Student nurses' experiences of discrimination and racism on work placements: What can higher education institutions do

Background: There is persistent interpersonal, institutional and structural racism within the health sector and higher education. Such anti-Black and anti-Brown racisms are experienced by nursing students, nursing apprentices and fully qualified nurses. This discrimination intersects with other characteristics, namely gender and student status, which can make the nursing profession an unsafe environment for many. Objectives: To understand student nurses' experiences of racism and intersecting oppressions, at university and on work placement. Design: A qualitative descriptive study with individual interviews and focus groups. Settings: A widening participation higher education institution in London, UK. Participants: Twenty-four student nurses and nurse apprentices studying on an adult nursing programme. Methods: Students were recruited through purposive sampling. In-depth data relating to student nurses' perspectives and experiences were gathered through two focus groups and three individual interviews conducted by student nurse peers. Interviews were transcribed verbatim and open coding was used to analyse transcripts using comparison and thematic analysis. Results: Three key themes arose: safety and support in the university space; hierarchical treatment in work placements due to intersecting race and 'student' identities, and; direct racism by patients and staff in work placements. Conclusions: Student nurses expressed their vulnerability to discrimination and racism whilst on placement in the National Health Service. More opportunities within university curricula are needed for student nurses to learn about, reflect on, and gain support for managing experiences of discrimination in the health system.