NRS 428 Topic 3 DQ 2 How does the community health nurse recognize bias, stereotypes, and implicit bias within the community?

NRS 428 Topic 3 DQ 2 How does the community health nurse recognize bias, stereotypes, and implicit bias within the community?

Even though it is difficult for nurses to accept that they are biased against their patient, it is important to accept is once it happens and continuously reassess their feelings and their approach to correct implicit bias. A latent human tendency is a type of implicit bias interfering with best nursing practices. By recognizing inherent bias, a nurse will recognize bias that might evoke some emotions towards some populations. Nurses should listen to views from their patients and think of experienced health issues from their perspective to avoid bias (Kaihlanen, Hietapakka&Heponiemi, 2019).

Nurses need to recognize an inherent bias, and by doing that, means they understand and might have certain feelings for a particular patient or a population. This includes their appearance and manners, which the nurses believe should be addressed and dealt with to

NRS 428 Topic 3 DQ 2 How does the community health nurse recognize bias stereotypes and implicit bias within the community

provide the best health care outcome (Falkner, 2018). There are few steps and strategies, a community health nurse should keep in mind while fixing a bias. First, a nurse needs to notice their assumptions, which includes everything from language barriers to patient’s job status to a community’s health status. These factors can automatically cause people to build up assumptions about the patient’s traits, behaviors, or beliefs that the nurse might disagree with. This should be noticed specifically when the nurse is providing treatments to a patient and tending to their needs.

How should the nurse address these concepts to ensure health promotion activities are culturally competent?

Noticing personal assumptions: This include language differences, work status, and regional inflections that might lead to the assumption that a patient has specific values, attributes, and attitudes that other people do not agree with. When a nurse is describing therapies to a patient, listen to their wishes, and work with active or extended families, one should notice assumptions that are likely to be made (Jongen, McCalman& Bainbridge, 2018).

Knowing patients: Nurses should talk to the patients to learn everything about them. This would help to understand cultural differences and also become mindful of implicit bias. By talking about implicit bias at the workplace, one would open up conversations, pave way for improved patient outcomes and patient care, and remove taboos. As explained by Masters et al. (2019), nurses should also understand assumptions triggering bias such as the patients’ race, appearance, accent, and clothing style that might spark instant judgment.

Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care.

Some strategies needed to provide culturally competent care by reducing cultural bias and dissonance are:

Acknowledgment: Kaihlanen,Hietapakka andHeponiemi (2019) argue that acknowledgment leads to acceptance of accountability and responsibility thus making a difference. With reactions that promote supportive attitudes like empathy, nurses would suppress implicit bias.

Education: Raising awareness would help acknowledge presence of implicit bias and reduce its rate. Education can be through standardized curriculum.

Personal awareness: It involves inwardreflection to accept ideas and biases that can lead to implicit bias. This can be achieved by gaining personal knowledge (Marcelin et al., 2019).

In the article Implicit bias can be deadly, it is summarized that ,Without a doubt, the nursing profession is rooted in scientific knowledge. We diagnose and treat patients based on their symptoms, resulting laboratory tests, and diagnostic procedures. As nurses and nursing students, we are taught to remain impartial while caring for patients. However, some nurses and health professionals do not practice this vital quality. However, it is crucial to give up our personal opinions or preconceived notions about “certain” patients as drug users/seekers because it can be the difference between a misdiagnosis or an epic salvation. As health professionals, we see patients at their worst. These people are giving up a hidden past that may be unknown to their spouse or dearest friend. They may share their darkest secret in the hope that we will diagnose and treat their problem

References:

Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency interventions: a systematic scoping review. BMC Health Services Research, 18, 232.doi: 10.1186/s12913-018-3001-5

Kaihlanen, A-M., Hietapakka, L., &Heponiemi, T. (2019).Increasing cultural awareness: Qualitative study of nurses’ perceptions about cultural competence training.BMC Nursing, 18(38). https://doi.org/10.1186/s12912-019-0363-x

Marcelin, J. R., Siraj, D. S., Victor, R., Kotadia, S., & Maldonado, Y. A. (2019). The impact of unconscious bias in healthcare: How to recognize and mitigate it.The Journal of Infectious Diseases, 220(Suppl2), 62-73. https://doi.org/10.1093/infdis/jiz214

Masters, C., Robinson, D., Faulkner, S., Patterson, E., McIlraith, T., & Ansari, A. (2019). Addressing biases in patient care with the 5Rs of cultural humility, a clinician coaching tool.Journal of General Internal Medicine, 34(4), 627-630. doi: 10.1007/s11606-018-4814-y

Wagner, A. (2015). Implicit bias can be deadly. Minority nurse. Retrieved July 5, 2022 from https://www.minoritynurse.com/implicit-bias-can-be-deadly/

Bias, Stereotypes, and implicit bias are evident in society. Its manifestation is seen in daily interaction when certain actions make one feel uncomfortable or aware of specific prejudice hold against their ethnicity or race. This paper identifies stereotypes and implicit bias and suggests solutions for community health nurses to improve health care.

Recognizing Bias, Stereotypes, and Implicit Bias in a Community.

Professions, must wary of any negative evaluation they make on a certain group of people, race, religion, and ethnic (FitzGerald & Hurst 2017). Biases are evident in vulnerable populations. Cases such as low self-esteem, avoiding eye contact during patient-nurse interaction, malnourishment, laxity, and low turn out to health facilities, indicates bias stereotypes and implicit bias in a community.  Stress is also being an indicator of consequences are in diseases such as high blood pressure, obesity, cancer, and death and damaging behaviours such as poor sleep, smoking, and substance abuse.

A nurse needs to overcome this and be the advocate for their patients. He or she is the voice to the patient who cannot speak for themselves and the health of their loved ones. The advocacy skill can be the positive influence that allows patients to feel empowered and in control of their health.

