Black History Month - Focus on Richard Desir

As part of our focus on Black History Month, we caught up with Director of Nursing for Primary, Community and Intermediate Care, Richard Desir who reflected on his route into nursing, where we are in relation to equality and diversity, and the work that he is involved in to drive forward the agenda.

Here’s what Richard had to say:

I am Richard Desir, Director of Nursing for Primary, Community and Intermediate Care at Cardiff and Vale University Health Board.

I was born in Manchester, my parents came over to the UK in the 1950s as did many black people from commonwealth countries, having been invited to work and shape post war Britain.

I am a proud Mancunian but I am equally proud of my heritage and I have traced it back to the Democratic republic of Congo, formally known as Zaire or the Belgium Congo which incidentally is the second largest country on the African continent. It is a country with a history blighted by its colonial past and the crime of slavery and racism. I have a strong sense of duty to share the history of the past and I am passionate about righting the wrongs of the present ensuring a fair and equal future for all.

My mother was 20 when she arrived in the UK from the Seychelles and was employed in many different roles, eventually finding her vocation as a carer. She did want to train as a Registered Nurse but the flexibility of entering the profession did not exist then. So, she was “proud as punch” the day that one of her four sons decided to enter the nursing profession as a young, naive 18 year old.

I literally fell into nursing as a result of an accident! At the age of 14 I badly fractured my ulna and radius, which resulted in an attendance at my local emergency unit in Manchester. This was my first experience of a hospital setting and I was totally in awe of the experienced practitioners I encountered there, but most notably the registered nurses whose coordination of care, kindness and expertise triggered my desire to enter the nursing profession.

Following my unfortunate accident and while feeling rather sorry for myself, my mother who was a carer within a joint health and social services team working with people with learning disabilities encouraged me to help other people. So as part of my recuperation I undertook some voluntary care work and witnessed learning disability nursing and care first-hand.

These two experiences were the catalyst for me deciding to explore a career in nursing. I applied for learning disability and adult nursing courses and ended up as an adult nurse, simply because that interview came first, and I accepted the post!

I started my career in nursing in 1986, I was one of 5 males in my group of 25 students, and I never met another black male student nurse during my nurse training so I was somewhat of a rarity. This has remained constant throughout my nursing career; a black male nurse in the community and a black director of nursing.

Fast forward 35 years and I think to myself what has happened and what has changed up to the year 2021. We have seen the development of the world wide web; fall of the Berlin wall; the rise of social media; Wi-Fi; smartphones; the smoking ban and over the last three decades England and Wales became more ethnically diverse.

What is clear is that Nurses in Wales are caring for a much more diverse population and although the Black, Asian and Minority Ethnic population in Wales is small in comparison to the rest of the UK, with just over 5% of the Welsh population identifying as from a non-white background. In the context of the health in Wales 7% of nurses on the NMC register describe themselves as non-white which means that there is an over-representation of nursing on the register compared to the population of Wales. However, I can count on both hands the number of Black male nurses working in the community and the number of Black, Asian and Minority Ethnic nurses who have obtained a Director of Nursing position or above. This is even more stark when you consider we have just over 35,000 registered permanent nurses on the register (NMC March 2021) within Wales.

I have had an amazing career; since qualifying I have worked in a variety of clinical settings, Cardiothoracic HDU/ITU; Medicine; EU, Elderly Care and of course working in the community setting.

I have lived in Cardiff since 2007; family ties brought me to the capital. I have been rather fortunate having worked within Health boards across the A470 corridor and also NHS Bristol. However, I only started my position in Cardiff and Vale UHB in June 2020 and I am excited by the challenges ahead.

I am pleased that Cardiff and Vale UHB is providing me with vehicle to promote Black History month which aims to celebrate the contribution of Black, Asian and Minority Ethnic healthcare staff and to share some of my story, hopefully it encourages others to break the glass ceiling and enter this most rewarding of professions.

As part of my role, I am involved with the Train Work Live campaign, which focuses on recruiting more registered nurses and other professional groups into Wales. My involvement is to encourage more men into the nursing profession. Only one in 10 nurses are men, which is a figure that has remained static since I started my career however, there are greater concentrations of male registered nurses in critical care; EU and mental health care nursing.

In addition to promoting gender diversity, I’ve used the campaign as an opportunity to embrace the theme of increasing diversity among other groups within the nursing profession, most notably recruiting Black, Asian and Minority Ethnic groups.

