Introduction

The United Kingdom’s National Health Service (NHS) is highly reliant on immigrant nurses.Footnote 1 While clinical staff shortages have been reported in the healthcare systems of other western countries due to shifts in demographic, economic, and social trends, Brexit has exacerbated the situation in the UK (Bailey & Mulder, 2017). Nurse shortages also stem from a reduction in young people entering the profession, which has been attributed to a greater range of professional options, nursing’s aging workforce, negative perceptions of the nursing working environment, and the low value given to the profession (Simoens et al., 2005).

Despite the current high demand for nursing staff, recent figures from the Royal College of Nurses (RCN) show that racism in the sector remains endemic (RCN, 2022). While the health system needs immigrant nurses and tries to attract them, they remain as subject to racism as other professionals who find upon migrating that they have become members of a disadvantaged group. This is especially the case for black and brown nurses. Nursing research shows that they encounter racism in their interactions with colleagues, patients, and patients’ relatives; they also face institutional discrimination in the form of escalated disciplinary hearings, limited professional advancement, and even limited access to life-saving PPE (Likupe and Archibong, 2013; Calenda, 2014; Muchina, 2021; RCN, 2022). These practices are unethical and unjust, reinforcing a toxic and unhealthy working environment for immigrant nurses. Furthermore, racism is associated with poor physical and mental health because it causes significant psychological injury to individual migrants and their communities (Wheeler et al., 2014). In the workplace, chronic racism has been shown to have deleterious consequences for individuals, resulting in decreased job satisfaction and higher rates of attrition (Tabor & Dalton, 2021).

Extant scholarship into the labor market experiences of migrants offers evidence that links poor integration with racial discrimination, underemployment, and exclusion (Behtoui et al., 2020; Wojczewski et al., 2015). Although knowledge about the persistence of racism in the European labor markets is widespread, there is a dearth of knowledge about how it can be remedied (Demuijnck, 2009). In essence, “we know a lot about the disease of workplace inequality but not much about the cure” (Kalev et al., 2006, p. 590). Further, while there is some scholarship on the underlying motives for racism in the workplace, “the effects on those involved and their coping strategies have less often been explored” (Verwiebe et al., 2016, p. 2469). In this article, I investigate how African nurses in the UK exercise their agency to cope with racism in the workplace while still managing the high emotional demands of their jobs. I draw on contemporary sociology in defining racism as: the “individual- and group-level processes and structures that are implicated in the reproduction of racial inequality in diffuse and often subtle ways” (Clair and Denis, 2015, p. 857). This definition underscores that although its effects are keenly personal, racism is located not only in individual beliefs and attitudes but also in the wider social, political, and economic structures.

In the article I describe my micro-level analysis of African nurses’ experiences based on their everyday interactions with co-workers and patients. I draw on the agentic lens and the coping framework to gain better insight into their coping process. African nurses are likely to face a disparate set of stressors in the workplace as they are more likely to acquire and retain an outsider status based on their culture, nationality, immigration status (Behtoui et al., 2020), and racial positioning. This links racial prejudice to the desire to protect the dominant group’s social position and privilege through a racialized hierarchy (George Mwangi, 2014). Research shows that African nurses, being distinct from the majority group on multiple dimensions, have a greater likelihood of being given a more hostile reception and of incurring penalties that stem from their background, which accelerates their sense of precarity (Ahmad, 2020; Calenda, 2014; Thomson & Jones, 2017). Given the multiple identities of African nurses and the observation that “immigrants do not leave their cultural identities and worldviews behind, but bring these with them wherever they go” (Nacpil, 2016, p. 139), it is likely that the coping choices of African nurses are influenced by their cultural identities as well as by their differing world and cultural views, religious beliefs, lifestyles, and backgrounds. Hence, the research question which is addressed in this article: Which forms of coping choices are African nurses likely to rely upon when dealing with racism in the UK workplace?

The findings that emerged from this research paint a fine-grained picture of how immigrants cope. While immigrant literature has noted the critical role that social bonds—such as ethnic/racial associations, community groups, and church/mosque congregational support—play in building resilience (Ciaramella et al., 2022) and serving as a protective psychosocial resource (Vasta & Kandilige, 2010; Covington-Ward et al., 2018; Dywili, et al., 2021), this study reveals the prevalence of religious/spiritual coping by African nurses who encounter racism in the workplace. The pervasiveness of this is partially attributed to the continuation of familiar practices from their home countries. It also implies that other coping strategies may feel rigid and narrowed in scope (Martinez et al., 2022), especially in the absence of organizational support and legislation to address workplace racism. It is worth observing here that the absence of such support is so marked it amounts to a violation of ethics.

The study makes three key contributions to the immigrant coping literature drawing on an agency perspective to explain how religious/spiritual coping strategies are deployed by nurses. First, it highlights the versatility of religious coping as a multi-faceted and multi-functional approach that encompasses intrinsic mechanisms (e.g., prayer and fasting) as well as extrinsic mechanisms (e.g., church attendance). As such, religious coping allows the individual to make sense of stressful incidents and manage their responses. Second, the research reveals the temporal aspects of coping, in that immigrant nurses adaptively alter their coping techniques over time in response to evolving stressors, often experimenting with different strategies to identify the most effective. This adaptive process unveils a strong vein of coping self-efficacy that enables individual nurses to exercise a degree of control over racist incidents and regulate the resulting stress (Bandura, 1995). Third, the study shows that religious coping is contextual, with the individual’s responses being influenced by factors such as their immigration status, their employer, the nature and frequency of the stressor, and the characteristics of the instigator. This underscores the complex interplay between the personal and situational elements of workplace racism.

Overall, by comparing experiences of workplace racism within the same racial group and using the same methodological approach across employment contexts which differ significantly in sociocultural terms, this article offers a valuable step toward uncovering the interaction between racism and immigrants’ capacity to cope. This revelation is particularly important given that recent research (Demuijnck, 2009; Larsen & Di Stasio, 2021) shows that institutional factors are less impactful on lessening racism in the UK workplace than is usually assumed. It is therefore important to give attention to the ways in which migrants exercise their agentic capacity to deal with racism in the workplace.

Coping Literature

African nurses—the focus of this study—are likely to face multiple forms of disadvantage. In cases where the individual migrant has limited access to organizational resources or where those resources are inadequate, it falls to the immigrant to utilize their personal, proxy, and/or collective agency, mobilizing their resources to make sense of the situation, change it, and/or manage their response to it.

