How nurses can reduce health disparities for LGBTQ+ people

Clare Madrigal, BSN, RN, a queer nurse and lesbian, gay, bisexual, transgender, and queer (LGBTQ+) nurse educator, knows the disparities and barriers LGBTQ+ patients face in accessing health care. Although many healthcare organizations are increasingly specializing in the needs of LGBTQ+ patients, stigma and discrimination still exist. A 2022 study by the Center for American Progress (CAP) found that over 30% of LGBTQ+ respondents reported a minimum of one negative experience or type of mistreatment by healthcare providers up to now yr.

“The lack of cultural competency in the health care system contributes to many of the health disparities faced by the LGBTQ+ community,” said Madrigal, who works as an LGBTQ+ nurse educator at Sibley Memorial Hospital in Washington, D.C., and as an emergency room nurse at Frederick Health Hospital in Washington, D.C. Frederick, Maryland. “Although some nursing schools are beginning to teach how to provide culturally competent care to LGBTQ+ patients, this has not always been the case.”

In fact, a 2021 study found the common to be 2.12 hours time spent on LGBTQ+ healthcare content within the nursing school curriculum. In her role as an LGBTQ+ support nurse, Madrigal serves as each a resource and advocate for LGBTQ+ patients and staff, and provides staff training through ongoing workshops.

Reaching further

Realizing that many other providers, healthcare organizations and personal practices also needed guidance in creating an inclusive environment for his or her LGBTQ+ patients, Madrigal founded

REACH: Rainbow Health Education and Consulting in 2019. She conducts each in-person and virtual workshops that cover topics comparable to the differences between sexual orientation and gender identity, the way to use inclusive language, and health issues women face LGBTQ+ community.

At work, Madrigal wears a rainbow pin along with her pronouns on it and introduces herself to patients by saying, “My name is Clare and I use she/her pronouns. How would you like to be addressed?” She also really useful avoiding assumptions and asking patients: “Who do we have in the room with you?” in order that patients can introduce a member of the family or partner. He then asks if medical matters might be discussed in front of them.

“Sometimes nurses and other health care staff are afraid of offending or saying the wrong thing, and they let that fear keep them from saying anything,” Madrigal said.

Madrigal says that as more hospitals and clinics begin collecting sexual orientation and gender identity (SOGI) data on electronic health records or intake forms, it could help nurses higher offer inclusive care while also making LGBTQ+ patients feel develop into appreciated. SOGI information typically includes the patient’s name, preferred name, preferred pronouns, legal gender, and gender assigned at birth.

Making inclusive care a priority

Josiane Hickson, EdD, RN, NE-BC, senior nurse education manager for orientation and implementation at Mount Sinai Health System in New York, said the priority is to implement policies, practices and programs that best serve LGBTQ+ patients and their families. Mount sinai.

Last yr, the health care system received the very best rating of 100 points and the title of “LGBTQ+ Equality Leader in Health Care” within the fifteenth anniversary edition of the Human Rights Campaign Foundation survey Healthcare Equity Index (HEI). The university is a national LGBTQ+ benchmarking tool that evaluates health care facilities’ policies and practices regarding LGBTQ+ patients, visitors and their employees.

Hickson oversees worker training offered twice a month at Mount Sinai’s eight campuses, which incorporates training in providing affirmative and inclusive care to LGBTQ+ patients.

“We also offer additional training throughout the year, as well as online educational modules and virtual training sessions on topics such as unconscious bias, using patient-preferred names and pronouns, and eliminating health disparities and improving outcomes,” Hickson said. “After training, nurses report greater knowledge of how to provide culturally competent care to LGBTQ+ patients.”

Additionally, employees are encouraged to make use of It helps (Acknowledge, Introduce, Duration, Explain and Thank you) A communication framework introduced within the mid-Nineteen Nineties that allows healthcare professionals to interact with patients in a way that demonstrates empathy, improves clinical outcomes and reduces burnout.

“It’s intended to inform patients and make them feel heard,” Hickson said. “I wish I had AIDET when I started my nursing career.”

Hickson said Mount Sinai also works to make sure that all patients no matter gender or sexuality have access to quality care. His Center for Transgender Medicine and Surgery was certainly one of the primary within the country and certainly one of the biggest gender affirmation centers within the country.

A patient population with a brand new set of challenges

As a gay man, John (Rob) Phoenix, MSN, APRN, FNP-C, founder and owner of Huntridge Family Clinic in Las Vegas, Nevada, has seen how current laws that directly impacts the LGBTQ+ community is leading to increased anxiety and depression in lots of his peers. patients.

The have to affirm the healthcare space was emphasized, amongst others, in: The Trevor Project’s 2023 U.S. National Survey of LGBTQ+ Young People’s Mental Health. The survey found that 86% of transgender and non-binary youth said recent discussions about anti-LGBTQ+ laws harmed their mental healthand 72% of transgender and nonbinary young people surveyed said policies that would prohibit health care employees from providing gender-affirming care make them offended.

Phoenix said that along with increasing anxiety and depression, a lot of these bills could discourage many LGBTQ+ patients from searching for medical care and missing essential screenings. He added that transgender patients need screening and treatment based on their sex assigned at birth, not their current gender identity. For example, people aged 21 to 65 who’ve a cervix should have regular pap smears. This includes transgender men and non-binary patients with cervix.

The value of coaching

Although some nursing programs are starting to show transgender health care, nurses already working on this field may have increased training. “Nursing care models such as Rivera’s model of gender-affirming nursing care offer nurses the opportunity to identify personal, implicit and explicit biases and guide transgender nursing care,” Phoenix said.

He added that it is vital for nurses to assist LGBTQ+ patients make higher health decisions and determine how they’ll engage of their care. review of the literature LGBTQ+ patients conducted by the American Cancer Society found that LGBTQ+ patients disproportionately suffer from seven varieties of cancer: breast, cervical, colorectal, lung, prostate and uterine.

Phoenix, which is the biggest LGBTQ+ facility in southern Nevada, said he and his colleagues use inclusive, patient-first language with all patients and avoid words, phrases or assumptions that stereotype, demean or exclude people.

As an example of patient-first language regarding the LGBTQ+ community, Phoenix said that as a substitute of asking about “preferred pronouns,” which imply a alternative in gender, nurses should as a substitute use the terms “pronouns” or “identified pronouns” “.

“As a nurse, I believe it is important to provide high-quality, compassionate care to all patients, regardless of gender [identity]gender expression, sexual orientation, sexual identity, race, ethnicity or religion,” he said.

Take these courses to learn more about caring for LGBTQ+ patients:

Lesbian, gay, bisexual, transgender and queer (LGBTQ+) people: an introduction

(1.5 contact hours)

Over the previous couple of a long time, sexuality and gender identity have received considerable attention across the spectrum of health and social services. This module provides a transient overview of the lesbian, gay, bisexual, transgender and queer (LGBTQ+) community and its history in society and health care systems.

Lesbian, gay, bisexual, transgender and queer (LGBTQ+) people: health disparities

(2 contact hours)

Health and Medical Division (HMD) Healthy People 2030 and the Agency for Healthcare Research and Quality highlighted health disparities affecting LGBTQ+ populations. As patterns of disease and health proceed to emerge within the literature, this module explores the complex social determinants of health specific to the LGBTQ+ community.

Implicit bias in health care

(1.5 contact hours)

The recent movement toward diversity, equity and inclusion (DEI) is encouraging for individuals who have been missed up to now. Diversity and inclusion bring diverse, often ignored perspectives and experiences, but they’ve also exposed the depths of hidden biases.