In recent months, many NHS workers from overseas have felt the sting of public conversations that question their competence, their right to be here, or even their fluency in English. When a public figure or MP makes comments that generalise and demean international healthcare staff, it does more than spark debate—it affects real people, many of whom left their homes, families, and comfort zones to serve the UK healthcare system.
If you are an overseas nurse, doctor, midwife, therapist, or support worker, your contribution is valued. This post explores how to emotionally cope with public negativity, how to identify microaggressions in your workplace, and how to build confidence in speaking up when needed.
1. Emotional Coping: Protecting Your Mental & Professional Well-Being
Working in a high-pressure environment like the NHS is hard enough. Facing xenophobic rhetoric or negative stereotypes adds an invisible burden. Here are strategies that help you stay grounded:
A. Separate Political Noise From Reality
Public debates often use “immigration” as a talking point rather than as a reflection of real-life experiences.
Remember:
- You passed the same NMC/HCPC standards as everyone else.
- You communicate professionally every day—with patients, colleagues, and MDT teams.
- You are already proving your competence simply by doing your job.
Truth: Patient satisfaction surveys consistently praise overseas staff for their empathy, professionalism, and kindness.
B. Build Internal Safety
Emotional safety matters. To do this:
- Talk to colleagues you trust—most will be supportive.
- Join affinity or peer support groups (e.g., international nursing groups, staff networks).
- Seek supervision or reflective sessions (e.g., PNA / Restorative Clinical Supervision) to process how you feel.
C. Avoid Internalising Stereotypes
Repeated negative comments can begin to seep into self-esteem. If you feel yourself thinking:
- “Maybe my accent is a barrier…”
- “Maybe I am not as good as others…”
Pause. You passed exams, OSCE, IELTS/OET, adaptation programmes, and you deliver safe care daily. Your accent is not a weakness. It’s a sign of your global skillset.
2. Watch Out for Microaggressions: Subtle but Harmful
Microaggressions are small, often unintentional behaviours or comments that make someone feel lesser because of their identity. For overseas NHS workers, these are common but frequently overlooked.
Here are examples to watch for:
A. Language-Related Microaggressions
- “Your English is actually good.”
- “I didn’t expect you to understand that.”
- Speaking to you slowly or overly loudly without need.
B. Competence-Based Microaggressions
- Assuming you don’t know UK guidelines even when you do.
- Skipping you in clinical discussions or decisions.
- Questioning your drug calculations, technique, or charting unusually often.
C. Cultural/Identity Microaggressions
- Comments like: “Where are you really from?”
- Oversimplifying your culture or making jokes about your food, names, or accent.
- Excluding you from informal team interactions.
D. Structural Microaggressions
These are embedded into workflow:
- Always allocating overseas staff to heavier areas because “you cope better.”
- Not offering you study days or leadership opportunities.
- Using you to “fill gaps” without recognition.
Why this matters:
Microaggressions add up. They lead to burnout, withdrawal, and emotional exhaustion—even if individually they seem “small.”
3. Learning to Speak Up: Practical, Safe Ways to Advocate for Yourself
Speaking up can feel risky, especially when you’re on a visa or new to the organisation. But there are safe, structured ways to do it:
A. Use Professional Language, Not Emotion
A simple formula:
Describe → Impact → Request
Example:
“During handover, I noticed my competence was questioned repeatedly. This made me feel undermined. Going forward, I would appreciate being spoken to directly if there are genuine concerns.”
B. Document Patterns
Keep a reflective journal or email to yourself:
- Date
- What was said/done
- How you felt
- Any witnesses
You don’t need to use it immediately, but it helps if things escalate.
C. Escalate Safely
Depending on the issue:
- Speak to your line manager
- Contact Freedom to Speak Up Guardian
- Approach a PNA / PNO / Wellbeing lead
- Seek union support (RCN, UNISON, etc.)
These channels exist to protect you. And using them does not make you “difficult.”
D. Boundaries Are Not Rudeness
If someone makes an inappropriate comment, a calm boundary works:
- “I don’t feel comfortable with that comment.”
- “I’d appreciate if my accent wasn’t part of the conversation.”
- “I’d prefer feedback about my practice to be specific and constructive.”
It signals confidence and trains others to treat you with respect.
E. Build Your Voice Slowly
You don’t have to confront every issue.
Start with:
- Asking questions during handover
- Participating in MDT discussions
- Taking small leadership roles
- Preparing for difficult conversations in advance
Over time, your voice becomes part of the team’s culture.
4. Final Thoughts: You Belong Here
The NHS would collapse without overseas workers. That is a fact, not an opinion.
You:
- care for some of the most vulnerable people in society
- bring multi-country clinical experience
- enrich team culture and patient safety
- help fill severe workforce shortages
And you do it while adapting to a new country, climate, culture, and system.
Whenever you hear public criticism, remember this:
You didn’t come here by accident—you came here by merit, by skill, and by professional strength.
You belong.
Your work matters.
And your voice deserves to be heard.
