Yung Anthony, Ishmael Terrence G, Llanes Aaron Cedric, Belthur Mohan V
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Shriners Hospital for Children-Philadelphia, Philadelphia, PA.
J Pediatr Soc North Am. 2024 Feb 5;5(4):791. doi: 10.55275/JPOSNA-2023-791. eCollection 2023 Nov.
In recent years, waves of civil unrest precipitated a national reckoning on the topics of racial injustice, diversity, equity, inclusion, and belonging. Despite playing an essential role in society, minority healthcare personnel are not immune to experiencing discriminatory patient behavior in the clinical setting. As the U.S. healthcare workforce becomes more racially and ethnically diverse, the frequency of negative encounters between patients/families and healthcare providers of varying social identities will likely increase. For minority healthcare personnel, patients' discriminatory behavior can be emotionally challenging, painful, degrading, and could cause feelings of distress, potentially leading to burnout. Patients/families who demean healthcare providers based on their social identity pose multiple clinical obstacles and ethical dilemmas to care, which unfortunately can elicit a significant psychological toll on healthcare providers. A stable therapeutic bond between provider and patient is built on mutual trust, respect, and understanding. This is the basis of a mutually fulfilling physician-patient relationship and efficacious patient care. In contrast, an incongruous therapeutic alliance poses challenges to achieve optimal patient and provider outcomes. We will discuss the prevalence of discriminatory patient behavior against minority health providers and explore the impact of these potentially distressing experiences. We will present coping strategies and resources for healthcare providers when directly facing negatively biased patient behavior. Finally, we will offer guidance and a framework that physicians, bystanders, and institutions that encounter racially motivated behavior from patients and/or their families can use to respond to these difficult situations. •Patients' racially discriminatory behavior towards minority healthcare providers is common, emotionally challenging, painful, and humiliating.•When encountering inappropriate patient behavior, individuals and teams should approach patients/families with compassion and provoke self-affirmation in prejudiced patients to reduce bias.•After the encounter, a team meeting can offer a supportive environment for affected individuals and team members. Furthermore, debriefing and reflection can facilitate discussion on future responses and improve morale.•Institutions and bystanders play an essential role in protecting and intervening in racially prejudiced patients' behavior against minority physicians.•Organizations and providers must aim to devise effective policies, develop mandatory anti-discrimination training for all healthcare team members, and cultivate a culture of safety and belonging in the work environment.
近年来，一波又一波的内乱引发了全国对种族不公正、多样性、公平、包容和归属感等话题的反思。尽管少数族裔医护人员在社会中发挥着重要作用，但他们在临床环境中也难免会遭遇患者的歧视行为。随着美国医护人员队伍在种族和民族上变得更加多样化，患者/家属与不同社会身份的医护人员之间负面接触的频率可能会增加。对于少数族裔医护人员来说，患者的歧视行为可能在情感上具有挑战性、令人痛苦、有辱人格，并可能导致困扰情绪，进而可能导致职业倦怠。基于社会身份贬低医护人员的患者/家属给护理带来了多重临床障碍和伦理困境，不幸的是，这可能会给医护人员带来巨大的心理负担。医护人员与患者之间稳定的治疗关系建立在相互信任、尊重和理解的基础上。这是实现医患关系互利和有效患者护理的基础。相比之下，不协调的治疗联盟对实现最佳的患者和医护人员治疗效果构成挑战。我们将讨论针对少数族裔医护人员的歧视性患者行为的普遍性，并探讨这些潜在令人痛苦的经历的影响。我们将为医护人员在直接面对存在负面偏见的患者行为时提供应对策略和资源。最后，我们将提供指导和一个框架，供遇到患者和/或其家属出于种族动机的行为的医生、旁观者和机构用来应对这些困难情况。
•患者对少数族裔医护人员的种族歧视行为很常见，在情感上具有挑战性、令人痛苦且有辱人格。
•当遇到不适当的患者行为时，个人和团队应以同情的态度对待患者/家属，并促使有偏见的患者进行自我肯定以减少偏见。
•接触之后，团队会议可以为受影响的个人和团队成员提供一个支持性的环境。此外，汇报情况和反思可以促进对未来应对措施的讨论并提高士气。
•机构和旁观者在保护和干预针对少数族裔医生的种族偏见患者行为方面发挥着重要作用。
•组织和医护人员必须致力于制定有效的政策，为所有医护团队成员开展强制性的反歧视培训，并在工作环境中营造一种安全和归属感的文化。
