Healthcare workers’ perceptions of ethnic-racial relations in the workplace: a qualitative study

Institutional racism shapes healthcare work by organizing professional recognition, authority, advancement and institutional protection across racialized hierarchies. This qualitative exploratory study examined how healthcare workers in Brazil, predominantly from the nursing workforce, perceived ethnic-racial relations and institutional racism in the workplace. In-depth interviews were conducted between August and December 2025 with 16 professionals, 15 of whom were members of the nursing workforce, recruited through snowball sampling across different Brazilian regions. Interviews were transcribed, manually validated, organized in ATLAS.ti and subjected to content analysis informed by a critical anti-racist framework. The analysis generated four interrelated themes: everyday racism rendered deniable through the scrutiny of Black bodies and aesthetics; the racial division of labor, suspicion of competence and contested Black leadership; fragile institutional responses that shifted responsibility onto Black workers; and denunciation, protection and resistance as Black workers’ political labor. Together, these themes support the concept of the racial ordering of healthcare work: institutional racism organizes who is recognized as competent, authorized to lead, protected by organizations and burdened with confronting inequity. Although grounded in Brazil, the findings offer transferable insights for nursing and healthcare systems internationally.