Racism enshrined in higher ed

Is this what nurses are being taught?

It’s also revealing how white people aren’t even mentioned. We are the standard by which all are measured; our responses are assumed and we just have to mention the differences, like that blacks are inured to pain and Jews complain a lot and Indians are stoic.

I’m not too surprised to see this kind of garbage in a nursing textbook. It’s no criticism of most nurses, but there’s a heck of a lot of bad woo in nursing programs — my university’s bogus Center for Spirituality and Healing is affiliated with the nursing school, to their eternal shame.


  1. peptron says

    I can’t help but read it as “Why waste painkillers on foreigners? Except Jews of course, who might see through our game and sue us.”.

  2. says

    “Tribal shaman” “the creator” “sacred number”. Where in the fuckety fuck are they getting this? Oh, right, some white person. Gods forbid they talk to actual indigenous people. We don’t have shamans. My people don’t have ‘a creator’ and don’t believe in one. I’m asked the 1 to 10 question every 3 months. I have never chosen a ‘sacred’ or ‘lucky’ number. Right now, my pain is at 9, and has been for much too long, and have weeks to go before pain clinic. Generally speaking, people in pain tend to report accurately, even if they are polite enough to refrain from screaming your ears off.

  3. davidnangle says

    This is incomplete. Perhaps I can fill it out a little more.

    Mexican patients wear large sombreros and siesta on street corners?
    Caucasian millennial females focus furiously on their phones while sipping pumpkin lattes?
    German patients tend to brew fine beers and attempt world domination?
    Alien infestations in arctic outposts react to pain by extending pseudo pods out of their detached heads, which scuttle away into hiding?
    Republican patients attempt to seize power in order to rob and destroy absolutely everything in the world?

  4. says

    Also, once again, “native american” – we are not monolith. Different nations, different beliefs, different traditions, different everything.

  5. peptron says

    – Native americans and east asians can only communicate using metaphors involving animals.
    – Caucasians hold stereotyped views of other groups of people. Caucasians are asked to refrain from rereading this list with that in mind.

  6. blf says

    Oh for feck’s sake:

    ● Arab ≠ Muslim.
    ● Asian, unlike all the other groupings, is geographic.
    ● Jews & Muslims, at least, can also be in any of the other listing groupings.
    ● None of the groupings is monolithic.

    And on and on and on. And that’s even without bothering with the alleged characteristics of each grouping.

  7. robro says

    And this isn’t just any old educational textbook publisher, this is from Pearson Education, formerly Simon & Schuster education and their Addison-Wesley division. Pearson is huge.

    A patient-centric unit on factors that affect a patient’s pain management is appropriate, and some of those factors may be culturally derived. Obviously, this is ridiculous stereotyping and harmful.

    Many years ago I had the joy of working in a hospital where most of the patients were older, affluent, Northern European Americans. Their response to pain was…
    • Complain to the nurses aid (me) and ask to see the nurse for more pain medication
    • Complain to the nurse about the nurses aid, and ask for more medication
    • Complain to the head of nursing about the nurse, and ask for more medication
    • Complain to the doctor about everything, and ask for more medication

    We can conclude from this that North European Americans are bunch of whiny ass drug addicts.

  8. The Mellow Monkey says

    Native Americans may prefer to receive medications that have been blessed by a tribal shaman? The fuck? In the vast majority of cases, indigenous people just want to get fucking treatment period, preferably without any racism involved.

    All of these are so grotesquely dehumanizing, while treating white non-Jewish people as so “default normal” that it never even mentions them. Never mind that there are distinct cultural differences between Midwesterners, Southerners, or others. Never mind that there different religious groups–even under the umbrella of Christianity–will have their own ideas about things. Never mind that white American cultures are different from European ones.

    NOPE. White people are all “normal”. It’s everyone else who has to be looked at funny.

  9. gorobei says

    Well, it’s horribly stereotypical and wrong, but if it makes nurses and doctors a little more aware that self-reported pain (pick from this scale of white smiley-face to red crying face) is heavily culturally and individually biased, we probably save a bunch of lives each year.

    That said, it’s horrifying that each group description starts with a “may,” except blacks who get an “often.” And whites from Moscow to South California are just culturally normal.

  10. says

    I’m with #7&#9. If you don’t have shit for brains it will hopefully read this as a reminder to consider cultural biases when judging pain and similar symptoms. But as it’s written it’s pretty much useless as a guide, as it doesn’t give you any indicators for when people are under- or over-reporting pain (relative to your own references).

  11. robro says

    Erlend — But why hope that nursing students get it? It isn’t hard to make the point that there are many factors in the experience of pain without including bigoted cultural stereotypes, which are almost certainly not true for specific individuals. Pearson Education is a large enough publisher to afford the writers, editors, and management to do the right thing here. This ain’t rocket surgery.

    BTW, Happy Diwali everyone.

  12. numerobis says

    Self-reported pain varies widely between people — and even for a given individual depending on circumstances.

    Throwing out these bullshit generalizations is toxic.

  13. lemurcatta says

    This is pretty standard fair for health profession textbooks. I was a paramedic, now in med school. Everywhere I’ve worked, these sentiments and others are widely accepted. I’m not saying it’s right, but generalizations about patient and family behavior are made from their ethnic backgrounds all the time, and everyone from techs to physicians do it. Medicine as a whole is actually fairly regressive socially.

