IRNs explained that they felt their ‘difference’ was seen as a social marker (Banton 1994) which affected their relationships with British nurses before their personal attributes could be judged. Their ‘difference’ could be either colour, culture or foreignness and, at times, it made them question whether they were viewed empathetically as fellow human beings:
When I came here I have to make them realise in my environment that ‘put yourself in my position, I want empathy, I don’t want sympathy. Put yourself in my position, if you go back to my country today, go to Africa, it will take you one month to pronounce the words and before you can get it right people will laugh at you’ (female, 46 years old, South Africa, black, D grade)
No matter if they know you are an overseas qualified nurse the way you are being approached or addressed is quite different completely from the so called UK trained nurses because they look at you as if you don’t have anything upstairs at all. They look at you as if you don’t know anything relating to nursing. So such attitude actually demoralise human being
(male, 39 years old, Nigeria, black, D grade)
Some IRNs were not surprised by their treatment and the impact their skin colour would have on relationships with British people and how they would be treated. They expected racism:
I’ve always thought that wherever you go in western countries you’d always be treated differently because of your colour and with that pre-set, with that frame of mind I came over thinking it’s going to be a struggle, it’s going to be one big hurdle for me to try and prove “Look, if you can do that I can do that.” You know
regardless of the colour and it’s always been a struggle. In the NHS now it’s still a struggle for me. I’ve been trying to get into a lot of things and I’m held back because I haven’t been trained in intensive care, I haven’t done …but I know what the bottom line is, it’s because I come from a different country. And my colour is different, so I’m held back by the very idea that I’m different
(male, 27 years old, Philippines, South Asian, E grade)
However, for other IRNs, the impact that colour made on their experience and relationships was unexpected and shocking:
But here I think you are made to realise what colour you are, something that you never thought about at home, but here you know I’m black. Even my son who is eight-years-old knows that he’s black and he …we are slaves. I don’t know where he got that from but he knows. So I think it’s not good for me, even for my children who are growing up to grow up in certain environment
(female, 35 years old, Zambia, black, D grade)
It’s a shame you had to leave your own countries to realise you were black…In your own country and then to be over here and to be labelled the way you have been. I think it’s disgusting as us as nurses [to do that]
(male, 35 years old, Australian, white, F grade)
I expected racism to be better in this country than where I was coming from, but instead I found there was, I was made to be more timid, more frightened about, you know, the profession …this is what I know. I’m not good at anything else other than my nursing profession, so it really made me feel unhappy to find that there was this much racism and all …It took me time to actually feel more comfortable and not …and in the end I ended up teaching other people and I had to tell them that never
The shock was particularly striking if these attitudes had not improved over a lifetime of working as an IRN in the UK. While most IRNs expressed anger and frustration over the discrimination and racism they met, this IRN explained how she had been able to deal with overt racism by understanding them:
... we had problems with the care assistants, not with management, not with them but with the carers and, uhm, it was, it was tough for some of my colleagues, but I’m the [inaudible]…type and the type who likes to find out why people behave the way they behave. If someone behave nasty I want to find out why the person is being nasty to me. So I think I got on quickly with a lot of the care assistants as opposed to my colleagues, they didn’t like it. ... I didn’t have any resentment at all because I just got on. First of all I remember my [IRN] colleagues [they asked:] “Why do you get on so well with them when they are nasty to you?” So I said “Have you considered that maybe they have never worked with black people before?” So I said “Well that’s what I thought.” And so they are not sure how to relate to us and, uhm, we have to help them. ... I was thinking of back home in the village when a white person comes they way the children will run away. I don’t know why they run but the children will all run away so scared because they’ve never seen ... a white and then when they come closer they will come close and touch, you know, touch. So I put it in that situation that maybe [inaudible]…black because we’re five sent to that nursing home and all black faces. That’s a lot of black people around.
(female, 46 years old, Ghanaian, black, G grade)
The ethnic mix of the focus groups allowed IRNs to share experiences across colour; and this white IRN, married to a British man, explained how her foreignness still stigmatised her:
I find this so interesting because having been here a long time … because for quite a while I went to work in a country hospital and the fact I was foreign trained,
although I’d worked here and had a midwifery qualification from here it was still more important the fact that I was foreign and people just treated me in such an odd way. I found it very difficult to adjust and in fact I really didn’t like the place at all in, uhm, I found it quite oppressive…But when I went back into nursing after having had my family and the first thing they asked me about [was] my training and when I told them that I was trained abroad, my general training was from abroad, they said “Well then there’s no way that we’re even interested in interviewing” and not discussing it with me because their hospital was for local nurses and they weren’t interested, they didn’t pursue it at all