Racial Biases Against Patients: Another Issue To Ponder
Norma, a 57-year-old African-American female, presented to the emergency room with chest wall pain at the community hospital in the small Midwestern city where she resides. After a battery of testing, she was eventually admitted to the telemetry floor for an overnight observation stay. The intended purpose of this article is to further explore the issue of racial biases in healthcare settings.
According to one definition, racial bias means a "pre-formed" negative opinion or attitude toward a group of persons who possess common physical characteristics (McCleary, 2009). Racial bias has been detected in school admissions, hiring practices, promotions, the legal system, the media, financial institutions, and other everyday components of United States society. Keep in mind that persons belonging to any racial-ethnic background may be subject to unfair treatment from those who harbor racial biases.
Racial bias also exists in healthcare, although it happens on a more subconscious level. Research indicates that physicians are major culprits. In a study published in a March issue of the American Journal of Public Health, researchers found that two-thirds of doctors harbored "unconscious" racial biases toward patients (Anderson, 2012). The study showed that the doctors overall had a moderate implicit bias against blacks and a stronger association of whites with compliance (Moyer, 2012).
Research suggests that some nurses and nursing students have subconscious racial biases toward certain patients in the area of pain management. College students and nurses went to greater lengths to ease the pain of members of their own race in a study led by Brian Drwecki, a psychology graduate student at the University of Wisconsin-Madison (Barncard, 2011).
The same study indicated that participants felt more empathy for patients who shared the same racial ethnic background. Despite a vast difference in experience and knowledge-the students had no medical training, while nurses are often directly involved in trying to monitor pain and keep patients comfortable-the two groups showed very similar biases (Barncard, 2011).
Furthermore, the Caucasian students and nurses aggressively managed the pain of Caucasian patients. White participants ordered significantly more pain treatment for white patients, and scored higher on tests measuring the empathy they felt for the patients who received preferential treatment (Barncard, 2011).
How does racial bias affect patients in healthcare settings? Well, it impacts patients negatively and often leads to feelings of mistrust and disrespect. Blacks whose doctors have an unconscious bias also reported reduced trust in their physician, less respectful treatment and a lower likelihood of recommending the physician to a friend (Moyer, 2012).
What are the solutions to racial bias in healthcare? A little empathy will certainly go a long way when dealing with all patients. Healthcare providers and students may want to place themselves in their patients' shoes prior to making decisions regarding care. For instance, in the aforementioned pain treatment study, simply asking the students and nurses to briefly put themselves in their patients' shoes had a drastic effect on their decisions (Barncard, 2011). Moreover, this is another issue where the Golden Rule may be applied: always treat patients in the same way that you would want to be treated.
Racial bias is deeply woven into the fabric of American society; therefore, the issue will not disappear overnight. Together we should do everything humanly possible to strive for equal treatment of all patients who enter the healthcare system as inpatients and outpatients. Even though belief systems do not easily change, each small modification in behavior can cascade into a wave of positively sweeping change.Last edit by Joe V on Jun 24, '12
About TheCommuter, BSN, RN Moderator
TheCommuter is a moderator of allnurses.com and has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.
Joined: Feb '05; Posts: 38,035; Likes: 69,274
CRRN, now a case management RN; from US
Specialty: 11 year(s) of experience in Case mgmt., rehab, (CRRN), LTC & psychJun 22, '12Very interesting article, as I will be starting nursing school this fall. Made me really think about a lot of things and to make sure I'm aware of my actions.Jun 22, '12I think this is very important in healthcare and other areas as well. Patients are "patients" for a reason and dealing with racial bias certainly does not have a positive impact on their expectations for treatment. Therefore, in practice I tend to treat patients the same way I would like my family members to be treated with respect and caring.Jun 23, '12Certainly something to ponder. A problem I ran into in nursing school was my classmates assumed because I was white I would have certain racial bias against them not factoring in I'm not an American and that changes the way I perceive other races. I didn't grow up with the same racial tensions so I feel I'm a little more open though sometimes slightly ignorant through lack of exposure.Jun 23, '12I had similar experiences as "tothepointeLVN". I am from the pacific northwest and did not grow up or experience any type of racial bias growing up. The few people I met from a different race never behaved differently around me and like-wise the same for me around them. We all got along and it was awesome. I have lived in a lot of places,(Washington state, Idaho, california, Germany) but when I moved down South 5 years ago and began working, for the first time in my life I saw how differently another race sometimes treated and reacted to me. It was very very difficult for me to get used to. I was pretty frustrated and sometimes angry if there was any type of issue made out of something that didn't exist for me. I can't change what happened in the 50's down south or anything else that happened down south that revolved around racial inequality. Sometimes a patient or a patient's family members automatically regard me with disdain from the time I enter their room. I get tired of the "stink eye" and attitude when I work my tail off to provide high quality care for EVERYONE regardless of race.Jun 23, '12I grew up a Navy brat, then served in the Navy. My home of record is Alabama. I had always been around people of all races. I am here to inform you that racial bias is not limited to the "South." Some of the most racially biased people I came in contact with were from upstate New York. Even people of the same race are oftentimes biased toward each other, Mongolians and Chinese (Learned this from my Physics Professor), Mexicans and Puerto Ricans, even light skinned African-Americans and dark skinned African-Americans.Jun 23, '12I think the term "blacks" should be changed to African-Americans, especially because Caucasians are not referred to as "whites" in the same article. It comes off as racially insensitive, ironically enough.Jun 23, '12Quote from tuhcoolyuhHi, there. I am the one who wrote the aforementioned article. I am also a black female, and I do not intend to be racially insensitive in any way whatsoever. I am simply bringing this issue to light.I think the term "blacks" should be changed to African-Americans, especially because Caucasians are not referred to as "whites" in the same article. It comes off as racially insensitive, ironically enough.
