Nurses of color experience disproportionately higher levels of emotional distress during pandemic

A recent Rutgers study found that non-white nurses experienced disproportionately greater amounts of emotional distress in comparison to their white peers during the coronavirus disease (COVID-19) pandemic, according to a press release. 

Charlotte Thomas-Hawkins, an associate professor in the School of Nursing and lead author of the study, said that approximately 800 licensed professional nurses in New Jersey were surveyed electronically about their experiences.

She said that nearly half of all nurses surveyed reported feeling very worried about COVID-19, while 27 percent of nurses reported feeling somewhat worried. Nurses who were worried about the disease were four times more likely to report higher levels of emotional distress. 

Thomas-Hawkins said that nurses of color reported significantly higher levels of emotional distress, concerns about COVID-19 and microaggressions in the workplace.

Among all nurses surveyed, Black nurses reported the highest levels of microaggression and negative workplace experiences, she said. Additionally, nurses experiencing workplace microaggression were two times more likely to experience greater emotional distress. 

Overall, the study found that nurses who faced both workplace racism and concerns about COVID-19 experienced severe levels of emotional distress, Thomas-Hawkins said. 

“This represented for (non-white nurses) a dual pandemic," she said. "Their experiences of workplace racism and COVID-19 worry were synergized to the detriment of their emotional well-being.”

Thomas-Hawkins said that the Centers for Disease Control and Prevention (CDC) have previously declared racism a public health threat.

The organization said that racism, by impacting the health of millions of Americans, affects the health of the nation in its entirety, according to a press release. 

The CDC said that racism includes both individual discrimination based on a person’s race or ethnicity and the societal structures that influence how individuals from different communities live.

“Over generations, these structural inequities have resulted in stark racial and ethnic health disparities that are severe, far-reaching and unacceptable,” the organization said.

Thomas-Hawkins said the study’s research team attributed higher rates of distress experienced by nurses of color to two factors: how the pandemic has disproportionately impacted their communities and how it has impacted their peers. 

She said that non-white health care workers accounted for more than half of all confirmed COVID-19 cases and related hospitalizations. In addition to this trend, nurses as a group overall represented the majority of all health care workers infected.

“Because of this, nurses of color were undoubtedly worried and highly vulnerable to work stress as they attempted to balance their workplace (COVID-19) exposures with ensuring safety for themselves and their families,” Thomas-Hawkins said.

She said that the study demonstrates a need for reform in hospitals and health care organizations regarding workplace racism.

Health care institutions can take steps to address these issues by taking steps like installing bias self-awareness training for employees and workplace inclusivity training for managers, Thomas-Hawkins said.

She said that having a safe and inclusive workforce allows nurses to both report instances of racism and discrimination, as well as have difficult conversations with managers when they occur. 

Additionally, Thomas-Hawkins said that health care organizations should reevaluate current hiring, promotion, interpersonal and reward systems in workplaces to remove racial disparities. She said that having a racially diverse nursing workforce is crucial to ensuring the care of racially diverse populations.

As of now, people of color only represent 28 percent of the nursing workforce, despite the fact that they constitute 40 percent of the American population, Thomas-Hawkins said.

“To recruit and retain a diverse nursing workforce, understanding the effects of negative racialized experiences in the workplace on nurses’ emotional well-being is important in efforts to create healthy work environments that foster the retention of nurses of color,” she said.