Project
TAYLOR 242
Disscusions.docxSocioeconomics – Sex Workers
IAT
Bias in healthcare
It is important to learn about biased behavior in healthcare. Being aware of how people around us are being treated differently because of race, culture, gender choices, ethnicity, and religion will allow us to be mindful of how we treat people who need our help. For the IAT quiz, I chose young people and old people/ good and bad evaluation because in my current role I work with both young people and old people so I was curious what the quiz would be about. My percentage for young people compared to old people was in favor of young with a 26% difference. I blindly chose this topic not fully understanding what the results would decide, since I did not read the instructions in their entirety before I took the quiz. I like the topic because I like old people. In my current profession, I work with a majority older population, so I thought, well, I know I intentionally treat older patients better than younger ones. I intentionally treat them better because in my unit the majority of the time my elder patients transition to hospice, and I feel as though it is important to treat them extra special during their last days. I personally disagree with my results, but I will pay attention to how I treat my elderly patients. Although I feel completely different from what I scored I am aware that I could have some sort of bias against old people. I will now pay attention to the way I treat older people not just at work but throughout my daily activities. Self-reflection is always good. This is a slight example of why being as though we as people we display certain actions unconsciously that affect the way we treat others, and we do not realize it.
DB #1
Sex workers are people of any gender who trade sexual services for money, resources, or anything they need or want. Just hearing the term “sex work” makes many people uncomfortable, which leads to judgment and mistreatment even from healthcare professionals. One common explicit bias toward sex workers is the stereotype that they are “promiscuous” and spread disease. Because of this assumption, some healthcare workers treat sex workers as if they are “vessels of disease” rather than human beings. This kind of thinking creates barriers to care.
Sex workers are at higher risk for sexually transmitted infections (STIs) and HIV, and they may avoid seeking medical help because they fear judgment or discrimination. In some cases, they are denied preventative information, services, or treatment because of the way they live. Other common stereotypes include the belief that sex workers are substance abusers or all survivors of trauma, which leads some healthcare providers to avoid or minimize their care. Many sex workers come from low-income communities or have faced violence, lack of opportunity, or trafficking at an early age. Every sex worker has their own story, and for many, this work may feel like their only choice.
When healthcare professionals hold these kinds of biases, they may focus only on a patient’s sexual activity instead of their overall health. This can lead to delayed treatment, dismissal of symptoms, misdiagnosis, and lack of follow-up care. Once sex workers experience the discrimination they already feared, they often lose trust in healthcare systems, which increases their vulnerability and risk for untreated health conditions.
A local resource that supports sex workers in the Washington, D.C. area is
Honoring Individual Power and Strength (HIPS). HIPS provides nonjudgmental services including harm reduction, mental health support, substance use services, and healthcare access.
A national resource is the Sex Workers Outreach Project–USA (SWOPUSA), which provides safety resources, advocacy, and community support for sex workers. These kinds of organizations help reduce stigma, build trust, and improve health outcomes for people who often experience discrimination in medical settings.
References
Chan, K., & Lee, W. (2019). A qualitative study into female sex workers’ experience of stigma in healthcare settings in Hong Kong. International
Journal for Equity in Health, 18(1), 1–10. https://doi.org/10.1186/s12939 -
· Lyons, T., Krüsi, A., Pierre, L., Kerr, T., Small, W., & Shannon, K. (2022). Experiences of stigma in health care settings among sex workers. BMC Public Health, 22(1). https://doi.org/10.1186/s12889 022 - 12786 - 8
· Singer, R. (2021). Sex work stigma and discrimination in healthcare:
Impacts on health outcomes. Journal of Social Health & Equity, 45(3), 112–120
https://www.hips.org/ https://harmreduction.org/
https://link.springer.com/article/10.1007/s00481 - 024 - 00815 - 8
Faissner, M., Beckmann, L., Freistein, K. et al. Healthcare for sex workers—access, barriers, and needs. Ethik Med 36, 151–168 (2024). https://doi.org/10.1007/s00481-024-00815-8
https://pmc.ncbi.nlm.nih.gov/articles/PMC8241054/
Singer RB, Johnson AK, Crooks N, Bruce D, Wesp L, Karczmar A,
Mkandawire-Valhmu L, Sherman S. "Feeling Safe, Feeling Seen, Feeling
Free": Combating stigma and creating culturally safe care for sex workers in Chicago. PLoS One. 2021 Jun 29;16(6):e0253749. doi: 10.1371/journal.pone.0253749. PMID: 34185795; PMCID: PMC8241054. https://onlinelibrary.wiley.com/doi/10.1111/acps.13559
Martín-Romo L, Sanmartín FJ, Velasco J. Invisible and stigmatized: A systematic review of
mental health and risk factors among sex workers. Acta Psychiatr Scand. 2023
Sep;148(3):255-264. doi: 10.1111/acps.13559. Epub 2023 Apr 27. PMID: 37105542.
