Communication Discrimination - page 4

Hi Everyone, I have entered a National speaking competition and have chosen a subject that we nurses experience on a daily basis; people being spoken to or treated differently because of the way... Read More

  1. by   TheCommuter
    Quote from twinmommy+2
    My husband also is told he isn't black enough because of the way he speaks, by his own family!
    Yep...I can unfortunately relate to your husband's predicament. Members of my own family have referred to me as an 'Oreo cookie,' a term that refers to someone who is "black on the outside and white on the inside."
  2. by   kakamegamama
    Quote from oldpsychnurse
    I'm not sure if this is exactly what you're looking for, but this is an example of culturally-based communication difficulty. I used to work at one of the state psych hospitals where there were a lot of foreign psychs (primarily from India). Now you have to keep in mind that we're in the South. Well, a common question to ask psych patients is "do you hear voices speaking to you?" Good Southern Baptists, particularly minorities, will always tell you that God speaks to them. When the Indian docs heard that, they immediately assumed there was a psychotic issue in play when, in reality, there was nothing wrong with them. It was to the point that administration had to make a blanket policy that patients were not to be asked about hearing voices. Sad because that's a valid question, but folks were being admitted to the hospital for being Baptist.

    Also, just being from the South is enough for many people (mostly our Northern friends) to decide that we're less intelligent or educated. Very sad misconception.
    Well, some of my fellow Southern Baptists might qualify as admittable..........and, I've probably been considered the same from time to time.

    Seriously, though....your post brings home an important part of assessing the patient for mental status...take into account their culture, their religion or lack there of, and, really listen to the patient, carefully..... and don't assume that just because they state they hear God that they are in a psychotic state--some people actually do hear Him, but that is a topic for another day........
  3. by   NurseLife88
    I worked in disability services for over a decade and saw my patients encounter this kind of discrimination on a regular basis unfortunately. Often times people who do this don't even realize they are doing it, but there are also those that just don't care. Here are just a few different encounter I have seen.

    I had one wheelchair bound client diagnosed with cerebral palsy. This disorder can affect all aspects of the neurological and muscular systems. This particular patient communicates with her eyes using a yes and no blinking system. So many times I can't count she was completely ignored. Instead of asking her what kind of cookie she wants they would ask me instead. She was more than able to communicate but was rarely if ever given the chance to do so. Sometimes out of impatience others out of ignorance.

    I had another blind patient. This patient had glasses and a walking stick and only needed me for med organization. Often when picking up prescriptions they would start relaying all this info but always directed to me as the man stood next to me. One day after a few months of this I think he got fed up. He politely says excuse me to the lady then tells her " Hey I know I'm blind, but I'm not deaf and I can speak. Please speak to me directly about my own meds." I swear the lady looked shocked as ever and apologized profusely. She was one of those who legitimately did not realize what she was doing in speaking to me instead of him.

    The last example I will use is my own grandmother. She suffered Alzheimer's and dementia for years but was still lucid and A&Ox3 most days, before a quick spiral downhill. She was often ignored and deemed too confused to understand the basics. It got to the point that people often never addressed my grandma but whoever was providing care. Grandma hated this. She would say she wasn't a child, she knew she was confused and dying but she didn't deserve to be ignored and overlooked because of it.

    These are just a few examples out of hundreds. Whether this type of discrimination occurs because of diseases, accents, culture, etc. It still happens and more often than not goes completely unrecognized by most.

    I'm glad the OP has brought some attention to this under discussed issue and one we nurses can play a big role in helping to fix.
  4. by   WinterLilac
    Quote from NurseLife88
    I worked in disability services for over a decade and saw my patients encounter this kind of discrimination on a regular basis unfortunately. Often times people who do this don't even realize they are doing it, but there are also those that just don't care. Here are just a few different encounter I have seen.

    I had one wheelchair bound client diagnosed with cerebral palsy. This disorder can affect all aspects of the neurological and muscular systems. This particular patient communicates with her eyes using a yes and no blinking system. So many times I can't count she was completely ignored. Instead of asking her what kind of cookie she wants they would ask me instead. She was more than able to communicate but was rarely if ever given the chance to do so. Sometimes out of impatience others out of ignorance.

    I had another blind patient. This patient had glasses and a walking stick and only needed me for med organization. Often when picking up prescriptions they would start relaying all this info but always directed to me as the man stood next to me. One day after a few months of this I think he got fed up. He politely says excuse me to the lady then tells her " Hey I know I'm blind, but I'm not deaf and I can speak. Please speak to me directly about my own meds." I swear the lady looked shocked as ever and apologized profusely. She was one of those who legitimately did not realize what she was doing in speaking to me instead of him.

    The last example I will use is my own grandmother. She suffered Alzheimer's and dementia for years but was still lucid and A&Ox3 most days, before a quick spiral downhill. She was often ignored and deemed too confused to understand the basics. It got to the point that people often never addressed my grandma but whoever was providing care. Grandma hated this. She would say she wasn't a child, she knew she was confused and dying but she didn't deserve to be ignored and overlooked because of it.

