Resisting the racialization of medical deservingness: How Latinx nurses produce symbolic resources for Latinx immigrants in clinical encounters.

Abstract

This paper investigates how Latinx nurses resisted the racialization of medical un-deservingness against co-ethnic immigrants in everyday clinical encounters. Drawing on 26 in-depth interviews and dialoguing with the literature on minority professionals, we find that, as a form of racialized equity work, Latinx nurses produced certain symbolic resources, specifically the interactional signals to counteract Latinx patients' internalization of un-deservingness and other medical staff's open hostility towards these "undeserving illegals." Latinx nurses hybridized neoliberal norms (self-sufficiency and responsibility) and social justice values (including healthcare as a universal right and compassion for members of the community): they emphasized Latinx immigrants' efforts at "becoming" self-sufficient and clinically responsible, debunked the relevance of citizenship to a right to healthcare, and highlighted their communal bonds with co-ethnic patients. Meanwhile, accentuating these communal bonds revealed hefty loads of previously self-censored healthcare needs among Latinx patients, which compelled Latinx nurses to reassert some professional boundaries. Whereas some Latinx nurses were able to engage in "moralized boundary-drawing," others experienced setting professional boundaries as "demoralizing boundary-drawing," which resulted in burnout, disillusionment, or internalized racism. Our findings indicate that the path to de-racializing medical deservingness needs to be multi-tiered. Latinx nurses' racialized equity work of generating symbolic resources for Latinx immigrants is only sustainable if supported by non-Latinx colleagues' cross-ethnic equity work. Furthermore, everyday resistance in clinical encounters is necessarily incomplete unless state-level policy initiatives transform the currency of symbolic capital for medical deservingness.