DEI: Facing Microaggressions Head On

Understanding our personal biases and having real — and sometimes raw — conversations with one another is the only way forward.

It has happened to me throughout my entire career. I’d walk into a different department to see a patient before surgery and be mistaken for a housekeeper, transporter or dietary staff member. Assumptions were automatically made that I couldn’t be a nurse or a doctor, so I must’ve been there to take out the trash or transport the patient. I’ve lost count of how many times people from different departments have approached the desk looking for the manager or charge nurse (me) only to direct the conversation to a white staff member next to me — often a tech or a housekeeper. When I let the person know I’m the charge nurse, sometimes they’ll still look to my colleague for answers.

Subtle or blatant acts that disempower

These are just a couple of the myriad of microaggressions that I, a person of color, have endured throughout the years. Microaggressions are comments or behaviors — verbal or non-verbal actions — that disempower minorities or other marginalized groups. Sometimes these acts are blatant; other times they’re much more subtle. Luckily, I’m currently at a diverse organization that’s committed to improving awareness, education and equity, but that’s far from the norm. 

Microaggressions are still prominent in the healthcare world and, when they occur, they can impact everything from the mental health and well-being of your staff to the care of your patients. That’s why it’s so critical for our leaders to not only make themselves aware of common microaggressions that impact staff and patients alike, but also to take the next step toward addressing these issues head on in a constructive way.

It starts with awareness, but…

Microaggressions stem from our own personal biases. It doesn’t matter what color you are, what gender you are or how successful you’ve become — we all have biases. Even the people who swear they don’t see color are biased, in a different and equally problematic way. Whether we like it or not, our biases are blind spots that can affect our relationships with our staff and our patients when left unaddressed.

When you’re a staff member on the other side of these microaggressions, it can be exhausting — especially when you deal with these indignities from the time you walk out the door in the morning until the time you go to bed at night, like so many minority and marginalized individuals do.

But when patients are on the receiving end of microaggressions, it leads to a disparity in care that can often be tragic. For instance, I had a friend who suffered a football injury in high school and wound up in a wheelchair as a result. His provider assumed he was injured through gang activity because it incorrectly stated he’d been shot in his medical record (and so he often experienced microaggressions and a lower level of care). He spent the rest of his life fighting to get that error removed, but ultimately passed away falsely identified in his EMR as a gang member whose injury was the result of a gunshot instead of from playing football.

At a bare minimum, we need to start educating people and help them understand their attitudes toward stereotypes. Helping everyone understand what their biases are and how those biases lead to microaggressions will go a long way toward helping the marginalized individuals who historically wind up on the receiving end of those slights.

… it needs to go further

Of course, awareness only goes so far. We can’t eradicate societally ingrained microaggressions through a couple PowerPoint presentations. We need to do the work and find the courage to have those difficult conversations that we so often avoid.

One day, someone came into the office and told me they didn’t want to work with another employee because that person made a racist statement. That statement? They didn’t really like being in this city because there are no Black people like her there. Now, here’s some context: The supposedly racist comment in question was made by a Black woman — and reported by a person who was white. I could’ve held my tongue, but instead I started a conversation and said, First of all, this person cannot, by definition, make a racist statement and second, as a Black person, I completely understand where they’re coming from. When I said that, I think everyone in the room was shocked and kind of appalled I would make such a statement.

But then we had a conversation about why I said it: Boston has a very large immigrant community. This person was from the South. The majority of people she interacts with at home are Black descendants of American slaves. Here she found she was more likely to meet someone who emigrated from the Caribbean or Africa. As a descendant of American slaves, I understood what she was saying.  White people tend to see us as “all the same,” but we are very different. Our trauma in America is different and generational. Like most groups of people, we are connected through our culture and shared experiences. Her statement didn’t mean that she didn’t care for the community here; she was just stating that she hadn’t met many people who had the same generational and cultural experiences as she had lived. She was looking for a cultural experience that she could relate to.

It wasn’t an easy conversation, and it was probably uncomfortable for some, but it was important.

To prevent microaggressions, it’s crucial to understand what our biases are and where they come from, and then use that information to take that next step. We need to get to a place where we can have those raw conversations about those biases in a respectful way and not be afraid to talk about our experiences regardless of whether we’re the person on the receiving end of a microaggression or the aggressor. OSM