Healthcare providers: understand the impact of your words

stock art of an apparently white doctor talking to a patient with darker skin

Near the beginning of the pandemic, an Asian family experienced an overt act of racism at a community center in the Pacific Northwest. It upset the two children so much that the family visited their pediatrician’s office for guidance and support. The healthcare provider dismissed the parents’ concerns and subtly criticized them for “deposit(ing) things in children’s minds.”

This real story is the heart of a new commentary paper published in the Asian/Pacific Island Nursing Journal.

Lead author Connie K.Y. Nguyen-Truong, an assistant professor in the WSU College of Nursing, said she and her fellow authors were prompted to write the article to help healthcare providers understand the impact of their words and actions. Co-authors are Shameem Rakha, assistant professor in the WSU College of Education; Deborah Eti, clinical assistant professor in the WSU College of Nursing; and WSU RN-BSN nursing student Lisa Angelesco.

“In writing the article, our team wanted to help people see themselves,” said Nguyen-Truong. “We wanted them to step back and say, if this is the family’s perception of the words said by a healthcare provider, what words have I used?”

In the article, the family are identified by pseudonyms, but the real adults and children agreed to have their story told.

It describes how the family is refused service at a community recreation center they’d visited often in the past. The wife, called Lan, narrates how she and her children grew increasingly afraid and confused, respectively, and the husband “rushed over and said to the crowd who appeared to have gathered, ‘We don’t have coronavirus!’ We were clearly not welcome in a place where we had been going for years, so we left. It took me a long while to stop shaking.”

Afterward, their children had bad dreams, mood swings and were sad. The parents took the children to their usual clinic where they saw a healthcare provider they hadn’t seen before. Recounts Lan, “Mustering my courage, I explained what had happened at the community recreation center and respectfully asked to have (the provider) explain how this experience might impact my children’s health now, and in the future, and what could be done in terms of healing.”

The provider responded dismissively and the family hasn’t returned to the clinic – disrupting a longtime care relationship.

Top row, l-r: Dr. Connie Nguyen-Truong; Dr. Shameem Rakha. Bottom row (l-r): Dr. Deborah Eti; Lisa Angelesco.

Nguyen-Truong and her co-authors explore the ramifications of this encounter through the lenses of critical race theory and AsianCrit, a related framework that incorporates Asian-American racial realities. Those tenets include that everyone deserves to be heard, but many are silenced; that racism is real and ubiquitous; and that people’s stories – called counter-stories – can be used to help illuminate what might be going on.

The article also discusses implicit bias and its possible effect on the ability of healthcare providers to hear and understand their patients’ stories.

Eti, one of the co-authors, said the team believe it’s important to write the article because it could help other healthcare providers.

“When someone is traumatized, let’s acknowledge it and identify ways we can do better,” she said. “We can’t just shove it to the side and say ‘They can deal with it.’”

Nguyen-Truong said she has experienced anti-Asian xenophobia and discrimination during the coronavirus pandemic. “Hate is real,” she said, “but I choose not to hate back. I think it’s important to put out there caring and healing messaging and actions.”

–Story by Addy Hatch


For more information: Connie Kim Yen Nguyen-Truong, PhD, RN, Alumnus PCCN; Shameem Rakha, PhD;  Deborah U. Eti, PhD, ARNP, FNP-C, PMHNP-BC, MSN-Ed, CNE, CEN; and Lisa Angelesco, BSN, RN;  “Deconstructing Racialized Experiences in Healthcare: What a Missed Opportunity for Healing Looks Like and Healthcare Resources for Children and Their Families,” Asian/Pacific Island Nursing Journal, 5(4). [Special Issue: Mental Health Issues Among Communities]