'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.
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.
When I worked in acute care 16 years ago at a small town hospital we would run into racial requests from the elderly several times a year. Now I'm in home health and what I hear from my elderly pts is I don't want a male nurse or, I don't want a female nurse. Well, the elderly woman ended up with a male nurse coming to see her just a couple of days after she had declared no male nurses. When I saw her two days later she was singing a different tune, he had won her over. As for the elderly gentleman who didn't want a female nurse attending to the rash on his private parts, his attitude changed to one of thankfulness for the care he was receiving. I am not the least bit surprised that in 2014, there are still medical facilities willing to reassign staff members because a pt has a prejudice against a black nurse, male nurse, gay nurse or female nurse. Corporations primarily care about their bottom line not their employees, so when these prejudices arise many facilities will try to accommodate. Pt's are revenue. Most prejudice is based upon fear and ignorance not choice, (skin heads and KKK type groups are the exception to the rule). Pity the prejudice, pray for them, or, teach them by example, but don't join them. Nurses are supposed to treat each and every patient with the same level of care, dignity and respect regardless of the pt's disposition, education or ability to pay. When I hear a nurse say "...patients who are not actually paying for their care have no business..." I am listening to that nurse' own prejudiced way of thinking, which in my mind is far worse than any prejudiced commentary a pt could make. As nurses we took an oath to first do no harm and to provide equal care to all of our pt's regardless of circumstance, and that includes whether or not they have offended us. I never attended a class where the instructor stood up and talked about how easy and rewarding it was going to be to deal with the public. If your a nurse and you are carrying your own prejudice towards certain types of pts, that is going to affect the level of care you provide to them. When you allow that to happen you become one of those nurses who can't be trusted to provide quality pt care and eventually the pt's family starts appointing someone to stay in the room with their loved one around the clock because they no longer trust the nurses at that facility. Some pts are just down right mean and they take pleasure in making you miserable, if you can't care for them the same as the sweet ones, maybe your forte is in administration and not bedside nursing. And, by "you" I mean any nurse.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Starfire61 said:
When I hear a nurse say "...patients who are not actually paying for their care have no business..." I am listening to that nurse' own prejudiced way of thinking, which in my mind is far worse than any prejudiced commentary a pt could make.
I'm the author of the piece checking back in. I just wanted to mention that every single person possesses distinct attitudes, prejudices, values and preconceived notions. No individual in existence is totally free from prejudice and bias.
Starfire61 said:
As nurses we took an oath to first do no harm and to provide equal care to all of our pt's regardless of circumstance, and that includes whether or not they have offended us.
I respectfully disagree with you on this particular point. No nurse took an oath to be offended, assaulted, called ugly names and disrespected due to reasons they cannot control such as racial/ethnic background.
A customer who mistreats a bank teller will be escorted out of the bank by security. A traveler who offends an airline pilot will be escorted off the plane by the Air Marshall. A client who offends his personal trainer will soon be without a personal trainer. On the other hand, nurses are expected to smile, suck it up and deal with the disrespect. After all, sick people act out. Right? Stressed family members act out. Right? Give me a break!
According to our health care law,facilities cannot discriminate based on race,disability,place of origin,sexual orientation etc;based on these tenets...... this holds true for patients as well as members of staff. When a patient/resident enters a health care facility,the patient or his relative already knows his rights,and responsibilities. The fact that the individual has consented to treatment,he has also consented to accepting care from the nurses, CNA's, techs etc.,unless he has a genuine complaint which should be thoroughly investigated,but a complaint of I don't want any negroes, or whites to be involved in my care should not be tolerated....this is blatant racial discrimination,and we should not accommodate such atrocity.
Specializes in L&D, CCU, ICU, PCU, RICU, PCICU, & LTC..
trishmsn said:
I agree with tolerating dementia patients, as they often get fixated on small things (such as being convinced that one CNA "steals" the eggs off her plate....she doesn't GET eggs due to an allergy!)
About twenty years ago, I was the DON of a 120 bed SNF in the south, and had a perfectly alert and oriented white patient AND his family insist that he absolutely, positively could not share a room with one of "those" people (melanin enhanced gentleman, who was post CVA and quiet as a churchmouse.) I agreed to move Mr. Bigot, but made it clear that I only had ONE male bed [which was mostly but not exactly true....] sooooo
INSTEAD of his quiet former roomate, he got to share a room with a demented patient who screamed most of the day...and had even louder screaming night-terrors when it was dark. But hey, he was WHITE!! (evil grin).
