Nurses, Empathy, and Blind Spots

Are there some types of patients who bring out in us a less-than-gracious attitude? A sobering study in the April 2023 issue of the American Journal of Nursing shared original research* describing how nurses working in hospitals tend to have negative attitudes toward patients with substance use disorders (SUD).

Often, the researchers noted, people with SUD (typically involved with drugs, alcohol, marijuana and/or nicotine) are characterized by nurses as intentionally choosing to be unwell, rather than afflicted with a chronic condition they cannot manage.

As we and other healthcare workers allow negative attitudes to influence the care we give, those with SUD are stigmatized and receive care different than that given to “sick” patients. Consequently, people with SUD avoid the healthcare system due to the treatment they’ve received, presenting for care most often to emergency departments.

Good news: The study found that nurses on mental health units had “significantly more positive attitudes” (p. 27) when caring for people with SUD. Older nurses also had more positive attitudes, compared to responses from younger nurses.

This problem of attitudes affecting care is increasingly important as substance abuse is becoming more common, including among children age 12 and up, and deaths resulting from substance use are surging.

As Christian nurses, how do we confront and engage with this problem?

We can reflect:

  • For what types of individuals or health problems does our empathy wane or disappear?
  • Have we perhaps treated some persons or patients with less compassion and/or more personal judgment due to their substance use?
  • Might we be influenced—consciously or unconsciously--because of personal experiences with substance use?

What now?

The research study in AJN delineates four resultant themes from nurses:

  • Affirm and advocate for more education for nurses about SUD and more resources (mental health care; aftercare) to treat people who’re using substances.
  • Recognize how our own substance use/abuse experiences influence how we view and treat others. Do our words and actions express God’s compassion and mercy?
  • Identify our personal beliefs about substance use. Are our beliefs biblically-molded? How would Jesus interact with a person addicted to drugs or alcohol?
  • Do we hold ourselves accountable for potential judgmental attitudes? Could we be reacting to unconscious biases?

This research brings out the human side of nursing—none of us is gracious in every patient care scenario. This knowledge also presents us with tremendous opportunity to consider our thoughts, attitudes, and beliefs, so we can extend God’s grace and ask for his enabling to practice with genuine concern for people who need Christ-like kindness combined with our professional skills.

  • How can James 2 guide us in revealing or examining attitudes and biases that are inconsistent with a godly mindset?

* The observational, cross-sectional, mixed-methods study used Facebook in 2020 to survey hospital-based nurses in the United States: 691 nurses participated.

Kratovil, A., Schuler, M. S., Vottero, B. A., & Aryal, G. (2023) Original research: Nurses' self-assessed knowledge, attitudes, and educational needs regarding patients with substance use disorder. American Journal of Nursing, 123(4), 26-33.



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