“I Want Someone American:” Protecting Foreign Workers from Discrimination

Imagine the Following Situation:

Maria, an experienced nurse originally from the Philippines, gently knocked on the door of a long-term care resident’s room. With a warm smile and years of professional expertise behind her, she stepped inside, ready to provide the attentive care her patients had come to expect. Before she could introduce herself, the resident glanced up, frowned, and interrupted.

“I don’t want you in here,” the resident said sharply. “Send someone else. Someone American.”

Maria paused, unsure whether to respond or simply back out of the room.

She had faced similar moments before—a comment here, a glance there—but this was direct and unmistakable.

She stepped into the hallway, wondering whether management would back her up or quietly comply with the resident’s request.

Would she be reassigned? Would anyone acknowledge what had just happened? Or would this moment pass in silence, as so many others had?

These are the moments when workplace culture is truly tested.

Unfortunately, incidents like this are not rare. Across healthcare and senior living settings, employees from diverse backgrounds routinely experience similar forms of bias, expressed through similar requests from patients, residents, or their families. Too often, the response is hesitation, avoidance, or even accommodation.

When organizations fail to intervene or, worse, comply with biased preferences, they send a clear message that not all employees are equally valued.

This problem is not theoretical. In several cases investigated by the Equal Employment Opportunity Commission (EEOC), employers failed to protect workers from racial discrimination and actively upheld exclusionary practices.

In one case, a senior living facility's general manager used secret codes on applications to avoid hiring minority candidates, justifying the practice by claiming that residents preferred White employees. In another case, management honored a family’s request that no minority staff care for their loved one, segregated work assignments by race, and denied qualified minority employees the opportunity for promotion.

These actions don’t just harm employees. They damage organizational culture, violate civil rights laws, and contribute to systemic inequities that have long-term impacts on workers’ livelihoods, mental health, and career advancement.

At the same time, these discriminatory practices stand in direct contrast to the realities of today’s workforce. In healthcare, senior living, and long-term care communities, foreign-born and minority workers are essential. Immigrants make up nearly one in five healthcare workers in the United States. Many provide critical services in high-demand roles such as nursing, personal care, and specialized medical care.

For example, Asian American healthcare workers, including a large number of Filipino nurses, play a vital role in patient care across the country. Tragically, Filipino nurses suffered disproportionately high death rates during the COVID-19 pandemic, highlighting both their commitment to service and the risks they face on the front lines.

Despite their contributions, foreign-born workers continue to encounter discrimination on the job. Requests from residents or patients to avoid care from certain workers based on race or nationality are still quietly accommodated in some organizations. These practices are not only unlawful; they undermine the foundation of workplace equity and inclusion.

In industries that already face staffing shortages, particularly in healthcare and senior services, creating respectful, inclusive workplaces is not just about compliance. It is critical for sustainability and success. Supporting foreign-born workers and standing firmly against discrimination are essential actions that protect both employees and the future of the organization.

How Organizations Can Protect Foreign Workers and Build Inclusive Workplaces

To create workplaces where all employees feel respected and valued, organizations should take the following actions:

1. Enforce Zero-Tolerance Anti-Discrimination Policies
   Make it clear that discriminatory preferences expressed by residents, patients, or families will not be accommodated. Ensure all staff members are trained to respond appropriately and with confidence when such requests arise. Communicate these policies consistently across the organization and to external stakeholders.
2. Provide Ongoing Cultural Competence Training
   Help all employees understand bias, microaggressions, and respectful communication. Provide training on how to respond when these situations occur and how individuals can support affected colleagues. Incorporate cultural competence as a core part of staff development and patient care standards.
3. Protect Employee Well-Being and Celebrate Their Contributions
   Create safe, accessible channels for employees to report discrimination or harassment without fear of retaliation. Offer mental health resources to support staff dealing with bias and trauma. Equally important: recognize and celebrate the contributions of immigrant and minority employees.
4. Ensure Fair Hiring and Promotion Practices
   Regularly review hiring, promotion, and evaluation processes to identify and eliminate bias. Ensure that opportunities are based on merit, experience, and qualifications, not on race, ethnicity, or national origin.
5. Support Employees Facing Bias from the Public
   Back your staff when biased behavior arises from patients, residents, or visitors. Reassignments should be considered only when safety is at risk, not to satisfy discriminatory requests. Establish clear procedures to protect employees’ dignity and well-being.
6. Embrace the Strength of a Global Workforce
   Celebrate the diversity of your team through recognition programs, cultural awareness events, and storytelling that highlights the unique contributions of foreign-born workers. Build a workplace culture that promotes belonging, respect, and shared purpose.

Another Essential Step: Meet Residents Where They Are

It is equally important to address bias and exclusion by engaging with residents who may hold limited or outdated views of cultural differences.

Leaders must bring empathy, patience, and emotional intelligence into these conversations, recognizing that many older residents are operating from an “us vs. them” mindset that may stem from lifelong experiences, generational norms, or fear of change.

Support residents through intentional education, guided dialogue, and informal relationship-building with staff.

The goal is to move them along the intercultural development continuum—from polarized thinking toward at least the minimization stage, where they begin to recognize the shared humanity and commonalities they hold with those caring for them.

This is not a one-time conversation, but an ongoing process that requires thoughtful leadership, consistent reinforcement, and community-wide commitment to creating an environment of respect and dignity for all.

Final Thoughts

Bias and discrimination don’t always enter the workplace through formal policies or overt decisions. Sometimes, they arrive in the form of a patient’s request, a resident’s comment, or a family member’s preference. These are the moments that define an organization’s true commitment to equity and inclusion.

When employees like Maria are left standing in the hallway, unsupported and devalued, the silence speaks volumes. But when organizations choose to stand with their workers, enforce their values, and create environments where every person is treated with dignity and respect, they send a far more powerful message: Everyone belongs here!

Building inclusive workplaces that protect foreign-born and minority workers is not only a legal and ethical responsibility—it is essential for creating resilient, high-performing organizations equipped to serve increasingly diverse communities. The future of our workforce depends on it.

Additional Resources

To help foster inclusion and cultural understanding, I’ve created a special resource just for you: Bridging Cultures with Care: Fun & Inclusive Activities for Nursing Homes & Assisted Living Facilities.

This collection features engaging activities—such as Cultural Bingo, storytelling, and “Getting to Know You” pairings—designed to strengthen connections, break down biases, and create a more inclusive environment in workplaces and communities.

If you’d like a copy, just send an email to <[email protected]> and I’d be happy to share it with you!