DiversityNursing Blog

When you first meet someone, do you automatically judge that person based upon their weight, skin color, clothing, piercings, hairstyle, disability, speech, etc? Many people automatically infer a stereotype based on someone’s appearance. This is known as unconscious bias.

Recognizing and addressing biases is not only crucial for Nurses to uphold the highest standards of care, but it's also a moral necessity in providing equitable and compassionate treatment to every patient. With commitment to self-reflection and continuous growth, Nurses can truly embody the principles of empathy and understanding in their practice. 

According to Project Implicit, "Implicit bias is an automatic reaction we have towards other people. These attitudes and stereotypes can negatively impact our understanding, actions, and decision-making."

Here are several approaches Nurses can take to evaluate their biases:

Practicing Reflection

Engaging in reflective practice is a powerful tool for Nurses to delve deep into their thoughts, emotions, and actions during patient interactions, especially with individuals from diverse backgrounds. By taking the time to step into the shoes of their patients and see the world from their perspective, Nurses can gain valuable insights into their own biases and prejudices. Picturing themselves in the patients' situations allows Nurses to foster empathy, understanding, and a heightened awareness of how their biases may influence the care they provide. This introspective practice not only promotes self-awareness but also cultivates a more compassionate and equitable approach to patient care.

Implicit Bias Tests

Taking implicit bias tests, such as the Implicit Association Test (IAT), is a valuable step for Nurses to uncover unconscious biases that may unknowingly influence their patient care. These online tests, like those offered by platforms such as Project Implicit, provide a glimpse into the subtle biases that can impact healthcare interactions. By shedding light on these hidden prejudices, Nurses can actively work towards addressing and mitigating them, ultimately fostering a more inclusive and equitable healthcare environment for all patients.

Feedback from Colleagues and Patients

Seeking feedback from colleagues and patients is an essential aspect of self-reflection. By seeking input from those around them, Nurses can gain valuable insights into their communication styles and interactions. Colleagues can offer a different perspective on how biases may manifest in their behavior, while patients can provide direct feedback on their experiences during care. This feedback loop allows Nurses to continuously evaluate and adjust their approach, ultimately leading to a more empathetic and unbiased practice. By fostering open communication and a willingness to listen, Nurses can create a supportive environment that encourages personal growth and professional development.

Cultural Competency Training

Participating in cultural competency training programs can help Nurses become more aware of their biases and develop strategies for addressing them. These training programs offer valuable insights into different cultural practices, beliefs, and norms, allowing Nurses to better understand and respect the unique perspectives of each patient. Additionally, these programs provide practical tools and techniques for navigating cross-cultural communication challenges. Embracing cultural competency training not only benefits patients but also enriches the professional growth and development of Nurses.

Journaling

Keeping a journal of patient interactions and reflecting on them regularly can be a powerful tool for Nurses to gain deeper insights into their own biases and assumptions. By documenting their experiences and emotions during patient care, Nurses can pinpoint any recurring patterns of biased behavior that may be impacting their practice. This self-reflection allows Nurses to not only recognize their biases but also actively work towards addressing and overcoming them. 

Seeking Diversity in Education and Experience

By actively seeking out opportunities to learn from and work with individuals from diverse backgrounds, Nurses can not only challenge their biases but also expand their perspectives in profound ways. Immersing themselves in a multicultural environment allows Nurses to gain a deeper understanding of different cultures, beliefs, and traditions, fostering a sense of empathy and appreciation for the unique experiences of each patient. 

Mindfulness Practices 

Engaging in mindfulness practices, such as meditation or deep breathing exercises, can help Nurses become more aware of their thoughts and emotions in the moment, making it easier to recognize and address biases as they arise. By incorporating mindfulness into their daily routine, Nurses can cultivate a sense of inner peace and clarity allowing them to approach patient interactions with a clear and unbiased mindset. Through mindfulness, Nurses can develop a heightened sense of self-awareness, enabling them to identify any negative thought patterns or biases influencing their behavior. 

Using Bias Checklist 

Utilizing bias checklists or prompts during patient interactions can serve as a valuable tool for Nurses to actively assess and address any unconscious biases. By incorporating these checklists into their daily practice, Nurses can create a structured framework for self-reflection, allowing them to consciously evaluate their thoughts, emotions, and behaviors for any signs of bias. This proactive approach enables Nurses to identify and challenge any preconceived notions or stereotypes influencing their patient care.

Healthcare organizations must recognize the importance of investing in resources and training for graduate Nurses during their first 2 to 3 years of employment in order to retain them in direct patient care roles. While some top Nursing schools are striving to produce practice-ready Nurses, not all graduates possess the expertise needed upon entering the workforce and may require time to build confidence in various situations. Consequently, new Nurse graduates face the highest risk of turn over within their initial years of employment.

