Ask any nurse of color her or his experiences of racism on the job, and you’re bound to hear dozens of painful stories. Tales of patients and their families hurling racial slurs, mistaking nurses for cleaning staff, and refusing care because of a medical professional’s race are all things that still happen in American hospitals. What effects does this have on the lives and practice of those professionals? What can be done in the face of such behavior? In an attempt to answer these questions, we will be featuring a two-part series on the issue of racism in medicine from the nurse’s perspective. As the nursing field becomes increasingly more diverse, and as very public tensions across the country highlight how deep racism still runs in medicine, we hope these posts can enlighten you on some of the things your clients may be facing and the effects it can have on them.
What exactly is happening?
Since a study done in 2002, it’s been fairly well accepted that patients prefer doctors of their own race,[1]but racism from patients, especially in the world of nursing, is commonly regarded as an open secret; most everyone in the field knows it happens, yet not many talk about it. Lawsuits have been filed over intense racist harassment, refusal to hire nurses of color, and refusing care,[2]but it’s the day-to-day instances of prejudice that are most common. Doctors with accents are questioned about their ability to speak English fluently. Nurses of color are quietly or sometimes loudly reassigned patients due to someone’s preference for a white nurse and a supervisor indulging them.[3]Even outside of hospitals, medical professionals have reported not being taken seriously, such as when someone on a Delta flight was unresponsive last year, and a black female doctor was entirely shut down by flight attendants for trying to help.[4]Stereotypes and assumptions affect patient-nurse interactions, leading to insulting, unjust treatment and a general lack of trust for non-white nurses.[5]
What are the effects?
Feeling marginalized is good in no setting, but a hospital is a particularly bad place to feel ineffective and undervalued. As one report points out, being told both by a patient they don’t want to be cared for by you, and having a supervisor validate their desire by reassigning you, can lead to a sense of rejection that might result in moral distress and burnout.[6]Demeaning language wears on people, and not being your best self in a medical setting means you’re not able to do your best work, which could endanger your patients, your career, and your wellbeing.
Nurses who help despite a patient’s dismissal can be charged with assault.[7]This puts nurses in a tricky position; if they follow their moral code, they face legal action, but if they obey at the cost of ethical principles, it can be terribly demoralizing and cause nurses to question why they’re even doing this job. Being in this position does nothing for job satisfaction, which is also of concern for hospitals employing diverse staff.
These problems are huge; systemic racism is not a problem that can be battled overnight, or even over the course of a decade, many would argue. Though legal action can assist some who have experienced racism as a nurse, it can also hurt others. In an attempt to work through some ideas that might alleviate either prejudice or pain from it, our next post will focus on some potential solutions.
[1]Hopkins Tanne, Janice, “Patients are more satisfied with care from doctors of same race,” NCBI, Nov. 9, 2002, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124573/
[2]Gibson, Angelina, “Racism in Nursing: An Open Secret,” Nurse.org, Aug. 15, 2017, https://nurse.org/articles/racism-in-nursing/
[3]Farmer, Robin, “The Impact of Racist Patients,” Minority Nurse,Oct. 15, 2014, https://minoritynurse.com/impact-racist-patients/
[4]Howard, Jacqueline, “Racism in Medicine: An ‘Open Secret,’” CNN, Oct. 26, 2016, https://www.cnn.com/2016/10/26/health/doctors-discrimination-racism/index.html
[5]Farmer, “The Impact of Racist Patients”
[6]Howard, “Racism in Medicine’”
[7]Farmer, “The Impact of Racist Patients”