For too long, there have been no standards of nursing care for lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) individuals. LGBTQ issues are often stigmatized, and it has been widely believed that LGBTQ patients don't have unique healthcare issues except for HIV. LGBTQ individuals face many challenges when they enter the healthcare system, such as being afraid of harassment, discrimination, or poor-quality treatment if they reveal their identities. It's time for nurses to take the lead in addressing these challenges.
Here are several tips for creating an inclusive environment to provide quality care for all patients.
Reflect on the experience of an LGBTQ patient in your setting. If you were an LGBTQ patient in your work setting, how would you feel about the waiting or reception areas, the pamphlets and patient education materials, and the forms and policies? Are same-sex partners treated the same as heterosexual married couples? Have all staff members had diversity training? Suggestions for steps you can take include:
- Find out about local LGBTQ community resources that might be useful to you, including the availability of training/education on LGBTQ issues and local health-related organizations or groups.
- Identify LGBTQ-specific materials for your setting, such as local or national LGBTQ newsletters or magazines, health education pamphlets, and/or books about LGBTQ health.
Develop policies and procedures for collecting information on sexuality and gender, dealing with confidentiality, recording information in patient records, and addressing inappropriate comments or behaviors among staff. Is there an opportunity for LGBTQ individuals to indicate their identities or relationships on your facility's written forms? Do staff members gossip or make negative comments about the sexuality or gender identities of patients or coworkers? What are the sanctions for unprofessional behavior? To take action:
- Include sexual orientation and gender identity options on written forms and oral histories, but respect patients' reasons for not disclosing this information whether you think the reason is valid or not.
- Ask permission from patients to record sexual/gender identity on medical records.
- Require professional conduct among staff members; be a role model for respecting the dignity of patients.
Nurses have an ethical responsibility to overcome stigmatizing practices and attitudes that compromise the quality of care for any individual or family. There are a number of resources available, including the Gay and Lesbian Medical Association (http://www.glma.org). We encourage nurses to take the lead in ensuring that quality care is provided for all LGBTQ individuals.
did you know?
The new field guide from The Joint Commission, “Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community,” urges U.S. hospitals to create a more welcoming, safe, and inclusive environment that contributes to improved healthcare quality for LGBTQ patients and their families. Read it at http://www.jointcommission.org/lgbt/.
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