3.5 What Is an Inclusive Assessment?

Inclusive health assessments should be grounded in social justice. Nurses must uphold the humanity of all clients in all aspects of care, regardless of the client’s race, ethnicity, gender, sexuality, age, ability, and any other factor that makes them who they are.

Inclusive health assessments are based on four key principles:

1. Treat every health assessment as an act of humanity. What does it mean to be treated like a human being? We all want to be accepted, respected, and feel a sense of belonging. If you make a client feel otherwise, you are engaging in an act of oppression, which can affect human dignity and capacity to grow and transform. It is important to recognize that even though nursing is a caring profession, nurses have the power to oppress. You must acknowledge differences among clients, while committing to dismantle social injustices within healthcare systems that treat clients inhumanely.
2. Health assessments are not about sameness. Every client is different, so health assessments have to go beyond the “normal” or standardized approaches to physical assessment. “Normal” is a social construct: a common social idea based on cultural values and relative norms. You need to obtain a nuanced understanding of each client’s unique health and illness experiences and help them move towards a path of healing. A health assessment should be more than a physical assessment: talk with the client to obtain their health history and get to know them. An inclusive health assessment means that you recognize and integrate the client’s unique experiences and knowledge in their care.
3. Examine your own personal biases. Everyone carries biases that are acquired through socialization. These may include biases about different races, cultural practices, body sizes, or religious practices. These biases can affect how you present yourself during a health assessment, and consequently how clients feel and respond in your presence. By learning about your own biases—how they developed and how they influence your actions—you can both understand how they lead to further injustices in nursing practice, and how you can start to unlearn them.
4. Cultivate a safe environment of care. Create an environment where the focus is on what matters to the client. Keep an open mind as you learn about the client’s needs and perspectives: accept the client for who they are, value their feelings and experiences, and don’t judge them. A safe space is important for clients to express themselves without fear of being judged and discriminated against. Clients will engage more when they feel they are collaborating with the nurse on a common goal in terms of what is important to the client. Feeling safe promotes self-worth and a feeling of belonging, which are critical outcomes of social justice in the healthcare system.

References

Inokuchi, H., & Nozaki, Y. (2005). “Different than Us”: Othering Orientalism, and US middle school students’ discourse on Japan. Asia Pacific Journal of Education, 25(1), 61-74. https://doi.org/10.1080/02188790500032533

Ogunwole, S. M., & Golden, S. H. (2021). Social determinants of health and structural inequities—root causes of diabetes disparities. Diabetes Care, 44(1), 11-13. https://doi.org/10.2337/dci20-0060 

Registered Nurses’ Association of Ontario (2007). Healthy work environments best practice guidelines: Professionalism in nursing. Registered Nurses’ Association of Ontario. https://rnao.ca/sites/rnao-ca/files/Professionalism_in_Nursing.pdf

Attribution

This section contains material taken from Introduction to Health Assessment for the Nursing Professional – Part I and is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.