Abstract
We investigate the determinants of perceived racial harassment at the workplace, and its impact on job satisfaction and quitting behaviour among ethnic minority nurses, using data from a unique large–scale survey of British NHS nurses. Nearly 40% of ethnic minority nurses report experiencing racial harassment from work colleagues, while more than 64% report suffering racial harassment from patients. Such racial harassment is found to lead to a significant reduction in job satisfaction, which, in turn, increases nurses’ intentions to quit their job. These results are found to be robust to endogeneity concerns, and have important policy implications for retaining qualified nursing staff in the NHS.
Highlights
Forthe lastfifty years,the N ationalH ealth Service (N H S)hasbeen the cornerstone ofthe w elfare state in Britain.H ow ever,since itsinception there have been persistentallegationsthatracialdiscrim ination isan inherentfeature ofits internallabourm arket.These allegations have arguably been strongestin the case of qualified nursing staff w ho are a key inputinto the production of health care.[1]
The sim ple calculations confirm our earlier expectations.The proportion of ethnic m inority nurses w ho are satisfied w ith their currentjob is inversely related to the frequency of racialharassm entthey experience.Interestingly,butperhapsnotsurprisingly,racialharassm entfrom staffcolleaguesresultsin a low er incidence of job satisfaction (12.8% and 30.1% ),regardless of frequency,w hen com pared to the m ore com m on racialharassm entfrom patients or their fam ilies (24.8% and 36.3%,respectively).This finding generally holdsforeach ethnic group asw ell.A ccording to oursam ple ofethnic m inority nurses, w orking in the British N H S is nota satisfying experience.Even am ongstthose w ho have never been racially harassed generally m ore than 50% are notsatisfied in theirjob
H ow ever, it m ight be the case that there exists an unobservable individual characteristic that jointly determ ines tw o or m ore of these outcom e m easures.Exam ples of such characteristics m ight be poor health ora general‘bad attitude’to w ork,w hich are unobserved in the survey.To provide a sim ple testof the robustness ofourfindings to endogeneity concerns w e have sim ultaneously m odelled perceptions of racial harassm ent, job satisfaction and intentions to quit using a m ultivariate probit fram ew ork
Summary
Forthe lastfifty years,the N ationalH ealth Service (N H S)hasbeen the cornerstone ofthe w elfare state in Britain.H ow ever,since itsinception there have been persistentallegationsthatracialdiscrim ination isan inherentfeature ofits internallabourm arket.These allegations have arguably been strongestin the case of qualified nursing staff w ho are a key inputinto the production of health care (see A kinsanya,1988; Baxter,1988;Beishon etal.,1995;D epartm entofH ealth,1998a;Ellis,1990;and Pudney and Shields, 2000a,2000b).[1]. Each question w asaddressed to the nursesin the survey,w ho could answ er‘yes’to one ofthe follow ing: D A ILY ,W EEK LY ,M O N TH LY ,LESS O FTEN or N EV ER.For ease of exposition,w e use the term ‘racialharassm ent’to coverallactsof‘difficult,aggressive orhostile behaviour’perceived to be based on the grounds of race or colour.H ow ever,there are a relatively sm allnum ber of cases in som e of these specific categories,especially w hen the sam ple is divided by ethnic group.,w e gathertogether those reporting racial harassm ent on a D A ILY , W EEK LY or M O N TH LY basis into a FREQ U EN T category.Forclarity w e use the term IN FREQ U EN T forthose in the LESS O FTEN category.[8] Table 1 show sthe distribution ofthe answ ersto these tw o questionsby ourfourm ain ethnic m inority groups.Itis im m ediately clear thatperceived racialharassm entis a substantialproblem am ongstN H S nurses.N early 40% (com pared to 4.3% ofW hite nurses)ofallethnic m inority nursesin oursam ple report having experienced som e racialharassm entfrom w ork colleagues in their careers,w ith 6.5% (0.9% of W hites)reporting thatthis occurs frequently (atleastm onthly).The incidence ofracialharassm entfrom patients,or their fam ilies, is even greater. N early 65% (15.6% of W hites) of these nurses have been racially harassed by those thatthey are seeking to help atsom e pointin their career,w ith alm ost10% (2.4% of W hites) reporting thatthis is a frequentoccurrence.Itis notable thatthe incidence of racial harassm entisgenerally higherforBlack nursescom pared to A sian nurses
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