In order to retain new Nurses and reduce turnover, it is essential to invest in their training and development. This can be done through programs such as Nurse residencies, mentorship, and access to clinical decision support resources. By providing these resources, healthcare organizations demonstrate their value and support for new Nurses. Collaboration between academia and practice settings is crucial to determine the necessary competencies for beginner Nurses.

The initial period of a Nurse's career is pivotal for their professional development, job satisfaction, and commitment to the organization. Here are some reasons why investing in new Nurses is good for retention:

Training and Development Opportunities

Offering comprehensive training programs is essential in equipping new Nurses with the skills and knowledge they need to excel in their roles. By providing ongoing professional development opportunities, healthcare organizations demonstrate a commitment to the growth and success of their Nursing staff, fostering a sense of value and investment in their development.

Mentorship Programs

Introducing mentorship programs connects novice nurses with seasoned mentors, fostering a nurturing atmosphere for growth and adaptation. Mentorship goes beyond imparting knowledge and helps Nurses feel a sense of inclusion, empowering them to navigate the demands of their roles with confidence and effectiveness.

Competitive Compensation and Benefits

Providing competitive salaries and attractive benefits is a clear indication of the organization's appreciation for the invaluable contribution of its staff. Adequate compensation plays a vital role in retaining highly skilled and motivated Nurses, ensuring their continued commitment to the organization's success.

Work-Life Balance

Promoting a harmonious work-life balance not only enhances Nurse satisfaction but also mitigates the risk of burnout. Implementing policies that prioritize scheduling flexibility, reasonable work hours, and ample time off significantly contribute to the overall well-being of Nurses.

Recognition and Appreciation

Acknowledging and valuing the hard work and dedication of new Nurses cultivates a nurturing work environment. Consistently providing feedback and recognizing their contributions not only instills a sense of pride but also enhances job satisfaction.

Career Advancement Opportunities

Creating a roadmap for career progression within the organization not only motivates new Nurses to stay for the long haul but also demonstrates a dedication to their professional development. Offering avenues for advancement, such as promotions, leadership positions, or specialized training, indicates a commitment to nurturing their growth and success.

Supportive Work Environment

Fostering a nurturing and inclusive work environment builds a strong sense of camaraderie among staff. Proactively addressing concerns such as Nurse bullying or workplace incivility plays a significant role in cultivating a positive workplace culture that values respect and collaboration.

Wellness Programs

Investing in wellness programs that prioritize the physical and mental well-being of staff showcases a genuine dedication to their overall health. These programs encompass a range of resources, such as stress management tools, mental health support, and initiatives promoting fitness and well-being.

Feedback Mechanisms

Encouraging a culture of open communication allows new Nurses to freely express their concerns, share valuable feedback, and actively contribute to the ongoing improvements within the workplace. By promoting an environment of transparency and responsiveness, healthcare organizations not only enhance job satisfaction but also create a strong foundation for collaboration and growth.

Investing in new Nurses not only supports their professional development but also creates a positive work environment that contributes to overall job satisfaction and retention. Organizations prioritizing the well-being and growth of their Nursing staff are likely to see increased loyalty and reduced turnover.

In the fast-paced world of healthcare, where long hours, demanding schedules, and challenging situations are the norm, it's essential to take a moment to reflect on the things that make the Nursing profession uniquely rewarding. Let's delve into the aspects of the field Nurses are thankful for.

Support Systems

Nurses hold deep gratitude for the unwavering support and love they receive from their families and friends. 

Carol, RN, BSN said, "After practicing 36 years, I appreciate my family that have supported me, gone on without me over weekends and holidays, birthdays, etc. I appreciate how they listened when I came home and vented about a bad day of being short staff or cried due to losing a special patient. I apologize for the times I ruined meals talking medical jargon at the table that doesn’t bother me anymore while I eat. What I guess I am trying to say is thank you for supporting me in my career because I certainly could not have done it without you!"

Patient Success Stories

Experiencing the joy of seeing patients overcome challenges strengthens Nurses' dedication to positively impacting the lives of those under their care.

Neonatal Nurse Practitioner, Josie Dotson, says "My job allows me to attend births and resuscitate 22-to-42-week infants, perform high-risk procedures, develop and manage care plans for NICU patients, and educate and support staff/families along the way. I feel so blessed to have such an amazing job where I make a difference in babies’ lives every day."

Professional Recognition

Nurses greatly appreciate the recognition of their tireless efforts and unwavering commitment, both within the healthcare setting and from the broader community. It is crucial for them to feel valued and appreciated in their workplace, as it fuels their motivation to continue making a difference in the lives of those they care for.

