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.
I noticed the very same thing when I started nursing. Not possible to miss when one work in the area of predominantly African American population. But it does not bother me at all. I give you my personal opinion on the matter.
The reason is, some of them, one portion of those ignoring African Americans is that they are exhibiting sings of racism, as they direct such a behavior to whites only. (Does not matter you are European. I am sure, they suspect you, that your grandma own plantage in Carribic and manages it by mail :) True history (just read about history of Zanzibar and events has no meaning to them, as they are not able to understand it. They do not know, and they are thought to think, what they are thought to think. Why you do not see it in all people of African descent, but only in African Americans, is given. Hopefully comparison of histories of Africans in America and Africans elsewhere could bring some light on the problem and could give you some clues about cultural thing.
If they do not want to talk, please be respectful and respect their wishes. I personally would not disturb them. I would comply with their wishes, and since they do not communicate at all - I give them out of respect the desired solitude. Many times when call light went on, and you come ask them - they keep ignoring you - it was probably pressed by mistake when they tried to change the channel on TV.) But I would for sure chart that patient was not cooperative, refused to communicate and answer any of my questions.
If you are worried if they are ok, you can always give them sternal rub. (I seen it, it performs miracles). They will start communicate loudly unless they are truly unresponsive, then, you trigger code.
You will provide them great service by asking MD for psych eval. because I guarantee you, they most likely have some sort of mental, or psych. issues. And by doing so, you enable them to receive the best possible care.
The other part of patients would truly give attitude to all, by ignoring, or by mistreatment. Those are bitter people who got bad diagnosis, did not comply, or did not know, or neglected their problem, when was a time and chance to fix the problem. Now there is no hope for them, and they wish to blame anyone. They are also very annoyed and tired of hospitals. Some of them feel like they are not being treated well. (They also would benefit from psych eval, as they have signs and symptoms of depressed mood)
Sometimes happens that the second group, will change their mind, and start treating nurse as human, if they seen that the nurse truly cared for them. Not always, but sometimes it happenes.
I noticed the very same thing when I started nursing. Not possible to miss when one work in the area of predominantly African American population. But it does not bother me at all. I give you my personal opinion on the matter.
The reason is, some of them, one portion of those ignoring African Americans is that they are exhibiting sings of racism, as they direct such a behavior to whites only. (Does not matter you are European. I am sure, they suspect you, that your grandma own plantage in Carribic and manages it by mail :) True history (just read about history of Zanzibar and events has no meaning to them, as they are not able to understand it. They do not know, and they are thought to think, what they are thought to think. Why you do not see it in all people of African descent, but only in African Americans, is given. Hopefully comparison of histories of Africans in America and Africans elsewhere could bring some light on the problem and could give you some clues about cultural thing.
If they do not want to talk, please be respectful and respect their wishes. I personally would not disturb them. I would comply with their wishes, and since they do not communicate at all - I give them out of respect the desired solitude. Many times when call light went on, and you come ask them - they keep ignoring you - it was probably pressed by mistake when they tried to change the channel on TV.) But I would for sure chart that patient was not cooperative, refused to communicate and answer any of my questions.
If you are worried if they are ok, you can always give them sternal rub. (I seen it, it performs miracles). They will start communicate loudly unless they are truly unresponsive, then, you trigger code.
You will provide them great service by asking MD for psych eval. because I guarantee you, they most likely have some sort of mental, or psych. issues. And by doing so, you enable them to receive the best possible care.
The other part of patients would truly give attitude to all, by ignoring, or by mistreatment. Those are bitter people who got bad diagnosis, did not comply, or did not know, or neglected their problem, when was a time and chance to fix the problem. Now there is no hope for them, and they wish to blame anyone. They are also very annoyed and tired of hospitals. Some of them feel like they are not being treated well. (They also would benefit from psych eval, as they have signs and symptoms of depressed mood)
Sometimes happens that the second group, will change their mind, and start treating nurse as human, if they seen that the nurse truly cared for them. Not always, but sometimes it happenes.
Specializes in Acute Care - Adult, Med Surg, Neuro.
Sorry if I offended someone. I was making an observation based on some things I saw in my nursing practice and was trying to be non-judgmental and understand if there was a reason for this behavior. I see now that this is not a cultural behavior. I was hoping it was not my approach, I do my best to treat all of my patients with respect and caring. However, I will re evaluate my approach from now on to make sure that it is not something that I am doing to cause these reactions. Thank you for your feedback!
Um. I don't notice this in African American but sometimes we have people who will do this. Or when mom speaks for the kid. Quit speaking for the kid. And when I say kid, I mean someone who is 18, 20, 25+.
Sorry, I am not sure where do you think it should go to? It is plain observation and division into two groups I found. Wasn't my description clear? Not sure where you going with your comment? Sorry, if it gave you a trouble to read or understand. Really sorry.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
The reason is, some of them, one portion of those ignoring African Americans is that they are exhibiting sings of racism, as they direct such a behavior to whites only.
Do you have a special crystal ball that tells you whether your 'ignoring' African-American' patients are being racist? Ignoring a person doesn't fall into the range of racist behaviors by itself.
and events has no meaning to them, as they are not able to understand it. They do not know, and they are thought to think, what they are thought to think. Why you do not see it in all people of African descent, but only in African Americans, is given. Hopefully comparison of histories of Africans in America and Africans elsewhere could bring some light on the problem and could give you some clues about cultural thing. 
coast2coast
379 Posts
every d*mn time! We all have our kryptonite!