I am not an American but from a European culture. I have cared for all kinds of patients and I have no problem with doing this. I have a question I have noticed about a trend I have noticed in some black American patients, but not in other patients I've cared for. (Please note I am not talking about patients from Africa, the Carribean, etc)
When I speak to patients of this culture, I have noticed a percentage of them will ignore me. This has happened many times, enough for me to take notice. For example, I will ask the patient "Are you having pain right now?" or "Are you feeling sick to your stomach?" In a clear tone. The patient will be awake, alert, but will lay on the bed with their eyes closed and not respond. I will ask again, and again they will not respond. Many times, worried that they have gone unresponsive, I will nudge them and say "Are you awake? Are you okay?" And get a look of annoyance from them.
I'm wondering if this is a cultural thing for some black Americans. As a European, who was routinely berated for not responding promptly to people around me, I find this behavior to be perplexing and a bit irritating, as it will go on like this through the interview (with the patient repeatedly not responding to pertinent questions). I know in some cultures, stoic-ness is valued, and I wonder if a history of oppression / discrimination has made some individuals feel that no matter what, their voice will not be heard, so they instead remain silent. I also understand that patients respond differently to pain and other ailments, with some shutting down and others showing their discomfort loudly.
In an atmosphere of today where diversity is a sensitive issue, I'm hoping I didn't offend anyone and hoping that someone can help me understand this behavior so that I can work more effectively with all of my patients.
Hi O.adamantite, maybe its how you present yourself, or initiate communication that is the culprit for the behaviors that you describe.
Yes, perhaps they are wondering if your culture shapes your approach.
Are you coming in reciting questions? Or are you find out and meeting them where they're at?
I've done the majority of my career in the home setting, walking in cold into their territory, I've learned to read and adapt in a matter of moments after many times starting off wrong. I think there's less motive to learn that in the clinical environment though many respect its importance there as well.
Playing possum is nothing new. I take care of older white people and sometimes they do the same to me. then they usually end up looking for me later anyway haha.
Playing possum is nothing new. I take care of older white people and sometimes they do the same to me. then they usually end up looking for me later anyway haha.
Visiting my dad in rehab and he's doing it right now and he's the whitest dude ever.
They may very well be reacting to you being white if they're black American. Some people just don't talk their business like some white people do. It takes time to open up to people that they may not like,etc.etc. different from them and so on. I wear a turban, I have light brown skin (i'm mixed race) and have had this treatment from people before. Don't take it personally. Make friends with them first.
I am not an American but from a European culture. I have cared for all kinds of patients and I have no problem with doing this. I have a question I have noticed about a trend I have noticed in some black American patients, but not in other patients I've cared for. (Please note I am not talking about patients from Africa, the Carribean, etc)
When I speak to patients of this culture, I have noticed a percentage of them will ignore me. This has happened many times, enough for me to take notice. For example, I will ask the patient "Are you having pain right now?" or "Are you feeling sick to your stomach?" In a clear tone. The patient will be awake, alert, but will lay on the bed with their eyes closed and not respond. I will ask again, and again they will not respond. Many times, worried that they have gone unresponsive, I will nudge them and say "Are you awake? Are you okay?" And get a look of annoyance from them.
I'm wondering if this is a cultural thing for some black Americans. As a European, who was routinely berated for not responding promptly to people around me, I find this behavior to be perplexing and a bit irritating, as it will go on like this through the interview (with the patient repeatedly not responding to pertinent questions). I know in some cultures, stoic-ness is valued, and I wonder if a history of oppression / discrimination has made some individuals feel that no matter what, their voice will not be heard, so they instead remain silent. I also understand that patients respond differently to pain and other ailments, with some shutting down and others showing their discomfort loudly.
In an atmosphere of today where diversity is a sensitive issue, I'm hoping I didn't offend anyone and hoping that someone can help me understand this behavior so that I can work more effectively with all of my patients.
Yea, I've seen this. Never could figure it out. But I've had black patients who will either shut their eyes and not respond to questions or just sort of glare at me. I do sense that it is because they are mistrusting or resentful, and I can only assume it is based on negative past experiences with white healthcare professionals.
I have noticed this behavior, but it's not exclusive to any specific race. I agree with traumaRus that it does seem to be more common with chronically ill people who are in and out of the hospital often. That may be an ESRD patient, sickle cell, COPD, or someone with chronic pain. Sometimes frequent flyers, sometimes people who generally exhibit drug seeking behaviors.
I just explain that I need an answer (pain assessment, nausea, ect) before I give the medication they have requested. If they won't answer (but obviously can) I'll say I will come back and try again later.
I definitely have an image in my head of a patient with the sheet pulled up over their head who I have to hunt down their wrist under their blankets for their armband to scan, or their IV line to push medication. They'll sigh angrily if the sheet needs to be removed, flip it back quickly, being annoyed that I have inconvinced them. I am the rude one for needing access to these things to give their medication.
Anyway, that sometimes goes along with the no response/blank affect type of patient the OP described, for me anyway.
monday2016
16 Posts
Hi O.adamantite, maybe its how you present yourself, or initiate communication that is the culprit for the behaviors that you describe.