Tackling Stigma Champion #1

In our first Tackling Stigma Champion Interview Series, we speak with Dr. Nhi Nguyen, an intensive care specialist at Nepean Hospital in NSW, Australia, a clinical leader for the NSW ICU network, and someone who has thought deeply about bias, language, and the ripple effects of stigma in healthcare.

In this candid conversation, she shares how her personal journey as a ‘boat person’ in 1970s Australia shaped her understanding of stigma, and why small changes in everyday practice can shift entire systems.

Nhi’s tips at a glance

Model vulnerability: As a leader, Nhi openly admits to her own blind spots. Creating a culture where it’s safe to say, “I got that wrong,” helps others do the same
Choose your moment: Calling out every slip doesn’t work, people tune out. Nhi suggests picking moments that invite reflection rather than defensiveness
Start with yourself: Change begins with self-reflection. Ask: What biases do I bring? What am I not seeing?
Pair feedback with learning: Informal feedback lands best when backed up by formal training or team discussion. It helps shift the culture, not just the moment
Use your influence: You don’t need to be in charge to create change. Whatever your role, use your voice to open up conversations and make space for growth
Start with a story: Whether it’s a patient or a staff member, grounding care or systems design in someone real keeps it person-centred and impactful
Name what’s not working: You don’t need to fix the system on your own. Simply acknowledging when something isn’t working can build trust and connection
Challenge shorthand language: Quick clinical labels can become stereotypes. Nhi reminds us that how we describe people shapes how we treat them

Tell us a bit about yourself and your current roles.

I’m an intensive care specialist, and I’ve worked at Nepean Hospital for a long time. These days I have a few hats. I’m the clinical director of Intensive Care NSW, which supports the 44 ICUs across the state. I’m also the clinical lead for the Nepean Redevelopment and sit on the boards of both the hospital and the College of Intensive Care Medicine.

Where does stigma show up in your work—and why has it become something you care about?

I came to Australia as a six-year-old Vietnamese refugee, what we called a boat person in the 70s. My family embraced Australian culture fully. At the time, I didn’t feel affected by racism or stigma, but looking back, I can see how subtly it was woven through the way we lived, how we practiced, and how our community functioned.

In intensive care, we look after the sickest patients in the hospital. Over time, I’ve become acutely aware of how the smallest things—words, assumptions, habits—can deeply affect patients and their families, often in ways we’ll never fully understand.

Can you give an example of how stigma shows up?

Handover is a good one. We often use shorthand to summarise patients quickly: “35-year-old homeless alcoholic, overdose.” In six words, everyone forms a mental image. That image shapes how the next clinician sees and treats that person, even before they walk into the room.

There’s a reason we speak like this: time pressure, clinical urgency, the need to communicate fast. But the impact? That shorthand becomes a stereotype. Unless we deliberately unpack it, we risk missing the full story, and compromising care as a result.

That’s such a good point. How do you personally challenge those moments in real time?

Calling it out in front of 20 people during handover can be really confronting, and often makes people defensive. A lot of it is unconscious bias, I’ve found it’s more effective to let the handover finish, then make a general comment. I’m in a position where I have the freedom to do that.

It’s not about being more senior, everyone slips up. What matters is creating space for reflection. I try to call out examples in a constructive way and pair them with more formal learning opportunities. Because unless we pause and reflect, people tend to think, “That’s not me.” But stigma often shows up in the language we use every day.

For people who aren’t in leadership roles, do you have advice for how they can speak up?

If you’re the person who calls out every little thing, every day, you lose impact. People start to tune out, or it just gets under their skin. So it’s about self-reflection first, and then choosing the right moment. Sometimes, you have to let it go.

But when the opportunities are there, take it. Whether it’s a quiet conversation with a colleague, a chat over coffee, or something more formal like an education session.

You mentioned the impact of unconscious bias. How does that play into all of this?

Unconscious bias is part of how we function as healthcare providers, it helps us make decisions quickly, spot patterns, act fast. That’s essential in healthcare. But the same mental shortcuts can lead to assumptions that don’t serve patients.

When do we pause and say, well, that summary has resulted in care that isn’t so supportive? That’s the challenge.

Are there any formal initiatives or training programs you’ve found helpful?

I was the Director of Pre-Vocational Education and Training, working with junior doctors and we made sure that training prioritised communication, diversity, and patient voice. The Ministry of Health has really embedded co-design into everything which is a must-have when tackling stigma. You need the voices of the communities you serve.

At the College of Intensive Care Medicine, we’ve long placed a strong focus on Aboriginal and Māori health. That lens doesn’t just benefit Indigenous communities, it sets a foundation for providing better care to all culturally diverse patients.

That’s powerful. Why do you think models of Indigenous healthcare have broader relevance?

We have to remember that the moment someone interacts with the healthcare system is just a tiny sliver of their broader life experience.

The person in front of you that day isn’t just shaped by what brought them to hospital, it’s shaped by their family, their community, the society they’ve grown up in, and even by generations that came before them.

That’s why I think the principles we use in Indigenous health—like storytelling and cultural context—are so important. They anchor us.

I often say: approach care with an open mindset and listen to learn. Because no two people have the same life experience. And if we listen with curiosity and respect, we’re better able to design care that’s genuinely helpful, rather than just assuming we know what’s best.

What would you say to someone who thinks tackling stigma is too hard or too big?

We need to create systems that can be more agile and reflect individual needs, and we need to be really clear how our structures are excluding people from getting the care they deserve and they need.

But it’s a balance, because we also need to have structure for systems to function effectively. I think the solution is that the people providing care need to be given the agency to modify as they need to.

On an individual level, work out your circle of influence. You can’t fix the system alone, but you can change what happens in your interaction, on your shift, in your team.

Even just saying, “This doesn’t make sense, but let’s do the best we can with what we’ve got,” can make a difference. It’s about taking small steps.

If you could embed one practice into every health training program tomorrow, what would it be?

Start with a story. Whether it's a patient, a staff member, or a consumer—whatever service you’re designing, anchor it in someone real. Otherwise, what are you doing it for?

I heard a story from a hospital in Amsterdam where, 25 years ago, they chose a photo of a local patient named Esther. Every meeting since then has asked: What would Esther need from this? Over time, Esther became the anchor for culture change.

It’s simple, but it’s powerful.

Any final thoughts?

People often think I’m in La La Land when I share these ideas—but I’m a glass-half-full kind of person. It’s easy to feel overwhelmed by how complex and entrenched the challenges are. But I really believe that small steps, taken by many, can create real change. It takes a village. It takes a whole community. And while shifting the dial won’t happen overnight, with time, it’s possible.

Breaking the Habit: Dr. Nhi Nguyen on Challenging Stereotypes in Clinical Care