Nursing Narratives: Racism and the pandemic
Lead Research Organisation:
Sheffield Hallam University
Department Name: Faculty of Arts Computing Eng and Sci
Abstract
This research will use storytelling as a methodology to develop our understanding of the impact of discrimination that BME nurses have experienced during the Covid19 crises. It will consider how this compares to their previous experiences of working in the NHS and their vision for a more equitable future. The project aims to collect direct testimonies from nursing and support staff to present detailed personal accounts of their experience both during the crisis and historically. The emerging discourse on the diverging impact of Covid19 by ethnicity has focused on pre-existing co-morbidities, cultural differences, possible genetics differences. While socio-economic factors have been referenced with comments on 'pre-existing inequalities in health and healthcare', there has been little address to questions of implicit and explicit racialised discriminations. It is however crucial to develop our understanding of the impact of racism. Feb 2020 BMJ special issue on Racism in Medicine highlighted continued inequalities and discrimination faced both by service users as well as staff in the NHS. Critical Race Theory suggests experiential knowledge, critical consciousness and centring research in the margins are essential strategies to further our understanding of structural inequalities. (Delgado & Stefancic 2017) Using an arts based approach that centres emotion as a resource for memory and recovery we will enable nurses to recount their experiences, visualise their traumas and those of communities worst affected by the crisis, and recognise their experience and insights as a crucial asset in creating significant change with which to support the building of a more inclusive society and a more equitable NHS capable of delivering the best patient care.
Publications
Ramamurthy A
(2022)
Challenging the Cultures of Racism at Work in the UK's Healthcare Sector
in SSRN Electronic Journal
Ramamurthy A
(2023)
Racialised experiences of Black and Brown nurses and midwives in UK health education: A qualitative study.
in Nurse education today
Ramamurthy A
(2022)
Nursing Narratives: Racism and the Pandemic - Report of Key Findings
| Title | EXPOSED |
| Description | Documentary film (57mins) produced in collaboration with Migrant Media. Exposed is a goundbreaking documentary that combines the stories of 19 Black, brown and migrant nurses and midwives to speak about their powerful experiences of racism before, during and after the pandemic. |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2022 |
| Impact | Over 4000 individuals have watched the film in the first two weeks of release. It is being used by health organisations to encourage discussions around racism. |
| URL | https://nursingnarratives.com/exposed/ |
| Title | Film testimonies for Nursing Narratives: Racism and the Pandemic |
| Description | A series of 18 in-depth interviews on film with some of our participants on their experiences of working in health care including the pandemic. |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2022 |
| Impact | There has been excellent engagement with the testimonies in the first two weeks of release. Stats will be added later |
| URL | https://nursingnarratives.com/film-testimonies/ |
| Description | In the first month of the UK lockdown, 72% of the NHS and social care staff who died were from black and Asian backgrounds. A Public Accounts Committee [February 2021] recognised that the government "does not know enough about the experience of frontline staff, particularly BAME staff" and the Lessons Learned report [October 2021] recognized that 'the higher incidence may have resulted from higher exposure to the virus'. Our research was undertaken by academics and professionals who have a strong track record in working with marginalised groups and understanding the dynamics of racism. We took a bottom-up approach to centre the experience of Black and Brown health care staff during the pandemic. We mixed social science and arts-based methodologies to offer dignity and trust with a collaborative film process as a core part of the research. 18 nurses and midwives have spoken out to create individual testimony films and the collective documentary: EXPOSED [Release March 2022]. Our storytelling approach highlights the importance of looking at historical experiences of racism and cultures of racism to understand the disproportionate impact on Black and Brown staff in the pandemic. Systemic neglect and exclusion with a resulting allostatic load that has created stress, ill health, loss of job opportunities and during the pandemic higher exposure to death, should be regarded as a moral injury to the black and brown workforce. Health care workers have collectively written a Manifesto for Change as part of this research. Key findings The majority of study participants did not see racism as individual, isolated behaviour but a structural practice embedded in the institutional culture. This was further exposed in the pandemic with devastating consequences. • All participants had experienced multiple types of racism in their working lives. It was described as 'endemic', 'cultural' and existing at all levels. • Widespread differences in workload allocation were raised both before and during the pandemic • Exclusion and neglect as a form of bullying were among the most widely recounted experiences. 'they just don't care', (Band 2) 'I was invisible' (Band 8b) • The failure to address racism must be seen as a systemic form of neglect: • Out of 73.1% (225 of 308) respondents who complained about racism at the workplace. 77.3% (174) said they were not treated fairly. During the pandemic: • 52.6% of the Black and Brown staff who answered our survey experienced unfair treatment (Covid deployment, PPE or risk assessment provision) • During the Pandemic the above patterns of workload allocation and neglect led to greater exposure to the virus through discrimination in workload allocation, access to PPE, effective risk assessments. • Migrant nurses felt particularly vulnerable due to work visa status and costs. • IMPACTS of racism during working life reported from our survey: o 59% had experienced racism that had made it difficult for them to do their job; o 53% said racism had impacted their mental health o 36% had left a job as a result of racism. o 31.7% were forced to take sick leave due to racism |
