Accomadating patients racist request?

Does your facility have a policy in regards to handling patients request made with regards to race? We recently had a family of "proud white supremacists" who tried to refuse care from any non white staff. One of our charge nurses tried to accommodate this request while making assignments, while a different charge nurse refused to use race in making the next assignment. The doctors eventually discharged them because they just refused EVERYTHING offered for 3 days and kept wanting to change doctors until they got a white doctor.

Our hospital does not have a set policy on these types of requests. Just the generic equal opportunity employer statement given to staff at orientation. However, a nurse manager did recommend "just try to accommodate them to keep them quiet".

Decades ago, a locally well-known white supremacist who wound up with a Jewish cardiologist and a Muslim surgeon because those were the ones who were on call when he needed them. He was relatively gracious about it. Now, folks aren't as gracious.

As a charge nurse, I'd try to accommodate the request for white nurses because I don't want to put my non-white colleagues through the hell of dealing with the family of racists. But if for some reason I could not provide a white nurse, they would be advised that they get who they get. Patient care needs come before that kind of nonsense. And I'd be escalating up the chain of command as fast as humanly possible.

I've seen the admitting physicians take care of it themselves, though, before the charge nurse had to get involved. I saw one of our surgeons (from Mumbai) dressing down a family (also from Mumbai) who didn't want an American nurse taking care of Mother. "You brought your mother to America to have surgery, surely you expected to have American nurses taking care of her. If you didn't, you are foolish and entitled. You get the nurse you get, and Ruby is the best there is. I don't want to pass by this room again and see you abusing Ruby or any other nurse. If it happens, you can take your mother back to Mumbai, and I will arrange the transport. It will cost as much as your Mercedes."

This reminds me of a book on my to read list : "Small Great Things" by Jodi Picoult. It's quite sad that a situation such as this is still happening outside of fiction.

Small Great Things by Jodi Picoult

A patient requesting same sex caregiver should be observed and if possible accommodated. The patient may have had a terrible experience that causes them to request the accommodation or it be due to religious beliefs or any number of things which could affect whether they refuse care. At the very least their reasoning should be listened too and if possible accommodated.

How about a psych patient in some form of transgender transformation who only insists on female non-white staff? We didn't have enough staff in our entire facility to accommodate this patient's requests/demands/preference. This patient got to the point where they requested and demanded that only ONE nurse care for them during their stay.

Not happening.

I had this happen.

I had one patient who kept refusing needed pain relief from my fillipino colleague declining the long acting morphine and only wanting the short acting morphine . He never had done it to me, and I'm damm sure that the only reason they were putting my colleague through it was due to the colour of her skin

I walked in there the other morning and told the patient that it was their choice to continue to decline care, however they would be the only one affected and that to refuse the long acting morphine would result in more pain than we could manage effectively with the short acting morphine

Next day, patient quite accepting of medications from my colleague and very nice and polite ever since.

Sometimes to confront racism head on is counter productive.

Personally I would give them the "this is how it is". If they dont like it, they have two choices, to stay and receive the care they need, or discharge AMA.

Overt disrespect of my staff would not be tolerated, fortunately we are well backed up. If patients become abusive, they can be criminally charged

The only time I could see doing such an assignment is for a dementia patient, so the staff person wouldn't get such grief. Otherwise, the choice should be 1.) you get who you get or 2.) we'll be glad to point you to the front door.

I would tell them then you better learn to care for yourself, because that and accepting whatever nurse or caregivers helps you are your only two options. You choose!

This isn't a hotel or Burger King, you cannot have it your way!

Annie

Interesting question. I actually had a very different, and not so different, conversation with a coworker. She informed me that black patients prefer black nursing staff "there is just stuff they understand about me that "other people" wouldn't." While I took her at her word I wondered about the reception for such requests and if they would be honored or even considered valid if it came from a white patient. Now, she didn't report her views as racist but there was a clear preference for a certain race, feeling the care provided would be superior based simply on race alone, supposing there would be a similarity of circumstance or experience. I wasn't offended but it is irritating to know that despite your best efforts you will never "measure up" because you don't share a skin color. Before anyone goes saying "now you know how it feels" ummmm...I went to high school on a native american reservation...I am pretty sure I know what it is like to be in the minority, treated as an outsider, judged by the color of my skin, etc.

I live and work in the deep south, and I never have anyone refuse a nurse based on their race. I have seen more racial discrimination in areas OTHER THAN the deep south! I do have the occasional female who does not want a male nurse, but that nothing is ever said about race.