Implicit bias is defined as the lack of awareness of your own potential unconscious biases. It is been noted that healthcare providers may not be aware of their actions and may suggest that these biases are active when providing care to patients (Marcelin, Siraj, Victor, Kotadia & Maldonado, 2019).
Patients from under represented groups in the United States can experience the effects of unintentional cognitive (unconscious) biases that is derived from cultural stereotypes in ways that perpetuate health inequities. Unconscious or implicit bias can also affect healthcare professionals in a variety ways, including interactions between patient-clinician, hiring and promotion, and their own professional interactions with other healthcare professionals (Marcelin et al., 2019). To be continued…
Marcelin, J. R., Siraj, D. S., Victor, R., Kotadia, S., & Maldonado, Y. A. (2019). The Impact of Unconscious Bias in Healthcare: How to Recognize and Mitigate It. The Journal of infectious diseases, 220(Supplement_2), S62-S73. Retrieved from https://doi.org/10.1093/infdis/jiz214
The past few days the citizens have been protesting the death of a Black man (George Floyd & so many others) by the hands of the police. It has been heart breaking to say the least. COVID-19 pandemic and this latest death of a Black man by the police while three other policeman watched has sparked outrage and disbelief by many including many white Americans.
The hypocrisy of the system has been put into question. As a result the call for equality in community policing as been the cry. Racism is active in many aspects of American life including healthcare.
COVID-19 has exposed the health disparities in this country. The poor, black and brown communities have to navigate through life without the lack of healthcare related to financial burdens, food deserts, and lack of interest by the masses.
Health care disparities refers to inequitable differences between groups in health coverage, access to care, and the quality of care received. These differences contribute to health disparities (Wasserman et al., 2019).
Individuals working in lower paying positions find it challenging to manage their health care because they may not have health benefits or make enough to purchase a plan. Some are essential workers that are risking their lives to provide services for the community.
The working poor cannot afford to buy health insurance to cover their healthcare needs. The neighborhoods do not have grocery stores. There are fast food restaurants, small corner stores and liquor stores that appear to be the only thing that thrives in the neighbor. It is cheaper to buy a happy meal than to buy a head of lettuce and a tomato. Why should that be?
Currently the Navajo Nation reported more coronavirus cases per capita than any state in America (Capatides, 2020). They too have issues with diabetes and hypertension and according to Capatides, (2020) the sickest coronavirus patients have to be flown out of the reservation to a hospital.
The reservation has no hospital to treat patients. They have a clinic. Doctors without Borders have gone into the reservation to assist them. The fragmented nature of how health care is delivered in the United States contributes strongly to health care disparities (Wasserman et al., 2019).
As the riches nation in the world why do we have these issues within this country? In the 1920’s Black communities flourished and took care of their needs since they were not welcomed in other communities. All over the United States during this time between 1863-1923 eight thriving Black communities were burned to the ground, desecrated and never rebuilt.
So as you see, things keep happening and many people do not know the plight of the poor, black and brown people. Many feel they should pull themselves up by their books straps, but there are no straps or boots, They were taken away too. Thus these communities are doing their best just to survive.
I do not know what to do about this and it keeps me up at night. The problem is enormous. The Office of Minority Health was created to study racial and ethnic minority health in 1986 (https://www.minorityhealth.hhs.gov/). It is 2020 it is time to implement the plan to change the health outcome for minorities and poor populations within this country.
“Healthy People is an HHS (health & human service)-led initiative aimed at improving population health and achieving health equity across the nation. For almost four decades, the Healthy People initiative has maintained a set of science-based national objectives for improving health, which has been the framework for public health priorities and actions. Healthy People 2020, The latest set of goals and objectives, features more than 1,200 objectives across 42 topic areas.” https://www.healthypeople.gov/2020/law-and-health-policy/topic/leading-health-indicators.
