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patient refusal

Video: A closer look at patient refusal

By: By Rob Senior

In the August issue of American Nurse Journal, Fidel Lim, DNP, CCRN, the author of our Can You Imagine? Nurse Influencer blog collaborated with Gary Sanin Camelo, MPA, LMSW, BS, BSN, RN, NE-BC to author When a patient refuses a nurse assignment.

Fidel and Gary took a closer look at the situations nursing leaders and hospitals confront when a patient, for any reason, decides he or she would prefer not to be treated by a particular nurse. They stressed the understanding of all three involved parties: the patient, the nurse, and the organization.

The article received enough attention and reactions that we decided to go deeper in this interview with the two authors. Gary and Fidel answer various questions about When a patient refuses a nurse assignment in our American Nurse Journal exclusive video.

“For too long nursing has turned a blind eye to micro- and macro-aggressions committed by patients,” the article read. “The sociopolitical upheaval brought on by COVID-19 and an increased consciousness of health inequities have prompted the need for nuanced discussion of the prejudice healthcare workers experience.”

Examples include cut-and-dry cases (a patient indicates he or she doesn’t want a black/white/male/female nurse) to areas including:

Implicit bias: A person might associate lower educational status with people of color without being aware they have this bias.

Microaggressions: A person might say “Your English is really good” to a non-white person born outside the United States.

Stereotype threat: Emphasizing a staff member’s race at work might undermine their performance because they’re concerned about confirming a negative stereotype.

In the interview, Fidel and Gary address their inspirations for the article, as well as questions on whether patient or nurse receives priority in addressing such a situation. Gary also explains his algorithm for addressing refusal, while Fidel offers his thoughts on including the material in the nursing curriculum.

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