Biased care in the ER?

Toots · Apr 21, 2000

Originally posted by Mijourney:
Hi,

I inquired about the following topic in the general forum. An article was published in this month's AJN about an Emory University study which recorded that black patients with trauma dx have been receiving substandard care in the ERs. Would like to see the opinions of ER nurses and other staff regarding this. Thanks.

Surprised nobody responded - but really think ER staff as really color blind. We went into ER because we want to make a difference in someones life and wouldn't work there if we were going to sort out our care by race or socio economics status. The only substandard care I can think of is perhaps someone who has an extremely foul odor (we're human too and sometimes the mask and the alcohol pads inside don't hide the smell) because nobody wants to go into the room and get sick or the patients that are abusive. With those two possible exceptions, think on the whole, ERs give patients the best care they can under the circumstances no matter what their color.

ZcorPion · Apr 22, 2000

Hmm, sounds very noble, but life over here is not that perfect. We do not have a large African community in Belgium, but we're confronted with an increasing population of Turkish and North-african population as well as former USSR (or whatever) residents.

I'd like to think we are all unbiased, but I see a lot of stuff that says we're not. It doesn't go as far as malpractice, but there are some remarks made by collegues, which I call racist. Treatment , however is not that different, but there's a lot less energy put in convincing them to stay for observation, than for a Belgian patient who'd present the same symptoms. I am half Moroccan myself, so that puts me in a tight corner sometimes.

But , to be honest, when there's a code, and stuff needs to happen, it happens equally fast no matter what colour skin.

Now, Insurance however...

seamus · Aug 19, 2000

Originally posted by Toots:

Originally posted by Mijourney:
Hi,
I do believe that care in the e.d. is color blind. All of us are there for our patients and want good pt. outcomes. I believe that first and foremost e.d. nurses are pt advocates. I wish I could say the same about all parts of hospitals.
I live in Alaska. In my state there is only one designatedTrauma Center.(level 2) That hospital happens to be a Native Hospital. We had a airplane crash in a remote area of Alaska,we stabilized the patient and tried to arrange transfer to the trauma center. The patient was refused . Why? He was white and therefore did not qualify for care in the states only designated trauma center.By the way I work for a Native run corp. in a Native hospital, I can assure it did not change the care our pt recieved.

I inquired about the following topic in the general forum. An article was published in this month's AJN about an Emory University study which recorded that black patients with trauma dx have been receiving substandard care in the ERs. Would like to see the opinions of ER nurses and other staff regarding this. Thanks.
Surprised nobody responded - but really think ER staff as really color blind. We went into ER because we want to make a difference in someones life and wouldn't work there if we were going to sort out our care by race or socio economics status. The only substandard care I can think of is perhaps someone who has an extremely foul odor (we're human too and sometimes the mask and the alcohol pads inside don't hide the smell) because nobody wants to go into the room and get sick or the patients that are abusive. With those two possible exceptions, think on the whole, ERs give patients the best care they can under the circumstances no matter what their color.

SuburbanER · Aug 21, 2000

I think that all ER staff is color blind and will help any one who needs help. I am only familiar with a few ERs however. However, these ERs would be possible text book cases for this problem do to their diverse patient population. They do not seem to have a problem. I am sure that all ER nurses would agree that diverse patient population makes the job more interesting, because my patients learn someting from me and I learn something from my patients. I was truly concerned about this problem and closely monitored it.

Trauma Columnist · Aug 23, 2000

I work in a large, level I trauma center and as long as trauma pts don't spit, punch or pinch me, I have no problems. However, if drugs or ETOH impair their social skills, that's why leather restraints and police standby exist. Color or ethnicity don't matter.

lids · Aug 23, 2000

Originally posted by Mijourney:
Hi,

I inquired about the following topic in the general forum. An article was published in this month's AJN about an Emory University study which recorded that black patients with trauma dx have been receiving substandard care in the ERs. Would like to see the opinions of ER nurses and other staff regarding this. Thanks.

hello

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CEN35 · Sep 4, 2000

We dont treat any differently, between black, and white and whatever? If anything, it is the Russian community......very large around here. However, the reason is more, because they come here, live here and don't speak a word of English which makes it very tough to work with them. WE were told by many Russian patients, cause of the field we are in, we should learn how to speak Russian?

But other than that...........nobody gets treated differntly.

CEN35

hollykate · Sep 4, 2000

Prior to "moving up" (I refer to up two floors, not up in status, lest I start a real argument here) to the ICU, I worked in a big Level One Trauma Center in the south where race always seems to be at issue. In a big Trauma, we do not think about color or anything but saving the pt. Now, when it isn't a trauma, I am not totally sure if some differences in treatment don't exist. CEN35, our problem with language barrier is with the Hispanic Community, though most of the MD's not speak a little Spanish, and we have a full time interpreter, it is still often difficult to understand for the patient and the nurse and the md....but I don't think the tx they receive is substandard, if anything it is overly cautious- our doc's send off a ton of test, just to be sure they are covering it all- Isn't that what you see with the RUssian community CEN 35? How's your Russian coming btw?

babynurselsa, RN · Sep 5, 2000

The times that I have experienced people using that line is someone who has been in the waiting room too long. (by their line of thinking) Usually for a complaint that does not belong on the ER. These individuals will begin to voice their belief that I have roomed the acute MI or difficulty breathing ahead of them due to race. After I assure them my husband would tell them differently they usually desist.

I honestly cannot say that I never observed an incident of bias in my ER based on race. On attitude and odor maybe but not race.

Overland1, RN · Oct 2, 2000

Originally posted by Mijourney:
Hi,

I inquired about the following topic in the general forum. An article was published in this month's AJN about an Emory University study which recorded that black patients with trauma dx have been receiving substandard care in the ERs. Would like to see the opinions of ER nurses and other staff regarding this. Thanks.

Coming from AJN (which is actually an acronym for something not very flattering to nurses ), I am not surprised. It is stuff like this that made me drop my subscription to AJN - the Nursing arm of the Democratic party.

When any person comes into my ER, that person is treated very well and with the utmost in courtesy and respect; this is regardless of skin color, etc.

On the other hand, if a person of any color comes in and cops an attitude, I will not be the one to advocate 'hugs for everybody' and/or take extra time to deal with that person. For AJN to promote this alleged racism indicates their ability to promote the class-envy which is pushed by their party every day in the media. AJN could (just as easily) come up with something about poorer/slower care rendered to those of "lower socio-economic status", or myriad other subcategories.

I have never seen, in any hospital or unit, any evidence of racially-motivated delays in care, nor of any substandard care based on racial category.

I have seen occasions when a member of a certain minority was standing in my ER yelling about having to wait for his sore toe to be looked at because he is ______ (fill in the type of minority). Even those people receive excellent care, but I do not move them ahead of the Cardiac Emergency patients.

I do not care what color a patient is. I do not even notice unless that person calls it to my attention.

[This message has been edited by Jerry Falletta (edited October 01, 2000).]

Tobash · Oct 3, 2000

I like the attitude and odor bias. I think from a racial standpoint our ED staff treats everyone equally, esp with regards to trauma.

Sometimes I do wonder about gender bias concerning cardiac care. Females sometimes do not get the more agressive treatment there male counterparts are given in similar situation. There treatment is usually the same, but is not treated with the same urgency. Just a hunch, what do yall think? (yes, I'm from the south too!).......Tobash