Cultural Competent
ANSWERS
Implicit bias refers to unconscious attitudes that influence understanding, actions, and decisions through cognitive shortcuts. Using cognitive shortcuts leads to decisions based on inaccurate or incomplete information, resulting in ineffective or insufficient care. Nurses, unfortunately, are not immune to implicit bias. According to studies, implicit bias among nurses is frequently directed toward the elderly, lesbian, gay, bisexual, and transgender (LGBT) people and obese patients. This bias interferes with nurse-patient relationships, assessments, and patient care.
Both patients and nurses are affected by implicit bias. As nurses, we must acknowledge the existence of implicit bias and address it directly. Failure to do so will only serve to exacerbate healthcare disparities. Healthcare disparities are not new. The Tuskegee Syphilis Study and the 1980s AIDS crisis are two recent examples of healthcare delivery and treatment inequalities. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, published by the Institute of Medicine in 2002, identified long-standing inequities among racial/ethnic groups and discussed how bias perpetuates health disparities. According to research, little has changed in the twenty years since this report was published. Pain in African American patients is treated less aggressively than in Caucasian patients. Women, regardless of race, are less likely than men to be treated for pain, and LGBT people continue to face indirect, subtle, or unintentional discrimination from doctors and nurses. In short, implicit bias perpetuates health disparities disproportionately affecting ethnic/racial groups, the poor, and other vulnerable people.
Nurses are uniquely placed to address implicit bias. This can improve the patient experience and promote equitable, high-quality care. What you can do is as follows:
Recognize implicit bias. The Implicit Association Test (IAT) developed by Project Implicit, a nonprofit organization dedicated to researching conscious awareness and bias, can help nurses identify implicit bias. Implicit bias training and assessment would also be ideal for nursing schools and colleges to incorporate into their undergraduate and graduate programs.
Establish a link. According to the Institute of Healthcare Improvement, meeting and engaging with people who are not like you is one way to reduce bias and increase understanding. Do you devote time to learning about other cultures? Do you know about the healthcare experiences of other racial/ethnic groups or LGBT people? Understanding the experiences of others can foster empathy.
Recognize your privilege and use it to advance equity. Everyone has privileges; learn to recognize your own. Are you an English native speaker? If this is the case, you can contact interpreter services when you are assigned a patient who is a non-English speaker or who is deaf. Do you identify as heterosexual? Remember that not every patient you encounter will be. When greeting your patients, make it a habit to ask them their names and what they would like to be called. This demonstrates respect and sensitivity toward LGBT people.
Exercise cultural humility. Recognize your lack of knowledge about a patient’s background, beliefs, or experiences. Allow patients to tell you their personal stories and collaborate with them on care. Simply listening to a patient can have a significant impact. Allow patients to assist you in helping them. When your patients seek spiritual guidance, inquire about their faith and request a visit from a chaplain, rabbi, or imam who adheres to their religious beliefs.
QUESTION
Cultural Competent
How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format.