Does white privilege mean anything in patient care?

Seeing People.

I was doing a follow up visit for a woman I am case managing.  She is living in a nursing home in Baltimore, but before that she was living on the street.  Her family has disowned her because of substance abuse.  Her children are in the system.  Life has not been kind to her.  She is in her early 40’s, but looks as though she’s in her 60’s.  she had a recent above the knee amputation and multiple surgeries to the leg for infection.  She is on dialysis and for the most part dependent on others’ to provide her care while in this facility.

On the day I went to visit her, before I stepped into the room, I glanced at her from the door.  She looked calm.  When I stepped in and started chatting with her I could tell she was sad.  She became tearful as she discussed the phantom pain in her leg and felt that nothing was being done about it.  She started swearing and threatening to pull out the dialysis and wound care lines because she couldn’t get what she wanted right away.

My first thought was “Do healthcare providers view this behavior differently coming from a white person than a person of color?” She just so happens to be a white woman. Does she benefit from white privilege?  My conclusion is most likely.



White privilege is a less about an individual white person exerting their privilege and more about societal implications of opportunities afforded for having white skin.  I think Peggy McIntosh describes it very well in her essay “Unpacking the Invisible Knapsack“. One example that Mrs. McIntosh lists’ that is fitting in this scenario is this privilege:  “I can swear, or dress in second hand clothes, or not answer letters, without having people attribute these choices to the bad morals, the poverty, or the illiteracy of my race”.


While I know this behavior is not unusual for clients with behavioral challenges, does anyone else look at her and thinks its because she is white that she does these things? Probably not.  However, for black patients and other patients of color exhibiting this type of behavior the likelihood of associating the behavior with their skin color is more likely. And because racism in our society is so endemic, it stains our attitude even in the healthcare setting.  One might view this white client as “struggling” or “down on her luck” and feel sadness for her whereas if this were a black client one might think “she put herself in this position” or feel apathy or anger.  Privilege is a matter of perception.


While most nurses don’t think about white privilege on a conscious level, it impacts us constantly nonetheless.  It colors the lens through which we see our clients on a subconscious level making it dangerous if not brought into consciousness.

  • Become more aware of your thoughts when you interact with patients.  Notice your thoughts and feelings about patients who are white versus those of color.
  • Notice resistance and defensiveness.  If you feel defensive about white privilege you are most likely benefiting from it and need to further educate yourself.  Read antiracist work by Peggy McIntosh, a white woman who didn’t realize until she was an adult how white privilege impacted her choices and chances in life.   Check out this interview with Dr. Beverly Daniel Tatum author of “Why are all the Black Kids Sitting Together in the Cafeteria?” to get a better appreciation for antiracist work.
  • Commit to seeing and not ignoring social justice at the bedside or in whatever community that you practice in.  Transformation begins with you, one step at a time, one day at a time.

nurse words



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