Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States

Abstract

A large number of internationally educated nurses are recruited each year from developing low-income countries to alleviate the nursing shortage experienced by US healthcare organizations (Kingma, 2007; Li, Nie, & Li, 2014). Many of these nurses speak with a non-native accent. As students, they may be considered English as a second language students or English language learners. According to the Pew Research Center, there were 4.2 million Black immigrants living in the United States in 2016, making up 10% of all Black people in the United States (Anderson & Lopez, 2018). Growth in the foreign-born Black population is fueled by African migration, with Africans comprising 39% of the overall foreign-born Black population (Anderson & Lopez, 2018). According to the Migration Policy Institute report, sub-Saharan African immigrants have higher levels of educational attainment compared to other immigrants and the native U.S. population (Echeverria-Estrada & Batalova, 2019), and a large share of them work in the healthcare sector (Anderson & Connor, 2018; New American Economy, 2018). The exact number of Black African-born nurses (BABNs) in the United States is not known. However, it can be reasonably assumed that they contribute to the 19.5% of nurses, who identify as ethnic minorities, and the 243,032 Black nurses, who comprise 6.2% of registered nurses in the United States (Smiley et al., 2018). The racial and ethnic identities of nurses who hold managerial and executive positions are not recorded in official nursing workforce data. Nurse migration is motivated by the search for professional development, better quality of life, personal safety (Tregunno, Peters, Campbell, & Gordon, 2009), and even the desire to experience new cultures. However, increased earning potential, career, and learning opportunities continue to be the most frequently reported incentives for nurse migration, especially by nurses from less-developed countries (Kingma, 2007). 1.2 | Discrimination Studies show that African-born students and nurses face numerous challenges during their transition to the United States

African born black nurses’ perception of their U.S. work environment: Race matters

“…This was often linked to the nurses' accents, and the inability or unwillingness of the native-born nurses to listen and understand them. The lack of respect and feelings of dismissal due to foreign accents was discussed in depth by the participants in (Iheduru- Anderson, 2020b). In Iheduru-Anderson (2020b) study, the participants felt that their accents were viewed as a measure of their intelligence and their contributions to the workplace were often disregarded.…”

Rejecting the myth of equal opportunity: an agenda to eliminate racism in nursing education in the United States

“…The issue of racism directed at EM nurses from many different sources is particularly apparent when considering internationally-educated nurses (IEN), or nurses who originate in non-Western countries and transition to Western workplaces, such as those in the UK, US, Canada or Australia [20,21]. One interview study of Chinese IENs transitioning to the US found several main themes, including "injustice and discrimination" coming from many different sources, including patients, colleagues, managers, and employers [22].…”

Discourse of race and racism in nursing: An integrative review of literature

“…Nurse leaders must recognize how gender, culture, and class become intertwined with race rather than existing as discrete, separate identities (Waite & Nardi, 2019). Preconceived notions about Black people's abilities converge with competency concerns raised because of race, which interact to create significant barriers to developing and maintaining a successful career in nursing leadership (Iheduru-Anderson, 2020b, 2020c. This discrimination as a result of intersectional status has led to significant disparities for Black nurses within the profession.…”

“…In fact, several studies have shown that immigrant nurses and nurses of color in the United States continue to experience acts of discrimination and racist comments from colleagues, and patients and their families (Beard & Julion, 2016;Deacon, 2011;Iheduru-Anderson, 2020a, 2020cIheduru-Anderson & Wahi, 2018;Moceri, 2014;Primeau et al, 2014). In some cases, immigrant nurses' accents have been used as reasons for discrimination in the workplace (Iheduru-Anderson, 2020b). In addition, studies have shown that nurses and nurse educators are not comfortable or feel ill-equipped to discuss race (Holland, 2015;Nairn et al, 2004Nairn et al, , 2012.…”

“…Racial minority registered nurses felt they always had to work harder, be smarter, and prove themselves more than their White peers (Iheduru-Anderson & Wahi, 2018;Moceri, 2014;Wheeler et al, 2013). In the academic setting, some minority students described their learning environment as adversarial and nonsupportive, stating that White students had the privilege of learning in a relaxed environment free of racial biases, where Black students did not have the same privilege(Coleman, 2008;Iheduru-Anderson, 2020b).Racial discussions in nursing are often one-sided; nurses of color are generally vocal about their experiences while White nurses remain largely silent(DiAngelo, 2018). This is evident in the statement byYu, 2008, describing her experience during a concurrent session of a conference program on marginalization, discrimination, and exploitation: "after several vocal African American nurses described their experiences of mistreatment during their nursing education and later their nursing career, the audience became silent.…”