Racial Refusals In Nursing

'Racial refusal' is a phrase that refers to the practice of patients and / or family members who refuse care from particular nurses, physicians, nursing assistants, techs and other types of healthcare workers due to the caregiver's racial-ethnic background. Nurses Relations Article

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For starters, 'racial refusal' is a term I constructed several years ago to denote the practice of patients and / or family members who refuse care from certain nurses, physicians, aides, techs and other healthcare workers solely because of the caregiver's racial-ethnic background.

Racial refusals can be inflicted upon staff members of any race, creed, ethnicity or national origin. Also, patients belonging to any racial-ethnic background are capable of refusing particular staff members for reasons that are purely race-based. Most importantly, these refusals tend to throb like a virtual slap in the face whenever they do happen to a person.

I currently live in a part of the country where racial refusals take place with regularity. In fact, the specialty hospital where I am employed is presently attempting to accommodate the racially biased preferences of a patient who has requested that no black members of staff provide any care for her.

Anyhow, these types of requests are normally accommodated at my workplace because nursing management and hospital administration wants to ensure that the facility's Press Ganey patient satisfaction scores remain above a certain threshold. In exchange for favorable patient satisfaction scores and repeat stays, management will attempt to 'WOW!!' the patient by making staff assignments based on racial-ethnic background.

On the other hand, the hospital where I work cannot always reasonably accommodate patients' race-based requests for staff members, especially on the night shift, due to the fact that every single one of the night shift nurses and techs in the entire building might be from the same racial-ethnic background on some evenings.

My views on this issue might be controversial, but here they are. I feel that patients who are not actually paying for their care (read: charity care) have no business refusing caregivers due to race.

I also feel that patients who receive help from the federal government to fund their care (read: Medicare or Medicaid) have no business refusing caregivers of a certain race.

After all, people of all races and nationalities pay taxes that help fund these programs. Finally, I feel that patients who are receiving care at any hospital or other healthcare facility because they lack the education and expertise to provide their own medical treatment and nursing care have no business refusing caregivers due to racial reasons.

One more thought before I depart for the evening.

As a black female, I would prefer that these racially prejudiced patients have their requests accommodated, as contradictory as this may seem.

Here is my reasoning.

A patient who does not want me to serve as his nurse can make boldfaced claims regarding poor nursing care and fabricate allegations of abuse that could make my professional life tremendously miserable. These patients are generally set in their ways, resistant to change, frequently spiteful, and sometimes elderly.

Their racial prejudice is their personal problem of which I want absolutely no part. I would prefer to live and let live.

No matter what you do, always hold your head high in the face of a racial refusal. Even though the patient is essentially rejecting you based on your race, you are still worthy of respect, dignity and a basic right to exist in the society in which we live. It is unfortunate that some people have not changed with the times.

Specializes in Eventually Midwifery.
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A patient once refused to let me take care of her because of how my deodorant smelled. As a member of the Old Spice community I was deeply offended.

jejejeje

Specializes in ICU.
Ruby Vee said:

Maybe it's OLD fat white nurses.

I once received a complaint regarding an unnamed 'fat blonde nurse' so I sent it back and stated it could have been anyone, questioned why they had sent it to me as the patient didn't give a name. I said it was offensive that they had chosen me and if they checked the roster I never was on duty when the patient was there. Nursing manager sent me on a customer care course for my troubles.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
amygarside said:
Your article is very well-written. I guess, nurses would really need to provide the best patient care to the patients. If refusing to a certain nurse of that specific race would make him feel better, why not? The patient has his/her own reasons beyond this. Let's not be skeptical about their reasons. They must have autonomy. Just a thought.

I can't believe I read this!

Discrimination is not OK. And as to patient autonomy -- your right to swing your arm ends where it impacts my nose.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
MaryAnnD said:
I once received a complaint regarding an unnamed 'fat blonde nurse' so I sent it back and stated it could have been anyone, questioned why they had sent it to me as the patient didn't give a name. I said it was offensive that they had chosen me and if they checked the roster I never was on duty when the patient was there. Nursing manager sent me on a customer care course for my troubles.

OUCH! It was offensive that they had chosen you! If they just checked the roster and sent copies to all of the blonde nurses, or checked the assignments to determine who actually took care of that patient. Otherwise, it's just plain nasty!

