It's kind of ironic. Thousands enter the hospital every year hoping not to die, and yet, there are mindsets that we, as healthcare professionals, need to kill. The old school term was judging. The new term, profiling.
It exists. Even those repulsed by it have to one extent or another, been guilty of prejudging a person. Something as simple as associating someone with a Latino heritage with tacos, or the Chinese with rice. Hey, Americans do it to themselves when they proclaim "Baseball, hot dogs and apple pie". It's part of human nature to draw certain conclusions because innocent generalities within races do exist.
The type of racial profiling that needs to die within society, not just our hospitals, is the kind of negative beliefs we presume about people we don't know, based on forbidden or immoral activities engaged in by one or more of that particular race. Ask Rodney King how it felt to be "punished" for what other young, black men did that proceeded him. Or how the white man feels about being profiled according to Civil War mentalities. And lately, Hispanics are afraid they are being stereotyped by those that enter the country illegally. There are certain generalities we would be better off not making in order to maintain peace and a positive working and treatment environment.
Those working on the front lines in the ER have the greatest burden when it comes to profiling. Watch as the healthcare worker fights to restrain himself as evidence of child abuse or wife abuse stares him in the face. Or how they must overcome emotional generalizations in dealing with a chained and cuffed prison inmate. Add profiling within a racial context and it becomes normal to view certain cases with a certain mind frame. The problem is not in having an opinion-you are free to believe as you wish. However, when your beliefs impact your ability to treat a patient with neutrality, it's interfered with your work. It's admirable to want to protect a patient that's been brought in beat up from a bully. It's illegal to with hold or change treatment that alters the best possible outcome.
Workers in the ER are at the greatest risk of profiling because they are the first to see the patient, with Physicians and Nurses coming in second as they orchestrate ongoing treatment. Yet, I can not overlook the power of emotion that rips through the x-ray tech as they peer into a lit box, shaking their head as they read a confirming film. I've walked by a few groups as they gathered around a lit up box, cursing, and I knew right away the patient was an abused child. Some things will passionately tug at you, but to remain professional, those emotions have to die to the greater cause-effective and unhindered treatment.
The list of obvious things not to do include:
*Referring to a patient by a racial slur or anything besides his/her name.
*Categorizing the patient in a group-learn to see a patient for who they are as an individual-not a certain race, or illness, ect.
*Determining to withhold, delay or alter treatment because you immediately dislike the patient.
Instead, when tempted to profile, spend a few minutes getting to know the patient. Learn one characteristic that sets them apart from the typical stereotype one may presume. Are they a mother, father, son, daughter? Try relating to one aspect of their lives and offer to momentarily place yourself in their position.
Lastly, even if your initial profiling proves to be correct, the patient is probably terrified to be in the hospital. They are unsure of their surroundings, intimidated by the tests and white coats, and fearful for what the treatment options may be. Try to be sympathetic to their emotions and particular injury and overlook their less than favorable qualities for the time being. If you are unsuccessful, and you find you can not overcome the emotions that threaten to overtake professionalism and fair treatment, turn the patient over to someone that can be objective. The patient deserves impartial treatment and that is something we can offer.
When all else fails, as you leave work following your shift, make sure to stop off at the gym and hit the bag an extra time or two. Don't carry the aggression home. It's not worth it.
Profiling by medical condition is important too. Having had hiv for almost 20 years, and receiving health care in several states, I have noticed a bias that creeps up every so often. It's sporadic though and most health care professionals by far that I've encountered are caring, educated, and not prejudiced. But profiling does happen occasionally.
ReplyDeleteSo true. Watch the initial reaction of people when you describe an abandoned child in Africa with AIDS and then mention a patient here in the states with AIDS. One provokes compassion-the other judgement. Let the guys in the research labs question why and try to get to the source of diseases. As an ER or OR tech, floor nurse or scrub nurse, it is not our job to ask why unless it is to better manage the patients treatment. To ask these questions and then base an opinion that somehow alters the treatment or attitude used in approaching the patient is profiling and wrong.
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