Pages: 15

In writing this book, we engage with new forms of nursing knowledge which recognise the social, political and historical context in which knowledge and nursing are produced. The authors in this edited book have set themselves the task of examining the influence of race and racial ideologies on disciplinary knowledge and inquiry. To introduce the chapters which follow, this chapter sets out the argument that racism is an ideology rather than a scientific theory and that the scientific theories of race represent human beings and their social relationships in a distorted manner. We start with an historical overview of race and racism, discussing the historical legacy of economic systems and the interplay between agency and social structures which contribute (in our view) to current institutional, structural and cultural racism and its manifestation: i.e. microaggression, indirect and direct forms of racism, intentional and unintentional racism and the effect of structural and institutional racism on patient outcomes. After reviewing briefly theories of race, we outline the history of racism in nursing and midwifery and the key discourses in the field. We will refer to research on racism in nursing and midwifery where appropriate.

Pages: 19

The first part of this chapter discusses the choices made by doctoral students in nursing regarding topic, methodology and theoretical framework. I argue that the complexity of some methodologies can distract early researchers from a focus on understanding social processes. I offer the examples of phenomenological approaches and narrative analysis. This chapter also looks at the advantages and disadvantages of approaching doctoral work late in a career. For example, such researchers may struggle—not to gain access to the research field—but to forge some distance from it, both intellectually and in terms of workload. The second part of this chapter discusses the complexity of the supervisor-student relationship in doctoral study. It focusses on the power imbalance where supervisors can sometimes act as gatekeepers to a research career and also, for some students from outside the UK, to a visa and right to remain. Finally, this chapter considers supervision across ‘race’ and gender.

Pages: 15

This chapter gives voice to a group of Guyanese women who emigrated to England over 40 years ago. The voices of these women were largely unheard as they tried to access health care for a long-term condition, in a society where they faced racist issues and oppressive practices. The researcher, a Guyanese woman herself, used participatory action research (PAR) methods of data generation consisting of storytelling interviews, focus groups and a research journal. The PAR approach endorses the centrality of storytelling in health care to transform peoples’ lives where participants bring their own knowledge and reflection to the research process. Constant validation of this knowledge is the cornerstone of the PAR process. For the researcher, keeping a journal was important because it facilitated reflexivity, which aided reflection, and encouraged the researcher to think about her reactions to the participants and record her feelings. This chapter will show how the women engaged in the PAR process, to increase their knowledge and understanding about their diabetes and take control of it. They changed their lifestyles, recognised the complications of diabetes and became more assertive when engaging with health care practitioners.

Pages: 19

In this chapter, I discuss institutional and structural racism in perinatal mental health services (PNMHS) involving migrant women of Sub-Saharan African origin who accessed PNMHS in the United Kingdom. Using my experience as an African migrant healthcare professional, and as part of my PhD, I investigated the lived experiences of this group of women. I discuss how my shared ethnicity and positionality as a male researcher working with these women shaped the research and how reflexivity aided data analysis. This chapter starts with an overview of perinatal mental illness and services in the UK. Using descriptive phenomenology and Critical Race Theory as methodological and theoretical frameworks, I present findings from the study which suggest the existence of racism contributed to the women’s reluctance to access PNMHS. This often led to deterioration in their mental health to the extent of reaching a crisis point requiring compulsory admission orders. The findings on racism and its impact in women’s experiences of PNMHS, issues around culture and the meaning of mental illness to these African women are explored.

Pages: 18

This chapter examines how looking diligently at who the researcher is in relation to the participants (reflexivity on positionality) effects the whole research process. Here, it involves an ethnographic study using participant observation. A white man exploring the experiences of minoritised groups is problematic and historically such research has frequently involved a lack of researcher reflexivity and an unconscious self-centring as the model of rationality. This overlooking of the imbalance in power, and lack of self-examination can impact on the validity of the process, the data produced and its analysis. Six key experiences are identified here; faith, diet as culture, race, class, sex/gender and age. The nature of each is explored in relation to their dynamism, (in)visibility and insider/outsider issues. In other words, how these experiences operated differently according to the context to help or hinder the research process. Consideration is given to how these experiences effect the nature of data generation, its quality and analysis. It concludes that it is impossible to completely and objectively tell another, less powerful group’s story but that through the use of robust and thorough reflexivity on positionality, it is possible to present useful and valid partial truths.

Pages: 20

I employ emancipatory theoretical perspectives to critique existing nurse registration structures, processes and practices in UK health care. I review the role of the UK Nursing and Midwifery Council (NMC) in recruiting Internationally Educated Nurses (IENs), from the UK government establishing the NHS in 1948 to recruiting IEN in 2023. Focusing on the role of the NMC in implementing the UK government immigration policies, I employ reflexivity to review the history and challenges of the past and existing policies and procedures regarding IENs’ recruitment, retention and integration to proffer a suggestion for addressing the continued nurse shortages and improving quality patient care in the UK health care system. I conclude that the NMC is placed to promote the benefit derivable from the international recruitment of nurses.

Pages: 24

Research has shown that black ethnic minority academics are subjected to discrimination, particularly in the form of racial microaggressions. This results in marginalisation, damaged self-esteem and limited opportunities for career advancement. Black female academics face even greater challenges due to the intersection of race, ethnicity, gender and class. Unfortunately, there is a lack of research on the experiences of black female ethnic minority nurse academics. Therefore, this chapter aims to examine sections of an interview transcript from a PhD thesis, focusing on one individual named ‘Pearl.’ To analyse Pearl’s data, a narrative methodology was employed, utilising a dialogic/performance approach that emphasises the importance of the narrative to both the storyteller (Pearl) and the listeners. This approach is supported by critical race and feminist theorists and will be used to better understand Pearl’s story. In her narrative, Pearl described a culture of white, male hegemony at her higher education institution, where black female academics experience sexism, bullying, systemic racism and interpersonal racism. Her story also highlighted the impact of racial trauma. Despite these obstacles, Pearl did not consider herself a victim and achieved success in academia. The intersecting systems of oppression can significantly shape the experience of black female nurse academics.

Pages: 21

This chapter explores the lived experience of Black and Minority Ethnic (BME) nurses when applying to access training and professional development programmes within the existing National Health Service (NHS) structure. The term BME is normally used in the United Kingdom (UK) to describe people of non-white descent. Whilst the term BME is used in this chapter, I acknowledge that its use is problematic as it conflates physical characteristics with geographical identity and fails to recognise individuality which suggests that BME people are a homogenous group. Additionally, Black, Asian and Minority Ethnic people do not share the same experiences, therefore, the term BME is not equivalent in its usage. For the purpose of this chapter, the socially recognised concept which is used to describe the term ‘Black’ refers to persons with sub-Saharan African ancestral origins with brown or black complexion.