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  1. #1
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    WA~State sued over patient requests for white caregivers only

    A very interesting article. I'm intrigued as this same thing has happened to two of my adult children, while working at elder care homes. Both my children are black and were told not to work with certain residents as those patients had requested white attendants only. One resident called for help and when my daughter quickly responded, the woman screamed at her to "go back to the cotton field". I was appalled that this type of behavior was not met with some sort of consequence but it was allowed to continue and several residents (at two different facilities) had their requests honored. This must happen quite frequently and there should be a strict policy in place to deal with it, IMO. I know we have some medical professionals on board. How have you seen this dealt with?

    http://www.oregonlive.com/pacific-no...vers_only.html

    9 hospital workers sue Washington state after mental patient requests white caregivers only

    "Nine Western State Hospital workers who said their bosses illegally accommodated a patient's request for white caregivers have filed a federal lawsuit saying the practice is not only discriminatory, but dangerous. After a mentally ill patient with a history of attacking hospital workers requested only white caregivers, managers agreed, and hospital executives declined to investigate when the workers complained about the policy, the workers said in the lawsuit, filed in U.S. District Court on Thursday.

    The workers, of various ethnicities, are assigned to Western State's Center for Forensic Studies, most of them as psychiatric security attendants who help with daily care of patients. They say that the ongoing practice barred dark-skinned employees from work they would normally be assigned to do and forced white or light-skinned workers to spend extra time with a violent patient.

    The Department of Social and Health Services, which runs the hospital, is named as a defendant....."

    more at link

  2. #2
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    I guess it's a difficult & delicate situation for the care facility as they are usually paid by the patients to care for them and patients who are elderly are often 'stuck in the past' (some even have regressed). If a patient is screaming or hostile with any caregiver, regardless of skin colour, the automatic response would be to switch out caregivers for that patient at least for that shift to keep both parties safe.

    Many caregivers are also sexually harrassed and there's nothing that can be done, other than to admonish the patient (who likely won't remember and do it again anyway) and/or switch out caregivers. I've heard some very strange stories from people I know who do this job and they really do tolerate a lot.

    In this story we have a mental care facility, where violent situations probably occur way more frequently than in elder care. When the racism is coming from someone with diminished mental capacity, I don't think the employer can be held to the same standard. How exactly would the employees propose that the employer remedy the situation? By allowing their black employees to attempt to care for a patient who will refuse care and even be violent? Wouldn't that put the employer at risk to be sued?

    Now, perhaps these employees feel that their managers are racist and maybe there's more to their claiim but on the surface it appears that their employer is doing what's necessary to keep them safe from a violent patient who has a history of attacking caregivers.

    Personally I would like to see some karma b*tchslap that patient, like someday he is dying and he has to beg for help from a black person. However, unless I see more, I don't see how else this employer can deal with this kind of situation. Certainly it's not ideal. Do you have any ideas MissIzzy?

    (Btw, I am not a medical professional.)

  3. #3
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    Suprisingly I find myself sympathizing with the employer. If they had not made a rule to honor the patient's request to only have white people care for them, likely they could have been sued to by either the patient or the caregivers. This person is violent as well as racist, and having a person of another color could very well cause him/her to become even more violent. Which endangers the caregiver.

    OTOH this is a mentally ill patient, possibly it could be not racism but fear that caused the patient to make the request for only white people. To force them to accept people of another color to care for them when they were in fear could exacerbate their mental illness.

    As far as the caregivers filing suit, I think that at best they are being shortsighted, at worst they are money hungry. Unless perhaps they are attempting to force the employer to assign more help to help them with this situation and the strains that it causes on patient care. Now that I can understand.

  4. #4
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    I was taught, and believe, that if a patient has any issue with you and requests a change, then you provide that change. Similarly, if you have an issue with a patient, and you feel unsafe providing quality care, then you are to request a change.

    Both requests should be honored by the charge nurse, and if necessary, a change with another RN can take place to provide safe, healthy, adequate care.

    I trained with an absolutely gorgeous black girl. She was warned about issues with some patients (especially inmates), and told to request reassignment should that assignment occur. She had NO problem doing so...no one needs to be insulted, possibly assaulted, and prevented from giving proper care.

    In an emergency, however, it doesn't matter. You get in there and provide whatever assistance you can; if someone is alive at the end of the day to complain about race, at least they're still alive to do so.

