'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.
What about just saying to the patient or family something like "I'm sorry, but according to law, we are not allowed to assign nurses (caregivers, aides etc.) on the basis of race. We have people of various races working here and everyone is properly trained. Perhaps you will get a "white" nurse (aide, therapist, doctor), but no one can guarantee it."?
Is this any different than saying, "I'm sorry but it is against hospital policy to have your own supply of medications at your bedside (or to keep alcoholic beverages in your room , or allow your dog to sleep with you in your bed, etc. etc.)? There are usually policies that we must acquaint patients with on admission. And if presented right away, before a situation arises, they are usually accepted, even if grudgingly. Even in the South where I live, patients may express preferences, but they have long ago learned to comply with antidiscrimination laws.
In my experience, when a patient is discharged, dissatisfactions are usually due to diet, loss of privacy, how he has been treated, how long he has had to wait for things etc. There may be complaints about certain people he has encountered, or what they did or did not do. But knowing from the start that he will have no choice about the race of hospital employees he deals with, the complaints are seldom if ever racial.
In fact, I've seen several cases when, having become acquainted with someone he initially sought to avoid, a patient ends up praising them the most.
I don't think it even matters how the bill is paid (private or government) As nurses we try to treat everyone equally. And I think we are not being unfair to ask the same from our patients
Here's the thing--If a patient doesn't want a certain race caring for them, and there is no other alternative, the patient already has pre-concieved notions regarding the caregiver. The last thing that I would want is a patient who is verbally carrying on the entire shift. And I would think it unfair to subject the nurse to this all shift. In the name of Press Ganey is equally as disturbing.
I am perplexed as to if a patient is critically ill, and needs medical care, the last thing on one's mind should be the race of the caregiver. If a patient is dependent on the care of others, I would think the goal would be to have medical needs met. It would be an interesting study to compare critically ill patients vs. chronically ill patients. Some chronically ill patients are not compliant regarless of race--but can and do use that "excuse" to be non-compliant at someone else's "fault".
In my neck of the woods, this doesn't happen. And quite frankly, if a patient is well enough to start in on the race of the nurse, then, welp, let's start a discharge plan, shall we?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
DosmoRN said:
What about just saying to the patient or family something like "I'm sorry, but according to law, we are not allowed to assign nurses (caregivers, aides etc.) on the basis of race. We have people of various races working here and everyone is properly trained. Perhaps you will get a "white" nurse (aide, therapist, doctor), but no one can guarantee it."?
Is this any different than saying, "I'm sorry but it is against hospital policy to have your own supply of medications at your bedside (or to keep alcoholic beverages in your room , or allow your dog to sleep with you in your bed, etc. etc.)? There are usually policies that we must acquaint patients with on admission. And if presented right away, before a situation arises, they are usually accepted, even if grudgingly. Even in the South where I live, patients may express preferences, but they have long ago learned to comply with antidiscrimination laws.
In my experience, when a patient is discharged, dissatisfactions are usually due to diet, loss of privacy, how he has been treated, how long he has had to wait for things etc. There may be complaints about certain people he has encountered, or what they did or did not do. But knowing from the start that he will have no choice about the race of hospital employees he deals with, the complaints are seldom if ever racial.
In fact, I've seen several cases when, having become acquainted with someone he initially sought to avoid, a patient ends up praising them the most.
I don't think it even matters how the bill is paid (private or government) As nurses we try to treat everyone equally. And I think we are not being unfair to ask the same from our patients
There's a lot of wisdom in nipping the whole idea of racial refusals in the bud by announcing right up front it's against hospital policy to assign staff on the basis of race. And who could publiclly find fault with such a policy? (Well, NeoNazi's, I suppose, but I don't count them as sane or reasonable people.)
As far as how the bill is paid -- the whole idea that it matters has been bothering me since it was first brought up early in the thread. I never know whether my patients have insurance, what kind they have or how their bill is paid, and I don't care. It doesn't make any difference in the way I take care of them, nor should it.
Specializes in TCU, Post-surgical, Infection Prevention.
It is interesting to read the perspectives and stories.
Bottom line for me, when I become an RN if I am refused for my blackness so be it. Last time I asserted myself when I was racially discriminated against, I was refused a raise on faulty grounds. This was in goofy Orlando Florida.
My ability to support my family and get what I need to progress supersedes the pride of stomping of in the name.of racial equality. been there, done that and have the ticket stub to prove it.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Preeps said:
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?
Here's a clarification. Below I'll describe a racial refusal that happened to an acquaintance of mine. BTW, she's an experienced telemetry RN who provides great nursing care.
A new patient was admitted to the telemetry floor of a community hospital located in a suburb of the city where we live. The charge nurse assigned my acquaintance to the patient so that she would have a total of four patients.
My acquaintance knocked on the door, walked into the room and announced, "Welcome to ***** Hospital! My name is ***** and I will be your nurse for the evening. My goal is to provide excellent care and get all your questions answered."
The patient snapped, "Get me a white nurse! I don't deal with black nurses!"
My acquaintance was never able to meet this patient's needs because he racially rejected her before she had ever had the chance to care for him. So, this particular racial refusal was never about a nurse lacking to meet the patient's needs. After all, the patient saw that she was black and essentially kicked her out of his room.
Specializes in TCU, Post-surgical, Infection Prevention.
I reread my post and hope it was received as intended.
My only problem with this scenario is those who don't experience this type of treatment seem to frequently respond like this is the most unusual scenario ever. Hello, ever since a certain someone became commander in chief it has started to give me a good idear what 1963 may have been like.
If it has never happened to you, I just request that folk respect the fact that it has happened to us. And we swallow it more often than not because there's no point to rallying the town with torches and pitchforks - unless we have our own Jay Brigance (A Time to Kill) - it's an exercise in futility. And our energies could be better expended in other ways.
In a perfect world that is how the situation would be handled. Unfortunately, we live in a society that values money over and above everything else and with most institutions it is about keeping the numbers up.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Starfire61 said:
In a perfect world that is how the situation would be handled. Unfortunately, we live in a society that values money over and above everything else and with most institutions it is about keeping the numbers up.
Please use the quote function. I have no idea who you're responding to.
I like and support your comments and views. Hospitals who allow these types of accommodations are only reinforcing racism. Shame on all administrator who do not respect their employees. The hospital should be a neutral environment who provide care and not reinforce racial issues. Chapeau .
My favorite was the psych patient purposefully acting out. He didn't like the doctor because she was a white b****. He didn't like the charge nurse because he was black but talked white. He didn't like the short Hispanic nurse because he was Chinese (he doesn't look Chinese). So basically, nothing would have made him happy.
Ruby Vee, BSN
17 Articles; 14,051 Posts
Good luck with that!