Publisher apologises after nursing textbook contains racist stereotypes

The nursing textbook has been heavily criticised by healthcare professionals for containing racist stereotyping. The textbook provides a section on advice for […]

Sarah Jane
24 October 2017

The nursing textbook has been heavily criticised by healthcare professionals for containing racist stereotyping.

The textbook provides a section on advice for nurses when administering pain relief to people from different ethnic backgrounds but the contents have been criticised for applying racial stereotyping.


It begins: “A client’s culture influences their response to, and beliefs about pain. Some cultural common differences related to pain are listed here.

The book, Nursing: A Concept-Based Approach to Learning, contains advice for healthcare professionals when dealing with different ethnic communities. Here are some direct quotes of the content;


  • May not request pain medicine but instead thank Allah for pain if it is the result of the healing medical process.
  • Pain is considered a test of faith. Muslim clients must endure pain as a sign of faith in return for forgiveness and mercy. However, Muslims must seek pain relief when necessary because needless pain and suffering are frowned upon.
  • Arabs and Muslims prefer to be with family when in pain and may express pain more freely around family.


  • 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.


  • Blacks often report higher pain intensity than other cultures.
  • They believe suffering and pain are inevitable.
  • They believe in prayer and laying on of hands to heal pain and believe that relief is proportional to faith.


  • Jews may be vocal and demand assistance.
  • They believe pain must be shared and validated by others.


  • Hispanics may believe that pain is a form of punishment and that suffering must be endured if they are to enter heaven.
  • They vary in their expression of pain. Some are stoic and some are expressive.
  • Catholic Hispanic may turn to religious practices to help them endure the pain.

Native Americans

  • Native Americans may prefer to receive medications that have been blessed by a tribal shaman.
  • They tend to be expressive both verbally and nonverbally.
  • They usually tolerate a high level of pain without requesting pain medication.
  • They may pick a sacred number when asked to rate pain on a numerical pain scale.

The publisher states the content has now been removed from the nursing textbook. In a statement the publisher said;

“While differences in cultural attitudes towards pain are an important topic in medical programs, we presented this information in an inappropriate manner.


“We apologise for the offense this has caused and we have removed the material in question from current versions of the book, electronic versions of the book and future editions of this.

“In addition, we now are actively reviewing all of our nursing curriculum products to identify and remove any remaining instances of this inappropriate content that might appear in other titles.”

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