This is the conversation nobody wants to have, but every Indian nurse needs to hear before moving to Europe. Racism and discrimination exist in European healthcare systems. Not everywhere, not always, but enough that you need to be prepared. This honest guide discusses what racism actually looks like in European nursing, how common it is, which countries are better or worse, and most importantly – how to handle it when it happens to you.

The Uncomfortable Truth: Yes, Racism Exists

Setting Expectations Honestly

Let’s establish facts from research and real experiences:

·       According to a 2022 survey of foreign healthcare workers in German university hospitals, 55% experienced discrimination based on language, nationality, or ethnicity

·       A UK Nursing and Midwifery Council report found internationally educated nurses ‘crying at the end of shifts’ and feeling ‘traumatized’ due to racist comments

·       Research shows internationally educated nurses leave European registers at 5-6x higher rates than locally educated nurses, with discrimination cited as a major factor

·       However, experiences vary WIDELY – some Indian nurses report zero racism, others face it regularly

The reality: Racism in European nursing is not universal, but it’s common enough that you must prepare for it. This article aims to educate, not discourage. Knowledge = power.

Types of Racism Indian Nurses Experience

1. Microaggressions: The ‘Death by a Thousand Cuts’

These are subtle, often unintentional comments that accumulate:

·       ‘Wow, your English is so good!’ (implying surprise that an educated Indian speaks English)

·       ‘Can you actually read the medical charts?’ (questioning competence based on appearance)

·       ‘Where are you really from?’ followed by ‘No, where are you REALLY from?’ (othering)

·       ‘You people are good at…’ (stereotyping, even if ‘positive’)

·       Being constantly asked to repeat yourself, while European accents are never questioned

·       Colleagues speaking slower or louder, as if you’re intellectually impaired

Impact: Each incident seems small, but daily accumulation leads to exhaustion, self-doubt, and mental health issues.

2. Professional Undermining

Discrimination disguised as ‘concerns about competence’:

·       Indian qualifications questioned despite official recognition (Anerkennung)

·       Being given simpler tasks than European colleagues with same experience

·       Your clinical judgment doubted more frequently than local nurses

·       Excluded from training opportunities or leadership pathways

·       Harder scrutiny on documentation or procedures

·       Taking longer to get promotions despite excellent performance

Real Example: ‘I had 8 years ICU experience in India. My German colleague with 2 years experience was training me on basics. When I corrected a medication error, I was told to ‘follow German ways.’ – Anjali, Munich

3. Social Exclusion

·       Colleagues going for breaks/lunch without inviting you

·       Conversations in rapid German when you’re present (intentional exclusion)

·       Not being invited to social gatherings or birthday celebrations

·       Cold shoulders, minimal eye contact, reluctance to chat

·       Gossip and talking behind your back (you sense it but can’t prove it)

Impact: Feeling isolated, unwelcome, questioning whether nursing in Europe was the right decision.

4. Patient Racism

Patients refusing care from Indian nurses:

·       ‘I want a German nurse’ or ‘I want a white nurse’ (direct rejection)

·       Patients questioning your qualifications: ‘Are you a real nurse?’

·       Refusing to follow your instructions but complying with European colleagues

·       Using derogatory terms or making racist ‘jokes’

·       Elderly patients especially likely to exhibit this behavior

Reality: This happens. How hospitals handle it varies dramatically.

5. Institutional/Structural Racism

·       Recognition processes that take longer for Indian degrees than European degrees

·       Indian nurses assigned to less desirable shifts disproportionately

·       Recruitment agencies charging Indian nurses higher fees

·       Accommodation provided to Indian nurses being lower quality

·       Slower salary progression compared to local nurses

Which European Countries Are Better or Worse?

Based on reports, research, and Indian nurse experiences:

Country	Racism Level	Key Characteristics	Indian Nurse Experience
UK	Moderate-High	Long history with Indian diaspora but also Brexit-fueled xenophobia. ‘Crying at end of shifts’ reported	Mixed – urban areas better, but discrimination common
Germany	Low-Moderate	Less overtly racist than UK, more subtle. Direct communication style can feel harsh	Generally positive, but microaggressions exist
Ireland	Low	Small country, welcoming culture, English-speaking eases integration	Most positive reports from Indian nurses
Netherlands	Low-Moderate	Progressive but can be blunt. Dutch directness ≠ racism but feels harsh	Generally good, language barrier protects somewhat
Italy	Moderate	Southern European warmth but also insular culture. Less experience with diversity	Very mixed experiences
Poland	Moderate-High	Less diverse society, less exposure to non-Europeans. Language barrier high	Challenging for many
Sweden	Low	Progressive values, but subtle social exclusion can occur	Generally positive

Key Insight: Urban areas (London, Berlin, Dublin, Amsterdam) are significantly better than rural areas. Multicultural cities have more acceptance.

