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Nurses' suggestion leads to changes on critical care patient assessment forms
CBC | Michael Gorman | July 2024
Yolanda Baker and Robin Fraser, both registered nurses and NSNU members in the ICU at Aberdeen Hospital in New Glasgow, noticed their assessment forms were not inclusive of an increasingly diverse patient population. The forms described skin color changes only with terms like pink, pale, mottled, or jaundiced, which did not apply to non-white patients. Baker and Fraser both found themselves frequently altering the forms to indicate “normal for ethnicity.”
Realizing they were independently making similar changes, both nurses contacted the health authority’s diversity and inclusion committee to express their concerns. The committee was receptive, and a working group was formed to address the issue. As a result, critical care records across Nova Scotia Health now include accurate skin documentation fields for all patient backgrounds and recommend checking pupils for jaundice, which can be a more reliable indicator than skin color.
Dr. Yinka Akin-Deko, a family medicine doctor in Cole Harbour, emphasized the importance of recognizing how various skin conditions, like jaundice and cellulitis, manifest differently on different skin tones. She noted that medical training and textbooks have historically presented a narrow view of patient care that often excludes non-white individuals. She stressed the need to individualize care, ensuring it is not uniform for everyone.
According to Akin-Deko, the changes initiated by Fraser and Baker serve dual purposes: reminding healthcare workers of the diversity among patients that must be considered during examinations and acknowledging patients’ diverse backgrounds to provide appropriate care. This initiative aims for everyone to receive the right assessment and care, leading to better health outcomes.
Fraser mentioned that their successful suggestion prompted them to reconsider other forms and aspects of care that might lack inclusivity. Both nurses were encouraged by the health authority’s positive response, which made them feel valued as employees. Akin-Deko highlighted the importance of the healthcare system supporting staff who bring forward ideas for improving patient care, advocating for continual change to maintain patient trust and engagement.
“We need to be driving the change. We need to be making the changes so that our patients continue to trust us and come in and engage with us.”