Originating in clinical psychology, the concept of coping has been defined as “cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” (Lazarus & Folkman, 1984, p. 141). These efforts are directed toward resolving a stressful relationship between the individual and the environment or alleviating negative emotions arising from a stressful situation. Stress is a personal perception, defined as “the subjective feeling produced by events that are uncontrollable or threatening,” producing symptoms such as anxiety and depression (Randy & David, 2008).

To better understand how coping processes work, it is important to note that they are dynamic. The processes are in flux because they are responses to the varying demands of stressful events. Coping processes are made up of several active and continually evolving elements (Pargament, 1990), including the situations that an individual encounters (e.g., major events, daily tasks, chronic problems), the individual’s appraisals (primary vs. secondary) of those situations, and their coping activities (e.g., seeking information or social support, emotional maintenance), and coping functions (e.g., problem-solving, emotional regulation, sense of meaning/control) (Lee et al., 2022; Hathaway, 2009).

The coping process is driven by a goal, which is to manage (as opposed to control) the sources of stress and the negative emotions that result from them (Lazarus, 1993). The coping process commonly unfolds via primary and secondary evaluations of the sources of stress (Sanchez et al., 2000). Primary evaluation is the first step in the coping process, describing how the individual recognizes and identifies a particular situation as stressful; the secondary evaluation involves the selection of an appropriate coping response. The focus is very much on the individual, their coping behaviors, and the available resources, although consideration is also given to how these evolve over time as the individual interacts with their environment to manage stressful situations.

A review of the interdisciplinary literature shows that while scholars agree on the multi-dimensional nature of coping responses, there is less consensus about how those responses are categorized (Partow et al., 2021; Skinner et al., 2003). Some dimensions are defined and measured by their function; hence coping can be problem focused or emotion focused (Folkman & Lazarus, 1980; Lazarus & Folkman, 1984; Li et al., 2021). Other dimensions concern the aim of the coping mechanism (approach vs. avoidance; Bachanas and Blount, 1996; Herman-Stahl et al., 1995). It has, however, been recognized that these coping strategies serve various functions simultaneously, and that they are not adequately reflected by binary categorizations (Lazarus, 1996; Liem et al., 2021).

The implication of this for the current research is that when individuals are faced with a stressful situation, they tend to employ a repertoire of coping strategies, searching for the most effective means of managing the stressor at hand. In the end, what determines the effectiveness of the repertoire is not the number of strategies applied but the way in which different strategies blend, based on their facilitating, inhibiting, and fallback roles (Achnak & Vantilborgh, 2021; Dewe, 2003).

Immigrant Coping

The coping framework has been widely used by immigrant scholars (Connor, 2016; Noor & Shaker, 2017; Yen et al., 2021) to assess the strategies immigrants employ—individually and/or collectively—to manage the challenges faced during migration and in host countries. An interesting aspect that has emerged from recent research is the fluidity of the coping process, which is seen to be influenced by the local environment (Yen et al., 2021). Even though immigrants may continue to draw on the coping strategies they employed in their home countries, they are compelled to adapt them to the new environment through the secondary evaluation process (Sanchez et al., 2000). This demands a reassessment of the home country’s coping repertoire to gauge its efficacy in a host country characterized by different norms and challenges. When immigrants are considering their past repertoires and devising strategies for adapting them to their new environment, they exercise agentic capacity to shape the outcome of their migration experience.

For migrants moving to western countries, racism is a profound difficulty they face in their new environment, and it is one they have probably not experienced in their home countries. Coping with racism is a complex and context-dependent process (Partow et al., 2021) arising from a myriad of moderating factors that impact the decision-making process. Such factors include the emotion elicited by the racist incident, the context of the triggering event (chronic vs. acute), the nature of the racist event (e.g., overt or covert) and whether the coping strategy employed is effective (Brondolo et al., 2009). Individuals who face repeated racist incidents are, given the pervasiveness of the stressor, more likely to rely on habitual, reflexive, and adaptive responses (Martinez et al., 2022).

There has been prior research identifying how immigrants cope with racism, such as through the use of problem-oriented strategies (Wheeler et al., 2014; Liem et al., 2021), reliance on ethnic and social support (Herbert et al., 2008; Sacchetto & Vianello, 2016; Turnbull et al., 2023), and deployment of emotion-oriented strategies, including emotional ventilation (Noor & Shaker, 2017; Skinner et al., 2003) and engagement in religious activities (Ojeda and Pina-Watson, 2013; Turnbull et al., 2023). For example, in an examination of how Ghanaian immigrants cope with exclusion in the UK, Herbert et al. (2008) observe that they use a range of strategies, some of which are rooted in their ethnic and cultural identities. For instance, to compensate for their devalued third world migrant identity, they rely on promotive tactics, tapping into their ethnic and cultural capital to create a positive identity sustained by their cultural heritage and diasporic social gatherings. Celebrating their culture reinforces positive identity by affirming that, regardless of the exclusion they face in the UK, they belong to a more significant whole. This is a motivational process that seeks to enhance the individual and collective selves and build perseverance; it is an exercise in both personal and collective agencies.

The influence of identity on the coping approaches of immigrants is also observed by Walsh and Tuval-Mashiach (2012) in the context of how Ethiopian Jewish immigrants deal with racism in Israel. The immigrants tend to employ a repertoire of largely passive oriented strategies, such as denial and avoidance. Their approaches may be influenced by their multiple, intersecting identities within a highly hierarchical ethno-religious country. Having likely encountered antisemitism in Ethiopia, they find themselves confronted by racism in the country they fled to in order to escape prejudice. This incongruous situation could explain their utilization of passive coping strategies aimed at taking self-directed steps to minimize their exposure to racism instead of directly confronting it. Although this approach is not an example of primary control, which allows the individual to directly tackle the source of stress, denial enables individuals to avoid stress by disregarding its source. Comparable passive approaches have been observed among Latvian nurses in Norway (Knutsen et al., 2020) who adopt a resigned acceptance in the face of workplace discrimination as well as Filipino nurses (Gotehus, 2021) who rely on small acts of resilience to persevere and make the most of the options available to them in the Norwegian labor market. While such strategies of coping with stressors may be perceived as lacking in agency, they serve as a means for the individual to maintain a sense of equality with others (Miller & Kaiser, 2001).