Each year, as part of its National Nurses Week celebration, Brigham and Women’s Faulkner Hospital celebrates its Nurses with awards recognizing excellence in critical thinking, commitment to patient teaching, continuing education and outstanding delivery of patient- and family-centered care with compassion and dignity.

Patty Barfield, an Assistant Professor at the Oregon Health & Science University School of Nursing, said the most meaningful recognition has come from patients. Recently, Barfield, who is also a Psychiatric Mental Health Nurse Practitioner, received an email from a patient she saw 10 years ago. Now 25 and with a family, the man thanked her for how she helped him as a teen. 

“It was the nicest thing ever to know that you made a difference,” she said. 

Patient Connections 

Nurses cherish the profound bonds they form with their patients. These meaningful exchanges create a lasting impact on both the Nurse and the individual receiving care. Nurses consider it an honor to provide solace and guidance during moments of vulnerability.

Jen Tobon, a Lead Clinical Nurse at Johns Hopkins, was nominated for the DAISY Award by the mother of one of her patients. The patient had been in the hospital for some time, on another floor at first, before being transferred to Jen’s unit. In the nomination letter, the patient’s mother wrote that Jen provided wonderful care and went above and beyond to make her son’s birthday extra special. “When we arrived that morning, his doorway was decorated with balloons and a poster that all of the nurses signed with their well wishes. She coordinated with the fourth floor to have a party for him in the conference room and even drew his favorite Bluey characters on the whiteboard.” Thank you, Jen, for making your patient’s special day even more meaningful.

Team Collaboration

Nurses deeply appreciate the sense of camaraderie they experience when collaborating with doctors, therapists, and their fellow nurses. This close working relationship fosters a strong sense of community and shared purpose, which ultimately creates a supportive and uplifting work environment.

Kathleen Lynam, after working as a Nurse for the majority of her life, has now moved away from bedside Nursing into coaching and teaching. She is most grateful for the lessons she learned while working with team members through hurricanes, blizzards, accreditation visits, power failures, and staffing crises.

Lynam has worked alongside some Nurses for more than 40 years. She celebrates these longtime friendships and the courage and perseverance they have shown her. She has a profound gratitude for her profession and all it's given her, like the resilience she witnesses in the people she's worked with most of her life.

"I have become grateful for a profession that has overcome unprecedented adversity," Lynam said. "My prayer for my profession is that we continually learn and support each other."

Advancements in Healthcare 

Nurses appreciate the continuous advancements in medical technology, treatments, and healthcare practices, which have revolutionized patient outcomes and elevated the effectiveness and fulfillment of their roles.

According to research, over 80% of Nurses believe that technology has improved their ability to provide quality care. This allows them to provide better patient care and helps reduce healthcare costs while ensuring everyone gets the best possible treatment. Technology has also enabled Nurses to stay connected as well as with other members of the healthcare team from any location – allowing them to collaborate more efficiently than ever before.

Professional Growth Opportunities 

Nurses are thankful for the countless opportunities to advance their careers within the profession. Whether they are pursuing advanced degrees, specializing in specific fields, or stepping into leadership roles, Nurses appreciate the continuous growth and evolution that comes with their chosen path.

Karrie Brazaski, a Nurse and healthcare Executive with three decades of experience says she owes her increased empathy and compassion to Nursing, along with her ability to climb the ladder from Staff Nurse to Chief Nursing Officer, to Chief Operating Officer, to now business owner and founder of Helping Healthcare Heroes.

Flexible Schedules 

Nurses are grateful for adaptability certain Nursing positions offer, including the availability of different shift options and part-time opportunities. These flexible schedules play a crucial role in fostering a harmonious work-life balance.

In a profession where compassion and care are at the forefront, Nurses find fulfillment in a myriad of aspects. This Thanksgiving, let's express gratitude for the remarkable individuals who dedicate their lives to the well-being of others—our Nurses.

Lately, the media has been filled with reports of devastating wildfires in Maui, destructive flooding in Vermont, and powerful tornadoes and earthquakes. These natural disasters serve as a reminder of the importance for Nurses to be prepared for any emergency.

Nurses play a vital role in disaster response, and being well-prepared for natural disasters is crucial to ensure they can provide effective care during these emergencies.

Here are steps Nurses can take to be prepared for natural disasters:

1. Education and Training:

• Emergency Preparedness Courses: Nurses should consider taking courses in disaster preparedness and response. These courses often cover topics such as triage, emergency medical procedures, and disaster management protocols.

• Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS): Maintaining current BLS and ACLS certifications is essential, as these skills are valuable in emergency situations.

• ICS/NIMS Training: Familiarize yourself with the Incident Command System (ICS) and the National Incident Management System (NIMS). These frameworks are used in disaster response and coordination.
  
