Imagine going to work every day, determined to be your very best for your patients, knowing that you will likely encounter a patient — or colleague — who makes you feel like you don’t belong, like an unwanted outsider whose nursing experience and skills don’t matter.

Becker’s spoke with five nurses who have been there, seen and felt that. In fact, they wonder what more they could be doing as caregivers if they weren’t always looking over their shoulder for racist behavior.

“I am constantly on high alert, anticipating racism and or racist beliefs and behavior. Imagine how much more I could do for our patients, our communities, the world, if I didn’t have to exert that energy and focus,” said Tina Loarte-Rodriguez, DNP, associate director of health equity measures at Yale University and Yale New Haven (Conn.) Hospital’s Center for Outcomes Research and Evaluation. “Now multiply that potential by the approximately 415,000 Black and Latino nurses in the U.S. That’s a lot of power.”

Results of a survey of more than 5,600 nurses, conducted by the National Commission to Address Racism in Nursing and published in Nursing World in January 2022, found that, “nearly half reported that there is widespread racism in nursing, demonstrating a substantial problem within the profession.

“Racist acts are principally perpetrated by colleagues and those in positions of power,” according to the report. “Over half (63 percent) of nurses surveyed say that they have personally experienced an act of racism in the workplace with the transgressors being either a peer (66 percent) or a manager or supervisor (60 percent).

Further, findings from a May 2023 Robert Wood Johnson Foundation survey found widespread racism in the nursing industry. The objective of the survey was to “better understand nurses’ perceptions of and experiences with discrimination and racism within their workplaces and nursing schools.”

Several nurses who spoke with Becker’s called for promoting nurses of color to leadership positions in hospitals to encourage equity and provide a place for meaningful conversation about diversity.

Editor’s note: Responses have been edited for clarity and brevity.

Question: What do you want white nurses to know about your experience as a hospital nurse of color?

Shondra Brown, FNP-BC. Family Nurse Practitioner at the U.S. Department of Veterans Affairs: We don’t trust you and we don’t have to. Trust has to be earned. Because we know racism and betrayal, and we know that no matter what, they’ll turn on us. And if you are uncomfortable with us calling out what we see, then you have your own issues to contend with. Everyone has biases but the way to get over them is to unpack them and get them out in the open. Quite honestly, we would prefer white nurses be upfront about their issues. We have a saying, “We like our racists straight, no chaser.”

Madeline Feliciano-Weiser, MSN, RN. Nurse Manager at Penn State Health Lancaster (Pa.) Medical Center: I want to think we’re past the point of being surprised. We don’t need to conduct more surveys or studies to prove what we already know; the nursing profession has a racism issue. I would say to white nurses, “We need allies and accomplices now to become engaged in eradicating racism in nursing. Our profession and our communities are waiting.” 

Tina Loarte-Rodriguez, DNP. Associate Director of Health Equity Measures at Yale University and Yale New Haven (Conn.) Hospital’s Center for Outcomes Research and Evaluation: It is exhausting to be a person of color in the United States. Being a nurse of color, the stress and burden is exponentially greater. As a member of the most trusted profession in the U.S., you need to do more to stop racism in nursing. Learn about your biases and blind spots. Understand your privilege. Use it to speak up for me in the large room, on the unit, or in the classroom. I need you to be an ally every time you witness a racist act. Don’t send me an email after the fact. Don’t talk to me after the meeting, apologizing for what transpired. Speak our names in the rooms we are not in. Invite us in. Sponsor our continued growth and development. Let us speak for ourselves. Never stop looking for ways to be an ally. 

Marilyn Mapp, DNP, RN. Director of Nursing at Jefferson Health New Jersey (Burlington): I want them to know we have to navigate the workplace as a “different person.” We are challenged when we are not being believed or having concerns. We also experience the challenge of working twice as hard to prove a point. We need them to listen, advocate and be our ally.

Deanna Stewart, DNP, RN. Health Services Manager at Optum Healthcare’s Landmark Health (Huntington Beach, Calif.) and Founder of nonprofit MyALLy Stewart Diversity Consulting (Clayton, N.C.): As a nurse of color, I face obstacles that involve my physical appearance, education, intelligence, speech, body language, thought processes and more. All nurses show up for work to provide high-quality patient care. However, a nurse of color has to pack extra information baggage to prepare for the environment surrounding them while providing the necessary care for their patients. 

I have to worry if my patients are getting what they need and if I’m perceived by my peers the way I intended. I fear that my high education will intimate my peers and leaders to the point of inferiority. Is my hair professional enough? Do I come off as intelligent or am I viewed as a braggart? Did I respond with a proper tone and smile so they won’t see me as the aggressive Black woman? I have an idea for process improvement, but should I mention it or do I keep quiet since I have a history of white leaders stealing my thoughts and taking credit for them? 

Yet, throughout the struggle, my main goal is to work collaboratively with all races and deliver care that produces optimal patient outcomes.