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How should nurses deal with patients' personal racism? Learning from practice



    1. Professor of Continuing Professional Development in Health Care, Faculty of Health and Social Care, University of Chester, Warrington Campus, Warrington, UK
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M. Deacon Faculty of Health and Social Care University of Chester Warrington Campus Crab Lane Warrington WA2 0DB UK E-mail:


Accessible summary

  • • Nurses and their colleagues experience patients' expressions of personal racism during their routine practice.
  • • This paper reports on how nurses managed patients' expressions of racism within an acute mental health ward.
  • • A key factor in deciding on a course of action is the degree to which a patient's anti-social behaviour can be absolved by their mental ill-health.
  • • The management of racism should be overtly confronted and managed by the health care team, including its consequent irresolvable tensions.


This paper aims to promote practice development in the difficult area of managing patients' expressions of personal racism within the clinical environment. Racism is a global phenomenon and it is well documented that nurses experience racism within their routine practice. Nurses face unpleasant dilemmas in managing racist patients who are also vulnerable because of their health status. The paper is based on the ethnography of acute mental health nursing, conducted within a UK hospital. The study found that nurses conceptualized patients' expressions of racism as a consequence of their mental ill-health and that they managed this difficult issue through nursing methods of direct engagement, trouble avoidance and the minimization of strangeness. It is concluded that patients' racism cannot be managed by following simple, procedural rules but neither should it be managed ‘behind closed doors’. A culture should be facilitated in which nurses can feel secure that colleagues and managers will take their concerns about personal racism extremely seriously and engage with, and value their contribution in working out just what to do in specific cases. The nursing methods discussed can be used as a basis for practice development in this unpleasant and uncomfortable area.