Building on the idea that identity influences immigrants’ coping approaches, prior research exploring how nurses cope with workplace racism has observed linkages between their coping strategies and the cognitive appraisals of their own identities (Berjot & Gillet, 2011). That is, how they perceive and evaluate their multiple identities is relevant to their coping strategies for dealing with workplace discrimination. In the absence of institutional support, the personal support systems of family and friends help to reinforce and enhance both their personal and social identities (Iheduru-Anderson et al., 2021; Sahraoui, 2020). Moreover, these familial and social networks serve functional purposes, being sources of valuable information and offering safe spaces in which immigrant nurses can examine and share their experiences with people who have faced similar incidents. For example, to cope with incidents of racist bullying and resentment, Filipino nurses in the US rely on familial and intracultural coping techniques tied to a culturally rooted sense of duty; from these, they seek emotional support and maintain their focus on their ultimate goals despite the hurdles they face (Connor, 2016). Immigrant nurses in Ontario facing physical abuse, harassment, and differential treatment via excessive supervision and punitive reprimands have also been observed to use family as a refuge (Hagey et al., 2001; Ontario, Boateng & Brown, 2021). For these nurses, who perceive the support offered by their union as inequitable and biased, family is a source of unwavering and impartial support.

Besides these established coping strategies, research has examined religion as an important resource that informs the feelings, thoughts, and behaviors of individual workers (Sav, 2019). In the case of nurses, research has focused on their use of religion as a strategy to deal with work-related stress such as discrimination (Connor, 2016), and as a means of dealing with the emotionally demanding nature of their work, which revolves around morbidity and death (Lavik et al., 2021). In the context of workplace challenges, the research focus has been on both the intrinsic and extrinsic orientation of religious coping strategies. Intrinsic orientation is based on an individual’s religious values and beliefs: their coping strategies center on their faith and their desire for closeness with God. As such, they appraise essential aspects of life, including their work life, through their religion (Perera et al., 2018). For extrinsically oriented religious coping, religion is employed as a personal aid, to (re)establish a sense of self-esteem, control, and self-actualization (Hathaway, 2009).

The role of religion as a resource that helps immigrants make sense of and respond to racism in the workplace has been explored in immigrant studies more generally (Morosanu and Fox, 2013; Walsh & Tuval-Mashiach, 2012; Datta et al., 2007). Researchers have assessed the impact of religious coping on immigrants’ wellbeing (Sanchez et al., 2012) and examined the relationship between organizational aspects of religion—such as church attendance and religious affiliation—and psychological adjustment to stress (Flannelly & Inouye, 2001; Gotehus, 2021). Researching the working conditions of Filipino nurses in the UK, Calenda (2014) finds that participation in religious organizations is more widespread than participation in non-religious organizations, including unions. The prominence of religious organizations in the lives of migrants is also highlighted in Menjivar’s (2006) study of Latino immigrants, which finds that the church fills the void left by US government aid in providing immigrants with resources such as legal counsel, community clinics, language and vocational classes, and financial assistance. Datta and colleagues (2007) observe that immigrants rely on ethnic, and nationality based religious organizations to counter the social exclusion they encounter in London. The church acts not only as a conduit for the gospel but also provides social relationships (which serve as psychological support mechanisms) and functional purposes such as finding work and housing. The significance of the church in the lives of immigrants is similarly revealed in Lee’s (2022) study, where the church is regarded as an extension of the family structure, with religious leaders acting as a common coping resource by offering counsel and comfort. As with the Calenda (2014) study, the South Korean immigrants in Lee’s study are more likely to seek help from the church than from other organizations, which in this case are professional social service centers.

It is not surprising that research exploring how immigrants cope in host countries largely focuses on external religious coping strategies, considering that the church plays a vital role in the lives of many who find themselves in a foreign land. Far from home, many immigrants rely on extrinsic religious orientation, using the church to attain non-religious resources to cope with difficulties in the host country (Perera et al., 2018). Studies rarely go beyond the extrinsic focus to assess how immigrants use intrinsic forms of religious/spirituality coping strategies, such as private prayer, fasting, cognitive framing, and meditation. I address that knowledge gap through this study. In order to gain a comprehensive understanding of how African nurses use religious/spiritual resources to cope with racism in the UK workplace, I look at both external and intrinsic religious coping strategies.

Employing such an approach allows for an assessment of how coping underscores the interaction of individual, relational, and contextual factors in determining the difficulties individual immigrants are likely to face, and the resources, such as religion, they use to cope with and adapt to stressful situations and alleviate the negative consequences of stress (Perera et al., 2018; Yen et al., 2021). The multiple identities of African nurses make them an ideal subject for the study. This is because the coping strategies they are likely to employ to deal with workplace racism will depend on their identities in terms of race/ethnicity, religion, country of origin, immigration status, and migratory duration. While these immigrant characteristics form what Morosanu and Fox (2013, p. 439) refer to as the “tribal stigma of race, nation, and religion,” African nurses, by using their religion as a coping resource to deal with workplace racism, are basically turning lemons into lemonade. Their choice of coping strategy is shaped by their background, incorporating their culture, education, worldview, lifestyle, and religious beliefs. For example, their African origin, associated with Christianity, indicates that African nurses are conscious to maintain their Christian identity, particularly in the secular west where Christianity is in decline and religion is marginalized in the workplace (Sackey-Ansah, 2020). Thus, given this context, I ask the question: how do African nurses employ religious/spiritual coping to deal with racism in the UK workplace?

Methods

Setting and Sample

The healthcare sector in the UK depends heavily on foreign nurses. This peaked in the early 2000s when 13% of all nurses in the UK were foreign trained (Winkelmann-Gleed, 2006). However, in 2006, general nursing was removed from the “shortage occupation list.” In the early 2000s, approximately 15,000 non-EU nurses registered in the UK each year, decreasing to 1,000 per year by 2008.Footnote 2 Subsequent and ongoing nurse shortages compelled the government to reinstate nursing as a shortage occupation in October 2015, but the shortfall remains. The Office of National Statistics (ONS) reports that in the quarter ending December 2022, the vacancies for full-time equivalent (FTE) staff working in NHS and adult social care in England stood at around 124,000. That number will be higher still if independent providers such as nursing homes and healthcare agencies are included. Moreover, the reduced supply of nurses is exacerbated by an extension of their roles and responsibilities, which are increasingly being expanded to meet physician shortages. Nurses are now expected to supervise clinical support staff while simultaneously ensuring the delivery of safe care (Allan et al., 2016).

In the African migrant community, nursing is viewed as a convenient way to acquire a work visa and a decent income. This may explain why the NHS employs a higher proportion of sub-Saharan Africa immigrants 1.9% (approx. 22,133 workers) compared with the wider economy, 0.9%.Footnote 3 These numbers may reflect immigrants’ preference for public sector employment and underscore the need to have a better understanding of the differences between public versus private healthcare employers, which would allow for comparisons to be made between the experiences of workers in the two sectors.

