Dealing with the Prejudiced (long post:sorry)...

  1. The analogy of the prejudiced patient that was brought up in the VIP suite thread has kept sticking in the back of my mind. I hope that raising this question does not offend anyone (ready for flames just in case...)
    In the course of my experience and in the area where I live, sometimes we encounter prejudiced and intolerant patients and/or family members. Unfortunately, bigoted jerks can become sick bigoted jerks and find themselves in our hospitals, and the illness may well bring out the worst in their personalities.
    Generally, if the patient or family does not way to have "one of those (insert racial, religious, gender-related or sexual preference expletive here) taking care of" him/her, we've usually respected their wishes. This is NOT because of any approval or support of their prejudice itself, but becasue we have no wish to expose our peers to their unreasonable behavior. Nursing is hard enough without having to face doubt, suspicion and outright abuse through no fault of our own.
    In ideal circumstances, this isn't an issue. However, sometimes staffing, patient condition or caregiver skill make such assignments difficult. In that case, is the optimal healthcare professional assigned to the prejudiced person in spite of having whatever characteristic that person finds detestible? Of course, this "optimal" assignment isn't optimal in view of the patient/family prejudice, so maybe the prejudice should be considered above the skill level of the caregiver, etc. etc. You see how you can think yourself into a corner on this one.
    Please share your thought and feelings on this, especially if you've experienced it directly. Perhaps you can help provide insight into the "right" thing to do in these circumstances. Thanks! Nursemouse :kiss
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  2. 40 Comments

  3. by   canoehead
    I agree that if it can be avoided we should assign someone that the pt will accept, to spare the staff only, not the pt. However if someone has particular needed skills they HAVE to be assigned to that pt and the pt in turn has the option of refusing care. My approach would be, you take this caregiver or you refuse the treatment that only they can provide...and then document, notify MD etc. But I am not so naive as to think that it would be that clear cut. I'm sorry there are no easy answers.
  4. by   Teshiee
    I do not. We are all nurses we come in different colors shapes, and gender. If the patient has an issue with a nurse based on prejudiced he or she should sign their ass AMA and go else where. There should be a hospital policy with "0" tolerance to racist patients. Cultural I can understand because it is a tradition and it should be respected but ignorance hell no! What if the particular floor had the same ethnic group of men and women on the floor? Then what float another nurse to accomodate an ignorant individual? Catering only means supporting that unacceptable behavior.
  5. by   canoehead
    I would support a 0 tolerance policy, but unfortunately floor nurses can't decide that themselves without hospital bigwigs approval. But I think her solution would be something that floor nurses could implement on their own.
  6. by   ChainedChaosRN
    Originally coming from Iowa I rarely experienced any predjudices from patients/families. After moving to the Detroit area it seemed it would be something I would have to learn to deal with rapidly. This area is a good cross section from the world. I've had patient families tell me they do not want a "foreigner" calling them, taking care of Mom etc. etc. Some do not like whites, blacks, the Phillipino's on and on. Dear God I got so sick of it.....now I just say: "My staff is professional, trained and some of the best staff in Michigan. If you have a specific complaint about someones performance please speak up if not, please feel free to see the Social Workers about alternate placement or feel free to find your own." Not once has it ended up being a specific complaint.
    Also...I've had some predjudiced staff...not wanting to deal with a certain patient or staff member. They basically get the same speech. If it's something specific let me know, I'll deal with it...if not you do your job or please find another. Predjudiced people just burn my a**. I have zero tolerance for it personally and professionally.
    I have some Arabic staff and patients and predjudice is starting to rear it's ugly head again. It is difficult to deal with.
  7. by   passing thru
    I've always said we are employees providing care, not contestants in a popularity contest. And if "they" don't like the nurse they got--tough--that's the one you drew. If you don't want her in your room? Fine. But you ain't gettin another nurse while I'm in charge.

    I've given this speech more than once. "They" always say they'll take her. (And believe me, the nurse spends minimum time in the patients room).
    On more than one occasion, the controlfreakpatient and family decided later that the nurse "was allright."
  8. by   Brownms46
    nursemouse, I agree with you, that no one should be subjected to pts. with these kinds of views, and/or ignorance. I have been in this situation many times before, and it has been dealt with, by changing nurses, or not assigning people who the pt. had a problem with.

    Not for the pt. but for the staff. I agree we have enough to deal with, without the unneccessary stuff that shouldn't even come into how we provide care.

    My first run in with a pt. like this, was as a student. I had a pt. refused to have me be assigned to him. My instructer was red in the face ticked, and told him it was his lost, not mine. That some other pt. would receive the benefit of my good care. And that was totally with me. Good topic .
  9. by   liberalrn
    Wow! We live in such an interesting world, no? You're sick and scared that it may be an MI or CA and you have time to pitch a fit about what color/ethnicity/sex orientation/gender your nurse is? I will never have that kind of time......People sure beat everything!
  10. by   dianthe1013
    Originally posted by Teshiee
    There should be a hospital policy with "0" tolerance to racist patients. Cultural I can understand because it is a tradition and it should be respected but ignorance hell no!
    Most racist people do consider their beliefs a "tradition," though. It's considered politically correct to cater to one's cultural beliefs because that is something that, as you say, should be respected. But, when you get right down to it, prejudices can be "cultural," as well.

    Let's say you have an elderly Italian gentleman who still clings to the Old World view that women shouldn't be anywhere outside the home. Maybe he can understand having a female nurse (he's seen plenty of those, after all), but on this day he also has a female transporter, respiratory therapist, and doctor. So, if he freaks out, is it okay?

    Of course not. Personally, I don't care whether its culture, prejudice, or sheer preference that's crawled up his behind and pissed him off; he can deal with it or - as someone said - sign out AMA. But, like some others said, any possible shuffling can be done - just to spare the staff, mind you.

    But I don't really see cultural quirks to be much different from racist "preferences."

    Donna
  11. by   LaVorneRN
    I have actually been in the position of having a patient who didn't want any black or Asians caring for him-aides or nurses-and that was all we had. It cracked me up to see his face after I told him-"wow, that's all we got here today. Sounds like you got a problem." He shut up and accepted the wonderful care he received that that day. giving a half-ass smile to everyone who walked in the room.
  12. by   Brownms46
    good one!
  13. by   nimbex
    I'm here down south, I'm not finding outright racial or ethnic denial of care.... I'm finding a pattern of refusing nurses with the same ethnic origin over several days, while siting "care" issues.... these people don't even have the guts to admit their predjudice.

    I've replied as chainedchaos and passingthu have, depending on the famiy. I've also said that it's best for the charge nurse to determine WHO is best based on thier skills, and although you may not care for a specific demeanor, you're getting top notch care with so and so, but if you absolutely insist...... leaves them second guessing themselves.
  14. by   Tweety
    I support the idea of not sending a minority into prejudiced patients room if it can be avoided.

    Suppose I am told to care for a known homophobe. I'm uncomfortable to begin with, but detach and provide care in a professional manner. He slurs an explitive my way and I cuss his ass out. I get fired.

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