The federal government has many initiatives that are rolled out to the states to address. Community non-profits agencies address specific core issues related to the communities within their state. Review of the (CDC) government website reveals Texas does not have a 2020 plan and maybe this state is utilizing non-profit agencies to address the vulnerable population within this state. The Affordable Care Act (Obama Care) was established to address preventative health and we all know how that is going in 2020. The resistance continues.
Wasserman et al. (2019)Advancing Health Services Research to Eliminate Health Care Disparities”, American Journal of Public Health, 109 (S1), S64-S69. Retrieved from https://doi.org/10.2105/AJPH.2018.304922
In light of the riots going on in the United States in varies cities, has caused me to be glued to the television. I have cried every day and it hurts me to see this uprising. I understand and have experienced the hurt and pain felt by the masses of the unfair treatment of my community.
I have not felt the need to join the protest but feel I need to do something. As the mother of two Black male sons, I am keenly aware of the conversations we have had to have regarding racism in this country.
What remains to be seen, is the results of COVID-19. I have friends working in hospitals taking care of COVIO-19 patients. They are afraid that they may take the virus home to their family.
They also have concerns related to their work environment, infection control issues, and patient assignment. I have tried to be a buffer for them, and listen. The overall stress and anxiety can be mentally exhausting. These stressors can affect your psyche and you have to unplug for your own sanity and well-being. You may be experiencing the same, take care of yourself, stay well and unplug! It’s essential.
All day I have been watching what has been going on in major cities in this country; Houston, Dallas, New York, D.C., Los Angles, Las Vegas, and Atlanta.
RACISM impacts all areas of life in the United States, including healthcare. This issue influences our individual health and wellness and should be addressed to make the necessary changes. Change can not be made if the problem is not acknowledged.
The truth is upsetting and as a society, we must stop normalizing and denying that there institutional racism. As John Lewis would say “when you see something that is not right, not fair, not just, you have a moral obligation to do something about it.”
I fell running about 6 weeks ago, right when COVID-19 hit Houston. I bruised my left hip and fell on my left hand. I decided I would take care of it myself, after all I AM A NURSE. I wrapped my wrist and took some ibuprofen, applied ice and kept going. The swelling did not resolve and the pain was minimum.
Last week my left wrist started throbbing and the pain moved from my wrist to inside my palm with an increase in swelling. After talking to a friend, I agreed to go to urgent care because I thought I might have a hairline fracture.
I arrived at urgent care and to my surprise the door was locked, and I was instructed to call them on the phone and wait in the car. I completed registration over the phone and waited in the car because they were seeing one patient at a time. The wait was not long. Once I was called, the clinic door was unlocked, and I could enter. My temperature was taken at the door and I was questioned about my current state of health and asked to take a seat. I was placed in a room where I met the provider, a physician’s assistant (PA).
The PA examined my hand and sent me to have an x-ray because it was visibility swollen and painful. After the x-rays she stated no fracture was note but said I had arthritis and referred me to a hand specialist because of the swelling and the pain. I asked her what the trade name of the drugs she was prescribing. She said one drug was Flexeril and she did not know the trade name of the other but because of MY AGE it would be good for arthritis.
The paperwork she gave me stated the diagnosis was swollen left wrist, contusion and a sprain, but she told me I had arthritis. I was given a brace and sent home with instructions and a referral. The prescription was called in and I picked it up on the way home. The side effects were shocking, warning of a stroke and heart attacks. I thought if she is worried about my age why would you prescribe such a drug to someone who she thinks is old.
I tried to call and get an appointment with the hand specialist that was referred. After several attempts, I reached out to my provider who gave me an appointment for June 18, 2020, which was a month away. I declined and decided to take care of my hand myself, because of the time factor. What would be the point, the wrist should be healed by then.
Lord and behold, my providers’ nurse called me back and offered an appointment for the following Wednesday. Dealing with the healthcare system is challenging. I feel badly for those who do not know how to manage the system or their health issues.
Please stay well!! As you can see, it can be frustrating even for those who work in healthcare as well.
I am fortunate enough as a registered nurse to work at home during this pandemic. Today is international Nursing Day, May 12, 2020. I would be re missed not to think about my colleagues and peers working in the trenches.
