Massive criticism. A new poll among nurses shows that nine out of ten nurses think that patients with an immigration background are a burden for the nursing staff. Language and cultural barriers are some of the causes, nurses think. Others point at the petrified danish hospital culture and rigid norms as the problems' causes.
They are time-consuming, ressources-swallowing, aggressive and noisy. They don't understand Danish. They react differently to pain. And they roll out their prayer rugs just on top of all.
'I must confess that I am frustrated when I - for myself - have to spend so incredibly much extra time on a stranger family with a - for the staff - minor problem, just because it turned out that we hadn't understood each other. Cultural differences lead to some strangers thinking they're polite, when they don't say that they haven't understood information, appointments etc', writes a nurse in the questionary, which she could fill in anonymously and return to the analysis office.
The poll conducted among the nurses indicates a lack of understanding on part of the immigrant patient with regard to a diagnosis or important details of the treatment - although she, writes a nurse, can see that they have been in Denmark for 15 to 25 years.
Language problems can often be solved via an interpreter, but even if the possibility exists to get one, this often isn't the solution.
'Our problem is that the interpreter never shows up, or he doesn't translate everything, or that the patient doesn't want an interpreter, instead his family members only', writes another anonymous nurse.
But family members as interpreters can be a bad solution.
'Family members acting as interpreters often think the patient shouldn't know everything of what we would like to inform him', explains a cancer ward nurse.
About half of the nurses responded in this poll that a different illness concept makes it difficult to nurse immigrant patients. Another nurse writes:
'The patient and his family wished exorcism performed by a priest/sage. And there were family members who wished to take care of the nursing during the in-patient stay.'
Several nurses mention that immigrant patients often do not follow the medical staff's orders, but prefer to visit doctors in their homeland.
'They don't trust the danish system. Instead they consult doctors in their home country which give other diagnoses and prescribe different medicine', explains one of the nurses.
Every fourth nurse says that the cause for the problems are unrealistic expectations towards the treatment's effect. And a little more than every forth points out that the patient didn't follow the hospital's routines or didn't repsect them.
Also in very everyday matters, the problems pile up. A nurse writes:
'A male patient speaking danish excreted his defecation on the floor and left, in a way that we were allowed to clean up after him. He considered it our problem, because we couldn't offer him a 'hole in the ground' type of toilette.' Another nurse writes:
'Ethnic patients - especially the older ones - react violently towards pain. The younger ones demand immediate treatment for their family members, thus here and now, irrespective of waiting times. If they can not be checked and treated immediately, they often call us racists. It is very unpleasant, when we try to treat all patients equally.'
In the deepening commentaries of the poll, many nurses state that another big problem is the immigration patients' gender discriminating and devaluating behaviour towards them.
The cultural difference is one of the causes most frequently mentioned by nine out of ten nurses why immigrants can be burdensome.
Examples mentioned by the polled nurses are strikingly different reaction towards psychic and physical pain, a higher degree of sense of shame, refusal of medicine, different educational norms and not observing appointments agreed.
Some point also at the condition that immigrants have little understanding for the necessity of a good hygiene.
In general, the nursing staff is - according to the poll - expected to show more consideration for immigrant patients than for danish such. Often, different meals are to be served, consideration has to be shown for prayers, and their many family members fill the wards and are noisy, the nurses say.
'When family members lay a prayer rug on the floor, then it can become difficult to nurse the patient, e g when the rug is close to the respirator or the pumps', a nurse writes.
Others are clearly irritated about immigrant patients in general:
'A certain group thinks they can permit themselves anything. E g, they empty the soda water-filled freezer, and they appear at any time day or night, an entire swarm, 8 to 10 persons.' Another nurse writes:
'They treat us like domestics. When they don't show up for treatament. When they show up much too late, still expecting treatment before the patient who has come on time.'
Several of them point out that immigrant patients are a difficult balance act for nurses, who may feel forced to intervene and to demand that patients respect the rules. On the other hand, many are afraid of being accused for racism.
'This is like sitting in a bee-hive. You have to step carefully, otherwise you get stung. It's so easy to say or do something wrong. On the other hand, I'm a human being living and working here. And there a limits for what I'm ready to put up with - also on the job. That's why I have become more like 'So that's the way we do things here, right? Like it or not.' (snip - starting here it's the 10 % politically correct ones' turn who consider an enrichment mohammedan shit, noise and carpet rugs, simultaneously blaming the danes and their health system for the problems)