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Culturally insensitive patients


A little background: I am Chinese American. I live in a university town in the Midwest that is fairly multicultural, but that is also surrounded by farming communities that are generally 100% white and very insulated.

I work at a magnet teaching hospital that is affiliated with the university here. The problem is, that many of the patients from these rural communities get transferred here. They have a tendency to say really awkward things to me.

For example:

"Your English is really good!" (English is my primary language)


"Where are you from?" And then they don't believe me when I insist that I am, in fact, from Midwestern America.


"Would you ever go back to China?" No, why would I do that? I'm a citizen and this is my home... They continued to look puzzled and then said, "but why not?"


Asking me a zillion questions about what China is like, and continuing to ask them when I've politely explained that I probably don't know any better than they do.

Or, my favorite is when gentlemen who are World War II vets start speaking Japanese to me, and look confused when I don't understand. (Actually the Japanese came over to china and committed horrible atrocities... But that's another thing entirely).

Generally I am polite, and patient with these patients. Most of the time i try to have a sense of humor abut the situation. i know they aren't being intentional in their insensitivity, but it still grates on me that despite growing up here, they insist on treating me like I'm a foreigner. I find that if I try to correct them, it just leads to things being awkward. "actually English is my primary language that I speak, much like you don't speak polish, mr. Wienawski (not an actual name)"

At the same time, if I ignore it, then it continues with the patient making my race and heritage a constant topic of conversation.

Has anyone else dealt with this before? How did you deal with it? Should I just ignore it, or should I try to politely correct them, if appropriate?

I've never dealt with those questions in that particular aspect. However, I think you should continue to answer the questions politely. I wouldn't let it bother you. The majority of people don't mean to offend you. They are just curious. When they say your english is really good. Say you are from America and that's your primary language. It corrects them but in a "subtle way" and it doesn't make it awkward. Make sure you smile when you correct them, that always helps! Talking about your race gives you and the patients something to talk about. It can also help broaden their knowledge about other races. If it is something you are uncomfortable discussing try to change the topic.

I understand your frustration. I too live in an area where I am a cultural and ethnic minority, although were I am 80% of the population is Asian or Asian-American and am often assumed to be a foreigner soley based on what I look like. Which is extremely annoying, to tell you the truth. I find myself often fielding questions and being called derogatory names by patients, and even other professionals unfortunately. I just tell myself they do it out of ignorance and are just unaware of how people from other cultures live.

I just wanted to share this with you because people of all cultures tend to do this any time they are the ethnic majority and aren't exposed to other cultures. I like what the other person says about using it as a time to educate. The caveat is that it is exhausting when you just want to be treated like everyone else and not constantly have to feel like you are "justifying" your right to existence.

I live in an area just like you described in the rural ne. I just pass as white american for the most part but sometimes get some questions like that. . Even "certain kinds" of white people get these comments or questions. ( we aren't all the same and some groups are not numerous in US). It is annoying to always be thought of as a foreigner or outsider when you are in your own country!! There isn't much for you to do or say. The questions will continue. Just say you were born here and do not know any chinese or anything about living in china (seems to be what you are doing). Some people are too stupid to understand that they are not the only americans and there have been chinese people in US for hundreds of years. Many of these people have just had very limited exposure to people that are not like them and are just curious I guess. in my experience , turning it on them (like your, "do you speak polish?!" example) flies right over most people's heads. it is different for them @@

Edited by anotherone

I think many are trying to make conversation. Unless its racist, let it roll off your back.


Has 8+ years experience.

I hear where you are coming from. I often get comments about my age (not race) and while people don't usually mean anything negative by it (usually), they also don't think about what they are saying or that maybe you've heard this all before. It's good that they aren't being hateful, but I do empathize with your frustration.

An example... Recently I was talking about having to do nights, and was barely finished saying that only having to do two in a row wasn't bad (compared to doing all nights). The person I was speaking to said, "That's because you are young."

Well, no. I didn't say they weren't hard. I only meant to say, comparatively, with just two a person can manage/recover/get into a routine. But no, this person had already decided that due to the age he perceived me as (I had only met him, so likely he thought me younger than I am), I was having no problems. He's not intentionally being insensitive or judgmental, but it's still irritating.

CT Pixie, BSN, RN

Has 10 years experience.

Unless there was a racist undertone to the questions/comments, I don't think these people are trying to be rude or insult you. They may be just curious about other cultures and countries. I, myself, love hearing about other cultures and countries. I would never assume that someone who looks to be of another culture MUST be born/raised in that country, however if they mentioned that they were from another country I don't feel at all like I'm being rude or insulting if I ask questions about that country and culture. It's more about me wanting to be more rounded and knowledgable of others.

Of course, I've never been in the situation that the OP has been so I can't judge him/her for their feelings of annoyance.

FlyingScot, RN

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc. Has 28 years experience.