Concerns of COVID-19
We don’t know when this pandemic will end but the mental effects have had a tremendous affect on all essential workers. Many staff feel fearful, complain of lack of PPE (personal protective equipment), receive misinformation, and have feelings of uncertainty which add additional stress.
It has been reported that some nurses have caught COVID-19 and did not survive. I was talking to a colleague who stated she thought nurses were being taken advantage of because of our sense of duty toward the patient. This maybe true. Many nurses are working long hours (usually 12 hour shifts) and long stretches before having a day off, which is also stress producing,
As the country reopens regardless of the data or the scientist who project a resurgence of the virus, please continue to be diligent and stay well. It appears people are not social distancing or wearing mask because its their right. One of my colleagues stated in a Facebook post, if you don’t like wearing a mask, you will not like being on a ventilator.
I am hopeful I do not have to stay home all spring and summer because of the poor choices others have made related to COVID-19. How are you feeling about staying in for the next month or so? Leave me a message.
The American Nurses Association (ANA) stated 2020 is the year of the nurse, Today is Nurses Day, May 6th, and International Nurses Day is May 12th. I want to wish all my peers and colleagues Happy Nurses Day! Nurses have been deemed hero’s during COVID-19, and it’s appreciated.
Nurses are doing what they do all the time and work in stressful situations and in many cases short-staffed with difficult patients and others that are unappreciative. The pandemic has given the public a glimpse of the healthcare system and the work of those who are in the trenches daily, including physicians, respiratory therapists, housekeeping, and of course nurses.
This poem is dedicated to all the nurses out there, written by my friend and colleague Marjorie McClean RN
Happy and blessed Nurses Day. Ode to a nurse. I am a strong individual who through blood sweet and tears have earned the right to be called to this remarkable profession,
I am a registered nurse. I have stood on the shoulders of various and sundry nurses in this profession and although I may not be Florence Nightingale or Mary Seacole, I bear the brunt of tirelessly working in the trenches for the welfare of my patients.
I may not get hazard pay but the satisfaction I get from seeing someone who was told they have a minimal chance of surviving walking home with their family is more than rewarding.
I am a proud registered nurse, I am not the physician’s helper. I know my scope of practice and function in it every moment of the day. I may not wear a uniform, stethoscope or identification badge hanging from my neck but the badge of honor I wear in my heart and soul, representing this noble profession everyday.
I see my patients through the eyes of a caring, selfless compassionate nurse who refuse to give up or give in when the going is tough.
If you see my clothes soaked in body fluid which is not my own, do not take pity on me. I am protected. I practice extreme measures when it comes to infection control. My garments are impervious.
Assessment, analysis, planning, problem solving are the earmark of my profession. I walk and run immeasurable miles throughout the day ensuring my charge are getting excellent care. Improvising is the order of the day.
My strides down the hall to a waiting patient’s room is that of a gazelle, although the unexpected lay in waiting. I am about to be puked on, clean and collect some fecal specimen, start an intravenous line, clean and dress a wound, administer medication, plan a specialized menus, mop the floor, counsel a distraught patient, find or locate a home for a homeless patient, train a family to care for the discharge patient, and the need is endless in that room.
I do not eat my young, I mentor and train, passing on the knowledge encase in my cranium. Do not look at me with distain at the end of a long arduous day, when I look like a rag doll who have been poked and prodded. I am ready for my second shift, home and family.
There are many things we can do to reduce stress, and many chose different options that include exercise, meditation, cooking, watching television, movies, or creating something.
I engage in many things to manage my stress, that include Zumba, jump roping, bike riding and coloring. Yes, coloring, I shared this with a friend and he said “thats different”. I have found coloring to be an activity that is very relaxing and I do not have think about anything.
This is also a great time to learn something about yourself, and do some self reflection. This can be challenging because many do not know where to start. Take this time and search your inner soul to figure out what you can do to keep yourself centered and healthy.