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Elizabeth Warren says doctors, nurses don't treat black women same way as other women

Specializes in Surgical, Home Infusions, HVU, PCU, Neuro.

Is another politician trying to infuriate nurses?

bug2621, MSN, APRN, NP

Specializes in Cardiology.

*sigh* Her political motives aside...she has a point. Now to generalize and say that all nurses and doctors treat black women differently, is far reaching but there is implicit bias out there, not only have I seen it, I’ve experienced it.

I worked PRN at a hospital and went in around 2 am with 10/10 colicky abdominal pain and I’d had n/v/d for hours. I went to that ED because it was closest to my house. The nurses were nice enough but didn’t seem to take me too seriously. The MD comes in and does an exam and when I wince as he’s palpating, he actually asked “ are you sure that really hurts” with a very condescending tone. They were treating me like a drug seeker, even after I told them I was a nurse there. They finally ordered a CT and gave me a bag of fluids and protonix, saying it was acute gastritis. The MD even said my CT was negative. The pain went away but returned with a vengeance that afternoon. This time I went to the hospital I worked full time at. One of the residents recognized and pulled my records from the hospital. He told me that everything I was experiencing sounded exactly like gallstones and when he pulled my CT (from the other hospital) it confirmed it. I went to surgery that night because it was so inflamed.

So whether you believe my story story or not, take a moment to do some research on this matter and you’ll see that lots has been done, especially in regards to the AA are treated for pain by providers.

I'm originally from Massachusetts.

I think her claim is as valid as her "claim"of a certain heritage she boasts of.

The percentage (degree) of it, doesn't provide the whole picture.

Will there be prejudiced individuals? Of course there will be.

Do those prejudiced individuals represent the "entire picture?" Of course not.

In this case, the "entire picture" according to Warren, exists on prejudice alone?

No way this nurse will be voting for her now.

MunoRN, RN

Specializes in Critical Care.

On 4/28/2019 at 11:43 AM, KonichiwaRN said:

I'm originally from Massachusetts.

I think her claim is as valid as her "claim"of a certain heritage she boasts of.

The percentage (degree) of it, doesn't provide the whole picture.

Will there be prejudiced individuals? Of course there will be.

Do those prejudiced individuals represent the "entire picture?" Of course not.

In this case, the "entire picture" according to Warren, exists on prejudice alone?

No way this nurse will be voting for her now.

Where are you getting that Warren said prejudiced individuals represent the "entire picture"?

1 minute ago, MunoRN said:

Where are you getting that Warren said prejudiced individuals represent the "entire picture"?

“That doctors and nurses don't hear African American women's medical issues the same way that they hear the same things from white women (Elizabeth Warren, 2019).”

Notice. She didn't use the word "some," or a few. She painted us nurses, and also the MDs to push her claim.

MunoRN, RN

Specializes in Critical Care.

On 4/28/2019 at 3:42 PM, KonichiwaRN said:

“That doctors and nurses don't hear African American women's medical issues the same way that they hear the same things from white women (Elizabeth Warren, 2019).”

Notice. She didn't use the word "some," or a few. She painted us nurses, and also the MDs to push her claim.

You quoted her stating that the "entire picture" exists on prejudice alone, it doesn't appear she actually said that, she specifically stated that there are other factors involved as well.

You're correct that she didn't use the word "some", she also didn't use the word "all" or otherwise imply that. You seem intent on criticizing her statement based on things she didn't actually say.

11 minutes ago, MunoRN said:

You seem intent on criticizing her statement based on things she didn't actually say.

“And there is a specific problem, as you rightly identified, for women of color who are three, four times more likely to die in childbirth,” Warren said. And here's the thing, even after we do the adjustments for income, for education, this is true across the board. This is true for well-educated African American women, for wealthy African American women, and the best studies that I'm seeing put it down to just one thing, prejudice,” she added (Fox News, 2019)."

Notice the phrase, "just one thing--and prejudice."

MunoRN, RN

Specializes in Critical Care.

23 hours ago, KonichiwaRN said:

“And there is a specific problem, as you rightly identified, for women of color who are three, four times more likely to die in childbirth,” Warren said. And here's the thing, even after we do the adjustments for income, for education, this is true across the board. This is true for well-educated African American women, for wealthy African American women, and the best studies that I'm seeing put it down to just one thing, prejudice,” she added (Fox News, 2019)."

Notice the phrase, "just one thing--and prejudice."

She acknowledged the other known causes of outcome disparities and pointed out that even when we adjust for those known factors there is still a disparity, the evidence shows that this remaining factor is prejudice, which is a correct statement.

Prejudice. A subjective variable that cannot be quantified nor observed, being stated as the one singular thing that explains a outcome in the health industry.

According to Elizabeth Warren.

Nah, not buying it. Seriously, how dare she place us nurses (and even the MDs) as being prejudiced for our patients.

MunoRN, RN

Specializes in Critical Care.

23 hours ago, KonichiwaRN said:

Prejudice. A subjective variable that cannot be quantified nor observed, being stated as the one singular thing that explains a outcome in the health industry.

According to Elizabeth Warren.

Nah, not buying it. Seriously, how dare she place us nurses (and even the MDs) as being prejudiced for our patients.

She specifically referenced that there are other known causes of disparity, but correctly pointed out that those causes don't explain the entire disparity, a portion of it is due to differences in how we treat patients based on race.

There are number of studies and meta-analyses on the subject, feel free to offer your criticisms of the evidence. But reflexively dismissing that this is a problem is a big part of the problem.

