Racial Refusals In Nursing

'Racial refusal' is a phrase that refers to the practice of patients and / or family members who refuse care from particular nurses, physicians, nursing assistants, techs and other types of healthcare workers due to the caregiver's racial-ethnic background. Nurses Relations Article

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For starters, 'racial refusal' is a term I constructed several years ago to denote the practice of patients and / or family members who refuse care from certain nurses, physicians, aides, techs and other healthcare workers solely because of the caregiver's racial-ethnic background.

Racial refusals can be inflicted upon staff members of any race, creed, ethnicity or national origin. Also, patients belonging to any racial-ethnic background are capable of refusing particular staff members for reasons that are purely race-based. Most importantly, these refusals tend to throb like a virtual slap in the face whenever they do happen to a person.

I currently live in a part of the country where racial refusals take place with regularity. In fact, the specialty hospital where I am employed is presently attempting to accommodate the racially biased preferences of a patient who has requested that no black members of staff provide any care for her.

Anyhow, these types of requests are normally accommodated at my workplace because nursing management and hospital administration wants to ensure that the facility's Press Ganey patient satisfaction scores remain above a certain threshold. In exchange for favorable patient satisfaction scores and repeat stays, management will attempt to 'WOW!!' the patient by making staff assignments based on racial-ethnic background.

On the other hand, the hospital where I work cannot always reasonably accommodate patients' race-based requests for staff members, especially on the night shift, due to the fact that every single one of the night shift nurses and techs in the entire building might be from the same racial-ethnic background on some evenings.

My views on this issue might be controversial, but here they are. I feel that patients who are not actually paying for their care (read: charity care) have no business refusing caregivers due to race.

I also feel that patients who receive help from the federal government to fund their care (read: Medicare or Medicaid) have no business refusing caregivers of a certain race.

After all, people of all races and nationalities pay taxes that help fund these programs. Finally, I feel that patients who are receiving care at any hospital or other healthcare facility because they lack the education and expertise to provide their own medical treatment and nursing care have no business refusing caregivers due to racial reasons.

One more thought before I depart for the evening.

As a black female, I would prefer that these racially prejudiced patients have their requests accommodated, as contradictory as this may seem.

Here is my reasoning.

A patient who does not want me to serve as his nurse can make boldfaced claims regarding poor nursing care and fabricate allegations of abuse that could make my professional life tremendously miserable. These patients are generally set in their ways, resistant to change, frequently spiteful, and sometimes elderly.

Their racial prejudice is their personal problem of which I want absolutely no part. I would prefer to live and let live.

No matter what you do, always hold your head high in the face of a racial refusal. Even though the patient is essentially rejecting you based on your race, you are still worthy of respect, dignity and a basic right to exist in the society in which we live. It is unfortunate that some people have not changed with the times.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

A patient who rejects a caregiver based on race reveal a lot more about themselves than they'd probably choose to if they were thinking clearly. And yet they know nothing about the caregiver they're rejecting. It could be -- and I've seen it happen -- that they're rejecting the most knowledgable and experienced caregiver, or the caregiver most up-to-date in the thing that's wrong with THEM.

I'm blonde. I've been asked to step in when a patient has rejected a Black nurse. I'm female, and I've been asked to step in when the patient has rejected a male nurse. I've also been rejected on the basis of MY skin color more times than the other two combined. People in my area don't like "fat white nurses." Or so I'm told. Maybe it's OLD fat white nurses.

Personally, I don't think racial rejections ought to be accomodated unless the patient suffers from dementia and is having flashbacks to their time in a Vietnamese prison camp, as a prisoner of the KKK or whatever. No, it's not fun to be racially rejected and have to care for the patient anyway. But it's not fun to be the nurse who is swapped into that assignment and have to listen to their B.S. all night (or day) long, either. Those patients are rarely any MORE pleasant to the nurse who gets swapped for the rejected nurse, and you have to listen to them tell you over and over how they triumphed over that (insert racial expletive and a few general expletives here).

I've always thought -- and think it more strongly all the time -- that Press-Gainey is the anti-Christ.