DB#2
-1. Briefly summarize the events that transpired in the prompt or video.
In the video, the charge nurse was overwhelmed. The nurse, a family member, and another staff member needed help, and the charge nurse stayed seated in her chair while on the phone complaining about the nurses.
2. Discuss your immediate feelings or reaction to the scenario; relate as applicable in your current role as a student nurse and future new graduate.
I feel like if things were that busy, the charge nurse should have never sat down to even take a phone call. She should have helped her team and complained when she left. The role of a charge nurse is to help and provide structure to the unit, not sit down and complain about all the things that are wrong. I think the nurse should have not taken what the charge nurse was saying personally and continued to help her team because of what the charge nurse says on the phone. Her job is to care for the patients. Not saying she should not address it at a later time, but being in her feelings and ignoring the family member was not solving anything.
3. Propose a group action plan supported by evidence-based practice to mitigate lateral violence in your future practice.
To prevent lateral violence in the workplace, the nursing team should create a committee that focuses on structure, communication, and teamwork. When communication and teamwork improve, nurses are more likely to work well together and support one another. If a nurse feels overwhelmed, she should feel comfortable going to the charge nurse or leadership for help to maintain patient safety and build trust. Having a supportive environment makes a big difference. Team-based care and strong leadership have been shown to reduce lateral violence and improve morale (ANA, 2023). Studies also show that bullying and lack of teamwork among nurses can lead to poor job performance and affect overall patient care (Wuni et al., 2025). Once trust is built, leadership should have clear policies that encourage de-escalation and respectful communication. Ongoing education and open communication can help resolve conflict and keep emotions from getting in the way of patient care. When nurses work together, especially during stressful times, it helps build a respectful and safe workplace focused on patient care and professionalism.
American Nurses Association. (2023). Addressing nurse bullying and workplace violence. ANA. https://www.nursingworld.org/practice-policy/workplace-violence/
Wuni, A., Musah, A., Sisala, I. M., Abdulai, A. M., Chanayireh, L., Nyarko, B. A., Buasilenu, H., Mohammed Ibrahim, M., Musah, S., Azure, D., & Abdulai, N. (2025). “We are our own worst enemies”: Workplace bullying among nurses and its implications on healthcare workers and job performance: A multi-facility study in the Tamale Metropolis. Nursing Open, 12(7), e70282. https://doi.org/10.1002/nop2.70282
DB1
1. The "Deserving Patient" Bias and How It Affects Sex Workers
Health care providers tend to deliberately perceive sex workers as morally inferior and less worthy of empathic care, which establishes what scholars term the "deserving patient" bias (European Sex Workers' Rights Alliance, 2023). This blatant discrimination is manifest in a variety of glaring respects: 67% of sex workers are inappropriately questioned about their income or clients during health encounters, 54% are discouraged from sex work by being told things like "consider what you're doing to your soul," 16% are denied treatment altogether, and 20% are coerced into redundant STI testing even if they've gotten test results recently (European Sex Workers' Rights Alliance, 2023). These stigmatizing behaviors lead to extremely poor negative patient outcomes, like healthcare avoidance generating threefold higher unmet healthcare needs than the general population, impaired pain control wherein experts take assumptions of drug-seeking, worsening mental illness as patients feel reduced to their occupational role, belowstandard reproductive health care in 48% of sex workers, and treatment non adherence when patients are stigmatized by professionals (European Sex Workers' Rights Alliance, 2023).
2. Local DMV Community Resource
HIPS (Harm Reduction, Individual Empowerment, Personal Advocacy, Social Change), 906 H Street NE, Washington, DC 20002Links to an external site. , has been serving sex workers and drug users in the DMV area since 1993, with a focus on dignity and respect regardless of whatever their profession is (HIPS, 2024).The agency refutes directly the "deserving patient" bias by providing full-spectrum services including escorting patients to appointments and helping them find non-judgmental providers, training healthcare workers on respectful care skills, providing on-site health services without judgment, operating a 24-hour crisis hotline for immediate assistance, and working to win policy changes to reduce healthcare discrimination. HIPS demonstrates to healthcare professionals how to provide good, respectful care without moralizing, creating new care models in which reducing harm is more important than moralizing and proving that outstanding healthcare can be provided to any patient irrespective of their occupation or lifestyle.
