RNOtherJournal of advanced nursing2022

Looking through racism in the nurse-patient relationship from the lens of culturally congruent care: A scoping review.

Mojtaba Vaismoradi, Cathrine Fredriksen Moe, Gøril Ursin and 1 others

PMID 35441739

WHAT IT FOUND

Racism in nurse-patient care appeared as implicit bias, guessing culture from names, and patients' aggression.

Reported consequences included patients' dissatisfaction, negative views of healthcare, nurse stress and leaving nursing. Nurses described patient-centred care, cultural understanding and reporting incidents as strategies.

Key findings

01Ten studies mapped racism in nurse-patient relationships and produced three categories: bilateral ignition, hidden and manifest consequences, and encountering strategies.

02Racism was reported from both sides: nurses' implicit bias and guessing culture from habits or last names, and patients' rejection of care or aggression tied to nurses' ethnicity or accent.

03Reported consequences included patients' dissatisfaction, negative views of healthcare, nurse stress and leaving nursing; nurses described patient-centred care, cultural understanding, advocacy and incident reporting as coping strategies.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This was a scoping review, not a test of interventions, so it maps what was studied rather than showing what works. Only 10 studies were included from 149 records, and the authors said the evidence base was small. Most included studies were qualitative, so they describe experiences and meanings rather than measuring frequency or outcomes. The authors did not assess risk of bias or quality, because they said this is generally not applicable to scoping reviews. Only English publications from 1 January 2009 to 31 October 2021 were searched, so relevant work in other languages or outside that period may be missing. The optional consultation step was omitted because of ethics and the sensitivity of the topic. Included studies varied by country, setting and focus, from primary care to neonatal and home care, so the themes cannot be assumed to apply to every nurse-patient relationship. The review did not report a total number of participants across studies, and some study samples were not stated.

The easy way to misread this

Do not read the patient-centred care, cultural understanding or reporting strategies as proven ways to reduce racism. This scoping review mapped reported experiences and coping strategies. It did not test interventions.

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