    These are just a few examples out of hundreds. Whether this type of discrimination occurs because of diseases, accents, culture, etc. It still happens and more often than not goes completely unrecognized by most.

    I'm glad the OP has brought some attention to this under discussed issue and one we nurses can play a big role in helping to fix.
    Your post is very much appreciated. I will use some of these thoughts. Thank you so much.
  5. by   Sweetheart2005
    Quote from NurseLife88
    I had another blind patient. This patient had glasses and a walking stick and only needed me for med organization. Often when picking up prescriptions they would start relaying all this info but always directed to me as the man stood next to me. One day after a few months of this I think he got fed up. He politely says excuse me to the lady then tells her " Hey I know I'm blind, but I'm not deaf and I can speak. Please speak to me directly about my own meds." I swear the lady looked shocked as ever and apologized profusely. She was one of those who legitimately did not realize what she was doing in speaking to me instead of him.
    my mom is legally blind and Ive had similar experience. She rarely uses her cane but when she does, people talk to me, not her. And if they do, they talk down to her like she's mentally incapable of speaking for herself and deaf. She's blind. She's perfectly competent and very independent.
  6. by   NurseLife88
    Quote from TheCommuter
    Yep...I can unfortunately relate to your husband's predicament. Members of my own family have referred to me as an 'Oreo cookie,' a term that refers to someone who is "black on the outside and white on the inside."
    I can also relate to this as well. It's like people talk to you in a certain tone or expect you to speak in a certain way because of your skin color. I often get suprised faces when I go to doctors appointments and know everything they are discussing, medical verbatim, etc.
  7. by   WinterLilac
    So we know of the 'Restraining factors' (keeping the problem status quo), what would you suggest as 'Driving factors' (changing the status quo)?
    Im thinking patience, don't assume (assume makes an ass out of u and me!) and speak normally - not too fast and not too slow.
    In my experience, people are more than happy to let you know how much they understand (if English is a second language) or how we can communicate the best.
    Thoughts?
  8. by   kakamegamama
    Quote from WinterLilac
    So we know of the 'Restraining factors' (keeping the problem status quo), what would you suggest as 'Driving factors' (changing the status quo)?
    Im thinking patience, don't assume (assume makes an ass out of u and me!) and speak normally - not too fast and not too slow.
    In my experience, people are more than happy to let you know how much they understand (if English is a second language) or how we can communicate the best.
    Thoughts?
    1). If a person is obviously challenged communication wise, why not just ask if there is a method to communicate with them that has been most helpful to them? Do they need/want a translator? (We have a high number of English as a second language patients at the clinic where I work. While many of them speak English, they often want a translator with them so that they can clearly understand and communicate with me their needs, etc.). If they are visually impaired, why not increase the font size on written instructions? If they are deaf, a translator's presence may help, but also, being sure to clearly articulate our own speech can go a long way in helping them.

    2) Slow down and not hurry through instructions/health review/etc.

    Just a few thoughts of mine
  9. by   audreysmagic
    Quote from kakamegamama
    OP---I don't know if this fits, but here are my "peeves" about communication.