With the intention of increasing the generalizability of the results in this study, three different-sized settings were selected. By using maximum variation sampling, I could ensure that areas with both high and low levels of immigration were covered; the sample cities were London, which is large (representing 8 million inhabitants), Bristol, which is mid-sized (500,000 inhabitants), and Bath, which is small (80,000 inhabitants). Generalizability was further enhanced by recruiting participants from a wide range of healthcare organizations including the NHS, independent care homes, private nursing agencies, and a big government department. Non-probability sampling was used to select interviewees. This was the most appropriate method because the population sampled was relatively small. Snowball sampling (with multiple entry points) was used to unsystematically recruit interviewees. One of the key entry points was the African Church of God (ACG), where six participants were recruited.

Data Collection

I conducted 43 semi-structured interviews with nurses from eight countries. The sample consisted of females (n = 35) and males (n = 8), who were Christian (42) or Muslim (1), and between the ages of 26 and 71. Most (21) worked for the NHS although 10 of these were also registered with nursing agencies. Eleven worked in independent nursing homes, five with agencies and six with a government department. Since the interviews, nine nurses have gone back to their home countries, and one has migrated to Saudi Arabia for work. Interviews were conducted individually, face to face at the nurses’ homes or in a café, and over the phone. Only one interview was conducted in a workplace. The demographic characteristics of the participants are presented in Table 1.

Table 1 Interview participants
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Following previous work on immigrant workers (Menjivar, 2006; Van Laer & Janssens, 2011), I adopted a constructivism-interpretive paradigm as it was the most appropriate for framing the research question under examination. According to Denzin (2001, p. 1) an interpretive paradigm “endeavors to capture and represent the voices, emotions, and actions of those studied,” with a focus on “life experiences that radically alter and shape the meanings persons give to themselves and their experiences." It acknowledges that the varying life experiences of African nurses determine how they, as individuals, interpret and respond to racism in the workplace.

The assumption of relativist ontology allowed me to grasp the complexity of the African nurses’ work lives. A subjectivist epistemology assumption underscores the interactive link between me as the researcher and the study participants (Lincoln & Guba, 2003). This connection was strengthened further by my “insider” role as a fellow member of the immigrant community in the UK. Throughout the interviews, I was conscious of my identities as both a researcher and an immigrant. The shifting insider–outsider boundaries were apparent in my interactions. While my origins made me an insider, which may have encouraged respondents to be open with me about their experiences connected to these factors, I was less of an insider in aspects pertaining to professional and educational qualifications. Nonetheless, to mitigate researcher bias and improve the credibility of the findings, I conducted synthesized member-checking. Validity of the results was also tested by converging information from different sources, including interviews and supplementary data from nursing journals, diaspora blogs, and websites.

Table 2 provides an overview of the various sources.

Table 2 Data sources
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Researcher’s Positionality

My insider status influenced my research undertaking which emerged from personal experiences as an immigrant, having interacted with African healthcare professionals in the US and the UK. The decision to focus on this group stemmed from the prevalence of nursing as a profession among my African friends in both countries. In the African immigrant community, nursing was viewed as a relatively accessible way to obtain a work visa and eventual residency as well as a good salary without requiring excessive time or financial investment. Most of those I knew in the US, many of whom had other qualifications, opted to pursue a two-year nursing diploma program, a more cost-effective alternative compared to the 4-year Bachelor of Science in Nursing (BSN) degree. For many, the diploma route provided an efficient means to transition into a new career within a relatively short timeframe. In the UK, the availability of NHS bursaries and grants to cover the costs of nurse training programs served as a major incentive for individuals, even though current access to this funding is restricted to those with residency or citizenship.

My intention was that this research shares the narratives of African nurses with the wider community, to contribute to immigrant literature and impart practical implications for healthcare policy makers regarding their workplace experiences. As a member of the African immigrant community in the UK, my personal lived experiences allowed me to closely relate to the interests and values of African nurses. This insider perspective provided me with valuable observational and contextual background, enriching the description, comprehension, and interpretation of the research findings. Further, this status afforded me access to the group as members felt that as an insider, I was positioned to better comprehend their workplace experiences of and responses to discrimination. Nevertheless, I acknowledge that this positionality introduces a limitation, in the sense that I bring an African perspective to the research. While being explicit about this and taking established theory into account may not fully mitigate my bias, it allows others to interpret my work accordingly.

Analysis

For data analysis, I followed an iterative process, moving back and forth between data and theory. The first phase began by writing individual cases. Once I had completed the cases, I created four separate groups: NHS (21), independent nursing homes (11), agencies (5 exclusively, 10 for NHS and agency), and government department (6). I compared experiences within and across groups. The empirical evidence and theory from prior studies (Ramboarison-Lalao et al., 2012) helped with the development of the nurses’ coping framework. The assumption of relativist ontology (multiple realities) allowed me to grasp the complexity of the experiences faced by African nurses. Data analysis was an emergent process that began by focusing on the participants’ reliance on personal, proxy, and collective agency to organize their migration journeys. During the data analysis process, five distinct coping strategies were identified from a group of 18 sub-categories (please see Table 3). Religious/spiritual coping was one of the five and, given its profundity and unexpectedness, it became this article’s subject of examination. The analysis revealed the nuanced, personal, religiously grounded ways in which African nurses of varying ages and in different work contexts relied on religion as a resource to ease the stress arising from unfair work practices, discrimination, and racial abuse in the workplace. This pattern was observed among both the older and younger nurses, underscoring the interconnected and varied nature of personal coping approaches.

Table 3 Analytical coding process
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In the third phase, with a focus on religious coping, I revisited the data and incorporated supplementary data. I built tables that summarized the different themes based on religious coping and included representative examples. I then coded the interviews line by line (please see Table 4). This was followed by writing integrative memos to link identified themes and categories. This process facilitated the interconnection of certain themes into the study’s storyline.

Table 4 Analytical religious/spiritual coding process
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The last step was member-checking, in which all study participants still living in the UK as well as one who had repatriated were sent interpretive summaries of the findings via WhatsApp. Member checking is a technique of exploring the credibility of results, where data are returned to participants to check that the findings accurately accord their experiences (Birt et al., 2016). To encourage a response, the text sent to participants was short and concise. The language was straightforward to foster their engagement with the conceptual themes. The purpose was to investigate the resonance of the study’s results with the nurses’ coping experiences. Of the 17 who responded, most were in broad agreement except for two: a nurse working for a government department and a clinic manager. The nurse with the government department underlined that robust organizational procedures were in place to minimize unfair workplace practices in the department, noting that employees had access to “an effective system of recourse.” In a similar vein, the manager underscored her use of voice to push back against unfair treatment.

