Chronic Illness, Bias, and Equitable Care
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- Providers need to be aware of their own biases because they will impact their decision-making as well as interactions with patients. People’s biases originate from their backgrounds, experiences, media, knowledge, cultures, and religions. Healthcare professionals must be aware of their prejudices and possess cultural competence to comprehend patient preferences, cultural traditions, values, and socioeconomic conditions without biases (Stubbe, 2020).
- One of the most essential roles of the nurse practitioner is to ensure equality in treating patients and providing them with the best care. Fortunately, I had no bad personal experience. However, I witnessed a lot of bizarre when I was working in the ER in Pittsburgh, which are the most biased, stubborn, and racist people or providers I have ever seen. One time, there was a Spanish couple came to the ER because the wife had stomach pain. This woman seemed to be in so much pain. The husband and the wife speak Spanish only, and they were new in the country and were very young. I heard the assigned nurse stereotype them because they did not speak English. She asked me to take over and deal with the situation. I informed her that I am not Spanish, but I know some, and I have lived in New Jersey and had a lot of Spanish friends, so I may be able to help the couple. While I was going to the room to see the patient, the provider came to the nurse and asked her if she had this patient, so she informed her that I would try to help translate what they said. Then she said,” I do not understand why these people come here to bother us; they should go back wherever they came.” This action explained to me her unconscious biases, which interfered with her focusing on the patient’s case (Vela et al., 2022). I informed the provider that I could help translate the patient’s pain criteria and that I would obtain the most subjective data if possible. I denied the provider’s attitude toward her patient because she was very judgmental. This experience showed how this provider was biased and made unfounded assumptions regarding the patient’s nationality, which were unrelated to the patient’s health condition (Vela et al., 2022).
My experience demonstrated how bias can adversely affect patient care and cause delays in management and treatment, resulting in negative health effects. As a result of this incident, I took a close look at myself to identify and analyze my own biases to prevent them from happening in my future career.
The Healthy People 2030 initiative identifies health disparities as conditions closely associated with social and economic disadvantages. Certain groups of people have been adversely affected by health disparities because of their racial or ethnic background, religion, socioeconomic status, gender, age, mental health, cognitive, sensory, or physical disabilities, sexual orientation, gender identity, geographical location, or other characteristics that have historically led to discrimination (HHS, 2023). Educating patients about their rights in the healthcare system is essential. Meanwhile, it is necessary to raise awareness about racial and ethnic disparities in healthcare among healthcare providers. Also, providing clinicians with cultural competency training and seminars will help them understand and respect cultural differences and implement a tracking and quality improvement system that can benefit all patients, regardless of race or ethnicity. It is necessary to build a political will to achieve these goals (Williams & Cooper, 2019). Under EMTALA law in the USA, every patient can get emergency medical treatment without any limitations based on race, age, or gender. Lastly, I am responsible as a provider for providing high-quality care, equality, and dignity to all my patients (CMS, 2024).
References
Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. (2023). Health equity in healthy people 2030. Home of the Office of Disease Prevention and Health Promotion – health.gov. https://health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030
Stubbe, D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus (American Psychiatric Publishing), 18(1), 49-51. https://doi.org/10.1176/appi.focus.20190041
U.S. Centers for Medicare & Medicaid Services. (2024, April 25). Emergency room rights. Centers for Medicare & Medicaid Services | CMS. https://www.cms.gov/priorities/your-patient-rights/emergency-room-rights
Vela, M. B., Erondu, A. I., Smith, N. A., Peek, M. E., Woodruff, J. N., & Chin, M. H. (2022). Eliminating explicit and implicit biases in health care: Evidence and research needs. Annual Review of Public Health, 43(1), 477-501. https://doi.org/10.1146/annurev-publhealth-052620-103528
Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: Using what we already know to take action. International Journal of Environmental Research and Public Health, 16(4), 606. https://doi.org/10.3390/ijerph16040606
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