Introduction to Bias and Microagressions

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

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    00:06 In this session, we're going to talk about bias and microaggressions.

    00:10 And, usually, when I talked about that, I like to invite people to brace themselves.

    00:14 I talk about it from a stance of turbulence.

    00:17 So think about an airplane ride, when I talk about this is a journey.

    00:21 We're going to get on that plane because we want to get to where we're going, right? And regardless of whether or not there's turbulence, we still get on the plane.

    00:30 So same thing with this.

    00:31 There are going to be some turbulent moments, but, remember in an earlier session, we talked about this is not about shame and blame, this is about talking about this issue so that we can move forward and go through that transformation and focus on it's a journey.

    00:47 So we'll land the plane in some sessions, but the turbulence is going to continue to happen and you have to continue to do the work and you do whatever you do for your own safety.

    00:58 So at points where something may be triggering and you need to excuse yourself from it, do so.

    01:04 But, come back to it, just like if you want to go somewhere, you have to get on that plane, if you can only get there by plane, you gotta get on.

    01:11 So same thing with this, and I want to invite you again to ask yourself how vulnerable are you willing to be.

    01:18 So this is where that self-awareness piece is so important that you need to make sure you stay focused on that.

    01:24 And when you feel those feelings of discomfort, maybe that's the point where you should write this down.

    01:29 Write down those words that you may be feeling like what your emotions are in the moment if I say something that makes you feel some sense of discomfort.

    01:39 And then you use that to work on that, that's one of those things that I know I need to get to a place of comfort so that I can work through whatever is causing me to be uncomfortable in that situation.

    01:50 Or maybe something you need to learn more about.

    01:53 So, we're going to talk about integrity again.

    01:55 And being a person of integrity, I want to remind you, it doesn't mean you're being perfect.

    02:00 It means being authentic and it also means you're going to be consistent, and consistent in your journey toward growing, to a place of positivity.

    02:10 You may remember that I like quotes. So I'm going to talk about extraordinary people.

    02:14 This is a quote by Shankar Vedantam, from the Hidden Brain.

    02:18 Good people are not those who lack flaws.

    02:21 The braves are not - the brave rather, are not those who feel no fear.

    02:26 And the generous are not those who never feel selfish.

    02:30 Remember, we are humans first.

    02:31 Extraordinary people are not extraordinary because they are invulnerable to unconscious biases.

    02:38 They are extraordinary because they choose to do something about it.

    02:42 And so by way of watching this, if this is the first part of your training journey, you're starting somewhere.

    02:48 From a standpoint of professional organizations, across all disciplines, we are being held accountable now in taking the initiative and moving into actionable steps to advance health equity.

    03:02 Remember I talked about that takes admitting things.

    03:06 We have to put labels on things, diagnose them to create a treatment plan.

    03:10 According to the American Academy of Nursing, there's a critical conversation on health equity and racism that was had in 2020.

    03:21 And so some key takeaways from that made me so excited when I saw that they talked about racism as a social determinant of health.

    03:30 So even though this is coming from a nursing organization, no matter which healthcare discipline you work in, you have to acknowledge that, because the key part of that is the determinant of health piece, and so no matter what your discipline is, you have to know that how we interact with patients, if we're doing that from a space of racism, it would negatively impact health outcomes.

    03:52 Another one is that diversity and inclusion advanced equity and helped organizations to thrive.

    03:59 So we've talked a whole lot about that.

    04:01 We have to have a diverse group of people, a diverse body that's representative of our population, not only thinking from an organizational standpoint but from a population health standpoint.

    04:13 And that again doesn't matter which discipline you work in healthcare.

    04:17 Many characteristics of diversity are invisible. Sit with that for a couple of seconds.

    04:24 So we talked about trust in one of the segments and we talked about vulnerability a lot.

    04:31 So if people don't trust you, they won't allow themselves to be vulnerable so you may never know about some of those characteristics of invisibility.

    04:40 From an organizational standpoint, if people don't feel that sense of trust and there's not that culture of inclusive excellence, people may just leave.

    04:49 They don't try to talk to you about what they're experiencing.

    04:52 They don't share some of those invisible characteristics because they fear those would be weaponized against them and they would be judged and labeled and they can't thrive in that organization.

