Workplace Discrimination Affecting Nurse Practitioners in US Hospitals

BACKGROUND: Workplace discrimination remains a concern in health care, contributing to burnout and turnover among nurses, particularly those belonging to racial and ethnic minority groups. Although evidence is growing for staff nurses, little is known about discrimination among hospital-based nurse practitioners. As nurse practitioners assume expanding roles in both primary and consultative inpatient care, they often navigate ambiguous professional boundaries and may be especially vulnerable to marginalization, particularly those from underrepresented groups. OBJECTIVE: To examine differences in workplace discrimination experiences between non-Hispanic White and racial and ethnic minority nurse practitioners. METHODS: This study analyzed data from 862 nurse practitioners across 397 hospitals in 10 US states using the 2024 Nurses4All Survey and American Hospital Association annual survey. Propensity score weighting was applied to address confounding factors, and weighted logistic regression was used to examine the association between nurse practitioners' racial and ethnic minority status and frequent workplace discrimination. RESULTS: Compared with non-Hispanic White nurse practitioners, racial and ethnic minority nurse practitioners had more than twice the odds of reporting frequent workplace discrimination (adjusted odds ratio [AOR], 2.09; 95% CI, 1.25-3.49). Odds of experiencing frequent workplace discrimination were particularly elevated among non-Hispanic Black (AOR, 2.63; 95% CI, 1.13-6.10) and multiracial (AOR, 3.45; 95% CI, 1.45-8.19) nurse practitioners. CONCLUSIONS: This study provides new evidence that discrimination in hospitals is a significant concern for racial and ethnic minority nurse practitioners, especially those who are Black or multiracial. Addressing institutional racism through system-level reforms is critical to improving workforce equity and retention.