    The only time I could see this presenting an issue for an RN is if it comes from management, and management prevents the RN from making a living. In other words, if the patient requests a different RN for a reason, and the RN, instead of being reassigned to another patient or floated to another floor, is sent home and not paid for that shift, then there is a real, honest problem.

    I will say that I've never had this happen to me. There have been some RNs that I refused to work with (because of safety issues - touching a contagious patient with gloves and then not ungloving while leaving the room, and entering another patient's room...improper medication administration, and so on. Unsafe stuff...), but never a racist (and I've had some), never an inmate (and I've had several), and never a dangerous, mental patient (and I've had some of those, too...). But I'm a white woman, so I wouldn't necessarily be exposed to general racism, although it can (and does) happen; I've seen it.

    It's interesting, in the abstract, as a patient who "enjoys" their hospital stay/care giving experience is far more likely to heal well, follow post care instructions, and learn what they need to learn for better living/health. If the patient protests (rightly or wrongly) to the skin color or religious affiliation of an RN, and it could impede the progress of the patient, to NOT change the assignment can be seen as aggravating the patient's illness.

    In this situation, with a violent, racist, mentally ill patient, we are taught to lower the triggers; if that means changing the RN, then that's what we do. We are not only responsible for the patient under our direct care, we are reponsible for patient safety of all patients...and if one goes off, it's often "contagious" and others will go off, and then it's utter mayhem. And yes, I've seen this happen. It's hard as heck to control 10 mentally ill, violent, acting out patients and keep everyone safe.

    Sticky, hard issues...but I stick to the idea that only if the RN is harmed by the change should there be a claim for damages.

    Best-
    Herding Cats

  5. #5
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    Quote Originally Posted by Herding Cats View Post
    I was taught, and believe, that if a patient has any issue with you and requests a change, then you provide that change. Similarly, if you have an issue with a patient, and you feel unsafe providing quality care, then you are to request a change.

    Both requests should be honored by the charge nurse, and if necessary, a change with another RN can take place to provide safe, healthy, adequate care.

    I trained with an absolutely gorgeous black girl. She was warned about issues with some patients (especially inmates), and told to request reassignment should that assignment occur. She had NO problem doing so...no one needs to be insulted, possibly assaulted, and prevented from giving proper care.

    In an emergency, however, it doesn't matter. You get in there and provide whatever assistance you can; if someone is alive at the end of the day to complain about race, at least they're still alive to do so.

    The only time I could see this presenting an issue for an RN is if it comes from management, and management prevents the RN from making a living. In other words, if the patient requests a different RN for a reason, and the RN, instead of being reassigned to another patient or floated to another floor, is sent home and not paid for that shift, then there is a real, honest problem.

    I will say that I've never had this happen to me. There have been some RNs that I refused to work with (because of safety issues - touching a contagious patient with gloves and then not ungloving while leaving the room, and entering another patient's room...improper medication administration, and so on. Unsafe stuff...), but never a racist (and I've had some), never an inmate (and I've had several), and never a dangerous, mental patient (and I've had some of those, too...). But I'm a white woman, so I wouldn't necessarily be exposed to general racism, although it can (and does) happen; I've seen it.

    It's interesting, in the abstract, as a patient who "enjoys" their hospital stay/care giving experience is far more likely to heal well, follow post care instructions, and learn what they need to learn for better living/health. If the patient protests (rightly or wrongly) to the skin color or religious affiliation of an RN, and it could impede the progress of the patient, to NOT change the assignment can be seen as aggravating the patient's illness.

    In this situation, with a violent, racist, mentally ill patient, we are taught to lower the triggers; if that means changing the RN, then that's what we do. We are not only responsible for the patient under our direct care, we are reponsible for patient safety of all patients...and if one goes off, it's often "contagious" and others will go off, and then it's utter mayhem. And yes, I've seen this happen. It's hard as heck to control 10 mentally ill, violent, acting out patients and keep everyone safe.

    Sticky, hard issues...but I stick to the idea that only if the RN is harmed by the change should there be a claim for damages.

    Best-
    Herding Cats
    I didn't think the thanks button was enough for you or LadyL.