I love those who handle people in this manner. Do exactly what they want, but still get your point across. Hard for them to complain about getting their 'due'. LOL
Give them the laziest white CNA's and the dumbest white nurses, and we all know most facilities have those.
I think it is a disgrace that there are patients presumptuous enough to make such a request. Don't even get me started on the ones who have medicare and medicaid. I seriously wish people would get over themselves.
I agree...it is a disgrace when patients make such requests. But...I have been left assigned to patients that have requested a different nurse and it make the shift miserable for both of us. If I requested a different nurse and something went wrong, I would be pretty quick to point that out. "I knew something bad would happen if that nurse took care of me!" My question is...why is making such a request worse if the patient is on Medicare? Everyone who works in the United States pays taxes specifically toward Medicare. I believe the current rate is 1.45% of taxable earnings. Medicare is available to almost everyone in the United States once they reach age 65. There is a tremendous difference between Medicare and Medicaid. Also...do people who are on Medicare and Medicaid have no right to complain about anything? Should someone be allowed to give substandard care because they don't have the "right" insurance?
"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! "
I agree 100% with you Yasmin. We nurses did make a choice to be in a caring profession. Like you, I wear a head cover for religious reasons (snood, not a veil), and it is amazing how many people, patients and co-workers, have difficulty looking past the head covering. I have been fortunate. So far, only one patient has out-right been rude about not wanting me to care for her, but wouldn't admit that prejudice was the problem. After observing her with a different caregiver, I went to one of my co-workers and we switched assignments. It was the right resolution for both the patient and me. Peace be with you. Miryam
MAKimsey, This is a question not meant to be disrespectful but shearly based on my own ignorance. With the issues about infection control, doctors are told not to wear ties, nurses stopped wearing nurses caps, do you think it will become an issue with your wearing of a head dress of any kind?
I have been living and working in South Louisiana for the last 35 years and cant recall any problems with people requesting no blacks. If so there would be times there was no one to care for them . I have offended people myslef and they requested I not take care of them. I believe this point can usually be handled by smooth talking administrators, etc.
In a private business like a restraunt you can request anything and the amount your business is desired it will be met. There are very few non hispanics working in restraunts around here. The skills used in a restraunt are quite different from those of a hospital and this is not a good comparison.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Lightning Lewis said:
In a private business like a restraunt you can request anything and the amount your business is desired it will be met. There are very few non hispanics working in restraunts around here. The skills used in a restraunt are quite different from those of a hospital and this is not a good comparison.
It's a fine comparison. It's not about skills -- it's about skin color. A restaurant patron who requested a different color of server might actually get it -- but I guess the cooks might pee in his soup, too.
Starfire61
19 Posts
When I worked in acute care 16 years ago at a small town hospital we would run into racial requests from the elderly several times a year. Now I'm in home health and what I hear from my elderly pts is I don't want a male nurse or, I don't want a female nurse. Well, the elderly woman ended up with a male nurse coming to see her just a couple of days after she had declared no male nurses. When I saw her two days later she was singing a different tune, he had won her over. As for the elderly gentleman who didn't want a female nurse attending to the rash on his private parts, his attitude changed to one of thankfulness for the care he was receiving. I am not the least bit surprised that in 2014, there are still medical facilities willing to reassign staff members because a pt has a prejudice against a black nurse, male nurse, gay nurse or female nurse. Corporations primarily care about their bottom line not their employees, so when these prejudices arise many facilities will try to accommodate. Pt's are revenue. Most prejudice is based upon fear and ignorance not choice, (skin heads and KKK type groups are the exception to the rule). Pity the prejudice, pray for them, or, teach them by example, but don't join them. Nurses are supposed to treat each and every patient with the same level of care, dignity and respect regardless of the pt's disposition, education or ability to pay. When I hear a nurse say "...patients who are not actually paying for their care have no business..." I am listening to that nurse' own prejudiced way of thinking, which in my mind is far worse than any prejudiced commentary a pt could make. As nurses we took an oath to first do no harm and to provide equal care to all of our pt's regardless of circumstance, and that includes whether or not they have offended us. I never attended a class where the instructor stood up and talked about how easy and rewarding it was going to be to deal with the public. If your a nurse and you are carrying your own prejudice towards certain types of pts, that is going to affect the level of care you provide to them. When you allow that to happen you become one of those nurses who can't be trusted to provide quality pt care and eventually the pt's family starts appointing someone to stay in the room with their loved one around the clock because they no longer trust the nurses at that facility. Some pts are just down right mean and they take pleasure in making you miserable, if you can't care for them the same as the sweet ones, maybe your forte is in administration and not bedside nursing. And, by "you" I mean any nurse.