| Exploitation Route | It is clear that there needs to be transparency and accountability for what happened in the pandemic in order to mover forward and meaningfully adopt a manifesto for change. Key recommendations: 1. The figures relating to health care staff deaths of Covid 19 by ethnicity should be released to the public 2. Adopt the Anti Racism Manifesto for Change. This includes: Actively adopting a culture of zero tolerance to racism in all NHS Trusts with accountability and statutory penalties for trusts who breach this duty. 3. To prevent the vulnerability of international health care workers, visas should not be tied to trusts, and expensive fees should be scrapped |
| Sectors | Healthcare |
| URL | https://nursingnarratives.com/ |
| Description | Our launch took place two weeks ago so the impact is growing slowly. However over 4000 people have watched the film exposed and the filmed testimonies. The report has been circulated and we have received press coverage. The RCN and institutions are looking at ways to use the film and the manifesto to stimulate discussion on issues of racism in health care in order to precipitate change. |
| First Year Of Impact | 2022 |
| Sector | Education,Healthcare |
| Impact Types | Societal,Policy & public services |
| Description | Conference and film launch for Nursing Narratives: Racism and the Pandemic. |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Racism like a virus spreads and causes significant harm.' Nursing Narratives: Racism and the Pandemic (an AHRC/UKRI Rapid Response to Covid-19 research project) has taken a grass-roots approach to understand the experiences of Black and Asian healthcare staff during the pandemic. This event presents our research findings which includes a new feature documentary and 18 individual testimony films. Come and be part of the discussions to call for systemic change. Meet and hear some of the nurses and midwives who told their stories and take part in our discussions with a panel of policy makers and strategic leads. The nurses and midwives have collaborated to produce a Manifesto for Change which they will present on the day. LIVE STREAM ADDED: For those unable to join us in person, please join us via live stream at the following link: https://youtu.be/XIZunKgSNo8 Timetable: 09:00 - Registration 09:30 - Plenary: Professor Carol Baxter, author of The Black Nurse: An Endangered Species 09:50 - Evidence 1: Overview of the project and headline research findings: Research team 11:00 - Break 11:20 - Evidence 2: Film screening, EXPOSED + Q&A with Director, Ken Fero, and participants 12:50 - Lunch 13:50 - Advocacy: A Manifesto for Change: Panel: Neomi Bennett, Equality for Black Nurses; Susan Cueva, Kanlungan; Felicia Kwaku OBE, Chair of the Chief Nursing Officer's BME Strategic Advisory Group; Rachel Ambrose, Nurses of Colour; Charles, Kwaku-Odoi, Caribbean African Health Network 14:50 - Break 15:10 - Action: Taking Change Forward: Panel: Professor Jacqueline Dunkley-Bent, Chief Midwifery Officer for England; Dr Habib Naqvi, Director of the NHS Race and Health Observatory; Liz Fenton, Deputy Chief Nurse at Health Education England; Professor Geraldine Walters, Executive Director of Professional Practice, Nursing and Midwifery Council; Dr Gloria Rowland, SWL Chief of Nurse (Turning the Tide) 16:30 - Close Black and Asian nurses and midwives, including those who have migrated to support our NHS, have made a critical contribution to health and social care during the Covid-19 pandemic. In February, a Public Accounts Committee (PAC) recognised that the government "does not know enough about the experience of frontline staff, particularly BAME staff". It asked the government to consider the "extent to which (and reasons why) BAME staff were less likely to report having access to PPE and being tested for PPE and more likely to report feeling pressured to work without adequate PPE". The October Lessons Learned report recognises that "the higher incidence may have resulted from higher exposure to the virus", but there is little address to racism in the report. The nurses and midwives who participated in our study are survivors of a pandemic and of a system that is stacked against them. https://nursingnarratives.com/ The Nursing Narratives research team: Principle Investigator - Professor Anandi Ramamurthy, Sheffield Hallam University Co-Investigators - Dr Sadiq Bhanbhro, Sheffield Hallam University and Dr Faye Bruce, Manchester Metropolitan University Film maker - Ken Fero, Migrant Media Research Associate - Freya Collier-Sewell, Sheffield Hallam University This event is funded by Sheffield Hallam University and the AHRC. The registration fee covers all refreshments and lunch. Spaces are limited so please let us know early if you register and later are unable to attend. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.eventbrite.co.uk/e/nursing-narratives-racism-and-the-pandemic-tickets-225226567727# |
| Description | EXPOSING RACISM IN THE BRITISH HEALTH CARE SYSTEM BY PROF ANANDI RAMAMURTHY |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | EXPOSING RACISM IN THE BRITISH HEALTH CARE SYSTEM BY PROF ANANDI RAMAMURTHY Volume 17, Issue 2 | Published 07/10/2020 Article in Awaaz Magazine |
| Year(s) Of Engagement Activity | 2020 |
| URL | https://www.awaazmagazine.com/volume-17-issue-2/cover-story/item/1182-exposing-racism-in-the-british... |
| Description | Nurse experiences of racism during Covid-19 focus of new film project |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Front Page article in Nursing Times by Megan Ford |
| Year(s) Of Engagement Activity | 2020 |
| URL | https://www.nursingtimes.net/news/research-and-innovation/nurse-experiences-of-racism-during-covid-1... |
| Description | Racism in clinical trials and health care - what must be done? |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Article on racism in clinical trials to explore the issues of lack of trust in black and Asian groups. The purpose was to create flow on our blog and on our twitter feed to encourage followers so we could promote our survey. |
| Year(s) Of Engagement Activity | 2020 |
| URL | https://nursingnarratives.wordpress.com/2020/12/18/425/ |
| Description | Survey launched for documentary on nursing and workplace racism |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Survey launched for documentary on nursing and workplace racism Article by Gemma Mitchell |
| Year(s) Of Engagement Activity | 2020 |
| URL | https://www.nursingtimes.net/news/research-and-innovation/survey-launched-for-documentary-on-nursing... |
| Description | The treatment of nurse Amin Abdullah was racist, and we need to call it out |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | The treatment of nurse Amin Abdullah was racist, and we need to call it out - article by Anandi Ramamurthy -Aim was to increase interst in the Nursing narratives project and increase participation in our survey. |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://nursingnarratives.wordpress.com/2021/01/14/the-treatment-of-nurse-amin-abdullah-was-racist-a... |