Addressing anti-black racism - advancing equity and empowering black registered practical nurses: A multiple method research design.

Background: Nurses form the backbone of the Canadian healthcare system, with the largest workforce representation across various care settings (Health Canada, 2024). The purpose of this narrative review is to critically examine from the literature the structural and systemic challenges experienced by Black Registered Practical Nurses (RPNs), within the broader context of the ongoing national nursing crisis. While RPNs form a significant portion of the nursing workforce, Black RPNs encounter unique and compounding barriers due to anti-Black racism (ABR) and systemic inequities. RPNs, who are invaluable healthcare providers that work in various disciplines such as education, informatics, policy and leadership, are increasingly impacted by workforce shortages, burnout, and structural challenges issues especially intensified for Black RPNs (RNAO, n.d.; Registered Practical Nurses of Ontario (WeRPN), 2024). Methods: Between January and March 2025, a literature search was conducted on the following databases: Emcare, Embase, Scopus, Medline (Ovid), CINAHL Complete, and APAPsychNET. Key search words such as "Black Canadians", "Black Persons", "Registered Practical Nurses", "Social Discrimination", "Prejudice", "Job Satisfaction", "Professional Development" were used. Out of 795 papers reviewed, a narrative review of eight qualitative and quantitative studies was conducted to explore the experiences of Black nurses in Canada. Thematic analysis identified four core themes: (1) navigating racism and discrimination in the workforce, (2) leadership and career progression in nursing, (3) diversity and inclusion in the workforce, (4) and strain on personhood. Results and discussion: Racism emerged as a key barrier at multiple levels. For example, historical exclusion limited early access to nursing education, while career progression remained hindered by structural inequities and lack of mentorship. Studies have also shown a pattern of internationally educated Black nurses facing systemic obstacles through immigration and credentialing processing, contributing to underemployment, and deskilling. Diversity initiatives also were often seen as symbolic rather than transformative. Conclusion: This review's findings highlight the intersecting factors such as unsafe working conditions, professional role conflicts, limited support for career advancement, and racial discrimination collectively impact the retention, well-being, and professional growth of Black RPNs. By highlighting these overlooked experiences, this review will contribute to further inform equity-oriented policies, education, and organizational change to promote the professional well being of Black RPNs.