The nurse proposes establishing an educational organization run by LGBTQ individuals to advance healthcare equity and opportunities for LGBTQ youth and families. The organization would design evidence-based programs and services to address healthcare disparities like reproductive health issues and mental health challenges. By demonstrating cultural sensitivity, avoiding judgment, and addressing patients' needs comprehensively, nurses can build trust and improve health outcomes for the LGBTQ community.
1. Identify one evidence-based intervention to reduce health
disparities in the selected population.
The hot spot I chose is Arizona and the selected population is
the lesbian, gay, bisexual, transgender and queer (LGBTQ)
community. I chose this state because I worked as a nurse in
Arizona in cities like Phoenix, Scotsdale and a few others. One
of the Phoenix LGBT Communities is located in the North close
to Roosevelt Avenue. I was in this state for 5 years and my first
apartment rental was from a gay young man. I did community
nursing where I visited patients at home. It is not easy
discussing this subject but I feel very strongly about this
minority and what they have to go through. I have had the
privilege to work very closely with families who are either gay
or have gay children. To be honest, my biases were finally
broken down as I allowed myself to feel deep empathy for these
folks after listening to some of their stories and the plight they
face.
By addressing the health disparities that are so prevalent in this
community and the need for health equity through evidence-
based solutions; by developing a therapeutic framework to
expressly ground the principles of health equity concerning this
community that is so stigmatized, advance practice nurses,
stakeholders and funders of this process can incorporate
practices that are inclusive as they embark on working with this
population.
Specifically, since I have worked closely with families with
teen-age youths that are either lesbian, or gay, I understand
what this community goes through at home, at school and with
their neighbors. In one of the instances, I had parked my car in
front of the patient’s house when I came to do an oasis
2. assessment. The harassing neighbors that hated the family
because the two ‘moms’ were lesbians, came and pitched a
basketball hoop very close to my car and told the parents of my
patient to ask me to move my car because her kids wanted to
play basketball on the street. This was just a hate-driven move
against anyone that associated with the lesbians. Now we are
talking about neighbors that do have a large yard and could
pitch a basketball net anywhere in their yard. This incivility
resulted in an altercation between the two families. The family I
came to work with had just bought the home but since the
purchase it was one form of harassment after another. It was not
until I worked with them and other gay families that I
discovered what this community suffered. Seeing their plight
and listening to their stories I was forced to examine my own
biases against this minority group of people.
Anyway, that aside, one issue that the family discussed with me
is that of healthcare inequality and how they had suffered
discrimination this area amongst other areas. I consider
evidence-based interventions and strategies that could leverage
science to promote equity-focused healthcare for youths and
families as a worthy cause. Starting an educational organization
whose curriculum is run by LGBTQ researchers, educators,
program designers, relevant publishers,/writers/editors, and
techies, all contributing their sympathetic skills and talents to
advance advocacy to improve lives and promote equity has
become something I would very much like to pursue. I now
reside in Massachusetts and I keep running into the same issue
in community nursing as well as school nursing.
My interest for this Arizona community runs deep with good
reason. I find myself driven by their mission to advance
healthcare equity and opportunities for youths and families
especially those parents that are reluctant about getting fair
healthcare treatment. I also saw how their children found it
difficult maintaining a steady attendance in school due to the
3. fear of stigmatization and ridicule. Laws are in place to protect,
but the public is still not sensitive enough to the needs of this
community and are very subtle in the way they practice
discrimination and bias within the healthcare industry.
Advanced practice nurses have a responsibility to educate
nurses in our hospitals and healthcare facilities. Our doctors
also need proper education on how not to discriminate against
the LGBT community. Advance practice nurses must educate
school nurses to exercise their leadership roles in fostering
safety by being supportive in our school environment. They
must deal with the unfairness and inequality to bridge the gap in
gender discrimination and health disparities. Collaborating with
the school and the community to advocate for change in policy
will go a long way to improve outcomes (Shattuck et al.)
Here in Massachusetts, I once visited the The Alnite Alliance
Group made up of connected voices that meet monthly and
presently, they do zoom meetings and consider this place a safe
hangout location where all LGBTQ members can assemble and
be free to express their challenges.
