ABSTRACT:
While research in North American and Australian contexts demonstrates how encountering racism in healthcare is burdensome, the impact of racism on healthcare interactions in Germany remains underexplored. This paper draws on a study examining the intersections of interpersonal, institutional, and structural racism in the professional experiences of internationally recruited nurses in Germany who self-identify as “affected by racism.” The aim is to deepen the understanding of the forms, dynamics, and effects of racism within a healthcare sector increasingly shaped by economization. Employing a qualitative research design, the study is based on 21 semi-structured interviews and 10 participant diaries. Data analysis followed an iterative process, integrating inductive and deductive approaches within a framework of qualitative content analysis, emphasizing participants’ perspectives. The findings indicate that the experiences of the 21 participants are shaped by intersecting processes of racialization and commodification. Racialization manifests in assumptions of professional incompetence, experiences of bullying, and assignment to less desirable roles with heavier workloads. Institutional practices—such as the issuance of employment contracts that create dependency, the denial of training opportunities, and disregard for minimum labour standards—further exacerbate the degradation and dehumanisation described by participants, laying the groundwork for their commodification and exploitation. In the absence of support from colleagues and managers, nurses report being left to choose between silence, resistance (often at personal cost), or bolstering their credibility through extra work. The paper identifies key areas for institutional transformation and highlights the power structures that must be addressed to advance equity and justice in nursing. Priority interventions include improving working conditions, strengthening monitoring and accountability of recruitment agencies and healthcare institutions, shifting from cultural competency to anti-racist education, enhancing onboarding programs, and advancing transdisciplinary and transnational research.