Coping Strategies of African Nurses

The African immigrant nurses involved in this study encountered numerous stressors in the workplace. Some occurred during formal processes and others during informal processes. The former included institutional and regulatory barriers, such as the immigration regulations or requirements for a nursing license. The latter were encountered during workplace interactions. One prevalent and recurring obstacle nurses faced during interactions with patients, patients’ relatives, and colleagues, was racism. This was in the form of racial harassment and bullying, discounting of skills, unfair treatment, and incivility.

To manage the resulting social, psychological, and physical stressors of racism, participants drew upon a range of coping strategies in their efforts to manage, endure, overcome, or disregard the stressful incidents they encountered. Strategies included problem-solving, acceptance, utilization of social networks, proactive approaches, and religious/spiritual practices in their efforts to manage, endure, overcome, or disregard the stressful incidents they encountered. The coping strategies were aimed at either changing the unpleasant situation or the nurses’ responses to them by altering their behavior or attitude. Although the nurses employed diverse coping strategies, the study’s most compelling insight was the extent to which they relied on religious/spirituality-based approaches. It was in fact the most widely used strategy—albeit often coupled with other coping techniques—employed by nurses to build resilience and derive personal strength.

Despite the workplace hurdles, participants exclusively engaged in positive religious coping practices, maintaining a view of God as gracious and benevolent. This reflects a sense of contentment in their personal faith, which stems from an assurance in their relationship with God (Park et al., 2018). Relating this to the determinants of coping strategies among immigrants, it is evident that African nurses were already accustomed to using religious/spiritual coping as a cornerstone of their coping repertoire before they migrated. Consequently, when faced with racism in the UK—an experience not encountered in their home countries—they turned, in the absence of organizational support, to familiar strategies that had proven effective in the past. This suggests that coping strategies are often reliant on past outcomes: we tend to repeat what has previously worked for us.

A thorough examination of the religious coping approach unveiled its multi-faceted and versatile nature, which is influenced by both temporal and contextual factors. In the following, I explain these aspects in more detail.

Religious Coping is Multi-Faceted and Multi-Functional

The diverse and multiplex aspect of religious/spiritual coping manifested itself in three different ways. First, religious coping was often combined with other types of coping strategies, such as problem-solving. Second, participants either actively or passively employed extrinsic and intrinsic forms of religious coping when dealing with racist incidents in the workplace. Finally, religious coping was a multi-functional resource that nurses utilized not only to help them manage their responses to racism in the workplace but also to alleviate the resulting distress by restoring their sense of purpose and personal control.

The various ways in which the complexity of religious coping manifests itself often co-occur. This is highlighted in the following account, where a nurse uses positive and extrinsic religious coping strategies alongside other coping strategies to deal with hurdles in the workplace.

“Some people can be picked on or victimized or racially abused…But I think most of it will come from the individual. If you are a hard worker … it’s different … I put everything in a spiritual way … you don’t go to work with your phone around and messing around, you go to work business minded … when it comes to a time, you can actually say ‘Papa God, I’ve put in my time, I’ve put in my effort, I’ve put in my commitment … I cannot be poor, I cannot lack … I should be hearing songs of melody in my life and in everything that I do.’ You put in demand on God.” – Salman (mental health nurse)

Salman (26) is a deeply religious nurse who attends ACG church where he leads the choir. Salman’s commentary underscores his adoption and concurrent deployment of various coping techniques: proactive, problem-solving, and religious/spiritual. He enacts proactive coping via overcompensation, going above and beyond work requirements. He credits his agency and amiable behavior for averting discriminatory treatment, ascribing racism to the victim for not working hard enough. This may be Salman’s way of seeking some control in a hostile and unpredictable workplace. He combines this with religious coping by referring to his Christian faith, which serves as both a guide and a driver for his work ethic. By framing his worldly affairs in a spiritual manner, he sets himself high work expectations, driving himself to perform at his best, thus allowing him to “put in a demand on God” for earthly blessings. Salman’s faith, in this case, serves as a framework for assigning meaning to his work.

For Salman, a resilient and strong work ethic should yield positive outcomes or “songs of melody”—both spiritual and material—in and out of the workplace. His belief that commitment and diligence in worldly affairs are recognized and rewarded by a considerate God exemplifies positive coping by positioning God as a source of hope and affirmation (Sen et al., 2022). Further, his belief that he can “put a demand” on God for his professionalism is indicative of extrinsically oriented coping, with religion serving as a way of obtaining some other, non-religious goal (Hathaway & Pargament, 1991).

Conversely, Salman’s belief in a God that rewards good effort implies a belief in a God that punishes substandard effort. This would signify negative religious coping, which stems from spiritual appraisals of an event as a punishment from the deity (Pargament et al., 2011). In this instance though, Salman adopts a problem-solving and collaborative religious coping approach, viewing the responsibility for tackling workplace racism as jointly held. God is not solely responsible and nor is Salman; they are active contributors who work together to manage a problem. In so doing, Salman simultaneously employs self-directive and collaborative orientations of coping, thus underscoring his role of influence as the agent of his work experiences (Pargament et al., 1988; Bandura, 2001).

Religious coping was observed to act as a multi-functional resource, offering participants an interpretive framework through which they could make sense of their workplace experiences; in the process, this reinforced their sense of agency (Ellison, 1991). The intention was primarily to maintain a sense of balance and control, with religious belief serving as a source of meaning for their work and a connection to something greater (Harrison et al., 2001). This multiple effect of religious coping on agency is noted by Ojeda and Pina-Watson (2013) and Diener et al. (1999), who argue that it increases an individual’s sense of control and efficacy, thereby augmenting their agency. In this case, religious/spiritual coping provided nurses with multiple ways to attain a sense of mastery and control via coping. The control is centered in various domains: the individual self, God, and the individual’s effort to influence God through, say, prayer (Pargament, 1997). In the next two narratives, Mugure (68) and Lucas (35) describe how their adherence to Christian values influenced their work ethic, ensuring their actions were pleasing to the divine who rewards good deeds:

"I worked, not for my supervisor but for my God, and I knew that whatever I was doing—these babies they don’t talk and they cannot ask anything—so whatever I do to them, it’s only God that can come in-between and can reward." – Mugure (pediatrician nurse)

“I’m not British … I’m a Nigerian. I would see myself as part of them if they accept me. But these people will not accept me … Though the Bible does not teach us to hate people, it says we should love one another … I don’t hate them. But I don’t like their behavior. They see themselves as superhuman beings. But they are not. They are not better than me." – Lucas (general nurse)