    I am a very part time back up receptionist at an assisted living center - what the health services staff puts up with is simply amazing to me. They seem to leave their feelings at the time clock, and take care of people, no matter how hateful or unthinking they are. I couldn't do what they do -

    I'm in agreement - only if there is actual harm should there be a claim.

  6. #6
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    I have worked with the elderly for 20+ years and I have seen this over and over. What I have seen far more often is an elderly lady absolutely refuse for a male caregiver to enter her room.

    In nursing school, we are tought to accomodate the patient. The employess I have worked with seem to take it in stride but I cringe everytime I hear them verbally abused by a patient due to their gender or race.

  7. #7
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    Is there any indication this mindset is lessening in younger patients? I hope this kind of thing really dies off-- sorry to sound crass, but I'm serious.

  8. #8
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    When I was younger (about 20 years ago), I worked in a hospital drawing blood. Many elderly patients are suffering from dementia. People with dementia often have bizarre personality changes. Some who were never racists, or people who wouldn't swear, would become cussing bigots. I was called the n-word more than a few times, and told to leave by the elderly patients, and I'm WHITE!

    I've also had the opposite happen, where black patients did not want me to take blood from them.

    I would venture to guess that many patients making these types of requests are not thinking rationally or clearly.
    I started out with nothing, and I still have most of it left.


  9. #9
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    Snipped from article:
    The lawsuit said that in 2009, one security attendant told the patient repeatedly -- in the presence of three other attendants, one of whom was African -- "They eat white people in Africa." The attendant who made the comments was temporarily reassigned to the kitchen.


    Sigh.

    If that's true - and it apparently is - I cannot help but think that some sort of issue is being covered up.

    Furthermore, if you have a "security" personnel saying this to someone who is in a facility and known to be both racist and violent...well...yes, I'm going to only assign white folks to his care too.

    Imagine this from the patient's perspective.

    He's been told that they eat white people in Africa. He is already paranoid, and not able to handle himself in society at large (or he would not be there). He's scared, feeling jailed/confined, and probably is either hallucinatory or delusional, and, like I said, probably quite paranoid.

    He's in his room, alone. Three black security guards, who the patient has been told might eat him, come to bring him "to dinner." He processes it through the filter of paranoia, and believes they mean he's dinner...and one hell of a fight ensues. He's hurt, the security personnel are hurt...and his paranoia is enforced. Now, he really has reason to believe that being white makes him at risk for being assaulted, killed, and eaten by the staff. (ETA: This is my imagining. I have no reason to believe this took place; I made it up. But it's a reasonable assumption, I think, that this could happen, or something like it, kwim?)

    I can see why this policy was put in place.

    And what happened to the guy who told this patient they eat white folks for dinner in Africa? He got sent to the kitchen for a while.

    IMHO (and it's very H...), the real culprit is not management. It is this guy, regardless of race or creed, who gave this mentally ill patient a reason to fear for his safety from people of different color than him.

    He's the one who should be sued. Fired. And barred from ever working in a mental health facility...he has harmed this patient, and harmed his colleagues, and put everyone in danger.

    He's the idiot responsible for the issue, not management doing their job of keeping people (patients and staff) safe. I cannot lay blame on the patient; he has a totally different reality than we do. I cannot blame management, who was placed in a no-win situation by this pure-D fool. I can say, that if this guy were someone I worked with, he'd be gone. I'd make it my personal mission to get him gone. G.O.N.E. He is the danger to my safety. He is the instigator of all the ensuing mess.

    It is so hard to get into the mentally ill patient's head and observe their reality. Not only is it hard for us, it's hard for them to let us in. But if we can take a brief moment and see this from the patient's perspective, we can't help but see why he's asked for only white attendants.

    Sigh.

    Best-
    Herding Cats

  10. #10
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    I feel that the management is just trying to protect both the employees and the patients. And as Herding Cats previously said many of these patients are possibly suffering from paranoia and are not thinking in their right minds. If I worked at that facility and heard the security guard telling the patient that white people are eaten in Africa, I would personally do whatever it takes to get him fired and not allowed to work with mentally ill people ever again.


  11. #11
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    Welcome, Bookgirl, glad to have you with us!


