Case Summary
This case introduces John, who identifies himself as transgender. John is a 23-year-old college student in the process of transitioning. John’s team won the NFL division championship, and after a celebration, he was involved in a road accident resulting from drunk driving. Following the accident, John sustained leg injuries and broken ribs. He was taken to a nearby hospital, where he was to be addressed. He was taken to an emergency room, where the medical staff assessed his wounds.
In the process, the nurses noticed that John had a tightly bound breast in his clothes. However, John’s legal documents, such as his driver’s license and identification card, still reflect his name. It was also reported that John had planned to change his legal documents and undergo surgery so that he could become a woman. This case, therefore, highlights the self-reflection questions that nurses need to know when caring for transgender patients.
Case Analysis
As a nurse caring for John, I can say that I am in the first stage of the Staircase model when it comes to caring for patients who are transgender. I have never had the opportunity to care for or interact with this group, and as such, I will need to learn more about the LGBTQIA community and what they do so that I can render quality care for John. To move to level two, I must examine my cultural origins through interviews, enhance my internal motivation, and seek knowledge from LGBTQIA experts (Kersey-Matusiak, 2018).
Reflecting on Prior Interactions with LGBTQIA Individuals and Clinical Preparedness
I cannot recall how many LGBTQIA patients or friends I have. This is my first time encountering a patient who considers himself transgender. This is why I considered myself in the first stage of the Staircase model when caring for John, who has decided to transform into a female. Therefore, it would be difficult to quickly notice that my patient is transgender for the first time. However, now that I have encountered John, I would readily identify such individuals in the future since I would strive to gain proficiency levels as far as the LGBTQIA community is concerned.
The Nurse’s Role When Family and Friends Respond to Gender Reassignment Plans
John’s decision to pursue a gender reassignment plan may not be readily accepted by his friends and family; as such, nurses have a role in harmonizing all sides’ thoughts and opinions. For instance, Safer and Tangpricha (2019) noted that approaching transgender issues with an open mind that facilitates communication is key to settling transgender issues. As a nurse, I would strive to create a safe and non-judgmental environment where John’s family and friends can express their concerns regarding John’s plan to transform.
I would actively listen to his concerns and feelings regarding the gender transition and respect his decision while educating his friends and family to respect John’s decision. Educating his family and friends would settle the misconceptions surrounding transgender people. I will also advocate for John to see that his rights, autonomy, and well-being are served, as his family and friends may hold different beliefs and opinions regarding his plan to transition. I would ensure he gets his wishes and that care teams and others respect his preferences.
Creating an Inclusive Environment and Recognizing When to Seek Support
Healthcare settings need to create a more welcoming environment for LGBTQIA patients to encourage openness so that quality care can be provided. According to Safer and Tangpricha (2019), several practices can be implemented by healthcare organizations to create an environment that suits all patients in this group. The first is staff training and education on matters related to the LGBTQIA+ community, including their roles, values, and beliefs (Safer & Tangpricha, 2019). The second practice that can be employed is the implementation of inclusive policies and procedures to prohibit discrimination based on sexual orientation, gender identity, and other related characteristics. Moreover, healthcare organizations can strive to create a safe space for LGBTQIA patients to preserve their safety and well-being.
Finally, adopting patient-centered care that highlights the unique needs of these patients can also foster an environment for patients like John. Using inclusive language and asking open-ended questions concerning gender identity and sexual orientation would provide patient-centered care. As I am in stage one regarding John’s care, I recognize the need to approach my colleagues, who have a vast knowledge of caring for LGBTQIA patients, to gain insights into the community so that I can give John the care he deserves.
Understanding Heterosexism, Cissexism, Homophobia, and Transphobia
There are several key sexuality terms that a nurse needs to know and understand to render effective, quality care to LGBTQIA patients. These include heterosexism, cissexism, homophobia, and transphobia. While heterosexism holds the assumption that heterosexuality is the norm and considered superior to other existing sex orientations, cissexism holds that cisgender individuals are superior to transgender individuals (Safer & Tangpricha, 2019).
Homophobia, however, refers to the fear, hatred, or prejudice that people have toward individuals who are gay or lesbian. On the other hand, transphobia is the fear, prejudice, or hatred that people have for transgender individuals. A nurse must possess a comprehensive understanding of these terms to provide adequate care to patients like John. To address the biases resulting from these key terms on sexuality, the nurse must reflect on their personal biases, embrace cultural competence and humility, and strive to create a safe and inclusive environment for LGBTQIA patients.
Eliciting Sensitive Health Information Through Respectful Communication
Honesty is crucial between a nurse and individual patients, as it allows for openness and trustworthiness. The most sensitive way a nurse caring for John and other transgender individuals can ensure an honest answer is by creating a safe and non-judgmental environment (Kersey-Matusiak, 2018). This involves creating rapport and trust with the LGBTQIA patients. Moreover, nurses can do this by affirming their sexual identities and preserving confidentiality. Therefore, as a nurse caring for John, I would first have recognized John’s preferences, given him a chance to express his feelings concerning transgender, and then supported him towards a successful transition.
References
Kersey-Matusiak, G. (2018). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.). Springer Publishing Company.
Safer, J. D., & Tangpricha, V. (2019). Care of the transgender patient. Annals of Internal Medicine, 171(1).