I'm sorry but I fail to see how these people are being culturally insensitive at all. What I sense from your description are people who are genuinely interested in you as a person. You are different from their normal exeriences and they are curious. I suppose if it happens all the time it could get tiresome but really, your interpretation of their motives is a bit over the top.


Specializes in PACU, pre/postoperative, ortho. Has 10 years experience.

I live in a similar area & tend to agree with the last comment that a lot of people are just curious, but don't consider that it may seem intrusive to ask you all kinds of questions & make assumptions about who you are & where you're from based on your appearance. I worked for many years for a doctor who is Iranian & has been here since 1976 when she was about 19. Based on where she is from, most people assume she is Muslim when in fact, she was raised Christian & married the son of a Methodist preacher! I've heard pts ask her about the Muslim faith & she would give them a big grin & say "You know as much about that as I do!"

proud nurse, BSN, RN

Specializes in Medical Oncology, Alzheimer/dementia. Has 15 years experience.

My hospital is a melting pot. There are many black people employed there. However, I'm one of 3 black nurses on my unit, and the only black nurse on nights. Some of my patients are surprised when they learn my role, because it's not one typically occupied by black females in this hospital (i.e. housekeeping, PCA, lab, food service). This leads to questions that I do get tired of, but as long as I don't feel they are racist or disrespectful, I will answer them. Plus, many people aren't themselves when they're sick and in the hospital...I take it with a grain of salt.

I think if you just explain that either a. you were born in America or b. state that you have been here since the age of (fill in the age) it would get the message across. I think for the most part people are just trying to make conversation.

Like most people have said, I wouldn't take it offensively unless your patients are being intentionally rude. Seems like good old-fashioned curiosity, and that isn't limited to one race or another.

For instance, I am active duty and have moved 4 times in the past 2 years. I am a white American originally from the north, but my accent is a little strange because I have been assigned to duty stations on the East Coast and the South. People frequently try to guess where I'm from to no avail.

I don't take it personally. I accept that I am a Yankee in a Rebel land with a strange accent, a penchant for slipping into East Coast jargon while spouting y'all's left and right, and that's bound to confuse people.

mclennan, BSN, RN

Specializes in CCM, PHN. Has 8 years experience.

How old are you?

Years of dealing with this inures you to it. I have dealt with it for 40 years and don't care any more. People are stupid. Let it go.

eatmysoxRN, ASN, RN

Specializes in Med/Surg,Cardiac. Has 1 years experience.

My accent is quite Northern and my southern patients spot it within minutes. I've lived in the South most of my life and I don't really notice an accent either way usually. It doesn't bother me to discuss that I am from up north. In fact, it gives me something to talk with them about instead of an awkward... "yeah, I guess I should know the answer to 'how are you feeling' is 'could be better otherwise I wouldn't be in the hospital'." I would answer politely and just tell them that you were born here and although you know about your heritage, you are much more familiar with the Midwest.

Thanks for the replies. I don't take it as an insult. Like I said, I try to have a sense of humor about it. however, its frustrating when i politely correct them and they either say something like ,"oh come on, now where are you really from?" Or otherwise continue to talk to me like I'm a foreigner. I work on a neuro unit, so I suppose some short term memory loss may be at play here too.

Thanks for your replies. I suppose I have to continue to let it roll off my back.

My grandmother embarassed the family often. She didn't have a problem with someone's color, but she had difficulty understanding anyone with an accent and preferred to cuss them rather than try to understand. I loved her because she was Grandma, but she was a cantankerous old bat even when she was healthy! Near the end, she had a catheter coming from her kidney and had to move into LTC. There, most of the CNAs had accents (mostly Filipino and Hispanic). The family was constantly apologizing for her. Most of these folks were very helpful and really sweet and trying their best to give her excellent care.

I work for a very culturally diverse company and come into contact with people who have lived in many different places. I find people fascinating and love to learn about different cultures. Now, I've never told someone "you're English is good", but after we've had a few meetings and we're moving on to sharing a little personal conversation, I will ask someone where they're from and, if they're open to it, I may ask more questions about their culture (if they're from other countries or their families are). I have no wander lust myself and don't care to leave the comfort of my own country, but I like to hear how other people live. I explain my fascination to them and they are usually very happy to share.

Some of your patients will be like my cantankerous old grandma but others are likely fascinated about learning about you. They don't know you're a boring American just like them. :)

My accent is quite Northern and my southern patients spot it within minutes.

eatmysox - I'm in a similar boat. Raised in OK, I joke that twang is my first language. I only hear my accent now when I get upset or have recently been speaking to family from NC (then it's THICK). But, living in sunny San Diego, I encounter many people who hear it and even my family will stop sometimes and look at me with a crooked grin on their face because of something I've said. The two that come to mind off hand are...

"I'm gonna thump your head in a minute" said to my middle child when he wasn't listening to me and

"Would you get done already?" - I used that one often and never thought anything about it until my sis-n-law brought that one to my attention one day. Then I realized that really isn't proper grammar.

I am proud of my twang, thank you very much, and I embrace it. :D