3. National Resource
The National Harm Reduction Coalition's Sex Work Program works nationwide to change the manner in which healthcare practitioners all over the United States engage with sex workers through system-wide intervention (National Harm Reduction Coalition, 2024).The organization also addresses overt bias by designing training materials that directly address provider stereotypes and moral assumptions, advocating for policy reform at the national level to protect sex workers' health care rights, establishing best practice recommendations for health care organizations willing to implement respectful care policies, designing educational materials that de-bunk harmful myths about sex workers, and connecting sex workers with trained, bias-free health care providers nationwide. Proof indicates that such comprehensive approaches, inclusive of provider education and policy change, substantially reduced discriminatory practices and improved the health experiences of marginalized groups, making the National Harm Reduction Coalition an important referent resource for instituting systemic reform in health attitudes toward sex workers (FitzGerald et al., 2019).
DB2
1. A new nurse starts her shift and asks questions. An older nurse is rude and dismissive. The experienced nurse ignores her, makes sarcastic comments, and doesn’t help her learn. The new nurse looks embarrassed and unsure of what to do. No one on the team steps in to stop the behavior.
2. I felt sad and frustrated watching this. As a student nurse, I experienced this with one of my nurses during clinical, so I understand how it feels to be new and nervous. It’s hard to learn when someone treats you poorly. In the future, I want to work in a team where nurses support each other. If I ever see something like that, I will speak up or inform a leader.
3. Action plans that can be implemented are more training on respect and communication so nurses learn how to treat each other kindly. Hospitals should have a clear zero tolerance policy for bullying and ensure staff know how to report it safely. New nurses should have mentors who guide and support them during orientation. Nurse leaders also need to set a good example, encourage teamwork, and address any problems quickly. Creating a positive and respectful workplace helps nurses feel safe and improves patient care.
DB#1
Healthcare workers perceive most sex workers to be involved in trafficking, and they lack the capacity to give consent for the sexual activity. This stereotype by healthcare provider assumes that sex work is forceful and not empowered, rather than view sex work as a real employment like any other where individual's agave the autonomy to consent for sex. Because of this stereotype, most sex workers do not openly discuss their occupation in fear of being judged as trafficking victims. This prevents healthcare workers from asking relevant health, mental, and occupational questions that can help in screening and diagnosing diseases, especially sexual transmitted diseases (STIs). It deals with access to health care services leading to delayed treatment and complications.
HIPS- (Harm Reduction Experts Improving Lives Since 1993) Washington, DC. This is a community-based organization that is helping sexual workers with judgment-free services such as sex supplies, syringe exchange, referrals to health care outreach, and basic support. The focus of the organization is to reduce harm in sex industry, it's there to provide safety for sex workers.
Sex Workers Outreach Project USA (SWOP USA), It is a national social justice network dedicated to the rights, dignity, and health of sex workers. It helps to shift narratives and support decriminalization of sex workers, and promotion of peer-led health and harm reduction initiatives. It helps reduce stigma and bias in structural stigma such as healthcare and justice by improving the care they receive when seeking help.
Reference.
Faissner, M., Beckmann, L., Freistein, K., Jungilligens, J., & Braun, E. (2024). Healthcare for sex workers—access, barriers, and needs: An exploratory qualitative interview study. Ethics, Medicine and Public Health, (advance online). https://doi.org/10.1007/s00481-02400815-8Links to an external site.
Sex Workers Outreach Project USA. (n.d.). SWOP USA. https://swopusa.org/
DB#2.
The video shows lateral violence incidence in a clinical setting where the nurse who is on phone with a friend undermines her colleague verbally in an unprofessional way. “Charge Nurse” is talking to her friend complaining about how two other nurses called out, and when one of the nurses asks for help, she refuses to help her. The environment is so toxic, there is no teamwork at all which will eventually impact patient care and safety in a negative way.