In the near future, I intend to build a strong, dynamic
partnership and collaboration with this group so I could better
inform the interdisciplinary team to seek strategies that foster
funding for LGBTQ cultural competence while lessening the
healthcare disparities. It all begins with educating the public
and raising awareness about their gender and sexual
orientation/identification. My motto is, fairness for all
especially when it comes to healthcare. Everyone deserves
fairness, whether or not we disagree with their lifestyle choices
and orientation. The masses need to understand that everyone
deserves to live in a safe and healthy community and to
participate equally in economic opportunities, affordable and
medically precise and inclusive healthcare services.
4. Through education and training and evidence-based research, I
hope to positively make an impact in areas such as reproductive
health including the prevalence of HIV that is so common with
this population. For the youth, school-based mental health and
wellness will be emphasized. Also addressing the drugs, alcohol
and experimentation with tobacco products as stress relief will
be addressed. Teaching inclusion science and healthcare equity
and how to recognize incivility, where to go to get justice will
be part of the strategic interventions of the program. With the
assistance of the gay/lesbian parents and their children, we will
collaboratively design customized, evidence-based programs
and services to adequately and accurately address the current
healthcare disparities still prevalent in the LGBTQ community.
Consider how the selected intervention addresses at least one of
the CLAS standards.
One of the CLAS standards that seem to stand out to me is how
an advanced practice nurse can demonstrate sensitivity towards
the culture of the lesbian, gay, bisexual, transgender and queer
community. Worthy of consideration for the nurse are culture
and gender as key components, foundational to inform practice
improvement leading to quality care (Surikova et al., 2020)
One of the challenges community nurses face is the discomfort
they feel when they suddenly are faced with having to address
patients’ sexual behaviors. This is particularly true with the
LGBTQ community, a factor that can result in serious
consequences (Landry, 2017).
Sometimes it only takes minor adjustments in a provider’s
approach to make a significant difference in the life of patients
to improve health outcomes especially with the healthcare
disparities this group faces.
There are mental, emotional, biological and psychological
5. issues ranging from anger, guilt, shame, feelings of
unworthiness, violence, fear, anxiety, suicide contemplation,
safety issues etc. all needing to be addressed, not ignored. As
health care professionals it is our job to make sure we do not
shy away from addressing issues around their sexuality when it
is called for. Part of cultural competence is being culturally
sensitive to the above-mentioned needs in order to provide top
quality mental and emotional healthcare for our patients.
When we demonstrate a sense of comprehension and empathy
towards the patients’ culture, and when we avoid a judgmental
approach toward their gender orientation, we show
understanding and accommodation, thereby building the trust
that is necessary for improving outcomes and eliminating
disparities.
How can nurse leaders and healthcare providers be advocates
and work in the best interest of their patients if they harbor a
repulsive or negative attitude towards those with gender
differences that is termed non-conventional? I had to deal with
my own biases when I got assigned to families with two moms
or two dads. At first it was awkward and challenging because I
was not prepared for this and had never been in very close
proximity with the LGBTQ group. But as time went on, the
walls got eroded because I chose to approach it from a scientific
and evidence-based standpoint. Many nurses from my
organization simply could not do it for some reason and I think
it is simply ignorance.
Gender flexibility orientation is something nurses must educate
themselves about. Just as discrimination due to race, culture,
religious beliefs, and age is wrong, discrimination because of
gender orientation is equally wrong and unethical. It is a form
of incivility because we are responsible for equity-based
healthcare.
6. References
Shattuck, D. et al. (2020, Aug). Recruitment of Schools for
Intervention Research to Reduce Health Disparities for Sexual
and Gender Minority Students.
Journal of School Nursing
36
(4) 258-264.
Landry, J. (May, 2017).
Delivering Culturally Sensitive Care to LGBTQI Patients.
The Journal for Nurse Practitioners
,
13
(5):342-347
Surikova, J., Payne, A., Miller, KL., Ravaei, A., & Nolan, RP.
(2020, July, 18). A cultural and gender-based
approach to understanding patient adjustment to chronic heart
failure.
Health Qual Life Outcomes,
18
(1), pp. 238. DOI: 10.1186/s12955-020-01482-1
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LATER THAN 5 YEARS.