Mugure’s focus on working to reap spiritual as opposed to material rewards came about after working with a prejudiced supervisor who undermined her skills and hindered her career progression by denying her sponsorship to a critical module. Deploying problem-solving techniques, she challenged this decision and was offered a place, evidencing self-direction and a sense of self-efficacy in exercising influence over unfair treatment. She integrated her problem-solving skills with religious coping, drawing upon her faith to realign the purpose of her nursing duties. For Mugure, this meant dedicated service to the children under her care, regardless of appreciation from mortals. Mugure relied on her religious belief as an aid, through which she could establish her sense of self-control and actualization, key elements in extrinsically oriented coping (Hathaway, 2009). For Mugure, divine approval was more important than human approval. Her expressions of selflessness and servanthood, which are key constructs of spirituality, confirm the proposition that spirituality influences work engagement (Roof, 2015). Spirituality in the workplace guides individuals’ behavior and attitudes, influencing whether they regard their work as mundane or engaging, and consequently their coping styles (Obregon et al., 2022). It has also been shown to alter employees’ perception of incivility from their co-workers, serving to improve their wellbeing (Lata & Chaudhary, 2021).

Like Mugure, Lucas utilized biblical teachings to reframe the disparagement he faced in a toxic work environment. In the excerpt, Lucas alludes to a racial hierarchy in his workplace that favors British nurses, grounding his response in his Christian convictions. He invokes the biblical mandate to love even those who harbor animosity, seeking to rationalize the mistreatment he faces. By asserting that he does not harbor hatred, given the biblical injunction to “love your enemies” (Luke 6:27), Lucas attempts to legitimize his stance. Furthermore, when Lucas characterizes his co-workers as “superhumans,” he veils this observation in biblical language by asserting that they are “not better than me.” In doing so, Lucas grapples with his own sense of equality in comparison with his British colleagues. However, to alleviate these feelings of self-doubt and enhance his sense of empowerment, he relies on religious coping. In Lucas’s case, religious coping offers him a multi-functional, interpretive framework through which he can make sense of his experiences, boosting his feelings of efficacy and control and regulating the stress arising from racist experiences (Ellison, 1991; Bandura, 1995).

The reliance on religious/spiritual belief as a guide to everyday workplace interactions is also observed in the case of Rachel. Facing racist treatment from a colleague whose membership of a toxic clique shielded her from managerial reprimand, Rachel taps into her spiritual beliefs to conscientiously attend to those under her care without being disillusioned by workplace politics:

“… what I always tell myself is that I can only do my best and leave the rest to God. I do what I know is right … work as if you are the only one and work diligently, make sure you do your own part. So at the end of the day I will come back happy.” – (Rachel, general nurse)

Drawing upon an intrinsically oriented coping approach, Rachel uses her faith as a source of comfort against the influence of a group that reinforces its power and privilege by mobilizing bias and designing the ‘rules of the game’ in a way that favors group members while excluding outsiders like Rachel (Van Laer & Janssens, 2011, p. 1206). Her faith is observed to produce an awareness and commitment to the biblical verse that beseeches: “Whatever you do, do your work heartily, as for the Lord rather than for men” (Colossians 3:23). She adopts a collaborative religious coping strategy by placing the locus of responsibility for problem-solving on herself and God (Pargament et al., 1988), even though she also refers to divine recompense and retribution if she does not do her part. Her determination to “leave the rest to God” reveals a passive orientation, signifying that Rachel may not feel in full control of the situation and thus she surrenders to God’s will. Although the use of passive strategies appears to be lacking in agency and can over time lead to burnout and a depletion of the drive to work (Srivastava and Tang, 2015), such strategies could also be pragmatic efforts by individuals to deal with intractable issues over which they have little control. In this interpretation, such approaches do not signify a lack of personal agency but evince an efficacious outlook.

Overall, the varying narratives of participants underscore that there was neither a unified religious coping approach, nor a singular strategy. A more accurate interpretation of the data is that nurses relied on the multi-dimensional and versatile nature of religious coping strategies, which represented a viable way of dealing with the racism they encountered at work.

Religious Coping is Temporal

Religiosity and spirituality were integral themes in the nurses’ lives. This was the case for both the sub-sample recruited from ACG church and the non-ACG group. Coping strategies were comprised of a mixture of prayer, fasting, gratitude, trusting God, church attendance, good deeds, bible reading, and adherence to Christian values. For many participants, coping was centered around “the use of faith and the desire for closeness with God in situations which may threaten the person” (Reilly & Falgout, 1988, p. 9). This is, for instance, revealed in the following excerpt, where Thandeka (59) explains how her spiritual growth over time altered the way she responded to racist incidents in the workplace:

“So I’m not as tolerant in this place as I used to be when I was in the old place [former workplace] of being patronized because now I’m so acutely aware of it [racism]and so I’m sort of dealing with it as I go along and correcting it and making my stand known … It’s gonna be a very different experience in this new place in terms of how assertive I am … in the old place, I sort of went with the crowd … laugh at the wrong things, listen to people criticize each other but now, no. But I think that this comes with the growth in my faith and with my understanding of God in that we don’t tolerate people being nasty about other people. I don’t have a right to join in, I have the right to say that ‘I don’t agree with that’.” – Thandeka (deputy ward manager)

Thandeka reflects on her personal faith in this narrative. She observes that it has changed not only how she regards racist incidents (e.g., by ignoring or discounting them), but also how she responds to co-workers who engage in racist practices. She centers her coping on her faith and her understanding of God. Thandeka’s spiritual growth over time influences her coping responses by enhancing her relationship with God and co-workers, giving her the courage to stand up to racial harassment. Thandeka’s narrative underscores the evolving nature of her coping journey. She asserts that she deals with challenges iteratively, “as I go along and correcting it,” which reflects Thandeka’s self-efficacy and purpose. She uses a trial-and-error approach to navigate hurdles, drawing on previous experiences and being guided by her new faith. This highlights both the temporal dimension of coping as well as its exploratory quality, with Thandeka relying on her religious belief in situations where her ability to cope is tested (Hathaway & Pargament, 1991).

Answering a question about the hurdles she has come up against as a nurse in the UK and how she has dealt with them, Janet, the highest ranked nurse in the sample, offers valuable insight into the coping process. Her account reveals both the temporal and contextual aspects of coping and how they influenced Janet’s coping responses.

