Staff perspectives on racial inequities in the neonatal intensive care unit: the REJOICE study

TL;DR

This study explores how NICU staff experience and perceive racial inequities in healthcare settings.

Contribution

The study provides new insights into the structural and interpersonal racism experienced by NICU staff and their patients.

Findings

Staff reported a wide range of denial and recognition of racism in the NICU.

Workplace culture both protected against and facilitated racism.

Staff witnessed biased communication and disparities in resource allocation.

Abstract

To understand staff perspectives on racism experienced by both parents and staff members in the neonatal intensive care unit (NICU).

Open-ended surveys and semi-structured interviews were conducted with staff at an urban level IV NICU from 2021 to 2022. Themes were generated and refined using thematic analysis. The main outcome constituted participants’ experiences of structural racism.

72 multi-disciplinary and racially and ethnically diverse participants completed the survey and 10 participants were also interviewed. Five major themes were identified: (1) a wide range of denial and recognition of racism existed, (2) workplace culture and relationships both protected against and facilitated racism, (3) staff experienced a lack of workforce diversity and minority tax, and witnessed (4) biased communication and language barriers, and (5) disparate resource allocation.

Similar to other healthcare worker and caregiver reports, NICU staff members also experience and witness interpersonal, institutional, and structural forms of racism.