You'll notice that the introductory paragraph describes 'Norma' as an African-American female. And in the fourth paragraph, the the terms 'white' and 'Caucasian' are both used.
You must realize that the sentences that utilize the term 'black' have been lifted from research articles with the original sources cited per APA format.Jun 23, '12I encountered an issue this morning. I am the minority in my place of work, being one of only a few white nurses in the whole hospital. This morning I was walking down the hall and my co-worker was by the nurses desk with one of her patients, flushing her PICC. The pt looked at me, smiled and said Hi, recognizing me by name, she then turned to the patient next to her (who also is white) and said "that one is my favorite right there" The nurse once finished, stormed away back into the med room yelling "you don't like me because I am not not white", "this is ridiculous these patients like her because she is white" Meanwhile I am hearing all of this while getting my meds ready. I didn't acknowledge a thing she was saying. This was not a racial issue at all. This nurse is known for being mean to patients and other staff. She was recently reported to the patient advocate by a patient earlier in the week, which I think fueled the fire. In her words she is "a kind, caring person". She is manipulative and lazy. The majority of the patients are drug addicts or previous drug addicts and she treats them as such, even the ones who aren't she treats them like they are all just med seekers. I don't agree with that at all, no matter what someones history is, they deserve to be treated with compassion when they are in the hospital. Patients have told me that she is often very slow at bringing their pain meds, and that I am the only one who asks "do you need anything" when I leave the room. So instead of recognizing that these patients prefer me because of my style of nursing, she plays the race card, and continued to mutter comments under her breath when I would walk through the nurses station. I sometimes feel that she has it out for me anyways, I haven't worked there a year yet and she has been there many many years. I come in with previous nursing experience and am already developed with my own nursing style. She has told me I "spend too much time with patients" "shuoldn't let them waste my time" and multiple things I have done she says "we don't do that on night shift, that needs left for days" no matter what the scenario is (changing a malfunctioning wound vac at 3am in the best interest of the patient is also the wrong thing to do. I should have turned it off and turned it back on at 630 am and left it to be dealt with on day shift. Sorry lady this is my nursing license and it is my job to look out for my patients, night shift or not. I know I went off on tangent away from the race issue but this is all very frustrating to me and puts me in an awkward position.Jun 23, '12Quote from tuhcoolyuhNot all blacks would consider themselves to be African American. Some actually prefer to be considered as a black American. I guess because their ancestors came here almost 450years ago. I have no problem with the term black. It's what I am, regardless of how any other race labels them self.I think the term "blacks" should be changed to African-Americans, especially because Caucasians are not referred to as "whites" in the same article. It comes off as racially insensitive, ironically enough.
Commuter. Another great article.Last edit by frankie,RN on Jun 24, '12Jun 24, '12But there can also be the issue in reverse---a patient who is not "white" not wanting to be taken care of by my totally Caucasian self. That.is hard, too.Jun 24, '12Quote from TheCommuterare you referring to the bias against white students here? i know when i was in high school and looking into there were many scholarships that i would have qualified for based on GPA....if i were black.Racial bias has been detected in school admissions
i never understood why african americans who fought so hard for equality would be okay with colleges allowing a LOWER gpa than what was acceptable for a white person.
i came across scholarships that specifically outlined the gpa needed to be a 3.0 for an african american, but 3.5 for a white student.
i thought, "how unfair and how insulting to the black race."Jun 24, '12Unreal! It always takes my breath away when I read articles like this in 2012.
My question is why is this still happening, what are we not doing to stop this unfair behavior and treatment of people!
I have friends from all walks of life, from all cultures and I see them as friends and people.
My daughter who is 11 is being brought up to look at people as people! Recently she learn't about MLK in school and we talked about life back then and I am proud to say she was shocked and could not believe people were treated this way. I am proud that I am bringing her up correctly. Abby actually cried at the movie 'the help', so I decided stronger movies were not the way forward yet.
I sometimes feel I am a minority because I inform anybody who discusses anything I perceive as a racial in my presence, that I will not listen to this kind of conversation nor will I stay in the room.
The most offensive thing to me is people look at me because I am white and assume it is ok to talk in this manner, they never make the same mistake twice.