Nurses who come from Bipoc communities disproportionately face many challenges both on the road towards becoming a Nurse and after they have become practicing nurses. One of these challenges is lack of representation. For example, Black nurses represent only 6.3 percent of nurses in the U.S. despite Black people making up 14.4 percent of the overall U.S. population. Furthermore, that percentage has decreased from being 6.7 percent in 2020 to just 6.3 in 2022.

This should concern everyone in the fields of healthcare and public health. Communities of color experience significant disparities in health outcomes and having enough Bipoc Nurses could help improve those outcomes considerably. But in order to address the problem, we need to first understand the reasons why there aren’t enough nurses of color in the field and why the ones we do have are more likely to quit compared to white nurses.

The Challenges Begin Early On

First, we should be cautious about grouping nurses of color into a single category. Depending on which specific communities they come from, BIPOC nurses may face some challenges that are unique to their own specific communities. But it is also generally true that nurses of color do experience many shared challenges regardless of their specific background.

These challenges do not begin in clinical settings. They begin at the level of K-12 education and long after. A big part of this is the overall educational disparities that Black and Brown students experience such as less funding for schools in underserved communities, a lack of qualified teachers, crowded and outdated classrooms, biased standardized testing, and curriculums that don’t reflect the lived experiences of Black and Brown students, just to name a handful. Disparities like these have long-term effects that can influence which university or career paths students believe are available to them. For example, the lack of role models in nursing who look like them can make students feel that a nursing career is out of their reach.

Racism and Lack of Support in the Hospital Setting

Black and Latinx nurses represent just 6.3 and 6.9 percent of all nurses, respectively, even though Black and Latinx people make up 14.4 and 19 percent of the U.S. population. This lack of diversity is reflected in nursing schools where, on average, almost 80 percent of the faculty are white and roughly 60 percent of the students are white. This can have numerous negative effects for BIPOC nursing students including loneliness and social isolation, lack of emotional and academic support, and being subjected to discrimination in both obvious and subtle ways (such as microaggressions) from faculty, patients, and other students.

BIPOC nursing students are also more likely to have to juggle major life responsibilities in addition to their studies such as full-time work, caregiving, or other family-related responsibilities. Because of all the challenges and barriers, many of them might also struggle with various mental health challenges but are also less likely to receive treatment and support for those challenges. This can make it more difficult to keep up with their studies and they become less likely to graduate from higher education.

The students who manage to graduate then enter hospital settings where there is often more discrimination, microaggressions, and lack of institutional support awaiting them. Again, this results in nurse burnout and attrition and it also leads to harmful effects that go beyond just the nurses themselves. For example, implicit bias is common among non-BIPOC healthcare staff and patients who are people of color often receive unfair treatment which can intensify any preexisting feelings of mistrust towards the medical establishment due to historical discrimination. With research showing that Black nurses do indeed provide better care for Black patients, one way hospitals can improve health outcomes for patients of color is by hiring more BIPOC nurses.

High rates of nurse burnout and attrition among nurses is also worrisome because there is already an overall nurse shortage, and the Covid-19 pandemic didn’t help matters. The healthcare system can’t afford to keep losing nurses this way. Unless the industry faces the problem, the U.S. will face a serious healthcare crisis in the future as elderly patients will need increasing care without the nurses available to provide it.

What Can Be Done to Reduce Nurse Burnout and Attrition

These problems can all be addressed, but it won’t take any one quick or simple solution. Instead, both nursing schools and hospital settings need to use holistic approaches.

A good place to start is better representation throughout the entire nursing pipeline—for example, hiring more faculty of color in nursing schools and more nurses of color in hospitals. Outreach programs that influence students early on, such as in high school, are also a wonderful idea. The better the representation for both BIPOC students and nurses, the less problems there will be and the better the health outcomes for both nurses and the patients they treat.

Providing more academic support to BIPOC nursing students can also go a long way towards reducing burnout and attrition. The same goes for providing support for nurses in hospital settings. Hiring more nurses of color would be ideal, but even just providing support for the existing ones would help them cope with the workplace discrimination and microaggressions they experience.

Support can also take different forms. For example, offering on-site mental health services can be one way to help BIPOC nurses cope with descrimination, but reducing the amount of discrimination in the first place would be even better. This can be done through additional training such as DEI workshops to improve awareness among the non-BIPOC staff so that they can avoid committing microaggressions and be more supportive when BIPOC nurses report experiences of racism.

There has been some recent backlash against DEI programs, but it is important that hospitals and healthcare systems don’t follow this backlash trend. Teaching and hiring more nurses of color is important but it takes time, and meanwhile DEI programs can quickly create a culture of awareness to improve BIPOC nurses’ workplace experiences. The research shows that DEI training and support for BIPOC nurses improves workplace diversity, communication, the well-being of nurses of color, and the quality of care given to patients.

Putting these ideas into actions won’t be easy but it doesn’t have to be all-or-nothing. Depending on their specific situations, nursing schools and hospitals can start small. They can start by hiring more faculty and nurses of color or providing more support for the ones that are already there. Ideally, they can eventually do both. Burnout and attrition are costly, and so are poor health outcomes and low patient satisfaction resulting from the lack of BIPOC nurses. At a time when the healthcare sector is facing a critical shortage of nurses, nursing schools and hospitals should both do everything they can to prevent the crisis from getting worse.

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