Of course racism is an issue but so is religious prejudice. I had a patient deliberately lie on me because he was willing to put my reputation in harm rather than be honest about his issues with me being a Muslim woman. He said I was rude to him for no reason. I got out of my way to make my patients and family members feel at ease. I love what I do. Most of us health care workers get in this profession because we generally care about the wellbeing of our fellow man so my message to current and future patients is see through the veil and acknowledge I am here for you, to help care for you and get you well. If you can't I have no problem stepping aside and letting someone else do the job for you. Your loss!

Specializes in Pediatrics, Emergency, Trauma.

Legally, it is against CMS policy for hospitals and facilities that use CMS funds to make such accommodations; and if found making accommodations can be fined for allowing specific accommodations to be allowed; that's why when reports of lawsuit settlements for making accommodations happen as well as make the news; it's not allowed; unfortunately it does continue to happen, and it will.

Specializes in Correctional, QA, Geriatrics.

Yet these same prejudiced patients will never say a peep if their server or sales associate or repair person is a person of color. For some reason they feel it is OK whenever they are receiving health care to complain. I mean I do know they might say something away from the store, restaurant, etc. about the race or ethnic identity of the employee but they will, almost always, eat their meal (most likely prepared by a person of color), wear their clothing items (most likely assembled by a person of color) or use their appliances/electronic devices (quite likely assembled by a person of color) without a murmur of protest. Crazy troll logic to use a

Buffyverse quote.

Specializes in orthopedic/trauma, Informatics, diabetes.

We have not had very many requests for racially chosen (or not chosen) nurses, but as a white nurse working with a very diverse nursing staff, I get many patients that will say something about another nurse assuming that I share THEIR views on a nurse that is Asian or African, or Indian, or Martian. I find THAT offensive: that just because I am the same ethnicity as they are, that I share their views on other ethnicities.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
txredheadnurse said:
Yet these same prejudiced patients will never say a peep if their server or sales associate or repair person is a person of color.

Then again, I received the occasional racial rejection when I was a grocery store cashier.

However, bigoted people tend to view their healthcare as a higher-stakes event than service at the restaurant or clothing store, so perhaps they want some semblance of control by picking and choosing the race of their caregivers.

Also, I've heard the term 'quota clown' thrown around by these people in the past. Some assume that certain groups of people were admitted into college based purely on Affirmative Action, and therefore, might not be as competent as others. For example, a person posted on the comments section of a website that he would never trust a black doctor because "they didn't earn their way into medical school."

Specializes in Correctional, QA, Geriatrics.

"Quota clown" sigh. When will people learn that slinging hate makes the hater look like,dare I say, a clown and ignorant.

Specializes in Critical Care; Cardiac; Professional Development.

I have had patients assume I share thir ethnicentric views as well as their political views. Both anger me.

Specializes in Short Term/Skilled.

I've only had it happen with demented patients, and I've never faulted them, just felt bad for them. I wouldn't want to care for(an a&o) someone who didn't want me to care for them based on my appearance, so It would be fine with me to find them someone else. I just can't fathom someone actually saying the words out loud. "I don't want a black/white nurse" My mind just can't wrap around that....I've suspected it with patients before when they've requested a different caregiver, but It was never confirmed. I just don't know what is wrong with people. So sad.

Your article is very well-written. I guess, nurses would really need to provide the best patient care to the patients. If refusing to a certain nurse of that specific race would make him feel better, why not? The patient has his/her own reasons beyond this. Let's not be skeptical about their reasons. They must have autonomy. Just a thought.

Specializes in Pediatrics, Emergency, Trauma.
amygarside said:
If refusing to a certain nurse of that specific race would make him feel better, why not?

Because of CMS regulations, discrimination is not allowed; that includes making accommodations for pts based on race, culture, ethnicity, religion.

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The patient has his/her own reasons beyond this. Let's not be skeptical about their reasons. They must have autonomy. Just a thought.

No one's being skeptical if they come out and blatantly say "no blacks/whites/Hispanics/Jews/Muslims" even "gays" :no:

Patients have rights AND responsibilities; autonomy only goes so far.

Specializes in Anesthesia, ICU, PCU.

A patient once refused to let me take care of her because of how my deodorant smelled. As a member of the Old Spice community I was deeply offended.