Question
How do power distance, privilege, and intersectionality affect psychological safety for respiratory therapists and other healthcare professionals?
Answer
Power distance refers to the degree to which societally perceived "less powerful" individuals accept and expect an unequal distribution of power. In healthcare, this concept is highly relevant. Those with high power distance have often been conditioned to know their place or have been minoritized by society. Those with lower power distance tend to be more comfortable addressing authority. If you are in a position of lower power distance, meaning you have more privilege in a given space, I encourage you to use it. If a colleague feels afraid to raise a concern because they fear losing their job, ask for their consent to raise it on their behalf.
Intersectionality, a term coined in the 1980s by Professor Kimberly Crenshaw, is a lens through which we can see where power comes and collides, where it interlocks and intersects. It is not simply that there is a race problem here, a gender problem here, and a class or LGBTQ+ problem there. Many times, that fragmented framework erases what happens to people who are subject to all of these things simultaneously.
Identity dimensions that can affect psychological safety include, but are not limited to: race and racism, sexual identity, gender identity, body size, ageism, educational background, geographic location, visible and invisible disability, socioeconomic status, literacy, mental wellness and access to resources, and personal history. These factors compound and intersect in ways that affect every interaction in a clinical setting.
This Ask the Expert is an edited excerpt from the course, Breathing Easy: Building Psychological Safety for Respiratory Therapists and Healthcare Teams, presented by Gabrielle Davis, MPH, MA, RRT, RRT-ACCS, RRT-NPS, TTS, LPC, NCC, FAARC.
