Assignment

(Note from me: you have already help with the main part of the assignment. The part that I want you to work on now is to help me responds to two post from to different colleagues. I have attached their post so read it and give a respond to their post. Just a page or less will be fine as long as it meets the discussion)

· As greater attention has been focused on systemic bias and racism, what should nurses do—as individuals and through our organizations—to address the impact of bias and racism on patients and our colleagues?

· What kinds of policy proposals or initiatives should we advocate for that could make a difference in addressing bias and racism in health care?

Responses Due: Sunday by

· Respond to at least (2) of your colleague's postings over the course of the week to continue the dialogue. 

DISCUSSION POSTER 1

Implict bias is known to be conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender (FitzGerald & Hurst, 2017).  In regard to systemic bias and racism, I believe that nurses should make it their priority to be self aware to avoid these situaitons and "self-check" themselves. Implicit bias in healthcare systems has been going on for quite a while, and as devil's advocate sometimes it is unintentional. Often times this occurs due to people's belief's and morals, but in the health care systems it is very important to remember that the patient's care and needs are our priority when we are in the role of nurse (ANA,2020). 

I believe that equal right initiatives should be in place so that bias is not tolerated towards the patients as well as staff including nurses and other health care professionals. Often times I see in the workplace that patient equality is vouched for, but I do not see much staff equality initiatives. Nurses tend to be overlooked in many areas, they received a lot of racism, and bias from patients but are still expected to withstand several kinds of disrespect. The situation is a slippery slope in comparison, but awareness and education is a start. As I always say the best way to solve a problem is to make sure that you are not contributing, if everyone incorporates that mindset I believe progression will be made. 

ANA (2020). 

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC medical ethics, 18(1), 19. 

  

DISCUSSION POSTER 2

As individuals, nurses can first examine their own implicit biases. Evaluating these biases is a necessary step in providing patient care that is both culturally appropriate and free from discrimination. Nurses should foster environments that are welcoming and supportive of all. In addition to addressing biases, nurses should also acknowledge and respect differences. One common issue I’ve seen while in the clinical setting is the denial that there are differences, whether cultural or other among patients. I believe that differences must be seen and appreciated to provide appropriate nursing care. One of our readings this week states, “…some U.S. clinicians proclaim that they “don’t see color.” But color must be seen. By looking through a racially impervious lens, clinicians neglect the life experiences and historical inequities that shape patients and disease processes” (Evans et al., 2020). To provide care that actively combats discrimination, nurses must recognize the history of racism in health care. “To carry out these duties, physician-citizens must recognize the harm inflicted by discrimination and racism and consider this environmental agent of disease as a vital sign — alongside blood pressure, pulse, weight, and temperature — that provides important information about a patient’s condition” (Evans et al., 2020). Nurses can advocate for patients’ needs and should speak up if they see discrimination occurring. “Medical skill has allowed us to respond rapidly to a novel virus to save lives; we must also use our expertise to address racism and injustice and to protect vulnerable people from harm” (Evans et al., 2020).

     Our organizations can begin to address systemic bias and racism by focusing on what our lecture this week mentioned: diversity, equity, and inclusion. Organizations can include more representation in advanced leadership roles. Health care organizations can also implement trainings to combat bias and racism in the clinical setting. The article, Understanding and Addressing Racial Disparities in Health Care, states “There is also a need for intensive and systematic educational campaigns about the problem of racial inequities in health care. The awareness levels of the public and professional community, especially the medical community, must be raised” (Williams & Rucker, 2000). Nurses and nursing organizations must recognize the crucial role nurses play in fighting systemic racism and bias.  The American Nurses Association (ANA) and the American Academy of Nursing’s statement from 2020 asserts, “The nursing profession, as leaders of compassionate care, upholds the highest commitment to achieving health equity and combating discriminatory actions” (ANA, 2020).

     One initiative that should be advocated for is an increase in the role of minorities in healthcare. According to Diagnosing and Treating Systemic Racism, by Michele Evans et al., “Black patients, who are already affected by health inequities and impaired health care access, have a much lower chance than white or Asian-American patients of finding a racially concordant physician. Correcting this disparity requires bringing more black people into the medical workforce, beginning with early messages sent to black children about their abilities and possible careers, and working to remove racial bias all along their educational path” (Evans et al., 2020). The need for this is seen with research, “Other research shows that in a world still shaped by systemic racism, black patients are more likely to trust, and heed the advice of, black physicians: a randomized, controlled trial found that black men assigned to a racially concordant doctor sought more preventive care than those assigned to a racially discordant one” (Evans et al.,2020). Overall, there is much to be done in combating bias and racism in healthcare, and I believe that as nurses we can have a direct positive impact.

