An unconscious patient is brought to the emergency department by ambulance for trauma treatment

Question

The patient is wearing a sweat-stained John Deere cap, a denim shirt worn out in the elbows, dirty bib overalls covered with patches, work boots worn thin, and ragged underclothes. Several staff laugh as they stabilize the patient, and one remarks, "Farmer John must have fallen off the tractor.". The most appropriate action for the charge nurse is to say: a. "So he's a farmer—get over it. Thank him for your food and move on.".
b. "You are violating this man's right to be treated with respect, and it stops now.".
c. "Grow up and do your jobs; I think you have all seen poor people before.".
d. "Perhaps you could find an outlet for humor that's not at a patient's expense.".

Answer 1

B
The scenario is an example of a stigmatization of a medically ill patient based on cultural differences such as a possible agrarian vocation and poverty. People tend to stigmatize those who are most unlike themselves, who they least understand or are most anxious about, or who are most disenfranchised. As professionals, nurses should recognize and correct behavior based on stigma, but those laughing at the patient have not done so and are not behaving professionally. They are also violating the patient's human right to dignity. The behavior is grossly unprofessional and carries a risk of compromised patient care; it merits direct and firm confrontation. The correct response labels it for what it is, with firm limits set thereafter. Stating that the staff's behavior is violating the patient's right to be treated with respect clearly communicates that their behavior is unacceptable and will not be tolerated. The other options all redirect the staff but do not carry the gravitas that is needed to indicate clearly how unacceptable their behavior is and set firm limits on it.