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.

[Ruby Vee, BSN]

applesxoranges said:

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.

Years ago, a fairly well-known neo-Nazi leader (locally, anyway) had an MI. He went down and came to our ER by ambulance. The physician on call was Black. The cardiologist was Jewish and the cardiac surgeon was Muslim. What surprised me was that the guy was very meek and very pleasant to all. The only person he objected to was his Native American nurse, and she was the kindest and sweetest person I've ever worked with!

[sandyfeet]

It makes me sad to hear that nurses even have to deal with this. It is a really depressing state of affairs and I would furiously defend any of my co-workers being maligned for such a lame reason! My virtual nursing cap is off to those of you who deal with this and maintain professionalism.

[eliza dumoure]

This is called discrimination and it is against the law. A place I once worked at had the following statement on the patient's careplan, 'no colored caregivers'. The institution was sued and lost, rightly so.

[dorselm]

I had a patient who had Alzheimer's disease. She was as sweet as pie while I was giving her some applesauce with her meds. She said can I please have some more and thank you. When I had to turn her to change her dressing, she called me the N word in every ugly way that you can think. I never responded. When I was finished caring for her, I made sure she was tucked in and comfortable and she said "Thank you sweetheart."

[la_chica_suerte85, BSN, RN]

Although it is a little whack for a facility's sole motivation to accommodate a patient is to keep scores up, it is how reality works -- money comes from metrics and there's no room for anecdotal evidence. I agree with you that these people are severely unaware of their hypocrisy in taking advantage of resources paid for with taxes paid by people from ALL backgrounds and it makes sense that there is no point in trying to do the noble thing and put your license/career in harm's way by taking care of someone who despises you based on the color of your skin. Yeah, it would be nice if people could just get real and get over themselves but, I guess, if a patient refuses care from anyone for any reason, it should be accommodated. We take care of the whole person, ugly, backwards ideologies and all and, though we know the haters tend to suffer more ill health than those who are more open-minded, that's on them. There's no point in causing them distress by forcing the issue, no matter how disdainful their beliefs about people different from them are.

[cinlou, BSN, MSN, RN]

It is painful to hear someone say to you they don't want you to care for them, no matter what the reason is. Everything in our heart and soul that made us want to be nurses, tells us that we are here to care for them and do our best job. We care and it is difficult to understand why someone would be selective about someone who cares for them based on their appearance and not the skill. We deal with all kinds of cultures now and we have to take cultural sensitivity classes. We take care of cultures who state that a male cannot care for a female patient, and yet the male doctor can, I have taken care of patients who didn't want the fat nurse because they must be lazy, older patients who didn't want someone because they looked to young, and yes those who did not want someone because of their color. If there are personality conflicts I have tried to adjust patient assignments because I did not feel it was fair to the nurse or the patient, but this is not always possible and I have told the patient this. As a manager I would try to support both my staff and the patient. When I started in nursing school many years ago we were taught that our feelings did not really count we were there for the patient and when we entered the facility we put aside our own beliefs and supported the patients. Abuse was taken because the patient was ill and we just accepted it, I have went home with bruises, hand prints, scratches you name it. But times have changed, and violence is not accepted and should never have been, (obviously different issue with a dementia patient). Working in the ED we can now call police and have a patient dealt with depending on their medical needs. We do not need to take being treated like dirt. But our managers and administration must also support this. We can not always change assignments, but if we can we should support our peers. We need to be advocates for each other, something that nursing has not been very good at.

[AdamantiteEnigma]

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.

Personally, I feel that the advent of the Press Gainey system had some pretty far reaching and unanticipated consequences for healthcare professionals. The new way seems to translate to good patient review scores at our cost. It's perplexing for sure in terms of how to suggest addressing the problem. There are some great things that have come to pass with the system as well. I'd hate to see those things lose importance. Yet less of those moments you feel run over by those reviews would be welcome.

[LBear76]

I think the biggest question of all is why someone would want to be the nurse for a patient who hates them because of their race, gender, eye color, or whatever else. Nursing is hard enough, who is seriously a big enough masochist that they want to spend a 12 hour shift with a bigot who hates them for no reason. If someone didn't want me as a nurse for some ignorant, redneck reason, I would probably be ******, but then breath a sigh of relief that I dodged that bullet. Then I would allow some other poor nurse to clean up that Miss Daisy's poop all day, and spend my shift taking care of patient who wasn't a complete waste of space

[anie10]

eliza dumoure said:

This is called discrimination and it is against the law. A place I once worked at had the following statement on the patient's Care Plan, 'no colored caregivers'. The institution was sued and lost, rightly so.

Not every organization is obtuse enough to document their foibles, like your former employer.

Many times it is very subtle, and very under the radar.

[tacomaster]

Obviously the only people who can be racist are white people towards blacks (sarcasm).

I've seen women nurses denied by Arab guys (and if they do have to have a female nurse the nurse is ignored all shift) , Pakistani patients not wanting Indian nurses, women not wanting any males, wives requesting male nurse only because they don't want their husbands to be with female nurses (fear the husband may cheat on them/seduce the nurse). I just let it roll off my shoulders. Who cares? Every one has their own issues and back story. If they're ignorant, that's their problem. I just provide them the best care that I can.

[ThePrincessBride, MSN, RN, NP]

tacomaster said:

Obviously the only people who can be racist are white people towards blacks (sarcasm).I've seen women nurses denied by Arab guys (and if they do have to have a female nurse the nurse is ignored all shift) , Pakistani patients not wanting Indian nurses, women not wanting any males, wives requesting male nurse only because they don't want their husbands to be with female nurses (fear the husband may cheat on them/seduce the nurse). I just let it roll off my shoulders. Who cares? Every one has their own issues and back story. If they're ignorant, that's their problem. I just provide them the best care that I can.

No one said racism only involved whites against blacks, however, blacks are definitely the most visible minority and have a pretty unique history that mirrors no other group in America. We're also the only group in America that has been systematically oppressed besides Native Americans. So it should be no surprise that most examples here on this thread involve a white and black person.

[texasboy]

The subject is so real and truth that we lost the feeling about it. We do a job daily which is "get to go" no time to look behind. I am not saying , we don't do the check & balnce , just don't have time to see everything. This thing were here , is here and possibly will be here for how long , just we don't have answer. I enjoyed reading it. thanks.