Introduction
This essay will reflect upon an incident of racial prejudice and discrimination experienced during placement between a patient and members of the multidisciplinary team (MDT). Having looked at reflective models by Carper (1978) and Gibbs (1988) I have chosen to reflect upon this experience using the Gibbs (1988) reflective cycle. This 6 step model is easy to follow and sheds light on specific aspects of my placement experience. Initially I will describe the situation as I perceived it, discuss my feelings, evaluate, analyse and conclude the situation; following this I will devise an effective action plan by exploring literature, values, beliefs, ethics, law and hospital policies summarising how these support practice for the patient receiving care.
Description
During placement on a surgical ward I was required to look after a man of 65 years. For reasons of confidentiality, and in accordance with the NMC guidelines which protect human rights and maintain professional practice (NMC 2008), I will not reveal any other details of patient information. For the purpose of this essay I will name the patient ‘Mr. Smith’.
Mr. Smith had just received total hip replacement surgery. Surgery had temporarily compromised his mobility and as a result he required assistance from staff. Members of the multidisciplinary team (MDT) were keen to assist him to mobilise, to perform prescribed exercises, and to maintain personal hygiene the day after surgery. Mr Smith was reluctant to move and refused to wash even when offered assistance.
Rumbold (1999) states that if a patient refuses treatment this can be seen as a function of their autonomy; following such a refusal it is the health professional’s responsibility to establish the reasons for refusal. When Mr. Smith was asked why he had objected to receiving care from nurses, physiotherapists and staff, he explained “I do not want foreigners helping me, I would rather do it myself”. He then insisted that only “white” staff should care for him.
Nurses present on the ward and those told about this insistence were appalled and offended by the clearly racist comments and tone of Mr. Smith. In dealing with such situations, nurses usually try to avoid conflict and confrontation. In this instance too, putting the needs of the patient Mr. Smith above their own legitimate feelings about his racism, they allowed him to be treated in accordance with his values and beliefs where possible. This meant that if there was a white nurse on shift this member of staff would care for Mr. Smith. Only if no white nurses were on shift was he offered assistance by nurses of other ethnicities. In response to nurses’ of a different ethnicity assisting him he would be verbally disrespectful, unappreciative and abusive. When it became possible to do so, Mr. Smith was moved to a side room to prevent his comments from offending other patients on the ward.
Feelings
My own personal values and beliefs have been acquired over the years through a number of sources. Some of my beliefs and values have originated from my upbringing parental influence and friends. I have also been brought up in a culturally mixed society and had friends of varied ethnicities. Although I do not practice any religion currently, from an early age I was introduced to Christianity and regularly attended church with my family. There I heard and absorbed messages about tolerance and respect between human beings. School, newspapers, news and education have also participated in shaping my personal values, teaching me about boundaries and what is acceptable and correct behaviour in a democratic society. Harmonising these moral and social value systems with those of others is what builds successful relationships, whether personal, professional or educational and ensures that society works for everyone.
My initial feelings about Mr. Smith and his racial prejudice were mainly of shock. I couldn’t believe that his unreasonable, offensive