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.

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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.

I have a pt with horrible offensive tattoos but the attitude hasn't reflected the tattoos (so far anyway, fairly new to us). I finished my care with pt, as outraged as I was at the tattoo of a rope, and reference to a certain type of justice. The nurse that did the discharge teaching noticed the other tattoo, of a symbol associated with Hitler and the Nazi party. That tattoo will be very visible to other pts when getting shots and I'm just waiting on the fireworks. We have pts of Jewish descent, one of our providers is Jewish, and this idiot (young person by the way) is going to be flaunting that symbol of hate in front of so many people. Like I said, pt has been nice so far, but when another pt complains or confronts this one, it's going to be interesting. . .

ETA--a majority of our staff are black/Latino/Jewish

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
T-Bird78 said:
I have a pt with horrible offensive tattoos but the attitude hasn't reflected the tattoos (so far anyway, fairly new to us). I finished my care with pt, as outraged as I was at the tattoo of a rope, and reference to a certain type of justice.

Well. . .even though the tattoos are blatantly disrespectful, I give the dude some credit for having a decent attitude toward staff.

Specializes in Emergency and Critical Care.

I wanted to share this with you all, I was talking with my niece about how my brothers could sing Kermit's song its not easy being green and it sounded just like him. I lost one of my brothers a few years ago to renal carcinoma. I have thought about the meaning of his song often over the years, it isn't the whole song but it says that some days are easier than others, enjoy and reflect. It brought tears to my eyes for many different reasons.

I see you are in Fort Worth, TX. Are you saying this is what I have to look forward to should I make it through nursing school? This is wild!

TheCommuter said:
I'm the author of the piece and I'm checking back in. . .

I totally agree with you that accommodating bigoted patients and/or family members sends a backward message. Unfortunately, I live in a part of the country where blatantly revealing one's racially prejudiced views is still somewhat socially acceptable.

You're the only one who came up with that conclusion.

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.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Nursinghopeful817 said:
I see you are in Fort Worth, TX. Are you saying this is what I have to look forward to should I make it through nursing school? This is wild!

It depends on where in DFW you work. These incidents are rare in facilities in south Dallas, etc. Many of my nursing colleagues report the most racially insensitive incidents in the Mid-Cities region and northeast suburbs (NRH, Hurst, Euless, Bedford, Grapevine, Colleyville, and so forth).

WOW!! I live in that area and will keep that in mind!

TheCommuter said:
It depends on where in DFW you work. These incidents are rare in facilities in south Dallas, etc. Many of my nursing colleagues report the most racially insensitive incidents in the Mid-Cities region and northeast suburbs (NRH, Hurst, Euless, Bedford, Grapevine, Colleyville, and so forth).

Me too, located in the very same vicinity !!!!

Here is my take on it. As an LPN, I have never had this happen. I feel if you dont want me as your nurse and you have a problem with me because I am black and your dumb (bleep) assumes that I didn't go to school and bust my (bleep) to become a nurse, and therefore I am incompetent, then take your (bleep) to another facility.

'Nuff said.

You are absolutely correct about those who receive Medicaid or Medicare refusing to have caregivers of another race take care of them.

Its like people don't realize black people and other minorities pay taxes too!

What hurts even more is though is minority pts refusing other minority caregivers.

I have seen many Hispanic patients refuse black caregivers,go figure!

That one boggles the mind!

I work in a small psychiatric hospital and the staff is predominately Caucasian. For the 100 bed hospital there is two African American registered nurses on days and one on at night, with one African American practical nurse that works at night as well. There is one per diem male mental health worker that is African American that is also at night. And two African American ancillary workers at night ; nursing assistant and mental health worker. none of these staff members work at the same time on any unit. Ten percent of the staff is also Asian. Regardless of the percentages racism is not presented that often by patients. But this is not to say that patients do not complain about their caregiver being of a different race. They do it in different ways. Instead of communicating with their nurse / mental health worker they are guarded and wait until they see a white staff and talk to them. On the geriatric unit the dementia patients are open with their issues. And the ironic part is the geriatric psychiatrist is a dark complexion Indian who does not tolerate the racism from the patients and counsels them in meetings when he learns of it. It is the culture of both our country and the times. One day it will truly be history, but now is not the time.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
smartnurse1982 said:
You are absolutely correct about those who receive Medicaid or Medicare refusing to have caregivers of another race take care of them.

Its like people don't realize black people and other minorities pay taxes too!

What hurts even more is though is minority pts refusing other minority caregivers.

I have seen many Hispanic patients refuse black caregivers,go figure!

That one boggles the mind!

I'm not sure which post you're responding to, but I don't suppose it really matters. There have been a plethora of posts saying it's not OK to refuse to have caregivers of a different race if you're on Medicaid or Medicare. The assumption, I guess, it's that it's OK if you have health insurance. Or if you're not intending that the bill be paid at all? Perhaps if you're Bill Gates or Donald Trump and could just buy the facility?

And is it OK for minority patients (which will be white, English speaking Americans in a few years, if not already) to refuse caregivers who are not minorities?

It's not OK to refuse caregivers based on skin color, period.