  

2. Workplace Protocols:

• Nurses should be familiar with their healthcare facility's emergency protocols, including evacuation plans, roles and responsibilities during emergencies, and how to access emergency supplies.

• Participate in emergency response drills and exercises at your workplace to become comfortable with the procedures and to identify any areas that need improvement.
  
  

3. Personal Preparedness:

• Create a personal emergency plan for your family, including evacuation routes, meeting places, and communication strategies. Ensure everyone in your household understands the plan.

• Build a personal emergency kit that includes essentials like water, non-perishable food, first aid supplies, medications, flashlight, batteries, and personal protective equipment (PPE).

• Regularly update and refresh your emergency kit to ensure that supplies are not expired.
  
  

4. Stay Informed:

• Keep informed about potential disasters or emergencies by following local news, weather alerts, and official sources of information.

• Download emergency alert apps or subscribe to text alerts from local authorities.
  
  

5. Networking and Collaboration:

• Establish relationships with other healthcare professionals and organizations involved in disaster response. This can include local public health agencies, emergency medical services (EMS), and disaster relief organizations.

• Understand your role within a disaster response team and how to collaborate effectively with other healthcare providers.
  
  

6. Triage Training:

• Understand the principles of triage, which involve assessing and prioritizing patients based on the severity of their injuries or conditions.

• Practice triage scenarios to improve your ability to make quick and accurate decisions during emergencies.
  
  

7. Psychological Preparedness:

• Be aware of the emotional and psychological challenges that can arise during disasters. Understand how to provide emotional support to patients, families, and even colleagues.

• Consider taking courses or attending workshops on psychological first aid and stress management.
  
  

8. Documentation Skills:

• Emphasize the importance of accurate and thorough documentation during emergencies. Ensure that you are well-versed in charting procedures, both on paper and electronically.
  
  

9. Continuous Learning:

• Stay up-to-date with the latest guidelines and best practices for disaster response and emergency medicine.

• Attend conferences, seminars, and workshops related to disaster nursing and emergency preparedness.
  
  

10. Community Involvement:

• Participate in community disaster preparedness efforts. This involvement can help you better understand local risks and resources.

By following these steps, Nurses can enhance their preparedness for natural disasters, contributing to more effective and compassionate care during emergencies. Preparedness not only benefits Nurses but also the communities they serve.

For Nurses and healthcare professionals who provide care to elderly individuals, it is of utmost importance to be able to identify and report signs of elder abuse. Elder abuse can take various forms, including physical, emotional, sexual, financial, or neglect.

The National Council on Aging, estimates up to 5 million older Americans are abused every year, and the annual loss by victims of financial abuse is estimated to be at least $36.5 billion.

Here's a guide for Nurses to help identify and respond to signs of elder abuse:

Educate Yourself: Familiarize yourself with the different types of elder abuse and their common signs. Understanding the various forms of abuse will make it easier for you to recognize them in your patients. 

Observe Physical Indicators: Look for unexplained bruises, burns, fractures, or other injuries. Pay attention to repeated injuries or injuries in various stages of healing. These may be signs of physical abuse.

Be Attentive to Behavioral Changes: Be mindful of changes in the elder's behavior, such as sudden withdrawal, depression, anxiety, fearfulness, or unexplained changes in personality. These could indicate emotional or psychological abuse.

Watch for Signs of Neglect: Unkempt appearance, poor hygiene, malnutrition, dehydration, or the presence of pressure sores are potential signs of neglect.

Pay Attention to Financial Indicators: You might be in a situation where you are caring for someone in their home or a nursing home. Keep an eye out for sudden changes in the elder's financial situation, such as missing money, unauthorized withdrawals, or unusual changes to their will or financial documents, as these may indicate financial abuse.

Listen to Their Statements: Sometimes, the elder may hint or express directly that they are experiencing abuse. Take their concerns seriously and document their statements appropriately.

Communicate with Family and Caregivers: Engage in open communication with family members and caregivers. They may provide valuable information and insights into the elder's situation.

Use Screening Tools: Some healthcare facilities may have screening tools to assess the risk of elder abuse. Utilize these tools to identify potential cases.

Document Thoroughly: When you suspect elder abuse, document your observations and conversations carefully. Include dates, times, and details of what you observed or what the elder disclosed.

Report Suspected Abuse: If you have reasonable suspicion or evidence of elder abuse, follow your institution's protocols and report it to the appropriate authorities, such as the supervisor, social worker, or Adult Protective Services (APS) in your area.

Support the Elder: Offer support and empathy to the elder. Let them know that you are there to help and that their safety is a priority.

Remember, reporting elder abuse is not only an ethical responsibility but may also be a legal requirement in many States. Taking action promptly can protect vulnerable older adults from further harm and help them access the support and resources they need.