What Discrimination Looks Like: Real Stories

Story 1: Priya’s Experience in Berlin (Germany)

‘I work in Charité, one of Germany’s best hospitals. Most colleagues are respectful. But one senior nurse constantly questions my work. She checks my documentation twice, asks if I’m ‘sure’ about assessments, speaks slowly to me despite my B2 German. She’s friendly to European nurses. I reported it to my supervisor, who said it’s probably just her personality. It’s been 6 months, nothing changed. I’m looking for a different ward.’ – Priya, 29, Kerala

Analysis: Subtle discrimination, difficult to prove, management minimizes concerns.

Story 2: Rajesh’s Patient Encounter (UK)

‘An elderly patient refused my care, said he wanted an English nurse. I called my supervisor. She took over his care, told me ‘some patients are like that.’ No consequences for the patient, no support for me. I felt humiliated in front of colleagues.’ – Rajesh, 32, Bangalore

Analysis: Management prioritizes patient satisfaction over staff dignity.

Story 3: Divya’s Success in Amsterdam (Netherlands)

‘My hospital has zero-tolerance policy. When a patient made a racist comment, my manager intervened immediately, explained hospital values. I felt supported. Colleagues are genuinely friendly, invite me to events. Yes, I’ve faced some microaggressions (surprising my English is good), but overall very positive.’ – Divya, 30, Mumbai

Analysis: Institutional policies and management support make huge difference.

How Common Is It Really? The Data

Research findings on prevalence:

Study/Report	Finding	Context
German University Hospitals (2022)	55% foreign nurses experienced discrimination	Language, nationality, ethnicity-based
UK NMC Report (2023)	Internationally educated nurses report crying, trauma from racism	Led to 37.5% leaving register vs 7.5% UK-educated
Systematic Review (PMC)	Foreign nurses at higher risk of discrimination than native nurses	Affects job satisfaction, retention
Canadian Study	Internationally educated nurses experience discrimination from patients, colleagues, management	Gender + ethnicity compound the issue

Interpretation: Not everyone experiences racism, but 40-60% do to some degree. Severity varies widely.

How to Handle Racism When It Happens

Immediate Response Strategies

In the Moment:

·       Stay calm and professional (difficult but crucial)

·       Don’t internalize it – the problem is THEM, not you

·       Document the incident immediately (date, time, exact words, witnesses)

·       If safe to do so, address it directly: ‘That comment is inappropriate’

·       Remove yourself from the situation if possible

·       Tell a trusted colleague or supervisor immediately

Reporting and Escalation

Step 1: Informal Report to Direct Supervisor

·       Document in writing (email is best)

·       Be specific: dates, times, exact comments, witnesses

·       Request action and timeline

Step 2: Formal HR Complaint (if Step 1 fails)

·       Submit written complaint to HR department

·       Reference hospital anti-discrimination policies

·       Include all documentation

Step 3: External Bodies (if Steps 1-2 fail)

·       Germany: Antidiskriminierungsstelle des Bundes (Federal Anti-Discrimination Agency)

·       UK: Nursing and Midwifery Council (NMC), ACAS

·       EU-wide: European Commission anti-discrimination mechanisms

Protecting Your Mental Health

·       Find support group: Connect with other Indian nurses experiencing similar issues

·       Therapy: Many European countries offer workplace counseling (EAP programs)

·       Document everything: Helps you recognize patterns, not gaslight yourself

·       Set boundaries: You don’t have to educate every ignorant person

·       Build support network: Friends who validate your experience

·       Know your worth: You ARE qualified, competent, and deserving of respect

When to Stay vs. When to Leave

Red Flags That Indicate: Consider Leaving

·       Management dismisses or minimizes your discrimination complaints

·       No consequences for perpetrators despite clear evidence

·       You’re experiencing anxiety, depression, or physical health issues

·       Multiple colleagues exhibit discriminatory behavior (toxic culture)

·       You’re being professionally undermined (career stagnation)

·       Your safety feels threatened

Green Flags That Indicate: Worth Staying

·       Management takes complaints seriously and acts swiftly

·       Clear anti-discrimination policies enforced consistently

·       Most colleagues are respectful and inclusive

·       Isolated incidents, not systemic pattern

·       You have allies and support within the organization

·       Professional growth opportunities available

Changing Hospitals vs. Changing Countries

Before leaving a country, try changing hospitals. Hospital culture varies DRAMATICALLY even within same city.

