In Health Care, We All Have Biases

Everyone involved in health care is likely aware of the disparities that exist in the system, from private patients who get fast-tracked and admitted to private rooms (all hospitals seem to have a “VIP” floor) to individuals who must wait until they are very ill and then can be treated as an emergency. And even though our ethics dictate otherwise, we know that, often unconsciously, we treat some patients differently.

Awakening to our preconceived notions and preferences.

Addressing Implicit Bias in Nursing: A Review,” written by Mary Curry Narayan and published in our July issue, discusses how preconceived notions and instinctive preferences can interfere with relationships and change how we treat patients.

Are you as comfortable walking into a room full of people similar to yourself as you are into a room full of people who speak a different language or are from a different background? Do you feel and act the same way towards a private patient with an MI who has a stable job and family as you would towards an unemployed person who has a substance abuse disorder? Will you spend the same amount of time speaking with them?

Recall conversations with colleagues at change-of-shift reports—in my experience, discussions there often color how we feel about patients before we even meet them.

Biases: we all have them.

Narayan points out that the first step in managing our biases is to acknowledge that we all have them—they’re part of our past experiences and are […]

A Health Care Proxy and an Act of Moral Imagination

“What would Joanna have wanted?” the ICU fellow (Dr. Smith) asked Sam, Joanna’s nephew and health care proxy, for the second time this week. Sam considered the question, furrowed his brow, and said, “I still don’t know, doc.”

The human costs of indecision.

Uncertainty can at times be better than false certainty. This may even be so, up to a point, when a loved one is on life-support and subject to invasive and painful procedures. It takes time to absorb the reality of a situation.

But any nurse can tell you that, at some point, indecision becomes a decision in itself, one that can lead to many unwished-for consequences.

Seemingly unanswerable questions.It

The quotation at the start of this post is from this month’s Reflections essay, “What Joanna Would Have Wanted” (free until July 15). The story, by nurse Jennifer Chicca, MS, RN, evokes the overwhelming sense of responsibility faced by a thoughtful young man in the role of health care proxy to a beloved aunt.

How is possible to be sure what someone would want, or not want, when their end-of-life wishes have not been clearly spelled out ahead of time? […]

Does Everything Happen for a Reason? One Oncology Nurse’s Perspective

Does Nature Argue Fate? The Acorn Contains The Tree/
charcoal, pastel, and ink on paper/ Julianna Paradisi 2019

The human need to find meaning.

“Everything happens for a reason” is a saying I hear a lot in my nursing practice, from patients and coworkers alike.

The need to find meaning in the events of our lives, good or bad, appears to be a distinctively human trait. Ancient Greeks believed Clotho, one of the Three Fates, spun the lives of humans. In medieval times, Anglo-Saxons may have believed in wyrd, a concept similar to fate in our modern language. Elsewhere, the idea of karma teaches a cause and effect perspective on this life, and on future lives. These are only a few examples.

Learning to ask ‘why’ as a pediatric ICU nurse.

I began questioning if everything happens for a reason as a pediatric intensive care nurse at the beginning of my career. Asking “why?” is a natural response to watching a child suffer. Why is a baby born without a functional left ventricle? Why does an infant contract leukemia or a brain tumor?

Certainly genetics or environmental factors cause some cases. Regardless, it’s difficult to […]

Welcome to Nursing’s New Grads!

Nervous and excited is normal.

It’s late June and by now most new grads are beginning their careers. Based on tradition, most of you will be working in the acute care setting. Some may have found positions, like my niece did when she graduated, in out-of-hospital surgical centers, or perhaps you’ve taken a position in a nursing home or long-term care facility. Wherever you’ve landed, we know you’re likely to be a mix of nervous and excited.

First, don’t worry—everyone, even the nurse manager who scares you, was new once. Over time, you’ll get more comfortable with your skills and gain confidence.

Photo by Ashley Gilbertson / The New York Times / Redux.

The basics.

Be prepared, show up on time, ask questions; be the person you’d like to work with. Offer to help others when you can and you’ll find it easier to ask when you need a hand.

One of our younger editorial board members, Amanda Anderson, has written several articles for our Transition to Practice column, all aimed at recent nursing school graduates. The articles range from preparing for the first day on the job to delegating and how to give report, and other topics. The latest, “Surviving […]

July Issue: Implicit Bias in Nursing, Grief Support for Hospital Staff, Understanding Malpractice, More

“Get to know patients’ former selves. Ask different questions. Discover their answers. I am so glad I did.” —Jennifer Chicca, author of the July Reflections column, “What Joanna Would Have Wanted”

The July issue of AJN is now live. Here are some highlights.

CE: Original Research: Helping Health Care Providers and Staff Process Grief Through a Hospital-Based Program

This study investigated the feasibility and effectiveness of offering an intensive bereavement support program—aimed at addressing grief and loss related to both professional and personal experiences—to hospital employees in a large health system.

CE: Addressing Implicit Bias in Nursing: A Review

This article describes the ways that implicit, or unconscious, bias among health care providers can contribute to health care disparities, and offers strategies nurses can use to discover and overcome their own implicit biases.

Special Feature: Rising to the Challenge: Re-Embracing the Wald Model of Nursing

The author discusses how Lillian Wald’s model of health care, in which nurses work at the intersection of medicine and society, may be useful today as nurses seek to address diseases of despair and improve health equity.

Transition to Practice: Surviving Your First Code

This article prepares new nurses for their first code, describes what happens during a code, and reviews the responsibilities of the resuscitation team.

2019-06-24T10:12:42-04:00June 24th, 2019|Nursing|0 Comments
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