Words matter: Labelling, bias and stigma in nursing

Abstract

I began learning 'labels' and stigmatizing phrases about patients when I was in nursing school. The first labels I learned were 'drug seeker' and 'non-compliant'. These terms were introduced when discussing pharmacology in my first year of nursing school. The nurse educators who introduced the labels and biases thought that they were teaching accurate and essential information. They learned their language from someone, just as I did, and spoke from their own experience and positionalities. After graduation, I moved into emergency nursing, and by the time I had 3 years of experience, I had learned many labels and stigmatizing phrases. I took them as fact and embedded them into my practice. These labels, stigmatizing language and biased communication are not only seen in emergency nursing. Scientific racism, ableism and gender essentialism are prevalent in healthcare.It took me many years to understand that the labels used to describe patients, families and community members by healthcare professionals were harmful. Over time and with the aid of diverse colleagues and accountability partners, I learned that labels lead to stereotypes and biased care, which results in harm and can result in adverse health outcomes. Nurses' messages about patients frame their care; therefore, nurses must be intentional and mindful with their communication to ensure that they are not biasing other care team members.The Joint Commission (2016) published a safety and quality advisory discussing the impact of cognitive biases in healthcare. There are numerous forms of cognitive bias that can impact patient care.Anchoring bias and confirmation bias are the two forms of bias that are common in nursing. Anchoring bias occurs when initial information or communication shapes the treatment of patients regardless of conflicting information. In this type of bias, the healthcare professional is anchored to the initial information (often from patient handoff), and delays in care or misdiagnosis can occur from not adjusting to new information (The Joint Commission, 2016).Confirmation bias occurs when people selectively seek or accept information that confirms their opinion despite information available to the contrary. Stereotypes and discriminatory beliefs about people based on their age, racialized identity, ethnicity, disability, gender, How to cite this article: Valdez, A.

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