Riverbend Micoagressions

Introduction
Microaggressions are statements or actions that stereotype, belittle, or discriminate against members of marginalized groups. These statements or actions are often subtle, indirect, unintentional, and seemingly “small.” However, for members of marginalized groups, these offenses can be common events that quickly add up. As human service professionals—who work with all kinds of people—it is important to be aware of common microaggressions, and to avoid committing them.
You are a member of Riverbend City’s Diversity Task Force. You have been asked to investigate a recent incident at Riverbend City Medical Center that received a good deal of negative local media coverage. This incident involved a Hmong child who was a patient in the hospital. The child’s family felt that their treatment from hospital staff members was insensitive–and they felt that they were victims of microaggressions.
As a part of your investigation, you will interview individuals who were involved in this incident. From these interviews, can you identify any microaggressions? If so, what recommendations would you make to these staff members about avoiding macroaggressions?

Scene 1

Email from Vicki Stephens

From: Vicki Stephens, RBC Communications Director

Subject: Vang Family Incident
I’m so glad to hear that you’re going to be investigating the recent incident involving the Vang family at the Riverbend City Medical Center Emergency Room for the city’s Diversity Task Force. I’m not sure how much you know about this incident, so I thought I’d fill you in with some background information.
Last month, Washington Allston Elementary School was evacuated after a nearby chemical spill. Three children with asthma reacted strongly to the chemicals and were brought to the emergency room, including first grade student Mee Vang. Mee, who is Hmong, immigrated with her family to Riverbend City earlier this year. Previously, the family was living in a refugee camp in Thailand.
Two serious issues arose that could have been handled better. First, Mee was treated by Jessica Jameson, an emergency room nurse. Jessica saw that there was a series of marks on Mee’s back. Jessica strongly suspected abuse and contacted Child Protective Services. These marks were actually the result of “coining,” a harmless traditional Hmong healing practice that involves pressing a coin repeatedly on someone’s back. Second, the family sent Mee’s 16-year-old cousin Jason—who was born in the U.S.—to take care of Mee until they could arrive, and then to translate. Hospital staff members refused to interact with Jason in this manner because he was a minor. After several frustrating altercations, Jason lost his temper and was removed from the hospital by a police officer.
As you may know, there was a good deal of negative local press about these events, and the hospital was accused of being insensitive to Hmong patients.
For additional background information, please take a look at a related article from the Riverbend City Free Press. Then, I’ve set up several interviews for you with individuals who were involved in this incident. We are looking forward to your feedback on how we responded to this incident, and how we can do better in the future.
— Vicki

Online Article
Riverbend City Medical Center: Are Hmong Families Welcome?

Written By: Laurie Boyette ([email protected])

All Jason Vang wanted to do was help a hurt little girl.
After the recent chemical spill that led to the evacuation of Washington Allston Elementary School, 16-year-old Kennedy High School student Jason Vang received an urgent phone call from his mother. Jason’s six-year-old cousin Mee, who has asthma, had been rushed to the hospital. Kennedy High is just blocks away from the hospital, so he could get there quickly.
Vang raced to the Pediatric Intensive Care Unit to get information about Mee, who came to America with her family earlier this year and is still learning English. Unfortunately, because Vang was underage and not immediate family, the nurses refused to give him information about his cousin. He was unable to text or call Mee’s parents with information. (Mee Vang has since recovered fully from the incident.)
“They were very rude to me,” said Jason. “They complimented me on my English skills—which was insulting because I was born in the United States. And they refused to help me out. I was really scared about my cousin, and they didn’t seem to care at all.”
The situation escalated. When Mee’s parents arrived, they arrived with a large contingent of Hmong-speaking relatives. Uncomfortable with the large number of people in the waiting area, hospital officials were flustered, Jason says. Jason, as the only fluent English speaker, tried to take control of the situation, but hospital staff again refused to let him act as an interpreter because he was underage. Jason lost his temper and kicked a trash can, and was escorted out of the hospital by a police officer.
This incident has left quite an impression on the Hmong community of Riverbend City—largely because it’s not the first of its kind. Tensions have been growing for years between the Hmong community and Riverbend City Medical Center. As the Free Press has reported previously, Hmong patients at RCMC frequently feel disrespected–their traditions mocked, their concern for extended family members seen as a nuisance.
Unfortunately, the Vang family situation escalated still further. Jessica Jameson, an emergency room nurse at RCMC, saw that there were suspicious marks on Mee Vang’s back. The marks were from a practice called coining, which is a traditional Hmong practice that involves pressing coins into the back of someone who is ill to help heal them. Nurse Jameson was not familiar with this practice and thought the marks were a sign of abuse—so she called Child Protective Services.
The misunderstanding was resolved quickly, but the family was horrified. “My cousins were already extremely upset because their child had suffered a life-threatening asthma attack,” said Kaying Vang, who is Mee’s aunt and Jason’s mother. “To be accused of abuse was humiliating. The hospital needs to be more aware of Hmong cultural practices and to treat us with respect.”
Family members are also upset at how their extended family was treated when they arrived at the hospital in support of Mee. It’s Hmong tradition for large groups of extended family members to do this. Unfortunately, according to members of the Hmong community, these groups have been less than welcome at the hospital — as was the case with the Vang family.
“The hospital kept telling our family members that we needed to get out of the waiting room because we weren’t immediate family,” said Bo Vang, Jason’s father. “Immediate family? What does that even mean? People were there because they were deeply concerned about a young family member. It’s like the hospital was saying they shouldn’t care so much because it was not their son.”

