Sociology, University of California-Davis, USA.
Sociology, University of California-Davis, USA.
Soc Sci Med. 2021 Feb;270:113677. doi: 10.1016/j.socscimed.2021.113677. Epub 2021 Jan 7.
This paper investigates how Latinx nurses resisted the racialization of medical un-deservingness against co-ethnic immigrants in everyday clinical encounters. Drawing on 26 in-depth interviews and dialoguing with the literature on minority professionals, we find that, as a form of racialized equity work, Latinx nurses produced certain symbolic resources, specifically the interactional signals to counteract Latinx patients' internalization of un-deservingness and other medical staff's open hostility towards these "undeserving illegals." Latinx nurses hybridized neoliberal norms (self-sufficiency and responsibility) and social justice values (including healthcare as a universal right and compassion for members of the community): they emphasized Latinx immigrants' efforts at "becoming" self-sufficient and clinically responsible, debunked the relevance of citizenship to a right to healthcare, and highlighted their communal bonds with co-ethnic patients. Meanwhile, accentuating these communal bonds revealed hefty loads of previously self-censored healthcare needs among Latinx patients, which compelled Latinx nurses to reassert some professional boundaries. Whereas some Latinx nurses were able to engage in "moralized boundary-drawing," others experienced setting professional boundaries as "demoralizing boundary-drawing," which resulted in burnout, disillusionment, or internalized racism. Our findings indicate that the path to de-racializing medical deservingness needs to be multi-tiered. Latinx nurses' racialized equity work of generating symbolic resources for Latinx immigrants is only sustainable if supported by non-Latinx colleagues' cross-ethnic equity work. Furthermore, everyday resistance in clinical encounters is necessarily incomplete unless state-level policy initiatives transform the currency of symbolic capital for medical deservingness.
本文探讨了拉丁裔护士如何在日常临床接触中抵制将医疗不值得性种族化，以反对同种族移民。通过对 26 名深入访谈的分析，并与少数族裔专业人员的文献进行对话，我们发现，作为一种种族化的公平工作，拉丁裔护士产生了某些象征性资源，特别是对抗拉丁裔患者内化不值得性和其他医疗人员对这些“不值得的非法移民”公开敌意的互动信号。拉丁裔护士混合了新自由主义规范（自给自足和责任）和社会正义价值观（包括医疗保健作为普遍权利和对社区成员的同情）：他们强调拉丁裔移民“变得”自给自足和临床负责的努力，揭穿了公民身份与医疗保健权利的相关性，并强调了他们与同种族患者的社区联系。同时，强调这些社区联系揭示了拉丁裔患者以前自我审查的大量医疗保健需求，这迫使拉丁裔护士重新强调一些专业界限。虽然一些拉丁裔护士能够参与“道德化的边界划定”，但其他人则认为设定专业界限是“道德化的边界划定”，这导致了倦怠、幻灭或内化的种族主义。我们的研究结果表明，去种族化医疗值得性的道路需要多层次的努力。只有在非拉丁裔同事的跨种族公平工作的支持下，拉丁裔护士为拉丁裔移民创造象征性资源的种族化公平工作才是可持续的。此外，除非州一级的政策倡议改变医疗值得性的象征性资本货币，否则日常临床接触中的抵抗必然是不完整的。
