One Size DOES NOT Fit All: Black British-Born Mental Health Nurses and Factors Influencing their ‘National’ Health Service Career Progression

Abstract

Evidence suggests that Black and Minority Ethnic nurses in England’s National Health Service significantly lag behind their White counterparts in Bands 8a, 8b, 8c, 8d & 9 and ‘Very Senior Managers’ positions. Some attribute unequal positions of these nurses to discrimination, racism, exclusion, classism and other forms of disadvantage. Other factors however, are obscured through the accounts of predominantly Black overseas nurses. National Health Service Trusts’ workforce data tends to be gathered using the acronyms BME or BAME. Narrow ascriptions of skin colour or ethnicity to signify experiences of nurses as BME or BAME overlook complexed factors influencing their career. The aim of this study is to understand the career progression of Black British-born nurses as current literature fail to meaningfully account for their experiences. To understand the issues influencing the apparent lag, this study utilised a qualitative approach. Data collection was supported by semi-structured interviews. Unlike other studies, participants revealed very little to suggest discrimination as a hindering factor of career progression. Such a finding indicated that socialised ‘British cultural capital’ constitutes a strong ‘helping factor’ to override the ‘hindering factor’ of their ‘Black ethnic identity’. This implies that National Health Service Trusts equal opportunities policy drivers should apply more robust ethnic monitoring and reporting systems. Consequently, its grading structures would be best placed to represent and compare intergroup nuances between ethnic minority nurses. It will become inescapable for the UKs National Health Service not to address intersectional factors of ethnic identity, due to historical and persistent exposure of workforce inequities.

The “nurse as hero” discourse in the COVID-19 pandemic: A poststructural discourse analysis

“…Subject to the effects of colonialism and gender discrimination, NHS nurses who are female and racialized experience greater disparities in promotions and pay when compared to others ( Milner et al., 2020 ). In an interview study, Isaac (2020) suggested that Black British-born nurses were socialized to employ a defence of their “British cultural capital” (p. 97), comprised of their British identity and positive social contributions, to override systemic racism in the NHS. Although additional theoretical work by critical race scholars is needed in this area, particularly in the contexts of Brexit and the rise of nationalistic populism, the hero discourse may perpetuate the idealization of certain archetypes of nurses based on whiteness and acceptable nationality.…”

Intersectionality and nursing leadership: An integrative review

“…The setting of the 16 articles spanned the globe; three were set in the United States of America (USA) (Moyer et al, 2018; Nazareno et al, 2021; Semu, 2020) and South Africa (Dworzanowski‐Venter, 2017; van der Heever et al, 2019; Shung‐King et al, 2018). Two articles were set in the United Kingdom (Isaac, 2020; Qureshi et al, 2020), and one paper had a global focus (Dhatt et al, 2017). The remaining seven articles were set in India (Timmons et al, 2016), Kenya (Muraya et al, 2019), New Zealand (Aspinall et al, 2021), Norway (Drange & Karlsen, 2016), Oman (Hallward & Bekdash Muellers, 2020), Portugal (Santos & Amancio, 2019) and Switzerland (Ammann et al, 2021).…”

“…Black and Minority Ethnic (BAME) nurses in England's National Health Service have been shown to significantly lag behind their White counterparts in the higher salary bands and at very senior manager level positions, suggesting discrimination is a hindering factor of career progression. For British born Black nurses, socialisation and internalising what Isaac (2020) described as the cultural capital that comes from being born in Britain helped to override the ‘hindering factor’ of ‘Black ethnic identity’. However, overseas born Black African nurses did not have the same experiences.…”

“…Interviews with British born Black nurses in a study underpinned by intersectionality theory also identified intra‐group differences (Isaac, 2020). Black and Minority Ethnic (BAME) nurses in England's National Health Service have been shown to significantly lag behind their White counterparts in the higher salary bands and at very senior manager level positions, suggesting discrimination is a hindering factor of career progression.…”

“…Interviews with British born Black nurses in a study underpinned by intersectionality theory also identified intra-group differences (Isaac, 2020)…”