Describing patients by race/ethnicity

dirtyhippiegirl, BSN, RN · Sep 21, 2016

But race/ethnicity can be important in devising a plan of care/treatment protocols/diagnosis of certain illnesses....seems like admitting should just do it properly so the physician has accurate info.

Been there,done that, ASN, RN · Sep 21, 2016

A most excellent question. The category of race is asked in many other areas as well.

I always answer .. "other." I am just a member of the human race.

Thinking that payment may vary depending on"race"? Congratulations on having a beautiful granddaughter. :yes:

Emergent, RN · Sep 21, 2016

But race/ethnicity can be important in devising a plan of care/treatment protocols/diagnosis of certain illnesses....seems like admitting should just do it properly so the physician has accurate info.

You think a $10 hr admitting rep is more qualified than a doctor to assess this? Can't the ER doc eyeball the socioeconomic/ethnic situation, and its possible healthcare ramifications?

Sour Lemon · Sep 21, 2016

I find the race/ethnicity questions one gets asked everywhere somewhat annoying ....maybe even antiquated. And since I'm ethnically ambiguous-looking, I frequently get miss-assigned. I've even had people "argue" with me or just change my answer ...so I usually just leave it blank and let them fill in what they'd like to these days.

Anonymous865 · Sep 21, 2016

The question is not for improving patient care. It is for government reports and for someone's research. (e.g. What ethnic group has the most gunshot or knife injuries? What ethic group has the most teenage pregnancies. What percentage of each ethic group are victims of child abuse. What percentage of each ethnic group does the hospital treat.)

I've noticed in my area that the forms now ask if you want to self-identify as a particular ethnicity. If you do not, you can leave it blank. I'm guessing they changed the form in response to complaints. I never answer.

In this country it would be unwise to base medical decisions on someone's ethnicity, since most people are descended from many different ethnic groups. Many people don't even know all their ancestry.

From my white blond hair, fair skin, and blue eyes, you would think I was anglo-saxon, but my great grandfather was 100% native American.

With another branch of the family we thought we knew where our acestors originated until my uncle got into geneology after he retired. He had a genetic test done. There is 0% chance we are from there. Turns out our branch of the family has no genetic markers in common with any of the other branches of the family. After much research it looks like our ancestor was unofficially adopted in the early 1800s.

I also object to the question

Are you married? Single? Divorced? Widowed?

How does that impact caring for the patient?

If someone isn't married, aren't they single? Why the divorced and widowed category?

You can't argue that you are asking to find out if they have a support system. A single person can have a strong support system of friends. The widowed person can have a strong support system of church members. The divorced person could have a strong support system of family. The married person may not have any support from their spouse. Many people who are single are living with someone and have been in a committed relationship for many years.

morte, LPN, LVN · Sep 21, 2016

single means never married. that used to mean the likelihood of children was small. divorced/widowed obviously opens that question up. next of kin would be the issue addressed, next of kin in not whom you want it to be, it is defined under law. that is why a HCP is so important.

KatieMI, BSN, MSN, RN · Sep 21, 2016

Noting patients race/ethnicity is absolutely mandatory for providers as for now and will become even more important in the near future. One may like or hate it but for reasons we do not know yet those 0,00002% or so of the genetic material which make a "black" human being different from a "white" also make these two somewhat different physiologically. We know now that even such common conditions as HTN and breast cancer might need different treatment approaches for two patients very similar in all profile points except that one of them being African descent and another one European.

I definitely would prefer that the job of taking medical history, including family, ethnicity, social and so forth was done by those actually supposed to do it - namely, physicians or mid-level providers. They are educated about significance of findings and can fit them into the disease's picture. Unfortunately, it is uncompatible with time constrains and requirements to report more and more statistics to research agencies. These research agencies, believe me or not, really need this endless checkmarked lists so they could, after sifting through massive statistical data, find correlations, request more data, formulate questions, etc., so eventually every provider in this country could be informed: please do not start treatment of HTN in African American population, especially middle-aged females, from ACE- inhibitors, and especially from lisinopril, they tend to react poorly on it.

Medical history includes tons and tons of questions which are at the best unpleasant and at the worst so personal and intrusive that providers avoid them ever since they got out of school or residency. In 98 times out of 100, none of them really matters, and everybody knows it. But the students, both doctors and mid-levels, are drilled to death in classic history taking because every encounter might be one of those 2 remaining cases. I will never forget a poot guy who was worked up for everything one can think of, partially because of his very concerned wife. Anorexia, weight loss, no energy, etc., and the age just ripe enough for cancer. Turned out, it was deep grief for his recently deceased secret lover of many years, of whom the wife had no idea.

EllaBella1, BSN · Sep 21, 2016

I also object to the question
Are you married? Single? Divorced? Widowed?
How does that impact caring for the patient?

Just my two cents to throw in here- I completely understand where you're coming from with that point, and I agree that in most cases it doesn't directly impact patient care. But as an ICU nurse it often can be important to know if the person is legally married/single/divorced etc from a POA perspective. I can't even tell you the number of times that we've gotten an unresponsive patient and have had to a) locate family, and then b) determine who the legal person would be for a POA... and if you're married it's your spouse, even if you haven't seen them in a decade. So that's why we always ask whenever we get an ICU patient. And if they say separated we have to ask if it's a legal separation.

Now the thing that really pisses me off is when we have a same sex couple who comes in and says they are married, we have to ask if they are legally married and explain that they may not be the POA if their marriage isn't a recognized one legally. That's a terrible double standard-filled conversation that makes me feel like crap to have to have.

NurseSpeedy, ADN, LPN, RN · Sep 21, 2016

I understand that sometimes certain diagnoses are more prevalent in certain populations but asking (or worse, assuming) every single patient that walks through the door seems like overkill (and yes, annoying).

Personally my family tree is so mixed I can't eliminate anything really. The only thing I can answer accurately is, yes, I've been told that I am part this, that, or the other. I remember my grandmother telling me that her mother was so against her being with someone who wasn't Catholic (not a race but using as an example) that my grandfather changed religions. Many years after his death we found out that he was part Jewish, American Indian, and about a dozen or so other backgrounds. Not so many people worry about something so irrelevant when it comes to relationships now. We are all human.

NurseGirl525, ASN, RN · Sep 22, 2016

It is simply for government reporting, nothing more. Certain areas that serve minority ethnicities will get additional government funding.

It has nothing to do with diagnosis or treatment. I honestly have never looked at that info in the chart or computer prior to looking at a patient nor is it designated in any type of unit report.

Asystole RN · Sep 22, 2016

Describing race or ethnicity is done for several reasons as you have heard in this thread and is I believe very valuable.

Identifying race/ethnicity can provide a clue into possible issues or help guide the nursing plan. I used to work in a hospital that was very close to a reservation. Knowing that the patient was native would help indicate what interventions might be successful and what would not.

For example, if you started them on a medication that needed a strict dosing cycle at home forget it...culturally time is not valued and little thought is given to it. Many of them do not have running water at home BUT do have access to clinics...if they can catch a ride or borrow a horse (not kidding). They also have a tendency to have certain diagnosis (lots of studies on this) that will also help clue you in.

Acknowledging race or ethnicity or culture =/= racism.

We are all different, by trying to ignore the differences we are doing the equivalent of sweeping things under the rug. Acknowledge and celebrate those differences.