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]

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]

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]

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]

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]

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]

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.

 

[flying_babyb]

my best freinds grandfather was in World War Two and at the time had a ethic issue with all German people. He was in the hospital after a heart attack and we spefically requested no german nurses and they told us that could be arranged. The German nurse thought it was funny. (I'm pretty sure that it was Germans he disliked but hes been gone now for 7 years so my memory is lax)

 

[MouseketeerOvaHere]

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.

This. ^^^

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.

That would be perfect, but what happens when the patient is in need of a diagnostic exam and there is only one person on that shift who performs the examination? Although, I believe patients have a right to their care and whom performs their care, the patient needs to be flexible in certain cases.

I have experienced racial patients simply because I am white, and frankly it is quite frustrating. I have always treated each patient with respect, even the ones that have been verbally abusive, but it's something that occurs everyday in the South. Racism occurs in other regions of the country, but I have never seen it as bad as I have down here.

 

[hemispheredancer]

Why does the race card always have to come into play??? No wonder we are in the society we are in!

 

[golfgal]

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.

I agree with you however if you request something like that you are immediately considered "racist". When our twins were born one of the nurses came into my room to see them. She asked me if they were identical--um, let's see, one is blonde and blue eyed, the other had gobs of dark hair--oh and one is a BOY and one is a GIRL--NO they are not identical. I asked that she not be assigned to care for them.

Why does the race card always have to come into play??? No wonder we are in the society we are in!

I agree. I firmly believe that racial issues are perpetuated by the minorities themselves. If you don't get a job it is because you are black-never mind you aren't qualified for the job it all has to do with your skin color. If someone doesn't like you it is because of your skin color not because you are a total jerk. This isn't to say that there aren't people out there that are truly racist but for the most part people don't care what color your skin is, they do care what kind of a person you are.

 

[agnes!]

Slightly off-topic to this discussion about Nurse/patient relations, but I wish that references to people of different pigmentations and various ethnic backgrounds would be characterized as *ethnic* (or perhaps "ancestral") origins and differences instead of race differences.

After all, aren't we're all members of the human race?

Yeah, yeah, I know, it's all a point of semantics - "black race", "white race" but lately it's started to bother me. We're not completely different genetic creatures or beings on the superficial factor of the amount of melanin in our skins. And do we ever say Latino "race" or Scandinavian "race"? I guess we (or more importantly, a government form) might say "Caucasian race", but even *that* bothers me. I'm not from the Caucasus! My ancestors are not from the Caucasus! That very term "Caucasian" is racist/scientific claptrap from the early 19th Century. Read this translated quote from Johann Friederich Blumenbach, the originator of the term:

From "The anthropological treatises of Johann Friedrich Blumenbach" (Page 269)
http://books.google.com/books?id=u9QKAAAAIAAJ&dq=Blumenbach Bendyshe&pg=PA11#v=onepage&q=&f=false

Caucasian variety. I have taken the name of this variety from Mount Caucasus, both because its neighbourhood, and especially its southern slope, produces the most beautiful race of men, I mean the Georgian; and because all physiological reasons converge to this, that in that region, if anywhere, it seems we ought with the greatest probability to place the autochthones [birthplace] of mankind. For in the first place, that stock displays, as we have seen... the most beautiful form of the skull, from which, as from a mean and primeval type, the others diverge by most easy gradations on both sides to the two ultimate extremes (that is on the one side the Mongolian, on the other the Ethiopian). Besides, it is white in colour, which we may fairly assume to have been the primitive colour of mankind, since, as we have shown above... it is very easy for that to degenerate into brown, but very much more difficult for dark to become white, when the secretion and precipitation of this carbonaceous pigment... has once deeply struck root.

Gack, even taken in historical context the whole passage just makes my skin crawl.


This recent essay on the genetic make-up of the human race makes much more sense to me...
From "Confusion about Human Races": http://raceandgenomics.ssrc.org/Lewontin/

The geographical maps of principal component values constructed by Cavalli, Menozzi and Piazza in their famous The History and Geography of Human Genes show continuous variation over the whole world with no sharp boundaries and with no greater similarity occurring between Western and Eastern Europeans than between Europeans and Africans! Thus, the classically defined races do not appear from an unprejudiced description of human variation. Only the Australian Aborigines appear as a unique group.

[SSRC - The sponsoring organization of the website "Is Race Real?". Their website: http://www.ssrc.org/]


Now, back to the nurse/patient thing - there are a couple of possibilities...
Patient is Miss Crabby-pants (maybe she doesn't feel well?) for reasons other than group differences.
Nurse is Miss Crabby-pants (maybe *she* didn't feel well?) for reasons other than group differences.
Patient hates people with skin-tone different from hers.
Nurse hates people with skin-tone different from hers.
The two of them just don't get along because of a personality clash completely separate from their skin-color/ethnic differences.

agnes!