How can nurses create a more inclusive environment that fosters open communication between clinicians, LGBTQ+ patients and their families?
Jennifer Detchemendy, DPN, RN, CCNS, assistant professor, Augusta University College of Nursing in Augusta, Georgia, discussed this topic during her NTI presentation, “Providing Safe, Sensitive Care to the LGBTQ+ Community.” – which is free to everyone.
Detchemendy recently spoke with AACN Clinical Practice Specialist Mary Stahl, MSN, RN, CCNS, CCRN-K, about simple ways nurses can contribute to a more inclusive environment when caring for LGBTQ+ patients and their families.
Mary Stahl: Hello. I'm Mary Stahl. I'm one of the clinical practice specialists at AACN, and I'm very happy today to be here with Jennifer Detchemendy. Jennifer is an assistant professor in the physiologic and technologic nursing department at Augusta University College of Nursing in Augusta, Georgia. She has almost 20 years of nursing experience in surgical and trauma ICU care, and over 10 years of experience as a critical care clinical nurse specialist. Her research interests include vulnerable populations, specifically sexual and gender minorities, and how the collection of sexual orientation and gender identity data can be used to improve outcomes in the acute care setting. Jennifer is a past president of the CSRA [Central Savannah River Area] Chapter of AACN and is a current chapter board member. Welcome, Jennifer. Thanks for joining me
Jennifer Detchemendy: Thank you so much for having me.
Stahl: What would you say is the most common question you get from nurses regarding care LGBTQ patients and their families?
Detchemendy: It's really more of a statement rather than a question. What I still get from a lot of nurses is, “I really strive to treat all of my patients the same, so I don't need any additional training in LGBTQ health issues.” And what we're really saying when we pride ourselves on treating our patients the same is, we [mistakenly] treat all patients as heterosexual and cisgender. So, we continue to exacerbate these health disparities that occur because we are continuing this invisibility. When we take a second to look at the differences and how those differences affect health outcomes for this population, we realize that we're able to provide more patient-centered care and improve outcomes when we do have this knowledge. Which is why I feel like it's really important to have this information that's in the presentation.
Stahl: That's wonderful. I'm really impressed with the work you've done educating our community so far. From the work you've done teaching nurses about this topic, what would you say is the greatest learning need to help them feel confident in caring for these patients?
Detchemendy: Most of the nurses I work with really struggle with what language to use when they are taking care of an LGBTQ-identified patient or their family. Or they struggle with language if they've mis-gendered or misidentified someone. In addition to the general LGBTQ competency training, I think an even greater need is for us to address how to incorporate the collection of sexual orientation and gender identity data into our demographic data and assessment processes. Then, we should look at how we mirror that language in order to put it all together in a comfortable way for ourselves and the patients. That is also in the presentation.
Stahl: For the years you've worked extensively in this area, what progress do you think we've made in healthcare that's improved the care that we're providing to these particular patients and families?
Detchemendy: Historically, the primary care sector has really been the one that has led the movement to address disparities in the LGBTQ population. I'm extremely happy that the acute and critical care community is now recognizing that sexual orientation and gender identity can, and do, affect health outcomes in our settings. While we do have a very long way to go, I feel like our greatest progress is that recognition and that willingness to be able to examine our care models and our processes, when it comes to sexual and gender minorities, and really make education a priority for all of our healthcare workers.
Stahl: If you could tell nurses, “Remember these three key things in your practice regarding LGBTQ patients and families,” what would those they be?
Detchemendy: I would say:
- Strive to ask open-ended questions when you're dealing with your patients. Follow the patient's lead when it comes to labels and identifiers and language.
- Really strive to use non-gendered and inclusive language, because that respects all of your patients' identities and relationships, even outside of the LGBTQ community.
- Finally, just be open-minded and curious, and understand that there's probably more than likely going to be terminology and concepts that you might not understand or be familiar with, when you're dealing with LGBTQ patients and their families. And just know that it's OK to ask. It's OK to have them educate you too. For the most part, patients and families are not going to be upset, and this is actually showing that you have a willingness to understand their issues so that you can really provide the best care possible.
Stahl: I totally understand that. Meeting people where they are makes a world of difference in their willingness to work with you and really brings the barriers down. I've found this topic fascinating. In addition to your NTI session - which we're making available to everyone - are there any additional resources you'd recommend for people who are interested in learning more?
Detchemendy: Absolutely. There are so many great free resources online, but I definitely recommend the Gay and Lesbian Medical Association, the National LGBTQIA+ Health Education Center, the Fenway Institute, the CDC and then the Healthcare Equality Index, are all just amazing free resources that you can use for yourself and your institutions.
Stahl: Thank you; those will be very helpful. Is there anything else you'd like to say to our audience?
Detchemendy: First, I'd like to say just thank you to all the nurses for the exceptional care that you give to our patients and families each and every day. I really hope that you take the time, not only to view this presentation, but to take it back to your units and your workplaces, and use it to either start a conversation or continue a conversation about improving the care that you provide to your LGBTQ patients and their families.
Stahl: Thank you, Jennifer. I appreciate that.