Understanding Your Own Bias in Healthcare: A Guide for Nurses

• Implicit biases are attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. 
• It’s crucial to acknowledge and understand personal biases to provide better patient care, as biases can negatively impact their care. 
• Recognizing and addressing implicit bias in healthcare is essential to creating a more inclusive and equitable environment, especially in the nursing profession where diversity is prevalent. 

Bias in Healthcare

Everyone, including nurses, is biased about something.  

Implicit bias refers to attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner, without us realizing it. These biases can be based on factors such as race, gender, age, sexual orientation, religion, or other characteristics.

Implicit biases can affect how we treat and interact with others and can lead to unfair and discriminatory outcomes. Recognizing and addressing implicit bias is an important step towards creating a more equitable and just society. 

As nurses, we all have biases, and it’s crucial to acknowledge and understand them to provide better patient care. Explicit biases are known, while unconscious biases are not.

If we act differently towards a patient, it could be due to an unconscious bias that might negatively impact their care. It’s essential to confront and learn from our biases to improve patient outcomes and experiences. 

Common biases include: 

• Race 
• Gender 
• Sexuality 
• Culture 
• Religion 
• Age 
• Weight 
• Drug usage 
• Homelessness 

As humans, we all have an opinion about everything. We have our own set of morals and beliefs. However, this is something that does not belong in healthcare and can interfere with caring for a patient—especially when the patient looks or behaves differently from us.  

The American Nurses Association (ANA) Code of Ethics for Nurses Provision 1 states that, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” 

Understanding Your Personal Biases

The Harvard University Implicit Bias Test is an online tool designed to measure unconscious or implicit biases that individuals may have. The test presents a series of images and words that are associated with different groups of people and measures the time it takes for the individual to associate the words with the images. The test is free and can be taken online, and covers a range of topics such as race, gender, age, religion, and sexual orientation. 

A test, like this, can be a great way to begin having an honest conversation with yourself about your internal, implicit biases.  

Take the test here! 

Acknowledging Your Bias in Healthcare

Acknowledging that you have biases is the first and most important step to minimizing their impact. To be clear, having implicit biases doesn’t make someone a bad person. When people feel they’ll be negatively judged for implicit bias. But when we acknowledge that everyone has biases, we can be more intentional about deciding not to act on them. 

Often, patients who experience bias in healthcare are considered vulnerable patients. This is unfortunate because a negative experience can decrease their chances of compliance, follow-ups, and any future care they may need.  

Let’s take a look at an example: 

A 35-year-old patient who was born male but now identifies a female had a negative experience at a medical appointment and has not been seen by a medical professional in 7 years. She gained the courage to make an appointment because she developed a health issue. She is anxious because of her past experience, but hopeful this time will be different. She is very disappointed when the nurse will not call her by the right name that is clearly written on her paperwork. The nurse refuses to call her by her chosen name even after the patient corrects the nurse. The patient immediately feels uncomfortable and leaves without receiving medical care.   

This nurse either had an unconscious bias that was obvious to the patient or an explicit bias that they did not hide from the patient. Either way, we see that the outcome was negative. Who knows when this patient will receive the care they need after such an experience? 

The Bottom Line on Bias in Healthcare

In conclusion, recognizing and acknowledging our biases is an essential step towards creating a more inclusive and equitable environment, especially in the nursing profession where diversity is prevalent.

By participating in bias training and embracing the diversity around us, we can enhance our cultural competency and provide high-quality care to all patients regardless of their backgrounds.

It is important to remember that biases are not inherently negative, but they can become problematic if we allow them to affect our interactions and decision-making. By understanding and managing our biases, we can work towards creating a more just and fair healthcare system that benefits everyone. 

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