A nursing textbook has been pulled from shelves after a student posted a page depicting woefully inaccurate stereotypes about different racial groups.
The book, published by Pearson, featured a table on “Cultural Differences in Response to Pain”, which asserted various minority groups handled pain in ways specific to their ethnic backgrounds. One portion asserted that Blacks “report higher pain intensity than other cultures”, Native Americans “may prefer to receive medications that have been blessed by a tribal shaman”, and that Jews “may be vocal and demanding of assistance” and that their pain “must be shared and validated by others”.
When discussing Asians — a racial group comprised of 4.5 billion people — the book stated the following:
- Chinese clients may not ask for medication because they do not want to take the nurse away from a more important task.
- Clients from Asian cultures often value stoicism as a response to pain. A client who complains openly about pain is thought to have poor social skills.
- Filipino clients may not take pain medication because they view pain as being the will of God.
- Indians who follow Hindu practices believe that pain must be endured in preparation for a better life in the next cycle.
The person who stumbled across this page, Onyx Moore, posted a screenshot on her FaceBook account.
“CN: Racism across the board
“This is an excellent example of how not to be even remotely culturally sensitive. These assumptions are not evidence-based, they encourage nurses to ignore what a patient is actually saying (if someone tells you their pain level is high, you need to believe them), they list common behaviors as culturally specific (most people are more comfortable being honest about their pain with family members/those close to them), and they don’t actually teach nurses how to engage in a CULTURALLY SENSITIVE way.
“This chart lumps together various groups whose belief-systems vary widely. Native Americans are not a monolithic group, so you can’t make a generic list of what is culturally sensitive to them. Asia is a huge continent and the chart completely glosses over that while leaving out countless groups in an attempt to convey the message quickly. If they are including African people under Black, then they’re intentionally shoving together a whole host of groups with different cultural customs; if they’re not including them under Black, then they just completely ignored an entire portion of patients. Jewish/Muslim can be both ethnicities or religions, so what happens if a Black Jew comes in? Or a Black Muslim?
“Seriously, I could go on for some time about how much is wrong with this and how outright harmful it is, so I’ll sum it up as this:
“If you want to be culturally sensitive, then you need to actually LEARN about other cultures. If a patient tells you their pain level, believe them- because *they* are the expert on their body. As a medical professional, your job is to provide medical care, the patient’s job is to convey their symptoms; when in doubt err on the side of better treatment, not disbelief.
“(I’m intentionally not delving into how racist some of these statements are. That doesn’t mean I don’t notice them, nor should you ignore them)”
It quickly went viral due to its audacious claims, with netizens offering their opinions on the matter:
Remember the Eugenics laws? How close is this to minimizing and “otherizing” other people? Will this be seen as a way to start “ethnic cleansing” in America, again? Not surprising to read this undercover BullS***.
— Mary Brown-Williams (@BabyBoomer752) October 19, 2017
— שֵׁײנָא🌺lynds (@LRwriter) October 17, 2017
Patient thinks the room is too cold? Is in pain? Needs help with whatever? All just poor social skills! Their fault! Not the nurse/hospital!
— Kelly Hills (@rocza) October 18, 2017
@pearson Putang ina mo, you know NOTHING about Filipino culture and society! Mag-aral ka ya muna, anak ng puta!
— Sarcastic Tarsier (@genius23sarcasm) October 19, 2017
Wow they really went out of their way to make *each section* both racist and nonsensical. pic.twitter.com/3hWJF745aP
— Nicole Gustavsen (@referencebird) October 17, 2017
Holy fuck. Well, I see why my pain care is the way it is if this is considered current and correct. UGH.
— Aleksei Valentín ♿ (@ai_valentin) October 18, 2017
— kaikai (@kai_cimone) October 18, 2017
No wonder black patients have such dismal rates of having their pain managed. Nurses taught they just *say* it’s more intense. https://t.co/PxR6ixHfbz
— Kate Sophia (@kasuso) October 19, 2017
What the actual fcuk? ” Native Americans tend to express themselves less clearly?” I’ve also never asked for “Shaman Blessed Medication”
— Atená:ti☕Kanien’kehá (@1mattbritton1) October 18, 2017
a SACRED NUMBER?!?!?!? WTF???? Now I’m imagining this person having a JD-like daydream:
NURSE: What’s your pain, from 0 to 10?
JEWISH PATIENT: חי!
— aleksandra אלכסנדרה (@schala09) October 18, 2017
Looks at Native American section. “You know a ton of us are Christian cause you killed anyone that didn’t hand over their babies, right?”
— R.E. Towers (@RE_Towers) October 17, 2017
They forgot the section on Whites, whose pain is greater than everybody else’s and will go to hypocritical lengths to explain this.
— Melinda R. Cordell (@rosefiend) October 18, 2017
While there are those who may look at each bullet point and agree with what was said, there are consequences for accepting blanket generalizations about culture and race as fact — especially in the medical field. To note that “Jews may be vocal and demanding of assistance”, for example, may indicate to the nursing student that a Jewish patient who is rightfully vocalizing their pain may be exaggerating, which, in turn, can lead the student to believe that their pain is not valid.
In contrast with the portion on Jewish patients, the book painted Asians as people who minimize their pain and may refuse medication, making an effort to highlight Chinese, Filipinos, and Hindus. One glaring issue with these groupings is that it erases the notion of intersectionality, as a person could belong to both a religious and racial group that may have polar opposite cultural responses as indicated by this page. Another issue is that it asserts that any given Asian person is likely going to be okay with suffering due to religious beliefs, meaning that medical personnel, upon reading this book, could foreseeably decline to ask an Asian patient if they’d like pain medication.
Pearson was made aware of the textbook and issued a public apology, promising to pull the offending tome from shelves.
We agree that it is wrong. We have removed it from current electronic and future print editions and apologize for its publication.
— Pearson (@pearson) October 18, 2017