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  • 16 July 2020
  • 9 min read

Why BAME Nurses Are Struggling To Progress Their Career

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"For most people from BAME backgrounds climbing the career ladder is more akin to making a hike to mount Everest with no pickaxe nor compass."
Band 8 Nurse, Maxine Obeng, highlights the racial imbalance within nursing, and discusses why more Senior BAME Nurses need to speak up.

Topics covered in this article

Why BAME Nurses Can Feel Like Imposters

The Imbalance Of Racial Representation At Senior Nursing Levels

BAME Leaders Need To Advocate Action To Make BAME Nursing Representation More Fair

How To Get Help And Support If You Are Experiencing Prejudice As A BAME Nurse

Why BAME Nurses Can Feel Like Imposters

BAME (Black, Asian and ethnic minority) staff continue to report more instances of personally feeling discriminated against by colleagues or managers.

BAME staff are disproportionally more likely to face formal HR disciplinary processes compared to White staff, and white applicants are still more likely to be appointed after shortlisting for all posts compared to BAME staff.

In other industries there are reported pay disparities between white colleagues and employees from BAME backgrounds doing the same role.

In healthcare and in particular in the NHS, we were promised fairness, transparency and equity of pay with the introduction of Agenda for Change.

However this has not done enough to unearth the real root of the problem, which is that of discrimination and racial inequity.

How can professionals from BAME backgrounds have true equity of pay if they are being overlooked for promotions, not being offered non-mandatory mentoring, and not being offered the same opportunities as our white colleagues to access non mandatory training in order to have meaningful continues development plans?

This exacerbates the crippling feelings of imposter syndrome resulting in the enormous underrepresentation of BAME professionals at senior levels.

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The Imbalance Of Racial Representation At Senior Nursing Levels

The 2019 WRES report (Workforce, Race Equality Standard, NHS 2019) showed that across all NHS Trusts and CCGs (Clinical Commissioning Groups), there were some increases in the attainment of senior positions for BAME staff.

However, of the 19.7% BAME staff across all NHS Trusts and CCGs – that is across 400 plus NHS Trusts and CCG organisations – only 8.4% (that is 1,399) are at AFC pay Band 8C and above (WRES 2019).

In the 2011 Census the data on ethnicity of the UK showed this split:

46% White, 33% Asian/Asian British, 13% Black/African/Caribbean/Black British, (ONS Report, 2011).

Black and Asian as % of UK population in 2011 = 49%

Black and Asian as % of NHS + CCG = 19.7%

Black and Asian as % of NHS Pay Band 8C+ = 8.4%

The total number of BAME staff in very senior manager positions (that is defined as Chief executives, executive directors, senior managers with board level responsibilities) is now at 143 individuals only having increased by 30% since 2016, (WRES 2019).

BAME Leaders Need To Advocate Action To Make BAME Nursing Representation More Fair

In order to fully appreciate the extent of the inequalities in progression experienced by BAME people and to understand whether any of the changes which have been made have been truly impactful, deep analysis is needed into how long it takes BAME staff to reach senior positions relative to their white counterpart.

For most people from BAME backgrounds climbing the career ladder is more akin to making a hike to mount Everest with no pickaxe nor compass.

You are walking an uncertain tight rope, and losing grip the closer you get to the other side.

Eventually you find yourself hanging on for dear life.

So, to introduce one more metaphor (😉) does the glass ceiling still exist?

This is the idea that that no matter how far you get, you always feel kept out at arm’s length from truly reaching the top.

For me it certainly does still exist.

I have spent my years progressing at a relatively steady rate, doing all the things expected of us in order to be able to do so.

However at a certain stage the opportunities available begin to wither and the rate of progression stalls.

Compounded by that, BAME people are also battling against unconscious biases and discrimination which results in our white counterparts being 1.46 times more likely to be appointed for all posts (WRES 2019).

So for those BAME individuals who are able to penetrate the snowy white peaks of NHS leadership, should it be their duty and responsibility to nurture and encourage the development of junior BAME staff so as to ensure there continues to be diverse representation of BAME people at senior positions?

The lack of opportunities and more crucially the lack of access to these opportunities afforded to BAME people mean that there sometimes develops a nonchalant attitude amongst BAMES on this matter.

In my opinion I believe that it is everyone’s responsibility to enforce this, and that diversity in leadership brings a richness and depth in knowledge and action.

However amongst BAME people, I believe it is also our obligation to consciously advocate for this.

How To Get Help And Support If You Are Experiencing Prejudice As A BAME Nurse

BAME people continue to experience Race inequalities in the NHS.

It shows up as both blatant hostility as well as more subtle but equally harmful forms of discrimination, such as being denied access to those informal, more effective routes to progression

That is, we are more likely to be denied access to stretch opportunities for professional growth.