“It’s a case-to-case basis. Sometimes I confront them and at times I look at it and say that ‘this is a passing cloud’ and I just ignore it. But if it’s a person that I will be dealing with everyday then I will say something, which I wouldn’t have done many years ago. I wouldn’t have confronted anyone; I would have just kept quiet … now I don’t do that anymore. I do speak more; I don’t let people walk over me … you do learn that sometimes things don’t go away because you’ve wished them away; sometimes you have to do something about it. I think it’s having the wisdom to know when to talk and when to zip it.” – Janet (clinic manager)

Janet’s narrative illustrates the dynamic nature of coping where strategies vary based on the stressor and the individual responsible for creating it (instigator). If she has daily contact with the instigator, Janet is less inclined to ignore or accept the situation, choosing instead to engage in actions aimed at changing it. However, if her interactions with the instigator are infrequent, she employs the tactics that are least likely to cause offense. Additionally, Janet’s account shows that the coping strategies adopted by immigrant workers are influenced by their length of residency in the host country. As a newcomer to the UK, Janet notes that she would initially “just ignore” workplace obstacles, regarding them as a “passing cloud,” which are examples of denial and acceptance coping. Over time, however, she became more confrontational, willing to actively engage in actions aimed at managing the course of an unfavorable situation, signaling her agentic capacity. Nevertheless, by asserting that one needs to “know when to talk and when to zip it,” she alludes to the personal cost of taking action while simultaneously highlighting the self-reflectiveness she applies to her actions.

The temporal aspect of religious coping is intriguing, as it links to the versatility previously discussed. Not only do participants adopt different forms of religious coping, which they combine with other coping styles, they also change how they deploy their coping strategies over time, which may be based on their length of residency in the UK or the length of job tenure. By offering nurses numerous coping choices that they test and amend over time, religious coping reinforces their sense of control, augmenting their agentic capacity.

Religious Coping is Contextual

African nurses adapted their coping choices to align with workplace obstacles, reinforcing their psychological resilience and expanding their reactive capacity in the process (Ciaramella et al., 2022). The coping strategies they employed were highly influenced by contextual factors, such as the type of stressor, the individual responsible for creating it, the frequency of interactions with the individual, their immigration status, and their employer.

Furthermore, the analysis shows that prior experiences of particular incidents (whether these are positive or negative, and experienced personally or within one’s reference group) influenced the coping responses adopted by participants. This is observed in the case of Hannah (58), a high-ranking nurse who decided to speak up after witnessing the unfair treatment of black nurses by a trainer, having experienced similar discrimination herself during a course conducted by that trainer. Deploying problem-solving coping, Hannah’s first response was to request her manager to arrange a meeting with the head of the training unit. She elaborates how it unfolded:

“… I mentioned nothing about color. It was all about the treatment that I got which I didn’t like. I told her that ‘you don’t just treat people like dirt and you don’t treat me like that and next time I will walk out’ … She said that ‘I’m very sorry’ and then she asked me ‘how do you feel now? ... I told her ‘let me tell you how I survive…I go in my closet and close those doors and windows and go on my knees and cry out to God and tell God that it really hurts’… that’s how I get by … with this kind of treatment, I think I would end up in a mental hospital cause I’ve had enough of this kind of treatment. It comes from you guys, from the patients and everybody. What is this all about?’ Then she kept quiet. She wrote an email to my manager and told her ‘… thank you for the meeting we had with Hannah and I was very grateful for getting that information … We are going to make changes from what she said.’ And it’s true as it has changed.” – Hannah (deputy ward manager)

Hannah’s genuine anguish after suffering public belittlement during a training session is apparent. To understand how this came about and manage the resultant stress, she takes deliberate actions: identifying the issue, resorting to prayer for emotional relief, filing a report, and requesting a meeting. These strategic responses are indicative of the four hallmarks of personal agency: purposeful intention, anticipatory planning, self-regulation, and self-reflectiveness. These actions fortify Hannah, showcasing her self-assurance and conviction in her ability to instigate change. They reflect a proactive approach to coping, mirroring Hannah’s robust sense of control. This is why Hannah threatens to boycott future training sessions if the xenophobic trainer continues to treat immigrant nurses like “empty vessels” by disproportionately failing them, a form of racialized othering that delegitimizes their cognitive and professional abilities. By choosing to tackle the issue directly and advocate for her colleagues, Hannah assumes the role of an active change-maker, exploring various strategies to rectify the situation. Here, religious coping serves as a tool for transformation rather than for the preservation of an unfavorable outcome (Harrison et al., 2001). While God’s involvement is seen as passive in contrast to Hannah’s proactive stance, he is, nonetheless, perceived as the source of strength that enables her to steer her actions toward self-fulfillment (Pargament et al., 1988).

Hannah also turns to prayer and fasting to manage the adverse emotions triggered by the event, striving for a deeper connection with God in circumstances that challenge her belief and ability to cope (Reilly & Falgout, 1988). Rituals facilitate proximity to the sacred and are therefore a source of comfort (Obregon et al., 2022). They enable Hannah to regain her psychological balance and ease her distress, offering her a way to safeguard her wellbeing. By combining religious/spiritual and active forms of coping such as problem-solving, Hannah’s psychological wellbeing experiences beneficial effects, which is an important outcome considering the negative correlation observed in research between discrimination and individuals’ wellbeing (Schmitt et al., 2014; Wheeler et al., 2014). However, Hannah’s assertion that “I go in my closet and close those doors and windows and go on my knees” signals the intimacy and secrecy of private prayer. It could be indicative of her awareness of the potential conflict between the expression of occupational and religious identities in the workplace, which are regarded as misaligned, consistent with the notion that religion/spirituality are irrational and thus have no place in the modern organization (Hill et al., 2000). Divergent identity demands are observed to produce internal tension for the individual and can adversely affect wellbeing (Héliot et al., 2020).

