We have to work so much harder to prove ourselves. I think expectations are different. When I first got my ward manager role, I had to have a degree. But the person who replaced me didn’t have one.

Photography by Leonora Saunders

Dionne

I’ve worked for the NHS for the past eighteen years and have been a senior nurse for fourteen months. I worked in Sussex previously and I had to make a decision whether I was happy to carry on at the level I'd been at for the last fourteen years, or if I wanted to move to get a promotion. I decided to do the commute to London, even though it kills me.

I normally start the day with coffee, for obvious reasons. My day starts at 3.45am when the alarm goes off – I have two alarms, just in case I have to snooze again – and normally I'll be running down the hill to get the 5.08am train just to get here on time. The journey here involves a train, two tubes, a bus and a bit of walking; I like to walk, so I get off a stop or two before. This evening, I'll probably leave here at 6.45pm and get home after 9pm, ready to start over again tomorrow.

I’ve got endometriosis. That impacts on my day-to-day. People see me running about and smiling, but most of the time I’m in pain. When I get really stressed, the symptoms exacerbate. Some colleagues know, some don’t. I try not to make it an excuse. I just like to get on with it.


I came from Trinidad after training as a nurse and working there for a few years; I actually moved up very quickly during that time. People assume that when you migrate, you come for the money. But I didn't come for the money; I came wanting to escape, for some space. Actually money-wise I would have been in a better place in Trinidad!
When I came to England I went for a post, and I was called twenty minutes before the interview and told there was no point coming – they wouldn’t give me the job because I didn't have two years' UK experience. I told them I would be coming to that interview. I don't know how I made it through the interview; I burst into tears afterwards, but suddenly I had the energy to go. And because I’d challenged them, they ended up changing the language they used in job adverts. That was powerful for me.

We have to work so much harder to prove ourselves; the pressure is on us a lot and isn’t always on our colleagues. Eighty percent of our workforce is from a BME background, but when I came here there was just one BME person at this level. One person, and I replaced her. Last year we had an interim director of nursing who was BME; she was the only one in London. Above me, up to hospital board level, there is no one else. That's just not practical to me; it doesn't make sense.

I think expectations are different. When I first got my ward manager role, I had to have a degree. But the person who replaced me didn't have one. I'm the only one in my peer group who has a masters or degree – that was a central criterion when I applied to this role, but not for anyone else. I think some BME staff are quite happy to stay where they are, or have given up. I did. It's not a level playing field at all.

I spent many years being pipped to the post but would still be expected to help the person who got the job. At my previous trust I spent years doing all the strategic work that was presented to the board but being paid at Band 7, while everyone else doing the same thing was being paid at Band 8. It gets frustrating and I think I had enough. I said I was looking for other options and they didn't think I would leave – but I did leave.

I sometimes wonder about my future ambition. For a long time, I lost my confidence and said I never wanted to go for a job at this level again. Even though I have now, I'm not a hundred percent confident even though my areas are doing well.


I get called aggressive and emotional a lot. I have an accent and I do speak quickly but I do get a lot of comments about my tone of voice, and I get told that it's going to be a problem. This is my accent. I’ve got some work to do but people also need to make the effort to work with me. I just don't think in 2016 I should have to hear about my accent and my tone. You would never be allowed to say that to a patient.

Recently I had a patient who was being racially abusive to staff and using some really nasty words. I said to him “This is not going to be tolerated” and he replied “I just want to be in England.” He wouldn't even open his eyes and look at me. And the people around us felt it was acceptable! That surprised me for London; you think London is this big melting pot of diversity, but there are still tensions here.

I think it's very important that patients see people who are like them. Very often we have patients say “It's nice to see someone senior who looks like me,” because often when they see people in positions of authority, they don’t look like them – unless they're doctors. When I got this job, a woman I mentor said to me, “You make me feel that it's possible for me to do as well as I can”. This was someone who grew up in London and lived there all her life, which I found really sad. I've had staff say to me, “I feel I can go and achieve a senior role because of you.” I think for years they never saw anyone beyond ward manager level who wasn't from a Caucasian background.

A patient once called me a “black bastard” and my manager was actually brilliant. She told him, “No, next time you do that you'll have to leave” and she encouraged me to report it.

I’ve also had lots of mentors who were from Caucasian backgrounds who encouraged me to be the best I can be, and I think that's been really valuable. I had a deputy chief nurse who was white, and she totally got it – she's actually a mentor to me now. I told her “I don't think I'm right to go to the next level” and she said “Look at your skills and experience – you actually can do it so stop that lie right now.” I think we all looked up to her because she saw us for our skills, for what we were.

I've come from a family where you were always told you could do anything and I think it was really a shock to my system when I realised, ‘Maybe not’. When I started working in the NHS I thought I would go as high as I was able to, I had ambitions to be a director of nursing. I don't know if it's possible now because I feel it's taken me so long to get to this level, and I don't know if I can be bothered to fight; if I'm honest, because I've been battling all the time and I'm tired. I just hope my goddaughters don’t have to live this experience in a few years’ time because I would hate for them to have limits.

At the moment our equality and diversity training isn’t online, which is not good enough. When we did a deep dive into our figures on staff undergoing disciplinaries, we found that if you were not from a BME background then managers are more likely to have a little chat with you: “That was silly, don’t do it again.” But if you’re from a BME background you’re more likely to go to disciplinary right away. This is why we’ve got to look at the data.

What we realised from this research is actually that’s how jobs are negotiated – in the pub or over a meal, and if some people don’t necessarily network like that, they’re not going to be part of that system. So there are things BME staff need to do and be aware of as well – be aware of how you sell yourself – so there’s more to be done both sides.
I'd like people to be more aware that there really is a problem with the system. It might take some time to get there, but we can get there if we work together and people take an active interest. When we start to talk about things like racism or sexism, people put barriers up. The BME agenda or the female agenda are sort of swept under the carpet.
I think we need to be open to hear people's views, even when they think there's no problem – but they need to be open to listen to the views of other people who share a difficult experience. And then we need to have some common understanding and acceptance of what behaviour is acceptable.

I do think things have moved on.

But we're still not there yet.