Personal awareness is an inward compass directing us on how to perceive others in our daily interactions. It helps recognize acceptable and unacceptable attitudes and behaviour and stay on the ground (Young & Guo 2020). Enhanced knowledge is central to raising awareness and promotes a good atmosphere for patient healthcare workers. They also understand their rights and foster equality in health care delivery. Acknowledgment of pre-existing problems brings acceptability and accountability to make the change.

Conclusion

From the findings, the healthcare professional must be liberal because of the variety of patients they meet. There is a need for a change of attitude and general assumption of particular ethnicities, especially in service delivery. It ensures equity and quality care in people from different backgrounds.

References

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC medical ethics, 18(1), 19.

Young, S., & Guo, K. L. (2020). Cultural diversity training: The necessity of cultural competence for health care providers and in nursing practice. The health care manager, 39(2), 100-108.

It can be hard to admit you might be biased toward some of your patients, but it happens, and the best approach to fixing implicit bias is to recognize it and then constantly reassess how you feel and how your approach is working. Inherent bias is a subconscious human trait and frequently interferes with best nursing practices (Quinn-Sczesuil, 2018). Recognizing an inherent bias means that you understand you might have certain feelings about a specific population, a person’s or groups appearance, or mannerisms that need to be addressed and dealt with to provide the best possible care.

Implicit bias exists in health care settings and impacts quality and equity of care. Language barriers, job status, or regional inflections can cause people to assume a patient has certain traits, behaviors, or beliefs that you might not agree with. We often notice that feeling when trying to explain treatments to a patient, when responding to their needs, or when dealing with an extended and involved family. We all know these patients or family members, they have googled their symptoms and know exactly what it is wrong with them and what we as nurses should be doing for them.

You might find there are certain accents, specific items of clothing, or ways of speaking that cause you to tag someone with undeserved qualities. A patient’s race, accent, clothing style, or appearance can spark an instant judgment in you. Do you hold back certain levels of compassion for patients who are more short-tempered? Do you assume low standards in a disheveled, unkempt patient? Does someone’s race affect how you see them?

An implicit bias is not only harmful because it is undeserved, but it can also lead to disparities in care. Even if you are unaware of how you are feeling, your body language, focused attention, and the level of care you provide can be impacted directly by the way you are feeling. Each patient deserves a nurses’ full care, so understanding what might trigger you to act differently will make you a better nurse.

It is crucial to relinquish our personal opinions or preconceived notions about “certain” patients like drug users/seekers because it may prove to be the difference between a misdiagnosis or an epic save. As health care professionals, we see patients at their worst. These individuals are giving up a hidden past that may be unknown to their spouse or dearest friend. They may be sharing their darkest secret in hopes of us diagnosing and treating their complaint. So, we must be diligent and set aside our pride and opinions to provide care that is based solely on the case at hand and not by public opinion. Listen to the patient; do not just hear him or her. Gather the patient’s backstory or social history, which can be helpful in formulating potential differential diagnoses. Nurses must never allow personal judgment about the patient’s actions sway how the patient is treated. Health care professionals are not the judge and the jury, instead, we are the detectives that collect the evidence and build the case (Wagner, 2015).

Talking with patients is a good way to learn more about them. Understanding cultural differences can also help you become aware of any unconscious bias and begin to overcome it. We all have a bias, but talking about implicit bias opens the conversation, removes the taboo, and paves the way for better patient care and outcomes. When nurses are able to address this topic in an open and nonjudgmental manner, everyone benefits.

References

Quinn-Szcesuil, J. (2018). Recognizing implicit bias in health care settings. Minority Nurse. Retrieved July 05, 2022 from https://www.minoritynurse.com/recognizing-implicit-bias-inhealth-care-settings/

Wagner, A. (2015). Implicit bias can be deadly. Minority Nurse. Retrieved July 05, 2022 from https://www.minoritynurse.com/implicit-bias-can-be-deadly/

The term ‘bias’ is typically used to refer to both implicit stereotypes and prejudices and raises serious concerns in healthcare. A patient should not expect to receive a lower standard of care because of her race, age or any other irrelevant characteristic. There are many reasons for health care disparities in the United States, but the IOM reported that one of the contributing factors is clinician bias toward patients of racial, ethnic, or cultural minorities. Nurses with implicit biases may demonstrate less compassion for certain patients and invest less time and effort in the therapeutic relationship with them, adversely affecting assessment and care (Narayan, 2019). A community health nurse can recognize bias, stereotypes within the community by being culturally competent. Understanding cultural difference can also help nurses become aware of any unconscious bias and begin to overcome it.

The Joint Commission specifically recommends that health care providers use emotional regulation (controlling thoughts and emotions during clinical encounters), partnership building (working with patients as equals toward the common goal of helping them achieve good health), and perspective taking (trying to understand the perspective of the patient) to decrease biases that may lead to health care disparities (Narayan, 2019).

Mindfulness is another bias-management strategy familiar to nurses. The specific goal of mindfulness is to empty the mind of distracting thoughts so that we might focus on the present moment, without assumptions or judgments (Kiken et al., 2018). It allows us to be more deliberative in our actions and enables us to recognize our biases before we automatically act on them. Mindfulness interventions have been used to reduce stress and to improve provider–patient communication. The concept of mindfulness is related to the ethical concepts of empathy and compassion, which are cornerstones of nursing.

References

Kiken, L. G., Garland, E. L., Bluth, K., Palsson, O. S., & Gaylord, S. A. (2018). From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual differences, 81, 41-46.

Narayan, M. C. (2019). CE: Addressing implicit bias in nursing: A review. AJN The American Journal of Nursing, 119(7), 36-43.