Racism Reporting Tool and Anti-Racist Framework

by Esther Akinpelu – Paediatric Emergency Nurse and member of Nurses of Colour.

I am a children’s emergency nurse and I have been qualified for 11 years. My whole life has been shaped by racism and it is a continuous fight for equality. I have joined Nurses United because I believe there is power in numbers and I believe that something can be done about the inequalities caused by racism in health and social care.

The systemic racism I see in healthcare is affecting patients and staff alike, it is a health issue and as nurses we are committed to tackling all sources of ill health. I was 2 years old when Rodney King, a defenceless black man, was beaten by policemen. When I was 4 years old Stephen Lawrence was murdered. The police treated his family as criminals. The locals all knew who it did but it didn’t matter. I was in my early 20’s before justice was served. And not all the perpetrators were charged. By then I was acutely aware of the risks to black and brown people faced from the Police. I was aware of the injustice our sisters and brothers from the Windrush generation faced when they came to build the UK decades before my parents came too for a better life. 

By the time I was 31, George Floyd was murdered, I was tired and hurt at the way that we again had the same discussions we had when I was a little girl. We need more than that, we need action. This isn’t just about other people but me as well. As a child I struggled to understand why someone would not sit with me because of the colour of my skin. Why I was graded lower than expected, why I had to work so much harder than my white classmates, why I was never given the benefit of the doubt and others were. It has become a sixth sense to find ways to protect my emotional wellbeing and happiness away from toxic environments that so harshly judge me.  As I have gotten older, I have become fearful about the police and the system they enforce.  We all know they abuse their power.  We all know that it is institutionally racist and that stats and their ‘education’ is not changing that. Just last week Bedfordshire Police and healthcare staff were found guilty of using forceful restraint on Leon Briggs, a black man in a mental health crisis. He needed care, he received abuse and it is well known that black people are 7 times more likely to suffer from mental health problems but 4 times more likely to be held in police custody.

When we talk about institutional racism people automatically think of just the police force.But it also exists in our NHS as well. Racism is a system and when we bring people together, in our institutions, our mutual biases and ideas come together so that my patients are put at risk. As a staff member or patient it is incredibly challenging to overcome this. The bottom line is it means we are dying, we get suspended from our jobs, we lose our income, and our mental and physical health suffers.

How are we meant to have an NHS if we treat our nurses like this? When I started to work in healthcare, I was convinced that it would be completely different to police. People chose to work in health and social care to help others. But even when people want to care for others, it is still the system that causes harm to myself and others. And I am faced with finding new ways to navigate racism. The racism that the Windrush generation faced was overt and horrible. 

We still get that but it is also more sinister, under the and façade of many things. 

Now we’re called an angry black woman when we assert our boundaries, stand up for ourselves or show some emotion.

As a senior nurse, I am often stereotyped as lacking knowledge in my field. It is so embarrassing and demoralising to work as a Registered Nurse with over a decade of experience and skills and be discredited in front of more junior colleagues I am expected to train and guide.  It has always been white colleagues that do this. But my fellow white senior nurses don’t get that treatment. I’ve even often been told that ‘for a black person you speak well like a white person’.  As woman when someone is very moody with you, you ask yourself:

Are they stressed?

Are they just having a bad day?

Has someone else offended them?

Do they just don’t like me?

As a black woman we do all of the above but we have to also ask:

Is it racism?

We watch interactions with other staff members.  Just to make sure that we aren’t being paranoid or gaslighted.  Because my time on this earth has taught me that a huge problem when trying to navigate the world of racism, is that the British are masters at gaslighting. Our regulator, the NMC, revealed that black practitioners are more likely to be referred to fitness to practice than our white colleagues but over half are dismissed with no case to answer. 

There are so many stories of black practitioners being targeted being by our employers- who represent the establishment that often deny people career progression. A prime example of this systemic racism is the recent case of whistleblowing at Whipps Cross Hospital in the last three weeks. Several people were all guilty of targeting black and brown practitioners to silence them and it was only when an ally spoke up that the trust was found guilty.  These challenges are reflected in my career which has often forced me to move jobs more frequently.  Never once has an exit interview been offered when I have been forced to leave.  I have been turned down for career progression. I have had the shame of hiding my ‘afro hair’ because I know you’re less likely to be hired following an interview. When I have asked for feedback it has been ignored.  So much so that I have been forced to email the chief nurse and chief executive. To force people to do their job properly.

I hear on a weekly basis of black and brown practitioners being turned down for senior positions but we are expected to train up a less experienced white practitioner? But the establishment can’t see this as racism? People will say it’s got better but it has not. 

The NHS’s Workplace Race Equality Standards are there to prove this. However, the data doesn’t even begin to uncover the damage that people are experiencing right now. COVID19 has ripped open the carpet of lies and laid bare the evidence of institutional failings based on race. A recent BBC documentary by David Harewood investigated this with shocking statistics like 95% of medics who died were of black and brown colour, even though they make up only 44% of the medical workforce.  I am in anguish when I read yet another story of a black woman dying in childbirth. Because it is known that black women are 4 times more likely to die in childbirth than white women and Asian women 2 times more likely.  Serena Williams nearly died and she is one of the world’s most decorated sports women.

Finally, as a healthcare professional myself I became familiar with the healthcare establishments failure on a personal level. At the lowest point of my life, I so needed help, but the words of a doctor betrayed the words of oath to her profession.  I was dismissed and told to go emergency, despite the tears flowing and struggling to find the will to go on.  I desperately needed help and that one encounter had such a profound negative effect on me getting better.  I got better and it took a lot, I complained but it took nearly a year to acknowledge. And of course, the practice manager supported and gave the benefit of doubt to the professional who failed me.  When writing this complaint, it felt like an attack.  But what if the next person wasn’t as vocal as me?  Was her ‘unconscious biases so bad she felt very uncomfortable seeing a black woman in a vulnerable state? I was tempted in her presence to demand proper help but I so feared the trope of an ‘angry black woman’ that I left. 

That’s how much power the plague of racism can have on our health outcomes. In the time of my recovery I realised that even in my personal crisis I was lucky. Because Amin Abdullah wasn’t, our society failed him; wrongly accused and suspended. He ended his life in the most painful way – fire. The institution admitted their failings but what has changed? Leona Goddard also felt unsupported, and she too ended her life. May they rest in peace. Silence will not make the issue go away. I encourage you all to come forward and get involved in our campaign. This can no longer continue. It is time for us all to confront the facts and act upon it. Not having badges, claps or awards. Together we can make changes for our patients and friends and family to make health and social care a safer place for all.  If you are tired of hearing about racism, then use your privilege to help us fight it because we are tired of dealing with it.

Esther Akinpelu is a Paediatric Emergency Nurse and is a member of Nurses of Colour. She has been qualified for 11 years. The above is her speech from the launch of the Racism Reporting Tool and Anti-Racist Framework organised by Nurses of Colour on March 17 2021.

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