By Beth Smith, Hondros College of Nursing

If asked, most people would likely say that in general they treat all people the same, but do they really? Sometimes it’s very hard not to pass judgement on others, and sometimes we aren’t even aware that we’re doing it.
Bias (i.e., stereotyping, prejudice, or discrimination) whether intentional or not, can create barriers between patients and the nurses caring for them. It involves “the negative evaluation of one group and its members relative to another” (Blair, Steiner, & Havranek, 2011, p. 71). Most of us aren’t purposefully biased and don’t see ourselves as being partial to some patients over others, but it’s a common and persistent problem in healthcare. We need to ask ourselves whether a patient’s race, ethnicity, sexual preference, socioeconomic status, or other characteristics that make them different from us change how we look at them and treat them.
According to Bucknor-Ferron and Zagaja (2016), “Unrecognized and unmanaged, unconscious bias can lead to health disparities which negatively affect patients” (p. 61). These disparities can include “lack of preventive care, mismanagement of symptoms, being underserved, experiencing extended waiting times for appointments and diagnostic tests, and dealing with professional caregivers who don’t take the time to understand language and cultural differences” (Bucknor-Ferron & Zagaja, 2016, p. 61).
Being sensitive to and eliminating cultural bias is important for all of us, but it is especially so for nurses who are caring for patients who are at their worst. The suggested strategies of Bucknor-Ferron & Zagaja (2016) presented below can be used to overcome unconscious bias and provide optimal patient care.
Personal awareness. Consider how and why you respond to people in a given way throughout the day. Were your actions, perceptions, and impressions of them fair and accurate or not? Constant self– reflection such as this along with a conscious change in attitudes and behavior will lead to better patient interactions and less bias.
Acknowledgement. Knowing that bias exists and can negatively affect patient care is a step in the right direction. We need to admit that bias can be a part of our interactions with others; without this acknowledgement, we can’t eliminate it.
Empathy. Try to see things from the patient’s perspective by considering the personal and social issues that are affecting him. Making an effort to hear and understand where he’s been and why will help you provide better care for him.
Advocacy. When you understand your patient and his situation, you are in a better position to advocate for him. Avoid using what you think you know when communicating needs and identifying best treatment options for him. You really need to know where he’s coming from, so you can help him get where he needs to be.
Education. Learning about unconscious bias, whether formally or informally, and working to eliminate it helps create an environment that allows equal treatment for all. Talk about it with co-workers and attend workshops and webinars to be more aware of bias and how to address it.
Nurses need to recognize and be aware of their personal feelings about cultural, socioeconomic, and personal choice differences and work to remove them from their patient interactions and care; doing so will allow them to truly treat the patient in front of them.

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