A few of the comments and gestures made by the lady giving me a report made me very disgusted and mad. The nurse started by stating the patient’s name which was difficult for her to pronounce. The nurse then said “Who knows where he is from” with a chuckle and an eye roll. This comment was weird to me as she just spent 12 hours with this person and didn’t seem to ask him how to pronounce his name or if that was what he wanted to be called. Another comment was made about his skateboarding accident. The nurse goes on to say “he is one of those people you know what I mean” with an eye roll implying that he is not a good person for enjoying skateboarding just because it is in a less fortunate side of town. The nurse also mentioned that the patient had a skateboarding accident and used air quotations. This implies that she doesn’t believe the patient’s story.
Each of these statements is important for me to address because they contain implied bias. This is a pre-reflective attribution of particular qualities by an individual to a member of some social out-group. The nurse is stereotyping her patient and this could affect the quality of care this patient may be receiving. The nurse may not trust the patient and it could harm the patient’s mental and physical health. The nurse may be implying that the patient was getting drugs since he was hanging out on this side of town and may not give him the proper analgesics because she thinks that he may be an addict. This is one of the ways these statements may be impacting this nurse’s delivery of care.
If I were the nurse to receive this report, I would feel confused and uncomfortable. I would be confused as to what evidence she has to be making such accusations. The way the nurse is implying that this patient is participating in illegal activities is harmful to him and his family. I would ask if she asked the patient how to say his name and if he has any nicknames. I would then ask the nurse if she asked the patient about his injury directly rather than just reading the notes. I felt uncomfortable because I did not know how I would respond to the nurse. I would ask her for the facts politely to try to restrict her use of bias within the report. I am not sure I would address each of the comments directly as I would be trying to get ready for my shift and receiving reports from other people. I would put it in the back of my head to ask the patient directly to prevent these biased thoughts from affecting my quality of care. The best thing any nurse can do is ask the patients questions directly to better understand their lives.
I have recently witnessed a report between two prenatal care nurses about a new mother who had a lot of mental health issues. The nurse began to say “My four-year-old knows how to function better than her” and began to laugh. This made me sad as the patient did have Asperger, anxiety, depression, and was on the Autism Spectrum. Birth is a traumatic and hard event for all new mothers. It is important to realize that this transition from pregnancy to postpartum is emotional and can be very stressful. This may alter the new mother’s way of thinking. This patient in particular has preexisting mental health conditions that are managed at home therefore this eventful time was a lot for her to deal with. The nurse receiving the report giggled at this comment as it seemed to not phase her. I did not say anything at the moment to the nurse I was following as I felt I did not have the authority to say anything. Thinking back now, I realized that if it made me uncomfortable I should’ve told my clinical instructor about this interaction.
