Ethnic inequalities during clinical placement: A qualitative study of student nurses' experiences within the London National Health Service

Chenel R. Walker, Cerisse Gunasinghe, Hannah Harwood, Annahita Ehsan, Farah Ahmed, Sarah Dorrington, Juliana Onwumere, Paula Meriez, Nathan Stanley, Nkasi Stoll, Charlotte Woodhead, Stephani L. Hatch, Rebecca D. Rhead*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: To understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups. Design: A qualitative thematic analysis with an inductive approach. Methods: Data from semi-structured interviews with 21 London (United Kingdom) hospital-based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement. Results: Five main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as “ward culture”) providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS. Conclusion: These initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity. Impact: Ward culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it.

Original languageEnglish
JournalJournal of Advanced Nursing
Early online date3 Oct 2023
Publication statusE-pub ahead of print - 3 Oct 2023


  • discrimination
  • ethnicity
  • health service
  • London
  • nurses
  • nursing
  • qualitative
  • student
  • thematic


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