As a student nurse, observing or even experiencing lateral violence from my senior nurses will make me anxious and doubt my capacity to care for the patient, affecting my confidence. Experiencing lateral violence as a student may make it hard to learn in such an environment because one will be afraid to ask for help or questions. As a future graduate nurse, this video shows the importance of having emotional intelligence and knowing when it is right to speak or keep quiet. The importance of teamwork is to help establish respect and a good working environment that focuses on the well-being of the patient. It is also important to pick up cues of lateral violence such as gossip, strange behaviors, etc. This will help in solving the issue before it advances to a different and harmful level.
To prevent lateral violence among nurses, Armstrong, N. (2022), emphasizes the importance of having policy enforcement and reporting mechanisms where nurses can report any violence or bullying in the workplace. This entails reporting pathways where nurses can report anonymously, having a third party who can help solve the problem, having this kind of structure displays transparency in case handling, building confidence in other nurses to report their cases without fear of being fired or the case being used against them. Having a rapid response team that deals with lateral violence builds trust between the nurses and the hospital. If Hospitals hold their leaders accountable of the behavior, it will create a safe workspace that promotes the well-being of their nurses to empower them and support them in ensuring that they are offering best services to their patients.
Reference.
Armstrong, N. (2022). Strategies to prevent workplace bullying and lateral violence in healthcare. Journal of Nursing Management, 30(4), 756–762. https://doi.org/10.1111/jonm.13675
DP#1
A prevalent explicit bias that negatively impacts healthcare outcomes for sex workers is the moralizing stereotype that associates sex work with immorality, promiscuity, and disease. Research shows that healthcare providers often hold explicit beliefs that sex workers are vectors of infection or are dirty or risky, which can lead to discrimination, shaming, and denial of appropriate care. This bias often results in sex workers delaying or avoiding care due to fear of judgment, which contributes to increased rates of untreated sexually transmitted infections, mental health challenges, and overall mistrust in medical institutions. Additionally, when providers make moral judgments rather than relying on objective sexual history assessments, they may fail to offer necessary prevention measures such as vaccines or trauma-informed counseling. Such explicit biases reinforce inequality, compromise the quality of care, and perpetuate the stigma surrounding sex work.
To address these disparities, both community-level and national resources play a crucial role in mitigating bias and improving healthcare access. Locally, HIPS (Honoring Individual Power and Strength) in Washington, D.C., provides harm-reduction-based services, mobile outreach, and nonjudgmental support for individuals engaged in sex work and drug use. HIPS bridges the gap between stigmatized individuals and healthcare providers by fostering trust and providing safe spaces for care and resources. On a national level, the Sex Workers Outreach Project (SWOP USA) offers advocacy, peer support, and educational materials to promote sex worker–affirming practices within healthcare settings. By partnering with these organizations and integrating nonjudgmental, evidence-based care frameworks, healthcare professionals can help dismantle explicit biases, promote health equity, and create safer environments for all patients.
•
References
HIPS. (n.d.). Mission and services. https://www.hips.org/
Sex Workers Outreach Project USA. (n.d.). About SWOP USA. https://swopusa.org/mission
Ma, H., & Loke, A. Y. (2019). A qualitative study into female sex workers’ experience of stigma in the health care setting in Hong Kong. International Journal for Equity in Health, 18(175) . https://doi.org/10.1186/s12939 - 019 - 1084 - 1
Singer, R., Crooks, N., Johnson, A., Bruce, D., & Sherman, S. (2021). Combating stigma and creating culturally safe care for sex workers. BMC Health Services Research, 21(1), 1–12. https://doi.org/10.1186/s12913 - 021 - 06535 - y
Langenbach, B. P., Göttgens, I., Loerbroks, A., & Schneider, A. (2023). Attitudes towards sex workers: A nationwide cross-sectional study of healthcare providers in Germany. BMC Public Health, 23(1), 1788 . https://doi.org/10.1186/s12889 - 023 - 16635 - 8
DP #2
The video shows a clear example of lateral violence between nurses on a hospital unit. An experienced nurse, already stressed and overwhelmed by short staffing and heavy workload, takes a personal call at the nurses’ station and vents about her frustrations. When a newer nurse politely asks for help, the senior nurse dismisses her and continues complaining on the phone, blaming new nurses for being lazy and for the unit’s low patient satisfaction scores. This interaction demonstrates classic signs of nurse-to-nurse bullying, including disrespect, gossiping, and dismissive communication in front of others.
Watching this scenario made me feel uncomfortable and empathetic toward the new nurse. As a student nurse, I can imagine how discouraging it must feel to ask for help and be met with irritation or criticism. It also made me realize how important teamwork and kindness are in nursing practice. When experienced nurses show support instead of judgment, it helps build confidence and fosters a safer learning environment. As a future new graduate, I want to be part of a culture that values respect, open communication, and understanding rather than frustration and blame.
