When a Patient Refuses a Nurse Assignment

Authors and Disclosures

Gary Sanin Camelo, MPA, LMSW, BS, BSN, RN, NE-BC and Fidelindo Lim, DNP, CCRN

Gary Sanin Camelo is the patient care director at New York Presbyterian Weill Cornell Hospital in New York City, New York. Fidelindo Lim is a clinical associate professor at New York University Meyers College of Nursing in New York City.

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Groundwork for Understanding

Addressing a situation in which a patient refuses to be cared for by a specific nurse requires clearly defined terminology related to inclusivity and discrimination. Although each incidence of refusal is unique, the terms below may be relevant.

• Implicit bias—An unconscious association between an individual's qualities and their race, gender, physical characteristics, or membership in a social group.

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

• Microaggressions—Brief and commonplace verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate oppressive ideology.

• Example: A person might say, "Your English is really good," to a non-white person who was born in the United States.

• Stereotype threat—Being at risk of confirming, as self-characteristic, a negative stereotype about one's group.

• Example: Emphasizing a staff member's race at work might undermine their performance because they're concerned about confirming a negative stereotype (for example, that minorities aren't smart).