NR 500 Week 3 Assignment – Addressing Bias in Nursing
Introduction
Hall et al. (2015) stated that implicit bias is the attitudes or stereotypes that unconsciously affect our understanding, actions, and decisions. Explicit bias is thoughts and feelings people deliberately think about and can make conscious reports about.
A biased manner can affect healthcare professionals’ behavior toward patients, which may result in alternative treatment choices. Unintentionally, healthcare professionals might have kept the patients longer in the waiting room than usual or delayed treatment. Healthcare professionals might have approached those patients with more authoritative stances that “decrease the likelihood that patients will feel heard and valued by their providers, failing to provide interpreters when needed, doing more or less thorough diagnostic work, recommending different treatment options for patients based on assumptions about their treatment adherence capabilities, and granting special privileges, such as allowing some families to visit patients after hours while limiting visitation for other families” (Hall et al., 2015).
Discussion of Bias
I am in the family nurse practitioner program. When homeless patients come to ER, most healthcare professionals’ first response is, “They are here again?” while shaking their heads. Even before asking for any health-related questions, the diagnosis of homeless patients is already made, and, somewhat literally, their discharge planning begins when they walk in. Such actions under bias may have resulted in less collaboration among healthcare professionals, less respect toward the patients, verbal dominance during encounters, and disparities in treatment options. Green et al. (2007) found that healthcare professionals are less likely to recommend thrombolysis treatment and ideal pain management; however, physical health outcomes appeared uninfluenced by bias.
Identification of Personal Bias
I identify my behavior as an implicit bias. When homeless patients come under my care, I try to accommodate what I can. I bring them food, juices, jellos, and socks. I have been doing it so much that my behavior toward homeless patients has become more of a reflex response to their requests. I make them happy as much as possible so they do not cause further problems because they tend to become quite challenging when they don’t get what they want.
Strategy to Reduce Bias
To reduce the bias, starting from myself, we all need to change our thoughts toward homeless patients. Some of the homeless patients are difficult to deal with. They may be genuinely tricky; however, “what recognized is that people who are difficult for one doctor may not be difficult for another doctor. And so it would appear that the variable is not the patient, but rather it’s the doctor” (Beckman, 2003). Also, systemic intervention, rather than individual intervention, would be necessary for those healthcare professionals in more time-pressured and critical care sectors. With systemic intervention, there is less room for healthcare professionals to impose any form of bias on the patients.
Self-Reflection
Such bias has been building up since I started working in the ER. However, from time to time, I recall those patients in mind and see if I have missed anything. Did I mistreat them? Did my bias lead to any healthcare disparities? Did I assess the patient with professionalism in mind? To be honest, I cannot say yes to all of them because they come, they get what they want, and it repeats again in a few days to weeks later. Based on such thoughts, healthcare disparities could have happened unintentionally. When those patients asked for pain medicine, I might have overlooked the seriousness of a patient’s symptoms. I could have transmitted the message to the ER doctor with less urgency,whic, which may have resulted in a delay, or the ER doctor could have ordered less potent pain medicine than the patient might have needed. “If healthcare professionals begin to doubt what a particular patient reports, we risk improperly treating patients with real pain. Keep in mind that in the past, physicians were notorious for under-treating pain” (Dougherty, 2012).
References
Beckman, H. (2003). Complex patients: Behavioral medicine in primary care. New York, McGraw-Hill Medical.
Dougherty, P. (2012). Is it possible to gain pain relief in the drug-seeking patient? Journal of Emergency Nursing, 38(3), 262-263.
Green, A., et al. (2007). Implicit bias among physicians and its perdition of thrombolysis decisions for black and white patients. Journal of General Internal Medicine, 22(9), 1231-1238.
Hall, W. et al. (2015). Implicit racial/ethnic bias among health care professionals and its influence on outcomes. American Journal of Public Health, 105(12), 60-76.
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Question 
Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics).
Discuss how biases can impact outcomes in selected nursing practice settings.
Identify personal biases and attitudes toward people with various cultural, gender, sexual orientations, ages, weights, and religions that are different than your
Select one bias that you have.
Develop one strategy to reduce this bias.
Introduction
The introduction includes general statements on biases and how biases influence interactions and affect outcomes. Identify sections of the paper. Provide support from scholarly literature.
Discussion of Bias
Identification of selected specialty track. Discuss how biases can influence and affect outcomes in specialty-chosen areas of professional practice. Provide citations from scholarly nursing literature that support your position.
Identification of Personal Bias
Identify one personal bias that you have. Identify if the bias is implicit or explicit.
Strategy to Reduce Bias
Develop one strategy to reduce bias.
Self-Reflection
Provide a self-reflection regarding what was learned from completing this assessment.