Friday, October 19th, 2018

LGBTQ panel helps fill current gap in nursing curriculum

Posted on April 15, 2013 in Perspectives
By lsawyer

From our very first semester taking nursing classes at USM, the emphasis has been on providing safe and high quality care to our patients. Unfortunately the nursing curriculum has come up short in its attempts to provide its students with an education that fully takes into account the diversity of the patients we will encounter, and the nursing students within the program.

Nursing is holistic in nature — we must take into account the whole person when we provide care for any patient. Part of that is understanding the inequality of power that can come along with minority status, whether it’s race, ethnicity, class, sexuality or gender. Although cultural differences are important issues to consider, as healthcare providers we also need to understand how issues of racism, classism, sexism, homophobia and transphobia can impact how patients access and receive health care. These are concepts that have not been mentioned within the context of nursing during my time at USM.

Coming up short of comprehensive

Cultural competency refers to the ability to provide high quality care in a cross-cultural setting. Although cultural competency has been mentioned since I’ve been a student in the USM nursing program, it generally consists of part of one day of class and is grossly glossed over. Diversity in health care is always one of the first chapters in our textbooks and, in my experience, it’s almost always not included in the course. What lessons in cultural competency we’ve had have been either inadequate or simply inaccurate. For example, Olds’ Maternal-Newborn Nursing — a widely used reproductive health nursing textbook — makes a gross generalization about family structure in “Muslim culture,” completely ignoring the great geographical diversity of followers of Islam.

In my fundamentals of nursing class, we completed an exercise that examined our own biases of how we would react to patients of various cultural backgrounds. Included in this discussion were patients of different racial and ethnic backgrounds, various sexualities and patients dealing with social issues like addiction. Not included were how a health care provider would feel working with patients who are white, upper-class and heterosexual — it might be safe to say the writers of this exercise clearly made the assumption that its participants were of a specific cultural background.

Last semester, many fellow classmates reacted with confusion when one of my professors used the word “queer,” not in a pejorative sense, but as an umbrella term to talk about sexual and gender minorities. Although the term “queer” can be used as an insult, it’s also insulting that our future health care providers don’t even know what we call ourselves.

It’s easy to say, “Don’t make assumptions about your patients” or “Treat all patients with respect,” but that won’t provide future health care professionals the tools necessary to provide competent health care to all patients. Respect is important, but if someone doesn’t know to ask patients for their preferred pronouns or don’t realize the impact of their patient’s economic limitations, they haven’t truly provided culturally competent care.

Engagement with the Community

Along with Sarah Holmes of the Center for Sexualities and Gender Diversity, and Maryalice Walker, a graduate nurse practitioner student, I have helped organize a panel hoping to address at least some of these gaps related to LGBTQ health in our curriculum. “Caring for the Invisible Patient” will address how health care providers can work towards providing health care justice for their LGBTQ patients. Panelists include patients and providers who will speak about barriers to accessing health care and what providers must know about this diverse population.

People working in health care have a responsibility to provide an actively anti-oppressive environment. This is not only because of their role in providing an essential service for the community, but because of the power that comes with this position. Many students within the USM nursing program will be graduating with a professional privilege that is supplemented by their own personal privileges (be it sexual orientation, race, class or country of origin). Unfortunately, a nursing program that does not provide opportunities for its students to explore these issues is not a comprehensive program.

Caring for the invisible patient: How providers can advance LGBTQ health justice. Monday, April 22, 6:00 p.m. to 7:30 p.m. Room 113, Masterton Hall.

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