- “Mrs. Longfellow, are you ready for me to come in?”
- “Sure!” She responds.
- I open the door to greet my new patient with a polished appearance from head to toe. I’m wearing designer nude heel wedges, tailored khaki slacks and a white blouse with a string of pearls - check. I’m in my favorite Medelita brand white coat, straight from the dry cleaners - double check. My hair is pulled back into a low bun and my minimal make-up look is flawless - triple check. My smile is bright and my Nurse Practitioner credentials earned from the prestigious Georgetown University adorns my white coat in friendly pink script - Jackpot.
- My patient is sitting on the exam table in her paper pink gown. She looks me up and down, studying me. She settles her eyes on my face. Her facial expression changes ever so slightly, a look women and men of color know all too well. This look conveys a million thoughts in a split second. The thoughts are equal parts doubt, dissatisfaction and curiosity. It all boils down to “I didn’t know you would be _____________.”
- Mrs. Longfellow flashes an uncertain smile, but decides to give me a chance.
Each and every day, we all face minor or major instances where biases, stereotypes and preconceived notions get in the way of doing business, placing an order at a restaurant and yes, the provision of quality healthcare.
Patients uncertain of an unfamiliar face in a healthcare setting can cause all kinds of challenges including slowing a visit, making a patient/provider interaction uncomfortable and in worst-case scenarios, cause such an offense the relationship cannot continue.
Early in my career as a nurse practitioner, encounters like one with Mrs. Longfellow used to consume me. I used unreasonable amounts of time trying to validate myself through my educational credentials, trying desperately to prove to skeptical patients how qualified I actually was to manage their care.
It was time and energy wasted that should have been spent focusing on my patient’s healthcare needs.
Understanding Biases and Microagressions
When I started my nursing career about a decade ago, it was not unusual to be met with comments peppered with racial undertones by patients and colleagues alike. I later learned these comments could be referred to clinically as “microaggressions”.
A microaggression is the casual degradation of any marginalized group. The term was coined by psychiatrist and Harvard University professor Chester M. Pierce in 1970 to describe insults and dismissals he regularly witnessed non-black Americans inflict on African Americans. Eventually the term came to encompass the casual degradation of any socially marginalized group.
As a minority healthcare provider, it’s our job to manage and mitigate impediments to providing quality healthcare and often times means the management of microagressions, unsavory comments or the questioning of your right and ability to serve as a healthcare provider.
Here are a few tips to deal with Mrs. Longfellow-like interactions as a minority healthcare provider:
“YOU’RE my healthcare provider?”
As a minority healthcare provider, you may be met with bias from patients that have not interacted with someone who looks like you. Whether you’re a person of color, wear a distinct religious headdress or speak with a non-American accent, most of us will encounter questions like these from time to time while providing healthcare services.
It’s important to remember that you are the professional and possess the knowledge and skill to redirect unproductive rhetoric and dialogue. Educate your patients on your position and remind them that you are looking forward to caring for them. Ask your patients if there is anything you can do to better serve them and be mindful that we aim to do no harm, including how we respond to our patients.
Everyone carries biases. When unfair or deconstructive exchanges present themselves, it’s our job as healthcare providers to avoid adding to the disarray and refocus the conversation on meeting the needs of the patient.
Continue the healthcare visit – be kind, confident and knowledgeable. My most difficult patient encounters almost always end in Mrs. Longfellow asking whether she can see me regularly, gushing about how wonderful her visit was.
One compassionate, knowledge-filled interaction can help re-shape a patient’s view of you and others who look like you. This is a win-win for the provider, the practice and the patient. The provider has built trust and gained a new patient, while the patient has had an eye-opening, positive healthcare experience.
Strength in Diversity
More than ever, diversity is being celebrated around the country. We know a diverse healthcare team produces better patient outcomes by providing culturally competent care and higher patient satisfaction scores.
If you’ve ever doubted your place as a minority healthcare provider, or have been made to feel you do not belong, remember the infamous quote by NFL running-back, Marshawn Lynch –“You know why I’m here.”
You deserve to be exactly where you are and are essential to the growth of the healthcare industry. Through compassion and the provision of competent care, we have the opportunity to promote kindness and inclusivity amongst our patients and colleagues.
And when there are particularly rough encounters, just remember – there are people whose lives quite literally depend on you being there.
About the author:
Monica (Elston) Carter is a Board Certified Family Nurse Practitioner in a women's health practice in Washington, DC. Prior to becoming a Nurse Practitioner, she worked as a Labor and Delivery nurse. She believes in providing the best care to women inspiring them to have the confidence to live their best lives possible. Monica enjoys guiding and educating new nurses and nurse practitioners. Outside of work she loves all things skincare, travel and spending time with her husband, family and friends. Follow Monica on Instagram!