Nurses have a responsibility to create a welcoming workplace community.

Q Recently, I witnessed something that made me uncomfortable. I was surprised when one of my more senior nurse colleagues referred to a newly graduated nurse on the unit using a derogatory and offensive term. What should I do in a situation like this?

A I’m sorry that you experienced this situation as it surely caused you some level of distress. Identifying your feelings of discomfort is important, and a key step in dealing with a situation like the one you witnessed. Episodes such as this present an opportunity for nurses to positively contribute to the work environment. Provision 6 of the Code of Ethics for Nurses (Code) charges nurses to “establish, maintain, and improve the ethical environment of the work setting that affects nursing care and the well-being of nurses.”

The Code sets the expectation that nurses express core values of the profession, including caring, integrity, and respect (Provision 6.1). It’s unacceptable for anyone, including nurses, to use demeaning language toward colleagues, patients, or family members of patients. The National Commission to Address Racism in Nursing’s research has shed light on the prevalence of bias and discrimination toward nurses in healthcare, not only from patients, but also from our peers and managers. Nursing as a profession remains on a journey, reckoning to confront racism in nursing. That journey begins with personal reflection. Silence implies acceptance of negative behavior. When an individual who behaves this way goes unchecked, it promotes social norms that negatively affect the ethical environment (for example, incivility, bullying, mobbing, cultural insensitivity, racism), and requires recalibration.

Expressing core values requires nurses to act, especially when other nurses compromise the moral milieu. In an ideal world, any one of us hearing the type of language you describe in the workplace would address the person who used the slur. The ethical challenge arises in speaking up in an uncomfortable moment. Overcoming the shock of hearing this language represents one hurdle since using it is disrespectful and inconsistent with nursing’s core values.

The Code outlines the responsibility of nurses to create a culture of inclusiveness, belonging, and community as an essential aspect of establishing an ethical milieu where all can flourish (Provision 6.2). Establishing a moral milieu requires intentional construction.

Speaking up in ethically challenging situations isn’t easy. It takes practice and a commitment to become allies to those who have experienced prejudicial discrimination in nursing. Nurses in all roles must strive to create a culture of inclusiveness and uphold practice environments that support nurses and others in the fulfillment of their ethical obligations (Provision 6.2). Nurses must remain committed to creating and sustaining an ethical environment where nurse-to-nurse relationships can flourish. This means being committed to the practice of speaking up and out when each of us hears comments that undermine all of us.

—Response by Lucia D. Wocial, PhD, RN, FAAN, HEC-C, 2025 Code of Ethics Revision Panel contributor

American Nurse Journal. 2025; 20(8). Doi: 10.51256/ANJ082536

References

Canty L, Nyirati C, Taylor V, Chinn PL. An overdue reckoning on racism in nursing.Am J Nurs. 2022;122(2):26-34. doi:10.1097/01.NAJ.0000819768.01156.d6

Moore S, Still C, Aaron S, Desimio S. Racial disparities in healthcare. Am Nurse J. 2025;20(3):18-22. doi:10.51256/ANJ032518 https://www.myamericannurse.com/racial-disparities-in-healthcare/