1. Runyon, Maggie C. MSN, RNC-OB

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Patient safety is an ongoing priority, magnified by rising rates of perinatal morbidity and mortality, birth trauma, and racism-driven disparities in outcomes (Hunte et al., 2022). Nurses are educated about protocols, care bundles, and requirements from regulatory agencies and accrediting organizations. However, we have not substantively addressed how nursing bias at the point of care affects patient safety and maternal and newborn outcomes.


In December 2022, nurses posted a video on social media following the "identify your 'ick'" trend. The camera panned around the nurses' station, capturing nurses in scrubs smiling and laughing as they shared labor and delivery "icks," each of which belittled a patient's action. Their highlighted offenses included parents immediately asking the baby's weight, patients requesting to eat and shower, patients experiencing early labor pain, parents requesting paternity tests, and people approaching the nurses' station for assistance (Melanin Mamis, 2022). People are in one of their most vulnerable states during labor, birth, and postpartum. Why then are these acts seen as egregious to some nurses?


Across social media, non-nurses expressed their horror at what they saw as an indictment of perinatal nurses. Comparatively, nurses viewed this as commonplace locker room chatter rather than patient dehumanization. The collective outrage from nurses was about how foolish it was for these nurses to post this online, with badges on full display. There was far less commentary around the content itself, with nurses even jumping in to defend it. A Twitter user identifying as a nurse said "You have to be a nurse to really understand what they are talking about. As a nurse, I'm telling you, some patients can be really 'icky'" (Tee, 2022). A brief perusal of social media shows a multitude of comments like this from nurses.


The video quickly gained traction outside social media with news sources including The Washington Post, The United Kingdom's Independent, and Australia's 7 News highlighting the incident and subsequent fallout as the four nurses were fired. Policies about social media use often focus on digital professionalism, including the identification of protected health information and the risk of employment repercussions (O'Connor et al., 2021). Missing from the conversation is the common nature of these comments and the necessary censure of the sustaining culture. These dismissals of reasonable and typical patient needs and concerns erode trust in the profession of nursing, negatively affecting nurse-patient relationships, contribute to patients feeling unsafe in our care, and should be considered "never events" (Lyndon et al., 2023; Steers & Gallups, 2020).


These four nurses may not represent an anomaly within perinatal nursing. Rather, they exposed a pattern of harmful rhetoric and bias that seems pervasive in our specialty. Conversations on the "icks" may speak to a deeper issue within our nursing culture. How are we addressing the desensitization to our patients' concerns that occurs when these conversations are frequent among nurses? How do we mitigate the potential for harm when these beliefs are upheld and joked about regularly? And how do we create perinatal care environments that are truly safe for patients? The problem is not the sharing of the video, rather that these thoughts were so routine for them and the culture of labor and delivery nursing that they did not think twice before posting it. The time to act on this harmful bias is now.




Hunte R., Klawetter S., Paul S. (2022). "Black Nurses in the Home is Working": Advocacy, naming, and processing racism to improve black maternal and infant health. Maternal and Child Health Journal, 26(4), 933-940.[Context Link]


Lyndon A., Davis D., Sharma A. E., Scott K. A. (2023). Emotional safety is patient safety. BMJ Quality & Safety. Advance online publication. February 2, 2023.[Context Link]


Melanin Mamis [@melaninmamis]. (2022, December 10). 4 Atlanta Labor & Delivery Nurses fired after making "ick" video about patients pic. [Tweet;] Twitter.[Context Link]


O'Connor S., Zhang M., Honey M., Lee J. J. (2021). Digital professionalism on social media: A narrative review of the medical, nursing, and allied health education literature. International Journal of Medical Informatics, 153, 104514.[Context Link]


Steers M. N., Gallups S. F. (2020). Ethical tipping point: Nurses' presence on social media. Nursing, 50(12), 52-54.[Context Link]


Tee [@NevaSellUrSoul]. (2022, December 11). You have to be a nurse to really understand what they are talking about. as a nurse, I'm telling you. [Tweet]. Twitter.[Context Link]