 

References:

ANA (2020). 

Evans, M. K., Rosenbaum, L., Malina, D., Morrissey, S., & Rubin, E. J. (2020). Diagnosing and treating systemic racism. New England Journal of Medicine383(3), 274–276. https://doi.org/10.1056/nejme2021693 

Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review21(4), 75–90.

DISCUSSION POSTER 3

As greater attention has been focused on systemic bias and racism, healthcare professionals and the organizations that support them continue to seek ways to address the impacts of inequality on patients and colleagues.  The unjust killings of Black and Brown people as well as higher rates of COVID-19 within these communities, have highlighted the need for social justice reform that addresses racism and realigns structures to enable the attainment of better health regardless of race, ethnicity, and gender (ANA, 2020). "The nursing profession must uphold the highest commitment to achieving health equity and combating discriminatory actions" (ANA, 2020). The first step for nurses to address this issue on an individual level is to start by checking our own biases.  We can become more conscious of our biases when we push ourselves to not only take time for self-reflection, but also utilize the tools available to us to fully do the work needed to create change.  An example of this would be using the IMPLICIT acronym. This stands for Introspection, Mindfulness, Perspective-taking, Learn to slow down, Individuation, Check your messaging, Institutionalize fairness, and Take two (FPM, 2019).  Doing work on an individual basis means that even if we can’t change the social determinants of health for any individual patient in each encounter, we can think more deeply about how they affect what the patient can and can’t do and tailor the patient’s care accordingly (Evans et al., 2020). Additionally, it is important to speak openly with colleagues, family and friends about race and ethnicity. As noted in one of our articles this week, color must be seen (Evans et al., 2020). By pretending that race does not exist, clinicians neglect the life experiences and historical inequities that shape patients and disease processes (Evans et al., 2020). When providers attempt to ignore the problem, they may unintentionally feed the structural racism that influences access to care, quality of care, and resultant health disparities (Evans et al., 2020).

At an organizational level, it is essential that we create and sustain cultures of understanding, belonging, open dialogue, and inclusion in workplaces, within healthcare and in the communities we serve (ANA, 2020).  An organization’s commitment to addressing bias is a meaningful starting point to make lasting change. This commitment needs to be put into action at all levels of the organization. This includes making an intentional and planned effort to diversify the medical workforce, engaging young students early in science and math, introducing diverse young students to a variety of possible careers in healthcare and working to remove racial bias all along the educational path (Evans et al., 2020). Nurses can advocate for policies at the local, state, and national level that address health equity, which will not only improve well-being now, but also continue to lay the foundation for better health in the future (ANA, 2020). US states have a long history of contributing to racial oppression, from the Jim Crow era to the contemporary racism evident in policies and practices such as voter disenfranchisement and mandatory minimum sentencing (Hardeman et al., 2022).  An emerging line of research finds that state-level structural racism is associated with higher rates of infant mortality, myocardial infarction, functional limitations, depression, higher body mass index, and worse self-rated health among Black people (Hardeman et al., 2022). As a policy priority, more attention is needed in future research to examine specific practices that create and worsen structural racism across domains (Hardeman et al., 2022). Effective policy and authentic antiracist research must engage the affected community and efforts to create measures of structural racism should be informed by community-based participatory research and public health critical race praxis principles (Hardeman et al., 2022). With sustained efforts, nurses can be change agents by responding to racism when they experience or see it occur, building an understanding of implicit and unconscious bias at an individual, organizational and policy level could contribute to greater inclusivity in healthcare.

References

American Academy of Nursing (ANA). (2020). The American Academy of Nursing and the American Nurses Association Call for Social Justice to Address Racism and Health Equity in Communities of Color. 

Evans, M., Rosenbaum, L., Malina, D., Morrissey, S., & Rubin, E. (2020). Diagnosing and Treating Systemic Racism. The New England Journal of Medicine, 383(3), 274–276. 

Hardeman, R., Homan, P., Chantarat, T., Davis, B., & Brown T. (2022). Improving The Measurement Of Structural Racism To Achieve Antiracist Health Policy. Health Affairs. 41(2), 179-186. 

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