Racial Refusals In Nursing

[TheCommuter]

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.

[NRSKarenRN, BSN, RN]

See my thread @ Why a Philadelphia hospital gave in to a racist demand

Ten years later, February 23, 2013, Houston Chronicle article illuminates this hidden healthcare issue: Some hospitals grant patients' racist requests

Quote

In the latest example, a white man with a swastika tattoo insisted that black nurses not be allowed to touch his newborn. That led several black nurses to sue the Michigan hospital, claiming it bowed to his illegal demands, and a rapid settlement in one of their lawsuits....

...The Michigan cases follow a 2010 decision by the 7th U.S. Circuit Court of Appeals, which held that the federal Civil Rights Act prohibits nursing homes from making staffing decisions for nursing assistants based on residents' racial preferences. The ruling stemmed from a lawsuit filed by a black nursing assistant who sued her employer for racial discrimination.

In another federal lawsuit filed in 2005, three black employees of Abington Memorial Hospital near Philadelphia claimed they were prevented from treating a pregnant white woman by her male partner, who was a member of a white supremacist group. The man used a racial slur when forbidding any care by any African-Americans.

The complaint alleged that supervisors honored the man's request. The case was settled confidentially before going to trial, and the hospital admitted no liability. Frank Finch III, the attorney for the employees, said hospital officials also cited employee safety in their defense.

"That defense doesn't fly under the anti-discrimination law," Finch said. "Hospitals cannot use that as a defense in nonemergency situations."

He said every hospital has a policy against discrimination and "undoubtedly acquiescing to such a demand is a violation of a written, internal policy in addition to being a violation of the law."...

[macfar28]

We have this happen all the time on my unit - free standing inpatient adult psych. Our management and many of my fellow staff members bend over backwards to accommodate these requests. Yes, sometimes patients are in fact delusional or truly influenced by their mental illness. However, more times than not, they are just closed minded and down right mean. It's very disheartening.

[Here.I.Stand, BSN, RN]

MaryAnnD said:

I once received a complaint regarding an unnamed 'fat blonde nurse' so I sent it back and stated it could have been anyone, questioned why they had sent it to me as the patient didn't give a name. I said it was offensive that they had chosen me and if they checked the roster I never was on duty when the patient was there. Nursing manager sent me on a customer care course for my troubles.

Must have been you b/c the pt described a FAT nurse?? It sounds like you handled that more gracefully than I would have...good for you saying something though.

[MECO28, BSN, RN]

I recently took care of a guy who likely assumed, because I am white, that I wouldn't be offended by his disgusting racial slurs. I was changing his dressing while he watched some stupid program on TV and he let loose with a bunch of crap about "dumb [insert terrible racial slur here]." I stopped what I was doing, gave him the Death Stare and told him that language isn't tolerated by anyone of any color in the hospital. He fell all over himself apologizing and when his non-white doctor came in the room he was Mr. Pleasant.

On a side note, if you're sitting there with multiple pus-leaking abscesses that are the result of shooting black tar heroin into every available space on your body then maybe you aren't in much of a position to look down on anybody else. Idiot.

[Preeps]

Ok let me ask you this, first you "profile" the patient that you say qualifies as one most likely to refuse on the bases of race. However, you in saying most likely elderly are in a sense continuing the very same profiling and prejudice you supposedly despise against a segment of the population.

Another question, would you consider every patient who is not black who complains about a black nurse as a racist? Or could you actually consider that this patient is not prejudice and this nurse is lacking in some way to meet the needs of her patent?

[NurseDirtyBird]

Preeps said:

OK let me ask you this, first you "profile" the patient that you say qualifies as one most likely to refuse on the bases of race. However, you in saying most likely elderly are in a sense continuing the very same profiling and prejudice you supposedly despise against a segment of the population.

Another question, would you consider every patient who is not black who complains about a black nurse as a racist? Or could you actually consider that this patient is not prejudice and this nurse is lacking in some way to meet the needs of her patent?

How is explaining that there is clearly a difference in values between one generation and another profiling? Nobody said all elderly people are racist. Just the ones that complain about (insert your racial slur of choice). Complaining about a black nurse because the nurse is black is racist. Complaining about a black nurse because s/he gave the patient poor care is not racist. And the OP did not say any differently. How is this difficult to understand?

[Ruby Vee, BSN]

Preeps said:

Another question, would you consider every patient who is not black who complains about a black nurse as a racist? Or could you actually consider that this patient is not prejudice and this nurse is lacking in some way to meet the needs of her patent?

I guess it would depend upon whether the complaint was worded "Get rid of this (bad word meaning a nurse whose ancestors may have originated in Africa) and get me a white nurse!" or "Can you please change nurses for me please? I'm concerned that this nurse never washes her hands and touched the needle with her bare finger before she tried to stick me."

[Preeps]

Yes I agree with you. I was specifically addressing it to the OP who coined her term, "racial refusing." I agree there are racist (of all colors) out there. But just because someone declines a nurse and they are of a different race does not mean they are racist.

[ClaraRedheart, BSN, RN]

This is something that I do not like to see... I've had patient's confide their nasty racist comments about my coworkers in me, assuming that I would be sympathetic because I am white. I'm honestly not sure of what to say, but I feel disgusted and horrified. We had many immigrant nurses at a hospital that I used to work at, and I've had patient's treat me (the CNA at the time) as sweet as pie, and then when the nurse is in the room (if he/she is of color) loudly accuse them of hitting them, stealing their things, etc... Unfortunately, management sometimes took complaints from these people seriously, so the nurses had to make sure they were accompanied by someone else when they ventured into these patient's rooms. It is sad that in this day and age many nurses still face a hostile work environment simply because of their skin color.

As Ruby mentioned, sometimes the complaints are valid, but in some cases patient's will look for any reason to complain against and fire a nurse of a different background because they are aware that their racism is socially unacceptable. Personally, I think that complaints by patients against caregivers deserve close scrutiny if racism could be suspected.

[TheCommuter, BSN, RN]

Preeps said:

But just because someone declines a nurse and they are of a different race does not mean they are racist.

True, but the patient who makes a racial refusal is usually straightforward about the nurse's race being the main reason for the rejection.

I'm the OP. I live in a former Confederate state where old attitudes toward the different races have not yet died. When a racial refusal is made, and the caregivers involved are black, a blunt patient or family member will usually tell the supervisor, "You'd better not have any more of those ******* (insert N-Word racial slur) in my room caring for me!"

A more genteel patient will word the request in this manner: "I don't want any (black, white, Filipino, Indian) nurses or aides in my room, please."

So if the patient is refusing a caregiver based on racial-ethnic background, this is usually indicative of lingering racist sentiments toward people.

[Ruby Vee, BSN]

Preeps said:

Yes I agree with you. I was specifically addressing it to the OP who coined her term, "racial refusing." I agree there are racist (of all colors) out there. But just because someone declines a nurse and they are of a different race does not mean they are racist.

I'm not sure if it's me you're agreeing with -- or addressing. There's a "Quote" button on the lower right hand corner of each post -- if you use it, we'll know who you're addressing and/or agreeing with. Thanks.

[Here.I.Stand, BSN, RN]

Of course not. Someone who complains about a black nurse who is incompetent is not necessarily racist. Someone who assumes incompetence and refuses care BECAUSE a nurse is black, is.

Preeps said:

Another question, would you consider every patient who is not black who complains about a black nurse as a racist? Or could you actually consider that this patient is not prejudice and this nurse is lacking in some way to meet the needs of her patent?