Reckoning With Racism in Nursing: Towards Structural Transformation and Epistemic Justice

Despite longstanding rhetorical commitments to diversity, equity and inclusion, racism remains a pervasive and a systemic force within the nursing profession, shaping experiences of both the workforce and the populations they serve. A recent UK survey found that 75% of nurses from ethnic minority backgrounds reported experiencing racial discrimination from colleagues or patients, resulting in stress, burnout and a heightened intention to leave the profession (Royal College of Nursing [RCN] 2024; Kapadia et al. 2022). In the UK, Black and racially minoritised staff experienced more harassment, bullying and abuse from patients, their relatives, and staff when compared to white staff in the English National Health Service (NHS) (NHS England 2023). However, focusing solely on interpersonal or overt forms of racism risks obscuring the more insidious manifestations embedded within the structural and epistemological foundations of nursing.

Structural racism in nursing is not simply a reflection of individual prejudice but is reproduced through institutional policies, curricula, leadership pipelines and regulatory frameworks that perpetuate racial hierarchies (American Nurses Association [ANA] 2025; Moorley et al. 2025; Robinson-Lane and Patel 2022). These structures systematically marginalise racialized nurses through inequitable access to mentorship, promotion opportunities and decision-making power, often under the guise of ‘neutral’ meritocratic standards. In Australia, the UK and Canada Black and other racialized nurses are significantly underrepresented in senior clinical and academic leadership roles despite comparable or higher levels of education and experience. These disparities are not coincidental but stem from historical legacies of colonialism and whiteness as normative within the education and professional identity of nursing (Jackson 2023).