stating that she did not want any more black nurses in her institution, an Ashford care home (Scott, 2013).
- Impact of Racial Bias in Nursing
The impact of racial discrimination in nursing is generally psychological for the staff belonging to the BME community. The discrimination has been reflected in the numbers of BME staff being recruited within the NHS. The small numbers of BME staff results in the organisation's lesser understanding of the local population and hence, they cannot serve to the local population in a satisfactory manner. Secondly, more and more BME staff discourages others belonging to the BME community to join NHS. The fact is that these BME nurses spend their entire life looking after and caring for patients and yet they do not get recommendations in the end just because they are a BME staff. This simply discourages the people from BME community to become nurses and serve the society.
- Fighting the Racial Discrimination: Is the Government Helping?
With such a lot of literature in front of us bringing to our attention, time and again, the extent of the racial discrimination within the NHS, the question to be asked is: how much are the government initiatives actually working in bringing about the equality in this profession? Further, we need to see how much effort the NHS is making in bringing about an organisational and policy change in order to address the issue of racial discrimination in recruiting.
The Past Efforts
The efforts have been continuing by the government since 2003, when the then Prime Minister Tony Blair asserted that the racial discrimination has much prevalence within the labour market when it comes to employment. However, within the next ten years, the racism will be rooted out and hopefully equality will prevail. Following this, in 2004, NHS chief announced that NHS and Department of Health would enhance its efforts in order to meet service needs of the ethnic minorities to make sure they meet the standards for improved services. Secondly, he promised to target different ethnic groups for recruitment and developmental opportunities. In 2004, further "Race for Health" programme was launched with the sole intention of bringing about legislative changes in the NHS in order to get rid of racial inequality. A survey conducted in 2006 by the Department of Health noted that "NHS organisations have generally made considerable progress in addressing race equality."
While these steps did bring about some change (2012 NHS staff survey reported that there was seen a rise of 7% in the recruitment and training of BMEs), it was also seen that almost 8% reported discrimination at workplace of which 4% was due to racial bias. Amongst the cases that were reported, majority were the cases where BMEs reported a bias based on race at their workplace, mainly through their employer or manager. It was further seen that despite all the efforts, only 1% of the NHS chief executives were non-white or from BME origins.
Another survey conducted by National Institute of Innovation and Improvement reported that even though the Break Through programme started in 2003, there have not been noted any significant improvements in the numbers of BME staff at executive directorial or higher levels.
In fact, one of the high profile cases of racial discrimination within NHS came to light in 2012 with the court granting £1m to NHS manager Elliot Browne (the only black man to get to that level), for racial discrimination he faced at work place (Furness, 2012).
In their recent business plan (2014-15), NHS is noted to be stating that their main focus this year will be to "retain the best people, from diverse backgrounds" and to ensure that there is seen "significant improvements in the diversity of our workforce" (Kline, 2013). The NHS constitution too was revised last year to incorporate the chief objective that all employees be treated equally and in a fair manner, free from all sort of discrimination.
- My Stand
It has been, undoubtedly, established that NHS has become the face of racial discrimination at workplace. While government and NHS itself have undertaken steps in order to combat discrimination against BME staff, it has proven to be not enough. While the passing of rulings and making amendments has been done, it is evident that the implementation is where it is all lacking. The government too is simply not dealing with the issue in a high-handed manner. Unless and until the perpetuators of racial bias are treated strictly, there is no example being set for the others to follow. Simply granting huge sum of money to one case of racial discrimination is not enough to combat the entire issue of racial bias. It seems that the government is only making statements to impress the masses to gather more votes. Had it really meant spreading racial equality within the United Kingdom, it would have taken some concrete steps instead of simply making speeches. UK stands for equality for all irrespective of the race, colour or gender. In such a situation, NHS is simply being an embarrassment to the face of it all.
What needs to be done is that more surveys need to be carried out regularly to ensure that the rulings and legislative changes being made are actually implemented in the right manner. Efforts should be enhanced to invite more BME applicants for employment within NHS. Further, all the employers under NHS should be instructed about the behaviour and treatment equalities to be practised. High penalties should be fixed for the defaulters of the code of conduct for the employers, who fail to follow the instructions issued by the NHS constitution.
Unless these steps are taken, all the efforts undertaken past these years would have been in vain. With no one on a look out for defaulters, it is evident that the employers continue to practice their old lodged beliefs with respect to the BMEs.
The government and NHS are simply not doing enough to combat the issue of racial discrimination within the NHS.