  12. #12
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    Reading this stirs up old memories of the horrible situation I dealt with in the last days of my mother's life. At 90 years old she was suffering from senile dementia and was almost blind from glaucoma. I put her in a nursing in the state where I lived and they immediately gave her Alzheimer medication which caused a psychotic reaction. She slugged an attendant and they rushed her to a geriatric psychiatric facility without even exploring the cause. My mother was a minister's wife and it had always been very important for her to appear proper and ladylike at all times. Til the day she died I was terrified if I accidentally used a mild swear word around her. She came from a racist background, lived in a racist culture and mainly would have never used the n word because she would have considered it a white trash thing to do. With this medication, to my shock and mortification she started cussing like a sailor and when a black attendant came into her room she said "get that fat n- out of here." I was extremely embarrassed but also extremely concerned about her mental condition. The behavior of all the staff at this place seemed surreal. They barely let me see her and totally ignored my attempts to talk to anyone about her condition. They had not even sent for her medical records to know what medications she should have been taking. They tried to force her into physical therapy she was totally incapable of doing. I realized this was not a good place for her and it took me a week to get her released from there. While she was there I bought her a pretty red outfit, a nightgown, and slippers. When I picked her up the nightgown and slippers were gone and the pretty red outfit had big splashes of bleach on it. These were my mothers last days and I can't tell you how bad I feel that she was treated that way. We can talk about racism in the abstract, but I think it is appalling that a patients care would be influenced by how racially tolerate they are and it was disturbing that the insulted employee would have retaliated so childishly.

  13. #13
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    Quote Originally Posted by Tuffy View Post
    When I was younger (about 20 years ago), I worked in a hospital drawing blood. Many elderly patients are suffering from dementia. People with dementia often have bizarre personality changes. Some who were never racists, or people who wouldn't swear, would become cussing bigots. I was called the n-word more than a few times, and told to leave by the elderly patients, and I'm WHITE!

    I've also had the opposite happen, where black patients did not want me to take blood from them.

    I would venture to guess that many patients making these types of requests are not thinking rationally or clearly.
    Thank you for posting this. Unfortunately we witnessed this firsthand with my husband's grandfather who suffered from Alzheimer's Disease for over 20 years before his death. Although no one ever knew him to be racist, in the last weeks of his life he became physically and verbally abusive, punching a shower wall (he broke the tile, although he was 83 and very frail!) and using the n word and other horrible language. It absolutely mortified his wife and children and grandchildren. We couldn't believe the things coming out of his mouth.

    There was no changing of caregivers, because virtually everyone who worked in this nursing facility was African American, but we are eternally grateful for the tiny little nurse who bravely took care of him almost every day of that miserable time, and reassured all of us that it was okay, he didn't mean it, his mind was sick, she was fine. She was the most wonderful woman, a true gift from God, and helped all of us survive this painful few weeks.

    I will never forget her, though it has been 18 years since he died. When people act ugly, I try to remember her serene belief that they are the ones to be pitied for being trapped in a mind so damaged.

    I hope this lawsuit brings out any true inequities in the system, but the culprit does seem to be the security attendant. Why wasn't he fired immediately??? A union thing?

  14. #14
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    Quote Originally Posted by Quiche View Post
    Is there any indication this mindset is lessening in younger patients? I hope this kind of thing really dies off-- sorry to sound crass, but I'm serious.
    In my experience, I believe it is lessening. I saw it much more often 10 years ago.

  15. #15
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    Missizzy, I'm sorry your kids had to deal w/ that in their work enviroment. I really do feel for anyone who is asked/told to do something based on their gender or race. I'm actually chuckling reading this cause we do adult foster care in our home. At any given time we have 5 elderly/traumatic brain injured people here and at this moment i have been up for 5 hrs cause our loudest most delusional patient was screaming in the middle of the night and was fighting like someone on pcp all because she did'nt want my husband to rape her(it was him lifting her tiny little 90 lb body out of bed)!She does this about once a week. The whole day today will be her talking non-stop about what a horrible place this is, she is incapable of reason and understanding. This same woman can not be brought to the dinner table when another elderly black male is there cause she wont get near him. She then has to wait until the table is clear. But let me tell you, she does'nt remember, she was brought up that way and there"s no teaching her now, so we have to deal w/ it. What's funny is that the gentleman is hard of hearing and has never heard her speak this way. but for the sake of my youngest boy and everyone eles, we move her away.
    Oh I have so many stories;-)

    The hospital would've gotten sued anyway they handled this.imo.

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