By Christie Taylor, CP-C
Remembering a call earlier in my career really taught me about myself, and who I was as a provider.
The pungent odor of alcohol flooded the back of the ambulance. The source of this smell – a young man laying on my stretcher –was babbling and telling me how much he hurt. He was the driver of a vehicle involved in a two-car motor vehicle accident. The driver of the other car was hurt seriously enough that we had to fly her off the scene, and her prognosis was not great from our initial assessment.
While listening to this 20-something-year-old drunk driver, my emotions took over. “I don’t want to hear your complaints or excuses, you are drunk, and you were driving and you may have killed another person.” His eyes were big, his face was without expression, which made me continue my verbal assault until he apologized to me with tears in his eyes. Honestly, it felt good to berate him, until the reality of what I had just done hit me.
Six months earlier, a 29-year-old husband and father of three children was killed by a drunk driver. He was a son, he was a little league coach, he was one of the best people to know – he was my brother, Trent. Around 1 a.m., Trent was driving home from work when a 20-year-old driver took his life and ran off into the woods after watching my brother die in a ditch along the interstate. He was located 12 hours later and arrested. At his arraignment, we learned this was his third DUI, and the second time he ran to evaded arrest. Police reported finding paperwork from a DUI class soaked in beer in his vehicle. My family was devastated as we buried Trent the day before his 30th birthday.
It took me a few days to figure out was happening with me after I reprimanded the patient on my stretcher. It felt good to take out my loss and frustration. However, it also made me feel grim when I realized what I had done. Up until that time, I took my job as a paramedic seriously and was the face you wanted to see during your emergency. Knowing I needed an attitude adjustment, I set off to determine what just happened to me, and how to ensure this bias did not end my career.
|More: Stopping the bias snowball, before it kills your patient
What is a bias?
During my research, I soon realized that my feelings were not siloed in EMS as many of my peers had some semblance of their own bias as well. This made me want to become an expert on the subject.
Bias is any thought or action that can either discriminate or extremely favor one person or group. This could be kept internal to the individual or shown outwardly with attitude. Bias falls into two categories; implicit or explicit [1].
Implicit and explicit bias
Implicit bias is a positive or negative unconscious, involuntary reminder of stereotypes we hold against people or social groups. This of course is something we are not aware of but will influence our decisions or behaviors. This usually happens without our understanding or knowing why we are reacting. When this reaction occurs, it just feels normal based on our beliefs.
Explicit bias happens when we are aware of our prejudice and attitudes towards certain people or groups. As with any other bias type, this can be both positive and negative [2].
In my case above, my bias was negative against drunk drivers.
Why is understanding bias important?
Reacting with emotion is always a challenge and something we must be highly aware of. When we went into healthcare, it was the intent to make a difference for those who were sick, injured or traumatized. We see people daily from all walks of life — they can be rich, poor and some marginalized groups. Sometimes, we even treat suspected criminals. As professionals, we must ensure that everyone receives appropriate, impartial and compassionate care. Understanding your own biases can help to alleviate treatment disparities and provide better patient outcomes.
|More: ‘A series of unfortunate events’: The danger of bias cascade in EMS
5 tips for managing bias behavior
Here are 5 tips for managing both implicit and explicit bias, which can help foster greater self-awareness and promote more inclusive behaviors [2].
- Increase self-awareness. Acknowledge that everyone has biases, both implicit (unconscious) and explicit (conscious). Reflect on your thoughts, behaviors and reactions in different situations to identify potential biases. Tools like the Implicit Association Test (IAT) can help uncover unconscious biases [3].
- Seek diverse perspectives. Engage with people from different backgrounds, cultures and experiences to challenge stereotypes and broaden your understanding. Actively listen and remain open to learning from others’ viewpoints without defensiveness.
- Practice mindfulness and reflection. Take time to reflect on your judgments before making decisions, ensuring they are fair and unbiased. Mindfulness techniques can help slow down automatic thinking and allow for more conscious decision-making.
- Challenge stereotypes actively. When you recognize biased thoughts or assumptions, consciously replace them with more accurate and individualized perceptions. Question stereotypes and remind yourself that individuals are unique, and assumptions based on group identity are often inaccurate.
- Commit to continuous education. Stay informed about bias, privilege and systemic inequalities by reading, attending workshops and engaging in discussions on the topic. Recognizing bias is an ongoing process, so regularly seek opportunities to grow and improve your awareness.
By practicing these strategies consistently, individuals can work towards reducing both implicit and explicit biases, creating a fairer and more inclusive environment.
Mind your words
This was my journey to ensure that all my patients received the very best care that I had to give. The driver that killed my brother was sentenced to 20 years in prison and served 7 years. Over the course of my career, there were plenty more drunk drivers on my stretcher, and my thoughts always return to my brother. Instead of taking my pain out on the patient, I am grateful to Trent for his one last lesson to me. Remember, your words can do just as much harm as practicing bad medicine.
ABOUT THE AUTHOR
Christie Taylor has been a paramedic for 25 years, spending most of that time working in 911 systems in and around Atlanta. Christie is an operations supervisor working for QuikMedic. QuikMedic focuses on giving healthcare providers the ability to extend their care services outside the walls of their practices. Christie received her CP-C Community Paramedic certification 3 years ago.
REFERENCES
- National Center for Cultural Competence. “Two types of bias”. Georgetown University Center for Child and Human Development. Available at: https://nccc.georgetown.edu/bias/module-3/1.php
- Perception Institute. (n.d.). “Implicit bias explained”. Available at: https://perception.org/research/implicit-bias/
- Greenwald AG, McGhee DE, Schwartz JLK. (1998). Measuring individual differences in implicit cognition: The Implicit Association Test. “Journal of Personality and Social Psychology”, 74(6), 1464–1480. https://doi.org/10.1037/0022-3514.74.6.1464
