Career advice

The perils of snap judgements

Making snap judgements about patients can have a negative impact on your practice and limit your ability to provide patient-centred care, says Mandy Day-Calder.

Making snap judgements about patients can have a negative impact on your practice and limit your ability to provide patient-centred care, says Mandy Day-Calder

Patients must be treated individually - however busy you are. 
Picture: iStock

Trust is one of the foundations of nursing. Whether it is with colleagues or the people you nurse, your ability to form trusting relationships can impact greatly on the quality of care someone receives. 

We know that first impressions count from a patient’s perspective, and a lot of emphasis is put on communication – verbal and non-verbal – as a tool to positively engage patients and increase their overall experience. But how often do you stop to consider how the first impressions – and judgments – you make of someone can affect the care they receive?

A few years ago, a friend was experiencing frequent bouts of severe diarrhoea. After several futile appointments, she asked if I would accompany her to see her GP. I don’t know what shocked me most – seeing my friend so poorly or the judgmental treatment she received from her doctor. 

A nurse’s duty

Within minutes, he had dismissed her as a hysterical housewife whose dramatic weight loss was attention-seeking behaviour, and me as an interfering busybody. Even as educated women, we lost our metaphoric voices. It wasn’t until a week or so later, when my poor friend had to go to the emergency department, that someone finally listened to her and she received the care she deserved. 

Just as patients easily form opinions about staff, the reverse is also true. Without realising it, you may be putting people into ‘boxes’, either because of their clinical condition or their appearance. But as a registered nurse you have a duty to treat people individually, and accept that not everyone presents as a true textbook case.

In my friend’s situation, she eventually saw a doctor who took the time to stand back and assess her as an individual. 

Be honest and open

I’m sure you’ve heard the saying ‘don’t judge a book by its cover’, but putting this into practice can often be hard. Wards across the country are busy to an extent that is unprecedented, and in the midst of yet another chaotic shift it can be easy to quickly form judgements.

But by doing this you risk giving care based on your fixed assumptions of what someone needs. Not only does this disempower patients, you may miss important clinical signs or symptoms. 

To overcome this, think of some of the common conditions or groups of people that you treat, and brainstorm any thoughts that come up. Try to be as honest and open as you can and don’t judge yourself: 

  • Do you have a picture of what a ‘typical’ patient looks like? Does this affect how you treat people individually? 
  • Think of the language you are using. Is it positive or negative? How do you think this impacts on your practice?

Keeping a reflective diary can help you spot any recurring thought processes or behaviours and identify any learning needs, and is a useful tool when preparing for revalidation. 

Mandy Day-Calder is a freelance writer and life/health coach

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