The study’s findings indicate that the specific religious coping techniques utilized by participants were contingent on the nature of the situations they faced. Stressful experiences, such as incidents of unfair treatment or racist bullying, prompted the use of coping strategies aimed at alleviating the resulting stress and providing reassurance. Conversely, positive occurrences elicited different coping responses from the participants. For example, when nurses experienced good fortune despite the hurdles they faced in the process, they attributed this to God’s benevolence and to luck, as revealed in the following narratives:

“I really think for me it’s really been God because it is really hard … I’ve found it very difficult in this country to go up [career ladder] … as foreign nurses, we can be very qualified, very experienced but sometimes we are overlooked and for me I can only say it’s been God and just being in the right place at the right time … it hasn’t been as straightforward as it can be or as I have seen it for some of my colleagues … I don’t like really using this colored thing but I think to be very, very, frank, it [racial discrimination] does exist.” – Janet, B (clinic manager)

“I believe that promotion comes from God … We don’t have fair promotion opportunities, and I happened to be one of the luckiest.” – Hannah (deputy ward manager)

Janet and Hannah draw on a religious framework to make attributions about their good fortune, appraising their job promotions as a reward from a loving God (Hathaway, 2009). In the first excerpt, Janet B, the highest ranked nurse in the study, attributes her career progression to luck (being in the right place at the right time), indicative of the randomness of success and divine intervention. Her account also highlights the obstacles faced by foreign nurses who attempt to climb the career ladder (the discounting of their skills and racial discrimination), contrasting these experiences with the straightforward career progression of white colleagues. Similarly, Hannah, the second highest ranked nurse in the study ascribes her career success to both luck and divine intervention, while also observing the unequal treatment that holds back the careers of foreign nurses. In recognizing the challenges encountered by foreign nurses, the nurses imply that their professional success did not stem from exceptional effort on their part. It was not the result of working harder or displaying greater loyalty than others. Instead, they attribute their progress to a combination of luck and divine intervention, an acknowledgment of God’s role in bestowing blessings to his faithful.

All in all, the study’s findings regarding context are consistent with Yen et al. (2021), who suggest that personal coping strategies do not exist in isolation. They are part of a complex web that encompasses the person, their family, the wider community, and even far-reaching ties, like those back in one’s native country. This accounts for the absence of a material difference between the coping approaches employed by nurses of varying ages. As members of the same community, it is probable that the coping strategies of younger nurses will overlap with those of their senior counterparts in the UK, rendering them more alike than different. Further, sharing beliefs that encourage one to seek God’s intervention in the face of adversity aligns with the notion that religious coping strategies are influenced by individual, situational, and cultural factors.

Contributions and Limitations

My study’s principal contribution to the current body of literature is grounded in empirical evidence, stemming partly from the surprising and unexpected research findings that highlight the widespread use of religious coping strategies among African nurses working in the UK. Writing the introduction to a special issue on spirituality in organizations, Neal and Biberman (2004, p. 8) note the importance of researching the topic given that the economic models that focus on the old “bottom line” do not appear to serve stakeholders. The authors urge researchers to ask deeper questions about the influence of spirituality. Nevertheless, variables related to spiritual values and practices have still not been thoroughly analyzed, even though their correlation with effectiveness at the personal, team, and organizational levels has been observed. This article supports that correlation by underlining the centrality of religion in the lives of African nurses in the UK, where nurses are seen to rely on intrinsically and extrinsically oriented religious/spiritual coping strategies to make sense of and respond to racist experiences in the workplace, through which they can continue to carry out their jobs.

The question of employee religiosity, an issue linked to morality and ethics, represents an important factor shaping the organizational environment (Cui et al., 2015; Obregon et al., 2022). While organizations are secular, the lives of some employees are organized around religion. This can of course be interpreted as a purely private matter. But understanding this aspect of an individual is as important as examining their educational background. For African nurses, religion is a salient part of their identity, serving to strengthen their sense of control and actualization (Reilly & Falgout, 1988). Assuming that the salience ends when they put on their nurse’s uniform is naïve, given that religion acts as their “meaning system,” providing African nurses with a sense of meaning and order (Barnard & Mamabolo, 2022 p. 9). It is their religious beliefs that, more than anything, determine how they conduct themselves at work. As such, and as western organizations continue to recruit internationally, it is imperative that organizations expand the room available for religious expression in the workplace (Ghumman et al., 2013) where this does not infringe on the rights of other employees.

Healthcare employers have an ethical obligation to change the toxic work environments in which African nurses find themselves. They can show their commitment to a zero-tolerance approach to racial harassment and discrimination by adopting requisite policies, ensuring that these are clearly communicated to all employees, and reviewing them regularly for effective implementation. This would signal the organization’s commitment to their employees’ respect and dignity, while fostering accountability. Supervisors also have an ethical responsibility to enforce workplace controls and ensure that racist incidents are dealt with in an impartial and speedy manner. Given that between 70 and 80% of healthcare errors are attributed to a breakdown in non-technical skills such as interpersonal, teamwork, and communication skills (Flin & O’Connor, 2008), the role of individual supervisors in nurturing a safe environment where these skills are prioritized is imperative. Research has observed supportive supervisors who facilitate immigrant workers’ use of voice, thereby enhancing their wellbeing (Behtoui et al., 2020). In the hospital ward, such supervisors can prioritize skills that foster collegiality and cultivate an environment in which both patients and employees are aware of the consequences of racial harassment. They can also set up supportive processes—e.g., assigning mentors to new employees—to help alleviate anxiety arising from cultural and organizational newness. In closing, racism should not have a place in any work setting, but particularly not in healthcare. It is the moral responsibility of the sector, its employers, and its managers to safeguard the rights of all employees to work in an environment free of racial harassment and discrimination.

The article has a few limitations. Firstly, I wanted to focus on the participants’ voices and their approaches to coping with racism in the UK healthcare sector. Therefore, I decided not to locate my research within, or contribute theoretically to the literature on intersectional racism. Secondly, the generalizability of the results is restricted by the study’s exploratory nature and a sample that lacks racial, gender, and religious diversity. The workplace challenges faced by African Muslim nurses, for example, are likely to differ from the current sample (especially given the current anti-Islam sentiment in western countries), and those faced by male nurses are likely to differ again. Thirdly, distinguishing between the religious coping strategies of first-generation immigrant nurses versus second-generation immigrant nurses is likely to yield differing results. There is probably also a distinction between the coping styles of immigrants in non-caring professions versus those in caring professions. Finally, extending the research to include nurses from the EU and/or Asia would add elements of immigration status, other religions, and nationalities, which are all factors that greatly influence the immigrant experience and shape their coping process.

Conclusion

African immigrant nurses face racism in the workplace, to which they respond with a variety of different coping strategies. My research hones in on one particular strategy: religious coping. I show that religious coping is multi-faceted and multi-functional, temporal and contextual. An obvious next step would be to build on these personal accounts and engage more deliberately with the literature on intersectional racism. This would facilitate an exploration of how factors such as race, immigrant status, gender, and nationality can potentially function as bases for discrimination while also influencing the coping strategies adopted by immigrant nurses to manage their experiences of workplace racism. Although several scholars have employed an intersectional lens (Crenshaw, 1989) to examine the workplace experiences of East and South Asian immigrant workers in western countries (Hwang & Beauregard, 2022; Qureshi et al., 2020; Syed & Pio, 2010), this analytical approach has not been as widely used to evaluate the experiences of their African counterparts. This is of course an interesting opportunity for future research.