Combating Implicit Bias in Nursing

As defined by Merriam-Webster dictionary, implicit bias is “a bias or prejudice that is present but not consciously held or recognized.” Because these thoughts exist in the subconscious, unique to an individual’s personal experiences, it can be tough to uncover these negative feelings and associations.

According to a 2017 study published in BMC Medical Ethics, implicit bias occurs in the healthcare system as frequently as in the general population. It has detrimental effects on clinical judgment and quality of care. In recent years and in the wake of the COVID-19 pandemic, there has been a renewed urgency to achieve healthcare equity among the population — a goal that individuals can only reach by confronting biases.

Nurse leaders are increasingly called upon to root out implicit bias, which is just one of the reasons why Master of Science in Nursing (MSN) programs include coursework on healthcare policy development, quality improvement models and emerging social issues.

How Does Implicit Bias Affect Patient Care?

Implicit bias has the potential to deepen existing healthcare disparities among “members of racial, ethnic or religious minorities and other groups that face discrimination because of such factors as sexual orientation, gender identification, disability or stigmatized diagnoses,” according to Lippincott Nursing Center.

Biases exhibited by healthcare workers may result in:

  • Rushed or inadequate patient assessments
  • Concerns and questions that are not taken seriously or fully addressed
  • Less time devoted to patient care
  • Incorrect diagnoses
  • Inappropriate treatment plans
  • Lack of patient follow-up, especially after discharge

What Are the Challenges to Combating Implicit Bias in Healthcare?

The primary challenge to combating implicit bias is its subconscious nature. Implicit bias is part of the brain managing vast amounts of information. According to Lippincott Nursing Center, individuals will “unconsciously categorize and assign judgments (with good or bad connotations).” This process leads to ingrained beliefs that “one particular group is trustworthy or pleasant and another is dangerous or disagreeable.” Without an awareness of what is happening, these biases will persist.

Can Nurses Overcome Implicit Bias?

Nurse leaders and administrators must prioritize efforts to mitigate implicit bias, which will improve quality of care. A reduction in healthcare disparities upholds the first principle of the American Nurses Association (ANA) Code of Ethics for Nurses: “The nurse practices with compassion and respect for the inherent dignity, worth and unique attributes of every person.”

The following strategies may also be effective:

Know your triggers. It is difficult to change behavior until you acknowledge your own biases. Whether it is a clothing style or speech pattern, accept what prompts the negative associations or judgments. Like the Implicit Association Test (IAT), testing and questionnaires are often anonymous and help measure “attitudes and beliefs that people may be unwilling or unable to report.”

Boost emotional regulation. Developing emotional regulation skills can counter implicit bias. By maintaining a positive outlook during patient encounters, says The Joint Commission, nurses are more likely to “view patients in terms of their individual attributes” and express greater empathy and inclusivity.

Talk about it. To remove the stigma, nurse leaders should have open and honest discussions about bias. Educational seminars, one-on-one sessions or a quick anecdote shared during a pre-shift huddle may prompt nurses to consider a different perspective.

Partner with patients. Instead of a hierarchical approach to the nurse-patient relationship, treat patients as equals. Often called partnership-building, this tactic overcomes biases and promotes communication and collaboration toward a common goal.

Everyone has implicit biases, but in healthcare, they can be particularly harmful to patient health. Therefore, nurse leaders must be diligent in identifying subconscious bias among their staff and providing self-analysis and personal growth tools.

Learn more about Lamar University’s online RN to MSN program.


Sources:

American Nurses Association: Code of Ethics for Nurses With Interpretive Statements

Lippincott Nursing Center: Addressing Implicit Bias in Nursing

Merriam-Webster: Dictionary: Implicit Bias

National Center for Biotechnology Information: BMC Medical Ethics: Implicit Bias in Healthcare Professionals – A Systematic Review

Project Implicit: Education

The Joint Commission: Quick Safety 23: Implicit Bias in Health Care

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