Whether we call it racism and discrimination, unconscious biases, or now macroaggressions, these prejudicial acts, whether overt or covert, or actions by omissions, have serious lasting consequences for BAME people individually and on our collective as a people.

Today it seems systematic racism is being disguised as micro- aggression.

However anybody who has experienced any form of racism and/or discrimination knows there is nothing micro about the lasting damage it has on your mental wellbeing and the lasting trauma it generates.

It’s the feeling and knowing that something unjust and unfair has been done to you because of the colour of your skin.

That feeling is sometimes difficult to express, convey, let alone to report.

Often the solution given to you when reporting an issue with a colleague is mediation, but how do you sit in front of someone whom, because of the colour of your skin, you have been made to feel bullied by, discriminated against, and made to feel you do not belong.

How can you be expected to verbalise this to your abuser?

Freedom to Speak Up (FtSU) Guardians

Freedom to Speak Up (FtSU) Guardians are a fairly new resource within the NHS. You can find more information about that and the directory of Guardians on the CQC website.

FtSU is a great initiative brought about following the Francis report which highlighted a series of institutional failings but also found that the negative culture which had developed did not support people speaking up against what they had observed, so instead these failings continued (Francis Inquiry 2013).

The role of the Freedom to Speak Up Guardian is to provide staff, service users, and carers an independent person who they can share concerns relating to or affecting patient care.

Staff can report concerns confidentially.

All Trusts are now required to have an appointed guardian.

This is a great medium to report concerns of racial abuse, where you may feel not ready to face your abuser.

BAME Network Groups

Similarly, BAME Network groups tend to be available in most if not all NHS Trusts.

These are often safe places where individuals can share their stories and get advice as to how to overcome difficulties.

Again this is a useful way to get support were you feel you are being discriminated against because of your race.

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About this contributor

I’m a registered Mental Health nurse, MSc, and Assistant Director at my NHS Trust. With over 10 years experience in mental health care, I’ve managed a variety of services including forensic mental health, and PICU. My passion is improving the representation of diversity in healthcare leadership. I have founded Niche Careers Consultancy to help BAME Nurses with targeted consulting on navigating career pathways and practical skills to achieve career progression success.

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    • Rovina Massaquoi 4 years ago
      Rovina Massaquoi
    • Rovina Massaquoi
      4 years ago

      An excellent and inspiring innovative. How can I join?

    • Ore Obey-Fabiyi 4 years ago
      Ore Obey-Fabiyi
    • Ore Obey-Fabiyi
      4 years ago

      You are spot on, don’t think our generation will get it right. Especially when a colleague abused you and you ... read more

      • Truly awful! There has to be systems in place that allow us to safely report these incidents without fear of further reprimand.

        Replied by: Maxine Obeng
    • Saheeda Sohun 4 years ago
      Saheeda Sohun
    • Saheeda Sohun
      4 years ago

      It is unfortunate to tell the truth, but with this campaign some BAME ARE REALLY SUFFERING MORE. Some of these ... read more

      • Hello Saheeda! You are absolutely right. It is a truly awful state of affairs for all minority groups. We must continue to advocate for change and hold the leaders In our organisations to account to c... read more

        Hello Saheeda! You are absolutely right. It is a truly awful state of affairs for all minority groups. We must continue to advocate for change and hold the leaders In our organisations to account to campaign for change. It feels like a huge task and it is, but together I believe we can achieve some positive changes if we are organised and intentional in our approach.
        read less

        Replied by: Maxine Obeng
    • Lucy Tsoka 4 years ago
      Lucy Tsoka
    • Lucy Tsoka
      4 years ago

      Great article, nurses from BAME; they have to apply into these posts keep knocking on all doors, request feedback,

      • Hi Lucy yes I completely agree! Its important we keep striving! And equally important to share our experiences publicly in order to campaign for change.

        Replied by: Maxine Obeng
    • lucy igweike 4 years ago
      lucy igweike
    • lucy igweike
      4 years ago

      Nothing can be done, I don’t think. I suffered stressful discrimination that made me resign as a nurse...

      • Very sorry to hear that Lucy.

        Replied by: Matt Farrah

        Hello Lucy , thank you for sharing. I’m so sorry to hear that was your experience. I hope you have been able to speak to someone about what you went through in order to get some closure. I would be ha... read more

        Hello Lucy , thank you for sharing. I’m so sorry to hear that was your experience. I hope you have been able to speak to someone about what you went through in order to get some closure. I would be happy to have a conversation with you offline if you would like some support with this. You can email me on Take care.
        read less

        Replied by: Maxine Obeng
    • Beaulah Chizimba 4 years ago
      Beaulah Chizimba
    • Beaulah Chizimba
      4 years ago

      Thank you for this great article! Very helpful 👍

      • Thank you Beaulah😃

        Replied by: Maxine Obeng
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