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 Educator.
On 3/30/2014 at 7:09 PM, TheGooch said:

IMO a person can't be all that sick if their main concern is not liking the sex or skin color of the person that is treating them.

Haven't checked in to AN for a while but the resurrection of this 2014 post peaked my interest. As a black nurse, I have had my fair share of racial refusals. As a younger nurse I was often re-assigned to accomodate the patient's request, but as I got more confident in my skills I had (and have) no problem infomring my patient that unfortunatley patients do not get to select their caregivers at this facility. They are of course welcome to go elsewhere for their care. It's 2020 and we are still dealing with this same @#$%

They should adapt a policy that if a pt. refuses care for racial issues they should be discharged.

I agree with how disagreeable it is to witness some of these racially motivated patients, but also equally disturbed by women who want only female nurses, although I understand if you were traumatized by a male. HOWEVER, as a white nurse, I am sometimes targeted by others in the nationality profiling, and quite frankly , if I know you already hate me... and some have made disturbing allegations which, if not directly witnessed by one or other nurses, could have ended my career... I would rather not be your nurse. When I find out that you are willing to make up incidents that never happened, I quickly request a change in assignment. That.... or if there are no other choices, put a camera on me at all times when I am in the room.

Specializes in NICU, PICU, Transport, L&D, Hospice.
33 minutes ago, eakirlin said:

I agree with how disagreeable it is to witness some of these racially motivated patients, but also equally disturbed by women who want only female nurses, although I understand if you were traumatized by a male. HOWEVER, as a white nurse, I am sometimes targeted by others in the nationality profiling, and quite frankly , if I know you already hate me... and some have made disturbing allegations which, if not directly witnessed by one or other nurses, could have ended my career... I would rather not be your nurse. When I find out that you are willing to make up incidents that never happened, I quickly request a change in assignment. That.... or if there are no other choices, put a camera on me at all times when I am in the room.

I am not certain that refusing a male nurse because of prior trauma can be compared to refusing or abusing a nurse because of skin color. When I read your remark it made me think of some of the most horrible, abusive, trouble making patients or families that I interacted with over my 40+ year career. There were some, not a lot, that I had to say "well bless their heart" and just do my job until I could walk away from the poison. I know for a fact that if I was black I would be much more practiced at blessing those who would curse me, while I did my job.

I had at first thought to not put in the comment about requests for the gender of a nurse. Often it is not as hard to accommodate, but on the other hand, I have seen my male counterparts sent home because of some useless allegation about misconduct... and of course it needs to be done, but all of us feel bad about it. So... sometimes a female nurse accompanies a male.

However, I kept the gender reference, because you can be blindsided, and the public under our care needs the best from us... sometimes caregivers cannot be switched out, and I still believe they are getting the best care possible, ... so it is a harsh reality to be blindsided for matters of individual perception that are not under your control and have nothing to do with the care extended or received. I also say, well bless their heart, because they need the blessing.

I’m a Black HHA, currently looking for a nursing program. I have been harassed by enough racist clients. By all means, feel free to get them a white nurse if it will make them happy. I don’t like being harassed at work.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

All hospitals post things on their walls and hand out leaflets about honouring diversity, patient rights and responsibilities, yadda yadda.

How hard would it be to slip in something about NOT accommodating race-based caregiver requests?

There are a lot of industries now that post notices that harassing staff will not be tolerated. Try making racial slurs in the TSA line at the airport. I think it's high time hospitals took a strong stand on this. Press-Gainey notwithstanding.

Specializes in Psychiatry, Community, Nurse Manager, hospice.
On 3/6/2014 at 1:02 AM, TheCommuter said:
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.

Your position in a nutshell: Poor people must accept the race of their caregivers. All others may select their healthcare providers based on race.

Sorry you're in this mess of a geographical area where this is commonplace. It's abominable. And I completely understand why you wouldn't want to care for a racist person.

However... here is what I think should happen.

Racist patients should be told that they don't get to refuse caregivers based on race. They can accept the race of the caregiver or refuse treatment and be discharged appropriately. Racist patients should be immediately identified and documented as such, and people of color should have a witness while providing care to protect against false accusations.

We cannot tolerate this bullsnot as a society.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
On 3/6/2014 at 11:18 AM, mamagui said:

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. 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.

I felt as you did for a long time.  Then a manager explained to me why they accommodate racial refusals.  "We don't want to force our colleagues to take care of patients who might have it in for them because of their race, or who might go out of their way to make the shift miserable for their nurse because they "don't like colored nurses, or male nurses or mothers who work outside the home or whatever."   We don't want to subject our nurses to possible frivolous complaints because a patient who has taken a dislike to them for whatever reason.  It's not about accommodating the racist.  It's about protecting our colleagues."  

I understood once I worked in Baltimore and had been fired a few times because people didn't want a "fat white nurse" or "an ugly OLD nurse" taking care of them.  

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
On 3/6/2014 at 11:25 AM, Irish_Mist said:

 Don't even get me started on the ones who have medicare and medicaid. I seriously wish people would get over themselves.

If you live long enough, you will be on Medicare.  Think about that for awhile.

Specializes in Mental Health, Gerontology, Palliative.

I categorically would not want to accomodate such a request. 

That said if the person was a complete rancid racist fetid dingo kidney, I would almost want to take over for my colleage just to they didn't have to be the target of such nastiness.

the key would be to ask my colleage and see what they would want to do. They may be fine with it in which case I would just run interference PRN

We are fairly lucky. This is not something we have had to deal with