Conversations about Bias in Healthcare

The problems of discrimination and oppression have recently risen to the surface of the American psyche as a result of the horrific acts of violence committed against Black and Brown people recorded and shown unfiltered to the public. The videos have caused protests to erupt across the nation. Regardless of where an individual resides on the political spectrum, the unrest is concerning.

The workplace is not immune to events happening in the country. Despite the expectation for employees to leave their feelings at home, people can’t unsee what they have seen and become uncaring robots. An organization acknowledging that bias and discrimination continue to be a problem in the nation, and therefore in the workplace, is the first step in addressing the concerns of its minority employees.

Bias in the Workplace

Healthcare organizations may believe policies and procedures prohibiting discrimination across several conditions address the issues adequately, and nothing else needs to be done. However, just because there is a rule or law in place does not prevent biased or discriminatory acts from occurring.

Prejudice and bias occur regularly, simply because they are a part of human nature. Everyone has biases or preferences. From food to cars to who they choose or not choose to associate with, people act on preconceived thoughts to direct their actions. Unfortunately, preconceived thoughts and beliefs about people form biases and often lead to discrimination. Implicit bias (people acting on the basis of prejudice and stereotypes without intending to do so) is a problem in the workplace because it affects employees’ careers, retards innovation, and contributes to an unhealthy workplace environment.

Safe Spaces

An organization should seek to learn what are the minority employees’ perceptions of the workplace. The question is, how does an organization begin to understand the feelings of employees, specifically minority employees, regarding workplace bias and discrimination?

Listening sessions, frequently dubbed as “Safe Spaces,” can be held. These are virtual environments where employees can voice their concerns anonymously and can be a tension-releasing activity for minority employees.

Companies have found “Safe Space” sessions are usually overwhelmingly well-received. They create an outlet for minority team members to 1) recognize they are not alone and 2) learn how to support each other. At my organization, the need for this conversation was affirmed by the large number of team members that participated and that multiple sessions were necessary. The overarching sentiment of the participants was that the conversation was a long time coming (being able to talk about race openly).

“Safe Spaces” can be utilized by an organization to begin to talk about minority employees’ emotional and psychological trauma caused by repeated exposure to videos capturing violence and aggression against minority and marginalized people. It is an indispensable event.

During the discussion, it is critical people are given “permission” to seek care by naming and describing the psychological effects of emotional trauma such as:

• Shock or denial

• Feeling numb

• Anger, irritability, mood swings

• Sense of hopelessness or sadness

• Confusion

• Anxiety and fear

A trained counselor or employee assistance program representative should be made available during and after each session to share contact information if needed by team members. Having a safe and open forum for employees to express their thoughts and feelings helps in reducing stress levels.

These sessions can be set up through videoconferencing using software programs like Webex, Zoom, Google Hangouts, and Microsoft Teams. Communication urging attendance needs to be frequent and widespread throughout all levels of the organization. Regardless of where a minority sits on the corporate ladder, from the frontline to the boardroom, it is highly likely they have been in some way affected (sometimes unconsciously) by recent and ongoing racial events, and therefore could benefit from participating.

Structured slides and targeted questions are a great way to begin and maintain the discussion. Participants can engage in the chat function, and more often than not, they will participate respectfully. Let the conversation happen organically.

Many people join and participate from a place of learning. There are two main “categories” of participants, those who just wanted to know they are not alone and share their thoughts and pain, and those who want to understand the pain and learn how to provide support. However, the discussion should be monitored in case it needs to be closed down.

Safe Space Follow-up

These sessions cannot be a “one and done” without follow-up. If the “Safe Space” is not followed up with tangible action, employees may perceive the event as an insincere performative act. The next step is formalizing a committee to put forth diversity and inclusion initiatives.

My hospital has created a Diversity, Inclusion, and Equity Executive Council to develop educational modules and videos to help employees and leaders learn about issues caused by implicit bias and discrimination. Most organizations have policies and procedures prohibiting discrimination, but few, if any, discuss bias. Forming a committee and empowering it to put forth initiatives and programs to help employees, especially leaders, to acknowledge and begin to address implicit bias and discrimination is a good place to start.

A Needed Conversation

Racial conversations are difficult and challenging. Passions run deep as well as behavior. Yet still, it is only through acknowledgment and discussion of racial and discriminatory issues can an organization begin to understand the perceptions of its minority employees. Talking about these issues is the first step in the right direction.

America’s strength lies in the diversity of its population. Prejudice, bias, and discrimination are a part of the human condition, and it is not surprising they occur within the workplace. Healthcare organizations should develop strategies to begin the discussion regarding implicit bias and discrimination happening around the nation and within the organization. It is a tough conversation, but a necessary one.