In a recent poll conducted by the Kaiser Family Foundation (KFF), LGBTQ+ people reported different, and in some cases more challenging, experiences accessing care than their non-LGBTQ+ peers. They were more likely to report that a provider did not believe they were telling the truth, suggested they were personally to blame for health problems, assumed something about them without asking, and/or dismissed their concerns. Over 36% of LGBTQ+ people reported at least one of these experiences with a provider, compared to fewer than one in five (22%) in their non-LGBTQ+ peers.
The National League of Nursing (NLN) seeks to address these issues through the development of instructional resources with the goal of equipping nurse educators with the tools necessary to teach care of LGBTQ+ people and help them graduate a new nursing workforce that is both knowledgeable and culturally competent to meet the needs of LGBTQ+ individuals and decrease the health disparities they experience.
Mount Wachusett Community College was selected by the NLN to run a pilot simulation program to aid in the development of these instructional resources. A significant component of this pilot program is that the scenarios are based on caring for an LGBTQ+ individual. The Mount was fortunate to have volunteers from the community to serve as patient actors for these simulations.
Collene Thaxton, Faculty Chair of the Practical Nursing program, facilitated the simulated patient encounter with students and volunteer patient, River Luck, a group therapist who identifies as trans-masculine non-binary.
“Often individuals who are trans or transitioning avoid seeking health care due to the scrutiny they receive with regards to their chosen identity and what their legal documentation lists,” notes Professor Thaxon. “The goal of these trainings is to teach our students to be affirming and accepting as they provide care. These skills will help in overcoming the patient’s reluctance in obtaining healthcare, ultimately leading to outcomes.”
The NLN simulations moved through three scenarios with the patient, Jayla, who is in transition and non-binary. The classroom is a simulated hospital room equipped with cameras and microphones connected to a nearby observation room where Thaxon and other faculty members can identify areas for improvement for both the students and the program. Following each scenario session, the students debrief with Thaxon and can ask questions to assess their performance.
In the first, the patient is presenting in a clinic setting with an injury that is several days old and needs attention. The students obtain the patient medical history and administer a tetanus shot. The student pairs then switch out for the second scenario, which involves the cleaning and dressing of the wound while continuing to learn more about the patient and encourage them to return for follow-up care. Finally, the third scenario is six months in the future, “Jaylen” has returned to the clinic and the nurses discuss continuing care and routine screenings.
For many of the students involved in the simulation, this was their first experience with a live patient, their work previously was conducted on patient simulation mannequins.
“Now is the time to do this, even if you don’t feel entirely comfortable, just do it. It’s how you will become comfortable,” Thaxon told her students. “We are so lucky to have someone like River here to help.”
“Having had negative experience in accessing healthcare myself, I was more than happy to participate in this program,” Luck notes. “These students did a wonderful job making “Jaylen” feel comfortable and accepted.”
“It is so important to not make assumptions about your patients. Encourage sharing by offering your own pronouns,” Luck adds. “Don’t make a big deal about it if you accidentally misgender the patient. Apologize quickly, fix it, and move on. If you get flustered and make it an issue, the patient will feel like it is an issue.”
“These educational resources will help train nurses to treat these patients in accepting and affirming ways, while still ensuring that the medical records of the patient are accurate,” Thaxon adds.
“MWCC is honored to be working with the NLN to help develop these vital instructional resources,” commented Dean of Nursing, Kimberly Shea, DNP, RN. “This is a valuable experience for our students and faculty alike. It is rewarding to know that we are playing a role in the advancement of equity and access to healthcare for LGBTQ+ individuals in our communities and beyond.”
About the National League of NursingThe National League for Nursing is the premier organization for nurse faculty and leaders in nursing education. The NLN offers professional development, networking opportunities, assessment services, nursing research grants, and public policy initiatives to its nearly 45,000 individual and 1,100 institutional members. NLN members represent nursing education programs across the spectrum of higher education, health care organizations, and agencies.