To help prevent situations like this, our group could promote an action plan centered on education, mentorship, and accountability. We could start by holding team workshops on workplace civility and effective communication, supported by the American Nurses Association’s Code of Ethics. Implementing a mentorship program where new nurses are paired with experienced, supportive preceptors can also build trust and confidence. Finally, encouraging open, judgment-free reporting of bullying and regularly recognizing positive teamwork can strengthen the unit’s culture. By fostering civility and respect, we can create a healthier and more supportive work environment for everyone.
WB: DISSCUSION POST 1
1. One common explicit bias in healthcare toward sex workers is the idea that they’re promiscuous or careless with their bodies. Some providers assume they all have STIs or use drugs, which leads to judgmental comments, less compassion, or even poor treatment. For example, a sex worker coming into the ER with pain or bleeding might be treated with suspicion instead of care. That kind of experience can make people avoid seeking help in the future, putting them at risk for more serious health problems.
Bias and lateral violence like nurses gossiping or making rude comments, creates a toxic environment that goes against nursing ethics and therapeutic communication. Even when we’re tired or burnt out, we have to check our own biases and step in when we see others being disrespectful. How we treat people matters, and showing empathy and respect can make a huge difference in a patient’s experience and trust in healthcare.
x2. A great local organization is HIPS (Helping Individual Prostitutes Survive) in Washington, D.C. HIPS provides nonjudgmental healthcare, harm-reduction education, STI testing, and emotional support for sex workers. They also train healthcare providers on how to deliver respectful, trauma-informed care.
Partnering with groups like HIPS can help nurses refer patients to safe community resources and build trust with marginalized populations.
3. A helpful national group is the Sex Workers Outreach Project (SWOP USA). SWOP focuses on reducing stigma and improving safety for sex workers. They offer health education, crisis support, and advocacy to make healthcare settings more inclusive. Nurses can use SWOP’s resources to learn how to provide unbiased, patient-centered care to this community.
References
HIPS. (n.d.). Helping Individual Prostitutes Survive (HIPS). Retrieved October 17, 2025, from https://www.hips.org
Sex Workers Outreach Project USA (SWOP-USA). (n.d.). About SWOP-USA.Retrieved October 17, 2025, from https://swopusa.org
WB: Discussion post 2
In this video, the charge nurse is sitting at the nurses’ station gossiping on the phone about the hospital unit instead of helping on the floor. The unit is clearly hectic, patients need assistance, and a visitor is waiting outside a room looking for someone to help. A new graduate nurse approaches the charge nurse to ask for help because the workload is overwhelming. The charge nurse dismissively agrees but then immediately bad-mouths the new grad to the person on the phone “I don’t know what’s up with these new grads, they don’t want to work hard.” The new nurse overhears this comment, leaving her visibly hurt and discouraged.
My immediate reaction was disappointment and frustration. As a student nurse, I can easily imagine how disheartening it would be to experience this kind of behavior from a leader who is supposed to offer guidance and support.The charge nurse’s gossiping, lack of professionalism creates a toxic environment that undermines teamwork and patient care. As a future new graduate nurse, this scenario reinforces how important it is to lead with respect and be supportive. Because I would want to work in an environment that values collaboration, open communication, and mutual respect rather than negativity and gossip.
To prevent lateral violence and foster a healthy work environment by prioritizing respect and collaboration, nurses will build a stronger team dynamic, reducing burnout, and ultimately improving patient outcomes and safety. My group’s action plan would include:
· Implement Education and Training: Providing mandatory training for all staff on professional communication, teamwork, and how to identify and address lateral violence.
· Promote Mentorship and Support: Paring new graduate nurses with experienced nurses that are supportive mentors who model positive leadership and provide emotional and professional guidance.
· Establish a Zero-Tolerance Policy: Create a clear policy that defines bullying and gossip as unacceptable behaviors, with reinforcement as needed.
· Leadership Role Modeling: Nurse leaders should set the tone by demonstrating professionalism, respect, and active engagement in the unit’s daily workflow.
· Encourage Open Dialogue: Hold regular staff meetings or debriefs to discuss teamwork challenges, share concerns safely, and promote a culture of accountability (like my floor does with cusps and quality meetings we have every 2 weeks).