    05:02 Same thing with the patient.

    05:04 If we're not fair, sincere, and authentic with patients, then they may never come back.

    05:11 And, then, we tend to label the patient.

    05:14 Oh, my goodness, they're so non-compliant.

    05:17 They don't come, they don't show up for their appointments, and we never think about how we may be contributing to the fact that they don't come back for their appointments.

    05:26 So, if a patient feels judged and they've shared with you what their symptoms are, the things that you can't see, they will never share things with you like maybe they don't have the finance or resources to afford medicines or a test, and then we just assume they just didn't go get take the test because they didn't want too, but maybe there's something deeper.

    05:45 So I'm inviting you to think about that whenever you have that first interaction with the patient in trying to build that trusting relationship.

    05:55 The next one of those key takeaways, from the American Academy, it says nurses, but we can replace the word nurses with any word for the next part of this.

    06:06 So as healthcare professionals, we need to critically examine how we relate to the populations we serve.

    06:12 If I don't know a whole lot about the population I'm going into, I would want to learn, that's what [SCQ 06:13] comes in.

    06:18 Remember when we talked about the motivation to know more? Gaining more knowledge, formulating strategies, and then putting those action plans together.

    06:28 So whenever we're thinking about community health, population health, and the social determinants of health, we need to develop a plan and the plan should include a partnership with people in those communities.

    06:39 In terms of the last key takeaway, same thing, it talks about nurses, because this comes from a nursing organization, but I'm going to replace it with health professionals, are committed to taking steps to ensure a less racist future.

    06:54 This is my absolute favorite point. but to do so, they must move beyond words to actions.

    07:00 Because we've been talking for much too long.

    07:03 We all know what the issues are, now we just need to embrace that these things are real, develop those action plans, and stop waiting.

    07:11 We don't need to take it slowly anymore, we just need to start.

    07:14 Start taking some steps and then continue moving forward.

    07:18 The National Academy of Medicine, is another one of those that's holding us accountable, and the future of Nursing 2020-2030 report, just remember it says, future of nursing, but this is an interprofessional body that includes nurses and physicians.

    07:34 So this report, charting a path to achieve health equity, in this, it talks about how nurses can reduce health disparities, because this portion is about nurses, but again, we can replace that with any health discipline.

    07:49 So how do we work together to reduce health disparities and promote equity in keeping costs down, I'm going to stop at that point and talk about, that's very important, but I want us to prioritize health.

    08:03 So sometimes, yes, we do need to look at cost but we also need to look at the health outcomes and if we focused too much on cost, sometimes, it obstructs us from doing the things we need to do to help people who can least afford things have that equal and equitable opportunity at health, optimal health.

    08:26 Then, using technology.

    08:28 We all know the world is evolving so we do need to become familiar with technology, at least at a basic standard. So when we talk about technology, it's important these days, because as we've seen through COVID, there are multiple different ways that we can engage with our patients, and telehealth is really popular.

    08:49 However, we also need to consider that everybody can afford Telehealth, right? Then we'll have the access to the technology so as healthcare professionals, we need to be thinking about how can we get grant funding, partner with the government, get involved in these health policies where people actually have access to those resources so they do have, again, those equitable opportunities even to engage in this health equity.

    09:17 And that would take some creative thinking.

    09:20 How can you partner with technology companies? So they may be willing to donate some things, but we do have to actively be a voice in terms of making sure people have access to these resources and not only access, we can't just give it to people and not teach them how to use it.

    09:38 So thinking broadly, if the person is an elderly patient, they may not be used to technology, do we have the manpower to go out there and teach and make sure we maintain the charging of the battery, even something like that, how do we maintain a relationship with the patient so that they can accurately utilize this technology.

    10:00 And then, maintaining patient and family focus care into 2030.

    10:06 The main thing I want to point out here is we're already in 2022, so we don't have a whole lot of time to put the wheels on the words, I like that better than put legs on, let's put wheels on these words and let's press that remote and get it going.

    About the Lecture

    The lecture Introduction to Bias and Microagressions by Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP, CDE is from the course Bias in Healthcare.

    Author of lecture Introduction to Bias and Microagressions

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

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

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