Example: Indian nurses in UK report vastly different experiences between NHS Trusts. Some have zero-tolerance policies with strong enforcement, others do nothing.

Protective Factors: What Helps

Factor	How It Helps	How to Access
Indian Community	Emotional support, shared experiences, practical advice	WhatsApp groups, Indian nurses associations
Strong German/Local Language	Reduces language-based discrimination, earns respect	Intensive courses, daily practice, B2+ level
Clear Hospital Policies	Provides formal recourse, deters discrimination	Review before accepting job, ask during interviews
Supportive Manager	Intervenes on your behalf, validates experiences	Crucial – ask about this in job interviews
Union Membership	Legal protection, collective bargaining power	Join nursing union immediately upon arrival
Legal Knowledge	Know your rights, can advocate effectively	Research country’s anti-discrimination laws
Documentation	Evidence for complaints, prevents gaslighting	Keep detailed records from day one

Distinguishing Racism from Cultural Differences

Not everything uncomfortable is racism. German directness ≠ rudeness:

Probably Cultural Difference:

·       Direct feedback: ‘Your documentation needs improvement’ (German communication style)

·       Punctuality expectations: Upset you’re 5 minutes late (German time culture)

·       Limited small talk: Colleagues don’t chat much (German work culture)

·       Direct questions: ‘Why did you do it this way?’ (seeking information, not accusatory)

Probably Racism:

·       ‘You people always…’ (stereotyping)

·       Different standards applied to you vs. European colleagues (discriminatory treatment)

·       Comments about your accent, appearance, or origin in belittling way

·       Exclusion from social events based on ethnicity

When in doubt: Trust your gut. If it feels wrong, it probably is.

Advice from Indian Nurses Who’ve Navigated This

From Priya (Berlin, 3 years):

‘Build a thick skin but stay human. Not everyone is racist – focus on the good colleagues. Document everything but don’t let it consume you. Join Indian nurses WhatsApp groups – they understand.’

From Rajesh (London, 5 years):

‘Know your rights. I joined the nursing union immediately. When a patient was racist, I followed protocol, it was documented, management supported me. The system works IF you know how to use it.’

From Divya (Amsterdam, 2 years):

‘Choose your hospital carefully. During interviews, I asked about diversity policies and how they handle discrimination. My hospital was transparent, had clear procedures. That told me I’d be safe here.’

The Bigger Picture: Is It Worth It?

Despite discrimination risks, most Indian nurses who move to Europe don’t regret it. Why?

·       Financial benefits remain significant (5-10x higher savings than India)

·       Professional development opportunities superior

·       Work-life balance dramatically better

·       Most colleagues ARE respectful and professional

·       Quality of life improvements (safety, healthcare, infrastructure)

The question isn’t whether racism exists (it does), but whether you’re prepared to handle it when it happens, and whether the benefits outweigh the challenges.

Key Takeaways

·       Yes, racism exists in European healthcare – 40-60% of foreign nurses experience some form

·       Types include: microaggressions, professional undermining, social exclusion, patient racism, institutional discrimination

·       Germany and Ireland generally better than UK; urban areas better than rural

·       Document everything from day one – crucial for formal complaints

·       Know your rights and local anti-discrimination laws

·       Find Indian nurse community for support and advice

·       Assess hospital anti-discrimination policies BEFORE accepting job

·       Distinguish cultural differences from actual racism

·       If management doesn’t support you, change hospitals or countries

·       Despite challenges, most Indian nurses find European move worthwhile

Reference Links

1. PMC – Health Situation of Migrant Nurses: https://pmc.ncbi.nlm.nih.gov/articles/PMC5484487/

2. Nursing Times – International Nurses Face Racism: https://www.nursingtimes.net/workforce/international-nurses-left-crying-and-traumatised-due-to-racism-03-08-2023/

3. PMC – Foreign Healthcare Professionals Discrimination: https://pmc.ncbi.nlm.nih.gov/articles/PMC9777572/

4. Taylor & Francis – Ethical Recruitment Germany: https://www.tandfonline.com/doi/full/10.1080/09692290.2025.2450399