  14. robro says

    WMDKitty — A fair question. The design appears to be relatively modern. However, according to a later tweet in the linked thread this content appears in two texts published by Pearson: one from 2014…a mere $234.99 new from Amazon, and the other from 2016, only $140.37. Of course, the material itself may be older than the publications. One way text book publishers make profits is reusing content…such as publishing the same material in more than one book.

  15. starskeptic says

    FFS – hospitals spend a LOT of time and effort to remind their employees that not everyone thinks and reacts the same and to be sensitive to our differences; this appears to be an outgrowth of that.
    For example, in AZ a hospital had to remove a fake owl that was used to scare birds away from its helipad due to the beliefs of some tribes. They could just be told them to fuck off, but I think most places have an investment in being accommodating…

  16. chigau (違う) says

    also, as someone with a variety of “chronic pains”, my self-reporting of my pains could really be understood only by someone who knows me.
    Some of my pains have been accumulating and worsening for decades.
    The ankle I sprained at the age of 18 now requires surgery.
    Ditto the sacroiliac injury from age 28.
    I’m 62 and have been doing work-arounds to accommodate my pains for decades.
    I’m willing to bet that Caine’s 9, would be a 17 or 18 to someone who has never had Pain.

  17. chigau (違う) says

    I can’t tell from the OP.
    Where is this textbook from?
    Are the nursing students really all white?

  18. sillybill says

    You have chronic level 9 pain and you still give us flowers and birds every week?
    Thank you.

  19. says

    I remember stuff like this when I was in nursing school 15 years ago; even though I was one of the few “white” people in my class in Queens white was definitely considered “normal”. I also remember learning a lot more useful, realistic information in nursing school about cultural awareness.

  20. Alt-X says

    I had a dentist here in Australia that wasn’t going to give me injections to numb up my mouth before pulling a tooth. He told me people like me have high tolerance to pain and don’t need it. Like I’m an animal that can be mistreated because I won’t feel it. I hate living here.

  21. says

    What this looks like is a very bad attempt to do what actually makes “some” sort of sense. Yeah, there are likely to be cultural differences in how people deal with things. We know this. Its been studied. It causes all sorts of annoying problems when trying to treat people. But that is “culture” a freaking African American that spent their whole lives living among Traditional Chinese, who would rather consult a fortune teller than go to a psychologist is going to react the same as any other person from that “culture”. They are not going to act like an African American, according to the absurd things in this list of traits.

    So, yeah, awareness of how different cultures might have certain… issues with certain things in medicine – yep, makes sense. Deciding that this is some trait you can attribute to people based *purely* on whether or not they are a certain “race” – you are actually making the problem you tried to solve here worse, since you can’t just assume from someone’s appearance that they “fit” into any of these categories, or heck, that, in the case of Native Americans, just to use one as an example, every freaking tribe has the same default responses, because, they are all vaguely the same, in some Disney like Pocahontas sense of “American Indian”. That’s just as bad as assuming every fool that walks through the door will have a White Male Privileged attitude about medicine (which ironically was the original problem that they where almost certainly trying to solve by recognizing that not everyone fits the default expectations the whole industry, until recently, assumed everyone that walked in the door was going to exhibit, before they wandered off into the land of excessive simplicity and unintentional? racism.)

  22. anbheal says

    @7 robro — yeah, funny, ainnit, how they didn’t parse the middle class straight white Christian man’s cold/flu from all the others. He lies in bed for three days, moaning and incapacitated and needy, while his wife with the same cold/flu feels shitty but does all the daily stuff that needs to get done. Almost as though HIS pain is privileged over all other. But honestly, shouldn’t the main sub-heading be “Men are pathetically unprepared for discomfort and pain while women tend to be stoic and resilient.”? I mean, far be it from me to indulge in gender essentialism, but if they’re going to “go there” with regard to all those racial and ethnic and religious essentialisms, hello, which is the Elephant In The Living Room??? Whiny white men who can’t stub their toe without needing it kissed by mommy and then posting their jeremiads on Facebook, after the weeklong recovery and hand-delivered chicken soup.

  23. says

    @25 Yeah, my brother, who annoys the heck out of me sometimes with his lack of awareness about it, is a total ass sometimes, and one of his biggest ass moments is almost always when *anyone* feels poorly, or is unable to do something, and he can’t comprehend why they don’t do the exact opposite of that – buck up, ignore the pain, and charge ahead like you don’t feel anything at all. I am sure some clown, if they decided to make a “list” would just decide, “Oh, well, maybe people of Scottish descent are like that, so lets list those as traits for them.”, when the real problem is, I think, having been an ex-sheriff reserve, in search and rescue, and possibly being a bit too sympathetic of fictional characters like John McClane, whom he can imagine acting just like. (Yeah, conversations with him on things like.. guns are a weird mix of agreement that there are serious problems, and a total refusal to believe that part of the problem is.. actually guns, and that the right wing claims that *every nation has the same problem*, and still would if they didn’t exist, and it was just knives, or something is, in his mind, perfectly reasonable. Sigh…)

    Like I said, the problem isn’t trying to address differences, even cultural ones, its assuming you know what the F those are, based purely on the shape of eyes, of color of someone’s skin, or other things that mean nothing at all, if they are ascribe to those “cultural” things.

  24. rietpluim says

    It’s also revealing how white people aren’t even mentioned. We are the standard by which all are measured; our responses are assumed and we just have to mention the differences

    I think it’s a little different. We are a group of great variety: different individuals with different needs. Jews are all the same.

  25. says

    Sillybill @ 20:

    You have chronic level 9 pain and you still give us flowers and birds every week?
    Thank you.

    Welcome. :) Thank you, very much. Comments like this keep me going.