    1. Please don't assume that just because I have white hair I am hard of hearing.
    2. Please don't call me "Sweetie". "Ma'am" would be okay, or Mrs. Kakamegamama, but please, not "Sweetie". I've never liked hearing older people addressed that way, and don't like it for myself, either. In the Southern United States, it is usually not meant condescendingly, but it usually comes across that way, at least to me.
    3. It's okay that people sound different than we do. Ask for clarification if you think you heard something different than what you planned to hear. It may be a matter of wrong words usage, or perhaps the person you spoke to didn't fully understand your question.
    4. Don't make fun of colloquialisms, especially to the speaker, unless you yourself use those same colloquialisms.
    I really find I have to watch the "sweetie" and "honey" because I'm both from the South originally and used to working with kids...it's become a part of my normal speech, and in the Midwest, I have to check myself because I don't want to unintentionally offend. People who do it anyway and then insist "it's just how I talk" when something is known to be condescending or offensive irritate me. It implies to me they don’t care enough to consider their audience.
  10. by   audreysmagic
    Quote from jaderook01
    Or, someone being described/charted as not completely oriented, when the reality is the nurse simply doesn't want to take the time to listen past someone's speech impediment. That happened with a patient recently. I discovered that he was perfectly fine regarding orientation and mental status. Others acted like he was mumbling nonsense. He was very difficult to understand, but once I adjusted my ears, he made perfect sense.
    Oh, my goodness – this one rings especially true! I had a pt years ago that was labeled as confused and hostile, and a mumbler. She did have a marked speech impediment due to no front teeth – and at first I thought she WAS confused because she kept calling me “Nurse Penny” despite several introductions and she would scream “PENNY!” down the hall when she wanted me. I very quickly discovered, after taking the time to get to know her:
    1.) She was not remotely confused. Actually, she was quite brilliant.
    2.) She was, in fact, hostile because she thought it was funny to see people’s reactions. She was that kind of person.
    3.) She kept calling me Penny because she wanted to. She smirked one day when I came in and told her to “be nice” to a new nurse and said, “Whatever, Nurse Audreysmagic.”
    4.) She refused until the day she left my unit to tell me where Penny even came from.
  11. by   kakamegamama
    Quote from audreysmagic
    I really find I have to watch the "sweetie" and "honey" because I'm both from the South originally and used to working with kids...it's become a part of my normal speech, and in the Midwest, I have to check myself because I don't want to unintentionally offend. People who do it anyway and then insist "it's just how I talk" when something is known to be condescending or offensive irritate me. It implies to me they don’t care enough to consider their audience.
    That's my main peeve about the use of "sweetie". I use that with a child, not a peer or older adult. I understand the South and its speech---grew up here. But, even then, those words were reserved for close family members or others we loved. Of course, if I'm out of it and in great need, and someone calls me "sweetie", I probably couldn't do anything about it....then :-).
  12. by   rntracy1
    There is also this type of discrimination in the reverse. It isn't only minorities who deal with it. How about the Spanish speaking people who speak Spanish because they KNOW others don't know what they are saying, or in the nail salons the Asian people (mostly Vietnamese but others too) speaking about customers in their native language? I work in an inner city public school and I constantly deal with having to call parents only to hear on the other end of the phone, "No speak a English." Well, I don't speak any other language and your child is sick. I was a floor nurse and one of the CNAs had to translate for the Spanish speaking patients quite often. One day, after apparently being tired of it, she said, "This is ridiculous. The nurses should be able to communicate with their patients. Speaking Spanish should be a requirement of the job!" THAT bothered ME! And I said to her, "EXCUSE ME! This is the United States! English is our primary language. You are saying that in order to get a job in MY OWN country I should have to speak another language so that I can communicate with people who refuse to learn the language of the country they are visiting or living in? I don't think so." She said, "I never really thought about it like that." If I went to/moved to Russia, Germany, Poland, or wherever (many of them speak English) I would either learn THEIR language or realize that if I ended up in the hospital, I probably wouldn't understand too much of what is going on. I guarantee, you won't be able to get "all up in arms" over the fact that they aren't providing interpreters 24hrs a day. They would tell you, "we will provide one if/when we can" and you would be lucky if one ever showed up. We cater to people way too much here. You all can be upset with me about this, but I feel speaking English should be a requirement of citizenship. It is for their own wellbeing as well as that of our own citizens.
  13. by   WinterLilac
    Quote from rntracy1
    There is also this type of discrimination in the reverse. It isn't only minorities who deal with it. How about the Spanish speaking people who speak Spanish because they KNOW others don't know what they are saying, or in the nail salons the Asian people (mostly Vietnamese but others too) speaking about customers in their native language? I work in an inner city public school and I constantly deal with having to call parents only to hear on the other end of the phone, "No speak a English." Well, I don't speak any other language and your child is sick. I was a floor nurse and one of the CNAs had to translate for the Spanish speaking patients quite often. One day, after apparently being tired of it, she said, "This is ridiculous. The nurses should be able to communicate with their patients. Speaking Spanish should be a requirement of the job!" THAT bothered ME! And I said to her, "EXCUSE ME! This is the United States! English is our primary language. You are saying that in order to get a job in MY OWN country I should have to speak another language so that I can communicate with people who refuse to learn the language of the country they are visiting or living in? I don't think so." She said, "I never really thought about it like that." If I went to/moved to Russia, Germany, Poland, or wherever (many of them speak English) I would either learn THEIR language or realize that if I ended up in the hospital, I probably wouldn't understand too much of what is going on. I guarantee, you won't be able to get "all up in arms" over the fact that they aren't providing interpreters 24hrs a day. They would tell you, "we will provide one if/when we can" and you would be lucky if one ever showed up. We cater to people way too much here. You all can be upset with me about this, but I feel speaking English should be a requirement of citizenship. It is for their own wellbeing as well as that of our own citizens.
    Thanks for your POV. I see the thread has branched off into languages rather than the initial intent of identifying the way we communicate rather than who speaks what.
    Accents, particularly strong accents, can make some people initially assume little English is known.

    I worked at a place where the the two managers spoke Turkish in front of me sometimes dropping my name in the conversation, it is a form of workplace bullying. In australia, it is taboo to speak in another language in front of customer's and you can lodge a complaint with the business. It once happened to me in a shop where two employees were speaking to each other in Tagalog. I asked what they were talking about which surprised them; they answered 'school' then proceeded to speak in English.
    When in Rome...

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