Nurse/Patient and possible race issue

[princesspumpkin]

I had a pt. that i was told was very challenging - anger issues, defiant, verbally abusive, etc. After having her for eight hours, I did not have one single problem with her - we talked, laughed, joked - I even had to re-start her IV (which I thought that she was going to go ballistic, after hearing how she was described) and she was totally sweet about it.

The previous nurse, gave me report that the patient said some racial comments against caucasians. The nurse is white, I and the pt. are black.

I gave report to the next nurse, who is black/hispanic and after taking care of her, she also had no problem with the patient whatsoever.

This got me thinking - if this pt. has another caucasian nurse, would it again be drama for both the pt. and the nurse? If that was the case, should they try to steer clear of assigning caucasian nurses to this pt.?

Then I remembered the case a few years ago where the pt. requested not to have any black nurses when she delivered her baby and the request was granted, and people got into a lot of trouble.

[Stacerita]

If I am not mistaken, if you make assignments based on anything other than ability, you may get in trouble. You can not make assignements based on protected classes. I would check with HR if you have any doubts.

[princesspumpkin]

Originally Posted by Stacerita

If I am not mistaken, if you make assignments based on anything other than ability, you may get in trouble. You can not make assignements based on protected classes. I would check with HR if you have any doubts.

i totally understand what you're saying concerning the legality of it all. Kind of wondering how people felt about it "off the record"

It's a shame that these things happen, and it was sad that the previous nurse had such a miserable eight hours with this pt.

[kwelch10377]

I would say no, especially with the situation of people getting in trouble when granting a pt request before. The only way I would consider doing it is if this issue is severly affecting her overall care and even then I would talk to your boss or HR dept first.

Maybe it would be helpful for you to jokingly say to her, I hear you have been giving some of the nurses a hard time and she what she says.

[Lisa loves Pooh]

I hate to say that I saw this on a tv show--but I did. (I think it was Grey's Anatomy).

No,I do not think you should cater to the patient's racist wishes. A correctly colored nurse won't always be available when she needs it.

Nurses and docs sometimes have tough patients.

It is a shame the patient is like this--but it doesn't provide her the best care to serve her wishes and could open you up to a host of issues at work.

I'd tell the patient to get over it, but know that isn't possible.


I don't exactly know how it was resolved on the TV show--other than one of the head residents wouldn't allow the discriminated against medical staff to avoid the patient over the patient's racist issues.

I think that should be the case in real life as well.

It is a shame that your staff is being abused--but it is their job and it isn't like you are purposely scheduling only caucasians. Just rotate the staff as your normally would and essentially ignore the patients issues.

If you have a staff member refuse to treat the patient--IMHO, it would be grounds for termination. Sucks--but that's medical care.

[princesspumpkin]

Originally Posted by Lisa loves Pooh

No,I do not think you should cater to the patient's racist wishes.

See that's the thing - it wasn't her wishes to not have caucasian nurses - but when she had one, it was disaster for both parties.

[Lisa loves Pooh]

Originally Posted by princesspumpkin

See that's the thing - it wasn't her wishes to not have caucasian nurses - but when she had one, it was disaster for both parties.

IF your hypothesis is correct--her behavior is her method of manipulating an outcome.

Folks don't always have to make a request. In their minds, they can just make things ugly until people figure it out--which it seems that you have.


In any case--sounds like the patient may be treating her own disaster--and again hate to mention the tv show--but if you give your nurses a pep talk (if they are the ones calling it to your attention)--they may be able to just develop a thick skin around this patient.

It is a sensitive issue--but essentially they have to ignore her nastiness. Easier said than done, I'm sure.

But similar issues could be had with a patient who is too free with his hands on a female nurse or a belligerant old goat who likes to use profanity around a nures sensitive to that kind of language.

[denisenh]

This got me thinking - if this pt. has another caucasian nurse, would it again be drama for both the pt. and the nurse? If that was the case, should they try to steer clear of assigning caucasian nurses to this pt.?

i would have social services intervene if that should happen. This type of "Drama" isn't good for the patient or the nurse.

[OceanAnnie]

Originally Posted by princesspumpkin

See that's the thing - it wasn't her wishes to not have caucasian nurses - but when she had one, it was disaster for both parties.

Maybe race is a coincidence. Could it be personality conflicts?

[Maridw]

I was wondering if possibly the nurse had a problem with treating a black patient. The nurse might not think she is a racist, but maybe in the back of her mind she has a problem dealing with black people. If you and your co-worker had no problem, it could be the other nurse not the patient.

I have known people who do not think that they are racist, but do treat people that are not their race differently. They would be friendly to a point to their face, but behind their back they were totally different.

[princesspumpkin]

Originally Posted by OceanAnnie

Maybe race is a coincidence. Could it be personality conflicts?

It the pt. hadn't made any racial comments, I would certainly think this. Happens all the time. But this pt. had been here for several days and her drama has been with caucasian caregivers. I just happened to have her for the first time and after hearing the previous nurse's report, was a little confused as to why I didn't have problems with her.

[monkey68]

Is it possible that maybe she was acting that way for a medical reason? Just a thought, but we've had patients described to us by the admitting team as mean, degrading, always cussing, etc. and then we see them and they're happy as a clam, usually because they forgot to mention that they have some psych issues and are on some sort of antipsychotic, so when a family member calls to tell us, we give them whatever they're on, and it's like a new person.

Could also be that the patient was just cranky during the other nurse's shift, some people are just cranky when they're sick, and take it out on everyone trying to help them. Course, it could also be a racial issue, or an issue that the nurse was having that day.

[Disney Doll]

I would check with HR with regard to assigning caregivers based on anything other than ability.

I have found, of late, that patients, regardless of their ethnicity, are becoming much more demanding and belligerent. And no, I don't mean more well-informed, I have no problem with someone taking control of their healthcare.

[Stacerita]

Originally Posted by princesspumpkin

i totally understand what you're saying concerning the legality of it all. Kind of wondering how people felt about it "off the record"

It's a shame that these things happen, and it was sad that the previous nurse had such a miserable eight hours with this pt.

There is no "off the record" if you are the scheduler or supervisor. Most companies have strict rules and regs that dictate how to schedule. A person can get into a lot of trouble not going by the book. Some people do not get the luxury of being "off the record". I was just made to take annual classes regarding this type of thing. If you know about it, its not off the record. To cover yourself, check with HR, and get it in writing.

[bumbershoot]

I believe, firmly, that a sick person, or person having a baby in a germ-filled hospital, or anyone who finds themselves in a hospital...should have the right to NOT have someone caring for them that they don't want caring for them.

And I don't care what the reason is.

So perhaps you could see if your hospital has such a caring thought, and if so, schedule by whatever method you schedule, but also let the patients know that if something is bothering them enough that it might be hindering their healing, that they can request someone else, and then you can see if someone else is available.

Regardless of how I feel about people not wanting someone to care for them based on race, if you are *caring* for a person's health, their emotional health counts too.