Bias-management Strategies

by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

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    00:06 So I have mentioned a lot about we can develop some bias management strategies and I do like theories, obviously, I'm a nurse so when theories make sense, I love to use them.

    00:17 And cognitive behavior theory is very important when we think about bias and bias management strategies.

    00:24 It also helps us to understand, where our biases come from and recognize when they're happening.

    00:31 So I talked about the cultural influences, I talked about how those help us become who we are.

    00:37 Well, guess what? I think about whenever a situation happens or I'm exposed to a person that I have a bias against, typically, we have some types of feelings, right? And they're automatic thoughts and images because we've practiced them for so long that's when we talk about the unconscious bias, so that's why we're not familiar sometimes because it just pops in our head and then we have reactions.

    01:03 So, you see something, it could be a person or a situation, whatever it is, then you have thoughts and images and sometimes those are based on myths and stereotypes.

    01:13 Then you have these reactions and these reactions can be emotional, behavioral, or physiological, or all three.

    01:20 That's the key to how we can shift biases from a space of unconsciousness to a space of consciousness.

    01:28 Because I can become aware of what's happening with me in terms of my emotions.

    01:33 I'm getting irritated and angry about whatever it is. Or if it's good, I'm feeling happy.

    01:37 And then my behaviors manifest so if I'm happy I'm smiling and I'm feeling excited, right? And if I'm irritated or angry, then I'm feeling that.

    01:46 If I'm irritated or angry, I might start developing physical symptoms.

    01:50 My heart rate might be increasing, my stomach's turning or I have butterflies if I like the person, so just think about that.

    01:57 When you see someone, if you're in love, you might get the butterflies.

    02:00 If you're in a situation where I just really cannot stand this person, then my hands are sweating, I'm angry, I might be sweating even on my forehead, I don't know.

    02:11 But my heart rate is increasing.

    02:13 So I can tell that when it's a negative bias, I can interrupt it based on, I know what I'm feeling, I just want to get out of this room, I do not want to interact with this person.

    02:22 Well, guess what? I need to shift that.

    02:25 Whether it's one of my colleagues or whether it's a patient; because I still need to operate as a professional in this space, so now that I recognize it, what am I going to do with that? And we're going to talk about some strategies.

    02:37 To go along with that, there's this Buddha quote that I absolutely love and I'm going to go to that quote piece by piece so you can think about how it just aligns and in such congruence with that cognitive behavior theory.

    02:52 So the thought manifests as the word. Think about that from biases.

    02:57 I'm thinking these negative or positive thoughts and then I give words associated with that and then the word manifests as the deed, so my behaviors or actions and when I'm doing that consistently, then that becomes a habit.

    03:11 The habit becomes who I am, hints why I said you become an -ist becomes I'm doing this so much that that becomes a part of my character.

    03:20 So watch the thought and it's ways with care when we think about how we're going to transform and try to undo that in terms of negative biases, and let it spring from love born out of concern for all beings.

    03:34 Remember, I said that a lot, all beings.

    03:36 We're talking about we're all humans who deserve peace.

    03:40 As the shadow follows the body, as we think so we become.

    03:45 So it's saying that it becomes harden into who we are.

    03:48 And also thinking about, I want to point this out.

    03:52 This is a Buddhist quote, I'm not Buddhist but I can take something from that.

    03:56 That's cultural intelligence. I don't have to practice a certain religion or be affiliated with something to get something out of it because I'm functioning as a human being.

    04:07 And how can we help each other in the space of moving toward positive in creating that equity and peace for everybody.

    04:16 Another one of those theories we can think about is the behavioral ABC.

    04:20 So there's an antecedent or something that causes it when we think about bias, right? So typically, it's either something we had to happen directly in our interactions with people or we're influenced by other people and that conformity bias shows up because this is what the majority of the people in my space believe, so I now I believe that to be true, too. It may or may not be true.

    04:43 So the antecedent is the cultural influences, our lived experiences, our preconceptions, interactions, just lots of things can be the preceding thing that leads to behaviors and beliefs.

    04:56 And what happens is, that turns into bias, violence, microaggressions, macroaggressions, -isms, discrimination, oppressive attitudes, all those different things.

    05:07 And the consequences in the space of healthcare can be the inequities, disparities, in the space of any type of interpersonal or interprofessional relationship mistrust.

    05:18 So whenever there's a fracture and especially a break in trust, it's really hard to move forward into a positive space in terms of organizational excellence or even in terms of optimal healthcare because if people don't trust you again, it won't be an optimal relationship.

    05:37 Consequences can be decreased diversity in the space so that [sameness 05:37] again.

    05:43 So homogeneity isn't -geneity, rather, is not always a great thing, right? It's better to have that heterogeneity in differences of thought and idea, and experiences.

    05:54 Because, remember we talked about what great innovations come out of those differences, and then sub-optimal health outcomes and literally, one of the consequences of bias that is the worst, is death.

    06:06 Another way to look at that behavioral ABC model, you know, remember, thinking about an activating event a belief or a behavior and then those consequences and you can ask yourself some reflective questions.

    06:19 So to help yourself move toward that, maybe think about some of your biases, and think about what created those biases.

    06:27 And as a result of those biases, what are your beliefs? And then in the past, what may have been some of the consequences of those biases and if there haven't been any, what could some potential consequences be? And you want to think about that from a personal and a professional perspective, and what are you going to do to help to move yourself forward.

    06:47 So, definitely, I want you to embrace that cognitive behavior theory, and think about it, to try to learn it, internalize it so that you are able to recognize some of those feelings that you're having when you are around a person or a situation that you have biases against.

    About the Lecture

    The lecture Bias-management Strategies by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE is from the course Bias in Healthcare.

    Author of lecture Bias-management Strategies

     Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

    Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE

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