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. How does an individual deal with a racial refusal, and at the same time, maintain self-dignity in the face of a powerful race-based rejection?
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.Last edit by Joe V on Jan 12, '15
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: 38,034; Likes: 69,279
CRRN, now a case management RN; from US
Specialty: 11 year(s) of experience in Case mgmt., rehab, (CRRN), LTC & psychMar 6, '14I went to a flu clinic in klan country and I was wearing a turban AND had olive skin. Feh... yes some did not want me giving them their needle sticks. Personally I don't care. That is their issue. I will take care of them all the same. It is funny how I interact with neo nazi skinheads better than ole klan geezers based on my keen knowledge of war history and tattoos.Mar 6, '14I don't understand why the hospital would fawn around these people like that. It's crazy.Last edit by JDZ344 on May 14, '14Mar 6, '14I live in the US and I work as a Nursing assistant. Sometimes, we have to sit with patients that are mentally ill or are psychotic. Personally, I was verbally attacked by a racist woman all night. She didn't want me in the room, and we didn't accommodate it. Once, there was a patient that refused to have a CNA in the room, so he was removed from her care team. He ended up suing the hospital and winning for racial discrimination. I feel like there are instances where it is appropriate, and others where the patient has to get off their high horse. I do agree with you that there is always risk of backlash from racist patients, that can complain and potentially get you in trouble. But, usually if it's well known on the floor that a patient is a racist, the managers are very understanding of this and take it into consideration. But I do believe it all depends on the circumstances whether or not to accommodate these patients' requests. On my floor, my coworkers are all different races, so usually this isn't able to be accommodated, especially at night.Mar 6, '14I have always found it amazing that if a healthcare provider refused care based on race, they'd be sued; however, the other way around is perfectly okay? You get what you get and you don't get upset.Mar 6, '14Quote from naturallynicoleOnce, A sitter had been assigned, but this elderly lady didn't like him. She didn't like black men, her family later explained. The lady had dementia, and for whatever reason, black males freaked her out. We were fine with that situation- it wasn't that she was deliberately being a racist. I swapped, and everything was fine. She was happy with a female of any race. I think there is a difference between that situation, and somebody with all their faculties who is just being a jerk.I live in the US and I work as a Nursing assistant. Sometimes, we have to sit with patients that are mentally ill or are psychotic. Personally, I was verbally attacked by a racist woman all night. She didn't want me in the room, and we didn't accommodate it. Once, there was a patient that refused to have a CNA in the room, so he was removed from her care team. He ended up suing the hospital and winning for racial discrimination. I feel like there are instances where it is appropriate, and others where the patient has to get off their high horse. I do agree with you that there is always risk of backlash from racist patients, that can complain and potentially get you in trouble. But, usually if it's well known on the floor that a patient is a racist, the managers are very understanding of this and take it into consideration. But I do believe it all depends on the circumstances whether or not to accommodate these patients' requests. On my floor, my coworkers are all different races, so usually this isn't able to be accommodated, especially at night.Last edit by JDZ344 on May 14, '14Mar 6, '14I think I'm a dreamer.... I just don't see how there is room in this world for racism. Why can't we all just enjoy the differences in people, and embrace something bigger than us. Race has nothing to do with the level of care one receives, or one gives (obviously).
That's it... my Kumbaya moment for the day.Mar 6, '14Uff, accommodating racists..mmm. In my opinion, it seems that would just make people think that it is ok to have that sort of mindset and perpetuate the situation. If they refuse service because their tech/nurse/doctor/etc. is of a race that they do not like, document it, have them sign a refusal of service and indicate why, then let them go somewhere else for treatment. It is 2014 for crying out loud- there is no longer any room for racism in our culture.Mar 6, '14I think it is a disgrace that there are patients presumptuous enough to make such a request. Don't even get me started on the ones who have medicare and medicaid. I seriously wish people would get over themselves.Mar 6, '14Accommodation for the purpose of not putting staff into a hostile work environment? Sure. Accommodation for the purpose of getting those Press-Ganey scores up? Disgusting.Mar 6, '14Quote from mamaguiI'm the author of the piece and I'm checking back in. . .Uff, accommodating racists..mmm. In my opinion, it seems that would just make people think that it is ok to have that sort of mindset and perpetuate the situation.
I totally agree with you that accommodating bigoted patients and/or family members sends a backward message. Unfortunately, I live in a part of the country where blatantly revealing one's racially prejudiced views is still somewhat socially acceptable.Mar 6, '14We recently had a patient who only wanted care from a white nurse. I was the only white nurse that day in our area (psych ER). I told him we had no white nurses, only nurses. He accepted the care provided. I do not cater to racism. In a few generations I predict we will not have "white" nurses or "black" nurses. We will have "taupe" nurses. I have no problem with blending the races and living in a multicultural society. If you differ, good luck finding someplace to go and don't waste time going there!Mar 6, '14A patient who rejects a caregiver based on race reveal a lot more about themselves than they'd probably choose to if they were thinking clearly. And yet they know nothing about the caregiver they're rejecting. It could be -- and I've seen it happen -- that they're rejecting the most knowledgable and experienced caregiver, or the caregiver most up-to-date in the thing that's wrong with THEM.
I'm blonde. I've been asked to step in when a patient has rejected a Black nurse. I'm female, and I've been asked to step in when the patient has rejected a male nurse. I've also been rejected on the basis of MY skin color more times than the other two combined. People in my area don't like "fat white nurses." Or so I'm told. Maybe it's OLD fat white nurses.
Personally, I don't think racial rejections ought to be accomodated unless the patient suffers from dementia and is having flashbacks to their time in a Vietnamese prison camp, as a prisoner of the KKK or whatever. No, it's not fun to be racially rejected and have to care for the patient anyway. But it's not fun to be the nurse who is swapped into that assignment and have to listen to their B.S. all night (or day) long, either. Those patients are rarely any MORE pleasant to the nurse who gets swapped for the rejected nurse, and you have to listen to them tell you over and over how they triumphed over that (insert racial expletive and a few general expletives here).
I've always thought -- and think it more strongly all the time -- that Press-Gainey is the anti-Christ.