Patient Prejudice: The View From Nurses

Laurie Scudder, DNP, NP; Stephanie Cajigal

Disclosures

October 18, 2017

What Do Nurses Do About Patient Bias?

The majority of nurses have never reported a bias incident to management (64% of RNs, 75% of NPs).

[L]arge majorities of nurses told us that they had never refused to care for a patient because of the patient's negative bias toward the nurse.

And there may be a reason why. The majority of RNs (53%) who told us that they had reported a bias incident said that they were asked by management to continue caring for that patient. A smaller percentage of NPs (28%) indicated that they were asked to continue to provide care, while 30% of NPs reported that management transferred the patient to another clinician at the same facility or that the manager took over care of that patient (25%). RNs were less likely to encounter these latter resolutions: Only 11% reported that the patient was transferred to another clinician at the same facility, and only 14% reported that the manager took over care of that patient.

A large majority of nurses also reported that they have never documented a bias incident in the patient's medical record (79% of RNs, 77% of NPs).

Similarly, large majorities of nurses told us that they had never refused to care for a patient because of the patient's negative bias toward the nurse (79% of RNs, 84% of NPs). And even larger percentages reported that they had never refused to care for a patient because of that patient's bias toward a colleague (93% of both groups)

The majority of nurses (60% of RNs, 54% of NPs) reported that they did not know whether their institution had a formal process that clinicians can initiate if discriminated against by a patient, although 25% of RNs and 19% NPs stated that their institution did have such a process. Approximately two fifths of NPs (41%) and a quarter of RNs (23%) reported that their institution provided formal training on how to handle patients' biases.

How Does Patient Bias Affect Nurses?

Nurses are people too, and a large percentage told us that being on the receiving end of patient bias had an emotional impact, although only a minority categorized the impact as strong. The absolute numbers of nurses responding to this question were too small to draw a conclusion, however.

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Methodology

Medscape's survey was emailed to Medscape members and completed by 100 RNs and 160 NPs from July 17 through August 22, 2017. Medscape members who completed the survey were entered into a sweepstakes that awarded 25 random winners a $100 Amazon gift card. The margin of error for this survey among RNs is +/-7.75% and among NPs is +/- 9.80%. Both are at a 95% confidence level, using a point statistic of 50%.

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