Sad world we live in. I wonder if that patient rather die then receive nursing care from someone of a different race?

Specializes in TCU, Post-surgical, Infection Prevention.

Are you sure you're not still in Los Angeles??? lol:D

I had the same experience while training to be a CNA in a little rink-tastic hospital in a tiny hillside town west of Long Beach. The housekeeper, who lied and said she was the wife, made it more than abundantly clear she didn't want a *mayete*. Funny thing is, I had just graduated with my degree in Spanish (in addition to my nursing prereqs), so I responded to her request in perfect Castilian spanish and watched that face turn girl-red (Roja).

I cried later on and of course, my classmates who were Latina had a slew of excuses for the patient's maid.

I chalked it up as experience and said a prayer for that biddy.

The more things change, the more they stay the same...sad that for all the advances we've made we still are stuck in a "racial rut". I started out as a Jr Nurse Aide while in high school. While I was making beds in a 4-bed room, one of the patients passed a comment to another patient about how "that poor white girl's face is so bad"... Oh yeah, did I mention that this was said in Spanish? Oh, and yup, did I mention that I AM SPANISH?? I walked over to the patient and very sweetly apologized for the bad looks The Lord had blessed me with and that I was sorry that I couldn't change them...in Spanish of course! Look on the patient's face? Priceless! Of course I went home and cried about it. 30+ years later I can laugh about it. Can you imagine if nurses could refuse to take care of a patient because they were ugly? Smelled? A different color? Gender?

Specializes in Eventually Midwifery.
mbkrn said:
Look on the patient's face? Priceless! Of course I went home and cried about it. 30+ years later I can laugh about it. Can you imagine if nurses could refuse to take care of a patient because they were ugly? Smelled? A different color? Gender?

You see, this is exactly what I mean. If we let them choose who gives them their care, this is EXACTLY where they are going.

And as a side note and public service announcement- "hispanic" is a linguistic group, not an ethnicity or race. Many people of varied colors speak Spanish (22 different countries!), so it is never safe to assume that a person speaks English/ Spanish based on their appearance. This goes for providers and patients.

Specializes in Emergency/ICU.

Twice I encountered ignorant patients who came into the ER and requested to "switch doctors" because of the MD's skin tone. The patients seemed quite confident that their requests would be honored and quite shocked when they were told to "take it or leave it" and "there's the door" instead.

One was angered and walked. Bye-bye, don't let the door hit you in the ...SLAM! The other one caved in and fell all over herself trying to convince us how great she thought the MD was and "how highly she thought of him" during the rest of the visit!

Specializes in Geriatrics, Dialysis.

I work with a PT population that is mostly older; from a time when racial, sexual orientation and gender biases were a more accepted part of American culture. Amazingly it is not an issue as often as I would expect, but when it is an issue we try to accommodate those pts [and families when indicated] as much as possible. Partly to meet the needs/requests of the pt and partly to protect the unintentionally offending staff member from false accusations.

OMG sick to my stomach, that in this day and age people are still acting like idiots!!

I work in LTC and this reminds me of an elderly patient I had. He was absolutely adamant that no nurses or aides of color attend him - that was the gist of what he said anyway. The thing was, he would scream and roar and refuse EVERYTHING until he got his way. It was his home and he demanded his living conditions included only white people. I went and calmed him down (without informing him that I am of Jewish background of course), and listened to his complaining and racial slurs. I told him he had no choice. I apologized that he was "unable to understand" his caregivers, but there were zero white CNAs on staff that night, and with 40 patients, I was not able to attend to his personal needs myself. I basically said, "Hey, I know you don't like these people, and that's your view and you're allowed to have it. But you really have no choice tonight or any other nights. These people have the exact same training as every other aide or nurse in the building, and you're going to get the best care we can give you. But I cannot guarantee your caregiver will be white. Your options are to refuse care from these people and sit in your own filth all night and be uncomfortable and risk pressure sores because you won't let them reposition you, or just deal with it and get cleaned up and comfy." He chose to deal with it and get cleaned up and comfy. As I was leaving the room, he asked me to get him some Oreos from his personal stash in his room. I had to bite my tongue and not ask him, "Do you only want the white part?"