NRS 428 How does the community health nurse recognize bias, stereotypes, and implicit bias within the community?

Community health nurses may recognize biases by being self-aware and self-reflective. Stereotypes and implicit biases are seen within many communities, especially in communities with little to no diversity. Latino and African-American prominent communities are typically lower income and more poverty-stricken compared to nearby neighborhoods with predominantly Caucasian and Asian communities. The communities with more funding and resources typically breed healthier and more intelligent children because they have more community resources available. Education systems, healthcare, grocery stores, gyms, and restaurants are noticeably different in the two types of communities. Community nurses create resources and provide community interventions to neighborhoods in need. Poverty-stricken neighborhoods are typically most in need because the people in the community typically have many health determinants. Community health nurses must be aware of their biases and stereotypical thoughts prior to working in such low-income communities. Being culturally competent is “the ability to interact effectively with people of different cultures, belief systems, and preferences” (Falkner, 2018). Nurses interact with various people in the community and cannot choose to only care for one specific race. They must be able to provide holistic care to every patient, regardless of race, gender, education level, or socioeconomic class. A nurse must assess the education level and language of choice of most members of the community to ensure the interventions are culturally competent. “Public health requires an understanding of the concepts of culture and cultural values as well as the importance of cultural competence in caring for diverse populations” (Green, 2018). Healthcare disparities might be reduced through a patient-centered approach to cultural competency training, general knowledge of the cultural context of clinicians’ patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff (Cuevas, 2017). For example, Latinos need more resources to be written in Spanish so they can understand the disease they need.

Cuevas, A. G., O’Brien, K., & Saha, S. (2017). What is the key to culturally competent care: Reducing bias or cultural tailoring?. Psychology & health, 32(4), 493–507. https://doi.org/10.1080/08870446.2017.1284221

Falkner, A. (2018). Community as Client. In Grand Canyon University (Ed). Community & public health: The future of health care. https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/3

Green, Z., S. (2018). Epidemiology and Global Health. In Grand Canyon University (Ed). Community & public health: The future of health care. https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/3

To help combat biases and implicit biases, there are several strategies that can be employed. Performing a complete assessment that includes discussion on beliefs, values, and preferences can help the nurse to understand the client and create care plans that incorporate culture and personal beliefs. Creating partnerships with clients, not just caring for them can help prevent negative thoughts and feelings toward others. Creating a diverse workforce and creating training exercises about stereotyping and bias formation can help reduce implicit bias among healthcare workers (Falkner, 2018).

Reference

Falkner, A. (2018). Community as a client. Community & Public Health: The Future of Health Care. https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/3

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Assessment on education and how patients learn is very important when making a care plan and planning interventions. This will ensure that the patient follows through with the care plan. Also having some knowledge in their culture to incorporate it to the care plan making it easier for patient to carry out the plan, with the ultimate goal to promote health. This is why many companies have cultural education for employees in healthcare in hopes to deliver better care to all patients. Your point on having education in preferred language is very true in giving proper education to patients that is culturally competent.

The community health nurse plays a pivotal role in recognizing bias, stereotypes, and implicit bias within the community. Cultural competency is a set of appropriate knowledge, attitudes, and behaviors that enable an individual to act effectively under different cultural conditions (Henderson, 2018). The nurse s role is to address these concepts with respect, active listening, and being aware of her own biases. The nurse should be well informed regarding stereotypes and biases in order to be sensitive to these issues and provide the most unbiased care possible (Falkner, 2022). Cultural issues can arise being a nurse. For example, some cultures do not take prescription medications or blood transfusions. However, the nurse must respect the patients culture and background to say that is ok. Strategies that one can use to reduce cultural dissonance and bias to deliver culturally competent care are to listen actively and to create a cultural assessment in finding out about the patients beliefs, religion, and ethnicity.

When patients know that they are being cared for and respected based on their background and values, higher satisfaction will occur. Consequences of cultural competence are satisfaction with care, the perception of quality healthcare, better adherence to treatments, effective interaction and improved health outcomes (Henderson, 2018). I would also propose trainings on cultural competency and diversity to be offered at the organization. In these trainings, employees can be informed of the LEARN model. The LEARN communication model (see Figure 3.1) has been used as an effective way to move through feelings of apprehension triggered by cultural dissonance (Falkner, 2018). It is important that employees receive these trainings as part of their annual training. Cultural competence and being treated ethically align hand in hand when understanding patients and treating them with respect.

Falkner, A. (2018). Community & public health: The future of healthcare. Grand Canyon University. https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/

Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & social care in the community, 26(4), 590–603. https://doi.org/10.1111/hsc.12556

Public health nurses work a lot with diverse members of the community and they do not get to pick and choose who they help or not. This is one of the many reasons that nurses need to be aware of bias and stereotypes. Stereotype is a perceived assumption regarding a particular group of people (Falkner, 2018). Bias is closely associated with stereotypes, bias is the feeling or emotion felt by an individual about the group that the stereotype is being directed to (Falkner, 2018). In healthcare there is a term known as implicit bias where attitude and care is molded based on the stereotype towards some groups of people, this affects the care and decision making towards that particular group (Falkner, 2018). Nurses need to be aware of such biases and stereotypes in order to provide the best care towards everyone (Falkner, 2018). As healthcare workers we must be advocates for all patients particularly towards the groups that suffer stereotypes in order to provide the most unbiased care towards them (Falkner, 2018).

In an effort to reduce stereotypes and biases the LEARN model can be taught among healthcare workers. This is a great way to teach healthcare workers about culture diversity. There are five steps to the LEARN model: listen, explain, acknowledge, recommend, and negotiate (Falkner, 2018). For the first step it is geared towards listening with empathy to the patient (Falkner, 2018). Next is to explain what was understood of the issue. The third step is to acknowledge and discuss the issue with the patient to gain similar perspectives (Falkner, 2018). Lastly we have to recommend and negotiate, where a plan is recommended and at the end a plan is negotiated (Falkner, 2018).

Reference:

Goel, D. M. (2018). Stereotyping, bias, and decision making in health care. In C. B. Travis, J. W. White, A. Rutherford, W. S. Williams, S. L. Cook, & K. F. Wyche (Eds.), APA handbook of the psychology of women: Perspectives on women’s private and public lives., Vol. 2. (pp. 331–346). American Psychological Association. https://doi-org.lopes.idm.oclc.org/10.1037/0000060-018

Community health nurses play a crucial role in delivering culturally competent treatment by detecting and addressing prejudice, stereotypes, and unconscious bias within the community. This process involves self-reflection, obtaining cultural competency education, and actively listening to patients’ perspectives while avoiding assumptions. The nurse should challenge unconscious biases, employ cultural frameworks and assessment tools, provide language support, and collaborate with the community to plan suitable health promotion programs. Continual learning and progress are vital to enhancing cultural competency over time, leading to improved health outcomes for all community members (Falkner, 2018).

To achieve this, nurses must first establish cultural competency by gaining a thorough understanding of diverse cultural values, health beliefs, religion, and human philosophy. Cultural competency training should be an integral part of nursing education and continuous professional development to ensure nurses are well-equipped to provide quality care to patients from various ethnic backgrounds (Červený et al., 2022).

Offering a variety of training approaches is essential to enhance cultural competency. By utilizing methods like face-to-face workshops, simulations, eSimulations, and web-based learning, nurses can gain practical experience and insights about cultural diversity in healthcare settings. Real-life examples and open discussions, along with interactions with people from different cultural backgrounds, foster reflection, and critical thinking during training (Červený et al., 2022).

NRS 428 How does the community health nurse recognize bias, stereotypes, and implicit bias within the community?