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“Outsider” culture is one factor why nurses are referred to NMC

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Studies suggest that some nurses are made to feel like “outsiders” because of protected characteristics such as ethnicity and gender, and are disproportionately represented to regulators. I’m here.

On the other hand, job types and work environments have also been found to contribute to discrimination against different groups of nurses and midwives.

These were the findings of Phase 2 of a Nursing and Midwifery Council study of how staff with protected characteristics are treated.

NMC published the first part of its Ambitious for Change report in October 2020. The report found several disparities among people with different characteristics in their experience and outcomes in revalidation, fitness to practice (FtP), education, and the overseas registration process.

A follow-up report analyzed the initial findings in more detail and spoke to employers as well as nurses, midwives and nursing aides to establish a qualitative picture of discrimination.

The people behind the survey interviewed 60 experts and 11 employers on FtP referrals, and 18 experts were also interviewed for qualitative research on revalidation.

Among its findings, the 54-page report draws attention to systemic problems in nursing, perpetuating a culture of ‘insider’ and ‘outsider’ defined by individual characteristics, which is characterized by ‘discrimination, prejudice, “The risk of stereotypes,” he said.

This culture has particularly affected staff who are male, black, and/or trained abroad, the report notes.

“Experts feel that introductions to particular groups are often driven by perceptions of them as ‘different’ or ‘outsider’.

“People described feeling like ‘outsiders’ in many ways, but important factors included ethnicity, gender, age, sexual orientation, gender identity, nationality, religion, and personal employment. It included belonging to a minority group in terms of morphology.”

The report highlights that “most” of the employers interviewed “do not agree that professional diversity characteristics play any role in whether or not they make referrals to NMCs.”

However, they acknowledged that black and ethnic minority professionals were more likely to be subject to disciplinary action, and recognized inconsistencies in how concerns were investigated within and between different organizations.

Both professionals and employers felt that the type of employment, role and environment influence FtP referrals.

The nurses and midwives interviewed for the study felt that their job role and work environment were the main drivers of differences in revalidation rates.

“Together we need to develop targeted solutions to these inequalities.”

Andrea Sutcliffe

The study showed that, for example, professionals working as agents or bank staff in settings such as nursing homes or general practitioners were more likely to have negative experiences with the regulatory process.

At the same time, people with certain diversity characteristics are more likely to work in these fields, with black African professionals, who make up 8% of NMC registrants, hold 14% of jobs in care homes and agencies. provides 36% of jobs. Men made up 11% of his registrants, while 20% of him had agency work.

In the report, the NMC will improve its overseas registration process, develop new resources to help employers investigate concerns locally, and better understand how it considers the context of FtP cases. He said he was already taking steps to reduce discrimination, including making it systematic.

However, regulators are taking further steps, such as commissioning more work to understand people’s recertification experiences and why employers and the public refer certain groups of professionals to NMCs. He said he would teach

It also committed to commissioning registration appeals and delayed review of FtP cases, focusing on cases involving men, persons with disabilities, or black professionals, and those who did not wish to disclose their sexual orientation. did.

In addition, we will strengthen our relationships with smaller employers and private sector employers, and strengthen our relationships with international recruiters to encourage them to include recertification as part of their recruitment and ongoing support. said it will develop new approaches to outreach work with employers, such as For international recruits.

Bruno Daniel, Diversity and Equality Coordinator at the Royal College of Nursing, welcomed the NMC’s commitment to action, saying:

“Referrals can cause serious distress among our members, and this report reflects what they have been telling us,” he said.

“NMC must continue to work with individual employers to ensure that staff are not improperly introduced and are guaranteed fair treatment at all stages of the process,” he added.

He said the coronavirus pandemic has “spotlighted systemic racism in health care services” and that the RCN’s own employment survey has shown that “systemic racism has a devastating impact on minority staff.” He emphasized that he showed that

“We need to see systemic change,” Daniel said.

NMC Chief Executive Officer and Registrar Andrea Sutcliffe said the report’s findings provided an opportunity for NMC to improve its regulatory activities and ensure that the process was fair for everyone. I was.

“It is also clear that deep systemic issues of inequality contribute to the disparities we see,” she said.

“This is not a question of whether discrimination or inequality exists. mosquito?

“It is very important to work with employers and other partners across the sector. We need to clarify what the experts have told us,” she said.

She added: “We need to develop solutions together to address these inequalities in professional work environments and the care people receive.”