Scene 2

Incident Statements
Read each individual’s account of the Vang Family incident.
Jessica Jameson
Nurse at Riverbend Medical Center
So I was the nurse who called Child Protective Services. I was examining that poor sweet little girl—they’re so little and precious, these Asian girls—and I saw all those horrible marks on her back. I didn’t know what to do. One of the other nurses told me she thought maybe it was an Asian folk practice or something. So I tried to find Dr. Yee to ask him if he knew anything about it, but he wasn’t around. I know—my supervisor gave me an earful about that later because Dr. Yee is Chinese and this little girl was Hmong—but how was I supposed to know that?
But anyways, like I said, one of the other nurses told me she thought this was some kind of folk practice, but that just didn’t sound right to me. I mean… well, we see lots of Asians in the emergency room, and they’re not the kind of people who have so-called “folk practices.” They’re always so educated–and articulate, too, even the ones who don’t speak English well. I mean, that’s such an important part of their culture, right? You hear about these tiger moms who are super strict about their kids excelling in school so they can go to prestigious universities. So that’s why I called Child Protective Services. I really thought someone was abusing this poor sweet little thing. But it turns out that those marks on her back, they were from some kind of folk practice called “coining.” I guess they press coins against someone’s back to treat things like respiratory problems? I was shocked to hear they do that. You would think they would know better.
Mary Jackson
School Nurse at Allston Elementary School
I’m the school nurse at Washington Allston Elementary School. I came in with the children who had reactions to the chemical spill, including poor little Mee Vang. I was really worried about her, and thank goodness she’s fine now. I was kind of in the middle of the altercation, unfortunately, and I hope I didn’t make it worse. I saw that Jason, Mee’s cousin, was getting very irate because they wouldn’t let him see Mee, since he’s a minor. I tried to calm him down by explaining to him that this isn’t how we do things in America, that he’s legally considered a child here.
Well, he kind of exploded at me and informed me that he was born in California. I know I was making an assumption about him, but, I mean, his little cousin Mee doesn’t speak English, right? So I assumed that Jason didn’t speak English well either and I was speaking slowly to him, like he wasn’t a native speaker. That made him angrier. I’m very sorry if I escalated things, but… sometimes people can be so sensitive about things like this. It certainly wasn’t my intent to offend Jason… I mean, I was trying to help him, right? People need to give each other the benefit of the doubt that they mean well.
Pete Salgado
Riverbend City Police Officer
I was the officer who removed Jason Vang from Riverbend City Medical Center. They called me in because he was being belligerent…he wouldn’t take no for an answer when they told him he couldn’t see his cousin because he’s a minor. I had to remove him from the hospital when he kicked a trash can. (laughs) Man, he really kicked that thing. Gave that trash can one serious Kung Fu chop.
I got to tell you, I was real surprised to see an Asian kid act so aggressive like that. You just don’t see that much… not like, well, you know. Not like some other kids. Asian kids, they work hard in school, they follow the rules, they make their parents proud. That’s what I told him when I tried to talk him down. I said, “Come on, Kimo Sabe. You’re no thug. You’re too smart to be acting like this.” I guess he was just real upset about his cousin though. He’ll be okay though—I’m sure he’s back in school hanging out with the Chess Club again.
Walt Gardner
Child Protective Services Case Worker
I’m a case worker for Child Protective Services. I got called in by a nurse after she treated Mee Vang and saw what she thought was evidence of abuse. I’m always surprised when we see abuse cases in Asian families because we don’t see that very much. So I went in to the hospital. By the time I got there, Mee’s mother and aunt were there. Let me tell you–these two tiny little Hmong girls were angry! You just don’t see Asian girls acting all irate and loud. One of them was yelling at me in English and the other was yelling at me in Hmong–I mean, sheesh!
I kept telling them repeatedly that they had to calm down before I would speak to them. I tried to reason with them because I knew it wasn’t abuse and I just needed a statement–and I said that. I said, “Girls, we can get this over with quickly if we all just calm down and relax and talk about this quietly.” I guess that just made it worse because the more I told these girls to calm down, the angrier they got.
Chandra Capshaw
Social Worker at Riverbend Medical Center
I’m a social worker at Riverbend City Medical Center. They brought me in to speak with Mee Vang’s mother after Child Protective Services left–with a translator. I had kind of a frustrating meeting with them, and honestly, that was my fault. One thing I kept asking was why they didn’t take Mee to see their primary care physician. Her mother said they’d been using their traditional coining method because Mee had a bad cold–but Mee has asthma, so I didn’t understand why in the world they didn’t also take her to her doctor. I asked this a number of times and I could tell the mother was getting pretty upset, and I didn’t understand why.
Well, it turns out Mee doesn’t have a primary care physician because the family is really struggling financially. They take her to a clinic sometimes. And the thing is, it took me awhile to figure this out because it just didn’t register with me that this family was poor. And that’s because, well, most of the Asian families I work with come from wealthier parts of town–and they’re well-educated and knowledgeable about the health care system. Once I figured out that this family needed affordable medical care, I was able to get them linked up to the right resources. But I’m embarrassed that I made assumptions about this family that were based on race.

Conclusion