Aisha and David: microaggressions and workplace racism
Setting: NHS ward environment: staff-to-staff racism.
Context
Aisha is a Band 6 senior staff nurse from an Asian ethnic background with seven years of NHS experience. She is respected by patients and colleagues for her calm approach and strong clinical leadership. David is a Band 5 nurse who is White and who joined the ward 18 months ago and works regular shifts with Aisha.
What happened
Over several months, Aisha notices repeated behaviour from David that makes her uncomfortable. He repeatedly mispronounces her name after being corrected, comments that her English is “surprisingly good” despite Aisha being born and educated in the UK, jokes about “where people really come from” during staff breaks and suggests during handovers that some patients may prefer “someone local”.
At first, Aisha tries to ignore the comments to avoid conflict and maintain professionalism. The behaviour gradually escalates. During a stressful shift in the emergency admissions unit, David becomes frustrated and says loudly: “People like you always make things difficult on this ward.” Several colleagues hear the comment. Aisha feels humiliated and upset but continues working through the shift.
Following the incident, she becomes anxious before shifts, takes two periods of sickness absence related to stress and becomes less confident contributing during team discussions. Team morale declines because some staff witnessed the incident but did not intervene. Communication between colleagues becomes strained.
After encouragement from a colleague, Aisha reports the incident to her line manager. The manager arranges a confidential meeting, formally documents the concerns, refers the matter to HR and considers immediate action to support staff wellbeing and patient safety. David is informed that concerns have been raised about alleged discriminatory behaviour.
The Trust begins a formal investigation, including witness statements, shift records, communication logs, previous informal concerns and supervision notes. David says he was “only joking” and did not intend to offend anyone. Several witnesses confirm the comments were repeated over time. One colleague admits they felt uncomfortable but did not know how to challenge the behaviour.
Impact
Aisha experiences anxiety, humiliation and sickness absence. The wider team becomes less trusting and less psychologically safe.
Staff who witnessed the behaviour but did not act also recognise that silence contributed to the harm.
Patient care risks emerge through poor communication, low morale and strained teamwork.
What anti-racist practice should look like
Microaggressions are not minor when they are repeated and unchallenged. Managers should take concerns seriously, support the person affected, document clearly and follow a fair process. Bystanders should be supported and expected to challenge racism safely and appropriately.
Key learning points
- Racism includes subtle comments, stereotypes, microaggressions and exclusion
- Intent does not remove the impact of discriminatory behaviour
- Repeated “jokes” or comments can create a hostile and unsafe working environment
- Bystanders have an important role in maintaining an inclusive workplace
- Managers should respond promptly, confidentially and fairly
- Clear documentation and fair investigation processes are essential
- Organisational culture influences whether staff feel safe to speak up
- Training should focus on practical behaviours, bystander action and accountability
- Inclusive workplaces improve staff retention, morale, teamwork and patient care.
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