Abstract
Introduction
The purpose of this study was to obtain a broad view of the knowledge, attitudes,
beliefs, and lived experiences of emergency nurses regarding implicit and explicit
bias.
Methods
An exploratory, descriptive, sequential mixed-methods approach using online surveys
and focus groups to generate study data. Two validated instruments were incorporated
into the survey to evaluate experiences of microaggression in the workplace and ethnocultural
empathy. Focus group data were collected using Zoom meetings.
Results
The final sample comprised 1140 participants in the survey arm and 23 focus group
participants. Significant differences were found in reported experiences of institutional,
structural, and personal microaggressions for non-white vs white participants. Respondents
who identified Christianity as their religious group had lower mean scores on items
representing empathetic awareness. Respondents who identified as nonheterosexual had
significantly higher mean total Scale of Ethnocultural Empathy scores, empathetic
awareness subscale scores, and empathetic feeling and expression subscale scores.
Thematic categories that arose from the focus group data included witnessed bias,
experienced bias, responses to bias, impact of bias on care, and solutions.
Discussion
In both our survey and focus group data, we see evidence that racism and other forms
of bias are threats to safe patient care. We challenge all emergency nurses and institutions
to reflect on the implicit and explicit biases they hold and to engage in purposeful
learning about the effects of individual and structural bias on patients and colleagues.
We suggest an approach that favors structural analysis, intervention, and accountability.
Key words
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Biography
Lisa Wolf is Director, Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL. ORCID identifier: https://orcid.org/0000-0002-7065-470X.
Biography
Altair Delao is Senior Research Manager, ENA, Schaumburg, IL. ORCID identifier: https://orcid.org/0000-0001-6017-3227.
Biography
Cydne Perhats is Senior Research Associate, ENA, Schaumburg, IL. ORCID identifier: https://orcid.org/0000-0002-6434-3534.
Biography
Anna Valdez is Professor, Sonoma State University, Windsor, CA. ORCID identifier: https://orcid.org/0000-0002-0204-3536.
Biography
Tania Strout is Director of Emergency Research, Maine Medical Center, Portland, ME. ORCID identifier: https://orcid.org/0000-0001-9053-1523.
Biography
Paul Clark is Assistant Professor, UNiversity of Louisville, Louisville, KY. ORCID identifier: https://orcid.org/0000-0003-4990-875X.
Biography
Michael Moon is Associate Professor, University of the Incarnate Word, San Antonio, TX. ORCID identifier: https://orcid.org/0000-0001-5490-242X.
Biography
Stephanie Frisch is Nurse Scientist, University of Pittsburgh, Pittsburgh, PA. ORCID identifier: https://orcid.org/0000-0003-3692-3125.
Biography
Michael Callihan is Assistant Professor, University of Alabama, Tuscaloosa, AL. ORCID identifier: https://orcid.org/0000-0002-5585-7701.
Article info
Publication history
Published online: December 16, 2022
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© 2022 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
