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Sandra: My advice to BAME nurses? Empower yourselves!

Sandra moved to the UK from South Africa in 2000, and is now a Lead Nurse for Integrated Sexual Health in the NHS. Last year she won a prestigious ‘Leader of Inclusivity’ Award from the


Sandra moved to the UK from South Africa in 2000, and is now a Lead Nurse for Integrated Sexual Health in the NHS. Last year she won a prestigious ‘Leader of Inclusivity’ Award from the NHS London Leadership Academy for developing and training a highly diverse team of nurses and this year was a runner up in the category for Leadership and Development of People. Here she relates the journey behind her success, and the struggle for recognition as a woman of colour.

I manage a sexual health clinic at Whipps Cross and at Newham University Hospital. When I attended the Chief Nursing Officer’s BAME forum , I was asked: ‘why are there so few nurses of BAME backgrounds in management within the NHS?’ After that, I developed a desire to work with this group of nurses.

In my current position as Lead Nurse, I work with two teams of nurses, 99% of whom are from BAME communities. Almost none of them were born in the UK. I have nurses from Sierra Leone, Ghana, Nigeria, the Philippines, South Africa, Zimbabwe, Malaysia and India. By their very nature of origin, they already face many challenges that most immigrant employees face – financial, family placement, lack of extended families, work permits – and that is even before commencing work.

At work they are expected to perform to a very high standard. When I first met these nurses they had had no proper leadership for several months, and therefore felt very unrepresented in the workplace. They appeared to be traumatised by their previous experience of working in different NHS jobs. These nurses were frustrated, as they didn’t feel trusted enough to be in the driving seat of the patients’ pathway through the clinic and would often seek a second opinion from doctors. They had not been given the opportunity to access the training that was very necessary for them to work autonomously.

They didn’t always feel confident enough to assess the patient from the beginning to the end of the consultation. This resulted in the patients’ waiting times being increased, and a lot of inefficiency in the system. Society often stigmatises attendances to sexual health clinics. For the patient, having to wait an additional three to four hours for treatment left many frustrated.

Training nurses to be competent cuts down waiting times

I knew as the Lead Nurse for the service that we needed to make drastic changes to the training and development of this group of nurses. Understandably, my team were intimidated by the plan of action that I put before them. However, I did promise them my full support in achieving it, and the most important thing was that they embraced the programme at that point in time.

I had all of them sign up to do the online Diploma in sexual and reproductive health. Last year, we had three nurses complete the Non-Medical Independent prescribing course, which is a very advanced course. I often say to them, “We’re here to take you right to that next level, but I don’t want you to stay there, I want you to move up and beyond that.” I’m sending them for management courses now in order to equip them not only to be operational, but to understand strategic participation as well.

When I look around me, these women are definitely not the same nurses I met two years ago. They’ve now got a voice. They are able to work autonomously and see patients from beginning to end. They’re walking and speaking with so much confidence. It’s wonderful.

Patients are happier and the whole team is happier. Our sickness and absentee levels have gone down tremendously. The team is very cohesive now, unlike before, when it was quite porous.

‘White peaks’ in the NHS

Research has shown many trusts in the NHS have ‘white peaks’ in management. The majority of senior NHS professionals are of white ethnicity and a large part of the junior staff tends to be from the BAME community. There seems to be a lot more management than leadership within some of these groups and a culture of ‘the buck stops with me’. Employees who do not have ‘the tools’ to do the job do not believe that they can challenge management. In my opinion, this contributes to a communication divide, making uncomfortable conversations difficult to have.

People from BAME groups within organisations like the NHS find themselves in places where the leadership is not representative of them. They don’t always have clear pathways on how to move up the career ladder. They express a feeling of being lost, and some come to work just because they’ve got to pay the bills. Some people express being afraid and intimidated by doctors and management, and people from BAME communities often use the phrase, “Oh it’s because of the colour of my skin.”.

In our profession, which is a caring profession, it is very difficult to walk around with a heavy heart and deliver good patient care – the two tend to contradict each other. What am I talking about here? I’m talking about nurses and doctors having to care for patients but not showing that compassion to each other.

My advice to BAME people? Empower yourself!

My advice to BAME people would be to remember that this life is not a rehearsal, it’s the real act. You don’t get a second chance to perfect it. Therefore you have to seize every opportunity to make your life beautiful at work and at home by engaging with people that you would like to emulate, empowering yourself with all the right skills that you need for your job right now and beyond, equipping yourself for future projects, and never letting go of a dream because everything is possible, but only with time. I want to emphasise that you have to be the best that you can possibly be at anything that you are doing.

Black and minority ethnic staff are more likely to report being bullied and harassed, the first national review by NHS England has suggested. If you’re being discriminated against in the workplace, consider voicing this with the NHS BME network. You can also find out more about Sandra’s achievements here.


1000women is a platform for minority ethnic women to tell their own stories, on their terms. To find out more about joining the team or sharing your story, write to 1000women@naz.org.uk

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