The best example of racism in nursing dates far back to 19th century when Florence Nightingale was accorded for her service to British army soldiers during the war; but on the other hand, no acclaim was given to Mary Seacole, who had also worked night and day to serve the injured British soldiers from the Crimean War.
In 1948, NHS was built which recruited young black women to do the work that their white counterparts would not do, i.e., working long hours as midwives, public health workers and nurses or even cleaning or cooking. After all these years of providing cheap labour to the high-minded in the British society, people belonging to the BME community are facing discrimination even today. While the white women overcame their high-headedness for menial tasks, it is those belonging to the BME community who have to pay the price. Where the NHS was built on BME staff foundation, these days BME constitute a mere 4% of the total staff hired within the NHS. So where did it all go wrong? The inherent bias that the British people have in their minds against the BME community is time and again brought to focus, more so when it comes to recruitment within the NHS. The background provided above has brought to light several cases of discrimination within the NHS.
The fact is that despite the government showing intent to work against the discrimination, not much has been done in that direction. Laws have been passed and policies have been made, nevertheless nothing much has been done in order to actually implement these changes. Even if implementation is done, it is not stringent enough and there is no framework in place to actually check if the policy changes and the laws are actually being followed.
So to conclude on whether the government is doing enough to combat racial discrimination within NHS, it would suffice to say that the government is still not doing enough. Even though it is aware of the problems that the BME staffs are faced with, not much has been done to ensure the interests of these staff. A lot more can be done and as I have proposed in the sections above, unless proper procedures are in place to continuously check for the welfare and equality of the BME staff, the equality initiatives will all fall apart and not bring about the desired results.
The NHS Chief, Sir David Nicholson had once commented:
"Equality must lie at the heart of the NHS - its values, processes and behaviours - if we are to create a service that is personal, fair and diverse, that meets the needs of every patient and all staff."
It may be time to take this seriously and actually work towards achieving it.
Calkin, S. 2013. Exclusive: Concern over race bias on nurse leadership course. Nursing Times.[online] 29 October. Available at: < http://www.nursingtimes.net/home/clinical-zones/leadership/exclusive-concern-over-race-bias-on-nurse-leadership-course/5064707.article> [Accessed at: 4 March 2014]
Chronicle world. Can racism in the National Health Service be cured? [online]. Available at: < http://www.chronicleworld.org/tomsite/archive3/02_HE_FD/02_HE_01.htm> [Accessed at: 4 March 2014]
Elliot, J., Walker, R., Balson, G., Choudhari, S. and Husband, C. 2002. Getting on Against the Odds: A Survey for the National Nursing Leadership Programme of Caribbean, African, Asian and Black British Nurses in Leading Positions.[pdf] National Nursing Leadership Centre. [Accessed at: 4 March 2014]
Erb, R. 2013. Nurse sues after hospital grants dad's racial request. USA Today [online] 18 February. Available at: < http://www.usatoday.com/story/news/nation/2013/02/18/black-nurse-lawsuit-father-request-granted/1928253/> [Accessed at: 4 March 2014]
Furness, H. 2012. £1m for NHS manager Elliot Browne who was targeted for his colour. The Telegraph [online]. 10 January. Available at: < http://www.telegraph.co.uk/health/healthnews/9003744/1m-for-NHS-manager-Elliot-Browne-who-was-targeted-for-his-colour.html> [Accessed at: 4 March 2014]
Giga, S.I., Hoel, H. And Lewis, D. 2008. A Review of Black and Minority Ethnic (BME) Employee Experiences of Workplace Bullying. [pdf] Available at: < http://archive.unitetheunion.org/docs/Research%20-%20BME.doc> [Accessed at: 4 March 2014]
Kline, R. 2013. Discrimination by appointment. [pdf] Public World. Available at: < http://www.publicworld.org/files/Discrimination_by_appointment.pdf> [Accessed at: 4 March 2014]
NHS Careers. n.d. Adult Nursing. Available at: <http://www.nhscareers.nhs.uk/explore-by-career/nursing/careers-in-nursing/adult-nursing/> [Accessed at: 4 March 2014]
Scott, J. 2013. 'I don't want more black nurses': Ashford care home manager Helene Coetzee banned over racist slurs at Warren Lodge. Kent Online [online] 18 July. Available at: < http://www.kentonline.co.uk/kentish_express/news/Racist-nurse-3572/> [Accessed at: 4 March 2014]
2013. Sharp increase in NHS racist attacks. BBC [online] 16 December. Available at: < http://www.bbc.com/news/health-25368332> [Accessed at: 4 March 2014]