I also have a lead role with Nursing Now Wales Cymru. Nursing Now was launched by the Duchess of Cambridge in 2018 and is an active network of groups working to influence global and national policy. One of the key agendas for the group is to actively encourage and increase diversity in nursing and midwifery, at all levels. This is something that I am really passionate about and I have actively engaged with the University of Cardiff and RCN to promote the profession to aspiring undergraduates from Black, Asian and Minority Ethnic backgrounds.

We know that Black, Asian and Minority Ethnic patients are amongst those with the worst health care outcomes, experiencing higher rates of hypertension, stroke and infant mortality, and that Black women are five times more likely to die in childbirth than their white counterparts. Broadening diversity within nursing is an important element of understanding and addressing some of these significant issues.

I am really proud of my work, I am one of 12 community mentors (consultants) who during 2021 have been involved in the development of the Race Equality action plan for Wales.

The Welsh Government recognised that there was time for urgent action. Together with partners and stakeholders including senior nurses like myself we are developing a Race Equality Action Plan which includes a vision for the change we want for this work. Our vision for Wales is a country that is anti-racist, where everyone is treated as an equal citizen. Our purpose is to create meaningful change to the lives of people from Black, Asian and Minority Ethnic communities.

Following a series of workshops, round table discussions, and in-depth examination of specific policy areas over the last six months resulting in consulting on this draft Action Plan which has now ended and we await the final document. It includes high level goals, actions and outcomes for the policy themes and cross-cutting issues. These sit under our vison for an anti-racist Wales, the purpose is to create meaningful changes to the lives of ethnic minority groups. In preparing this Action Plan, we have put the lived experiences of ethnic minority people, as well as past research on race disparities at the centre of the co-creation process.

I am also involved with the development of a new digital platform called Careersville working with Health Education Improvement Wales, which launches later this month. The platform will give young people aged 14-16 an insight into the world of nursing, as well as tips and hints in relation to applying for a position via the UCAS and degree process, so in addition to working to improve gender and ethnicity diversity within nursing, I’m also involved in encouraging young individuals to pursue careers within the profession.

I think it is fair to say that addressing issues relating to diversity and inclusion has been a fairly slow burn and there is still a long way to go, but there have been some significant changes over the past five years across the NHS in Wales.

Here at Cardiff and Vale UHB, we have seen improvements over the past 18 to 24 months, which I would say has been driven by the work of passionate individuals such as Keithley Wilkinson capturing the experience of COVID-19 and its impact on Black, Asian and Minority Ethnic communities.

The organisation is beginning to focus its attention on issues of race and equality, diversity and inclusion, and I am really pleased to say that we've established our first Race Equality Inclusion Group, which met in July and is due to meet again this month. We are actively pursuing improved awareness regarding this important agenda, and as the group is about inclusion anyone can join, regardless of their background.

As the Vice Chair of the new Cardiff and Vale Racial Equality Inclusion Group, I am keen to address racial sensitivity, inclusion and diversity and make sure that these are not just buzzwords, this is about actions that we as an organisation and individuals can take to challenge stereotypes, which I would break down into four key areas.  

Firstly, if we are to challenge these stereotypes, we must offer sensitivity training. It is not about mandating the training, but ensuring that training is made available and that it becomes centre stage in leadership and management development. Our leaders need to be aware of the diversity; equality and inclusion agenda.

The second thing is about creating a diversity group, committee or forum, which as I mentioned earlier I am pleased we have done in Cardiff and Vale UHB.

Thirdly, it is about listening to our employees which is something that our equality team has worked closely with our CEO and other senior leaders over the last year, listening to the views, thoughts and concerns raised by employees from Black, Asian and Minority Ethnic groups. But we need to see the actions from these discussions. 

Finally, we also have to understand the data, capturing information about the workforce and plotting trends to see whether or not we are doing what we said we would do, and whether actions we have taken to promote diversity and inclusion are producing results in terms of the make-up of our workforce.

The Black, Asian and Minority Ethnic Community is estimated to treble in 25 years, and as I’ve described it is important that nursing becomes more reflective of the population we serve.

Cardiff and Vale UHB is a great organisation to work for, where staff from Black, Asian and Minority Ethnic communities will have the same opportunities and open doors that I’ve had to share and voice views on this issue of inclusiveness and diversity.

There are so many opportunities available here for those who are willing to work hard and aspire to the values of the organisation, and I would encourage anybody in the nursing community, or young people from all backgrounds who are considering a career in nursing to join us here.

The issues we are working to address are not just about the month of October - we need to continue making strides across all months. Of course, Black History Month provides an important spotlight, but it is important to continue the great work through the calendar year.