And which of these studies can quantify the variable, "prejudice?"

The burden of proof exists with Elizabeth Warren. She claimed prejudice.

Now, quantify it.

MunoRN, RN

Specializes in Critical Care.

23 hours ago, KonichiwaRN said:

And which of these studies can quantify the variable, "prejudice?"

The burden of proof exists with Elizabeth Warren. She claimed prejudice.

Now, quantify it.

Prejudiced based health disparity refers to differences in health outcomes that are due solely to differences in how patients are treated based on race, where all other known factors have been removed, as an example this can include that black patients are less likely to receive diagnostic tests given the same presentations and factors other than race.

The main metanalysis on this came out in 2002, with subsequent research continuing to show the same findings.

subee, MSN, CRNA

Specializes in CRNA, Finally retired.

3 hours ago, MunoRN said:

She acknowledged the other known causes of outcome disparities and pointed out that even when we adjust for those known factors there is still a disparity, the evidence shows that this remaining factor is prejudice, which is a correct statement.

OR it could be due to an unknown factor, if you want to be logical about it . She probably heard the same program on NPR that I heard. I'm evolving as fast as I can(!) but I admit that I have unconscious prejudices that influence my behavior with patients, as much as I don't want this to happen. Could Elizabeth Warren please explain what we are supposed to DO to solve this incredibly complex problem? She is mouthing off about a weakness to curry votes and it's just a little sleazy. It's a cheap ploy. Too bad because I like some if her policies but she isn't going to beat Trump with this throwaway comment.

MunoRN, RN

Specializes in Critical Care.

22 minutes ago, subee said:

OR it could be due to an unknown factor, if you want to be logical about it . She probably heard the same program on NPR that I heard. I'm evolving as fast as I can(!) but I admit that I have unconscious prejudices that influence my behavior with patients, as much as I don't want this to happen. Could Elizabeth Warren please explain what we are supposed to DO to solve this incredibly complex problem? She is mouthing off about a weakness to curry votes and it's just a little sleazy. It's a cheap ploy. Too bad because I like some if her policies but she isn't going to beat Trump with this throwaway comment.

The reasons why non-whites receive different care likely contains at least some if not many unknowns, but we do know that they receive different care, and that those differences are likely result in different outcomes.

It should noted that much of this is likely not due to overt racism, there are a variety of reasons why providers may treat non-whites differently separate from any intentional discriminations.

As an example, there is evidence that non-whites more likely to decline taking a new medications, separate from lack of insurance, financial hardships, or other concomitant factors. A provider considering prescribing a new medication may consciously or unconsciously consider this and be less likely to prescribe medications to non-whites.

bug2621, MSN, APRN, NP

Specializes in Cardiology.

31 minutes ago, subee said:

OR it could be due to an unknown factor, if you want to be logical about it . She probably heard the same program on NPR that I heard. I'm evolving as fast as I can(!) but I admit that I have unconscious prejudices that influence my behavior with patients, as much as I don't want this to happen. Could Elizabeth Warren please explain what we are supposed to DO to solve this incredibly complex problem? She is mouthing off about a weakness to curry votes and it's just a little sleazy. It's a cheap ploy. Too bad because I like some if her policies but she isn't going to beat Trump with this throwaway comment.

You don’t have to be “logical” about it. There’s studies on top of studies about it. Honestly, the first step is to acknowledge you have a bias and that these biases exist. Then taking the steps to try to combat these biases.

Heres maybe a starting point: http://www.ihi.org/communities/blogs/how-to-reduce-implicit-bias

Statistics and studies back her claim. Instead of arguing about the (multiple) studies, we could all proactively acknowledge our potential biases and work towards fixing the problem.

Leader25, ASN, BSN, RN

Specializes in NICU.

Oh Pocahontas,look how many women have been spared an early demise by you not practicing in the Medical field.Thank you for not being an RN,MD,Nurses Aide,NNP-you have spared many innocents.

KalipsoRed21, BSN

Specializes in Currently: Home Health.

I think the hardest thing for white people to ever admit to themselves is that, by far and large we have benefits related to our skin color. It is really hard to see because we are like “Dude, I’ve struggled, how is that different from others struggling?”

Well here is a real time example. In Illinois they just enacted a minimum age to be at home alone law. The minimum age is 13 and if your children are at home alone and underage your children can be taken into custody and you get charged with neglect.

The majority of white people are like well that’s ridiculous! Now I have to hire a baby sitter or get my mom to come over.

The majority of minorities are like I can’t afford a babysitter, I don’t live close to an after hours school program, my mom’s in jail for double parking, my employer won’t adjust my schedule, and if I quit my job I get kicked out of my housing. So I’m going to tell my kids to be quite until I can get home because that is all I see as an option. Then they get caught disobeying the law, the kids now have no family because mom’s in jail and she can’t get a court hearing for 2 years because of back log. And white people are like, “well it is the law and you have to obey it, I mean really it is for your children’s safety.”

Is it for the children? (‘Cause y’all I was home alone at 8.) Or is it a legal way to keep those of color in the worst socioeconomic part of society and then we can tell ourselves we weren’t being racist?

BTW I am white. I hate ANY accusation that I have treated any patient unequally, but I have started to recognize that some of the “rules” that make patient non compliant are really kind of elitist and racist too.

I truly don’t believe any of us want to treat non white citizens differently, but I do believe we do.

Edited by KalipsoRed21

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