Betty, a 45 years old woman, is referred to a local clinic because of feeling depressed. She has a history of three divorces and thinks that she is tired of living the old way. That is why now she is involved in relationships with a woman. In fact, she is bisexual. Another reason for feeling depressed is that her mother died of cancer, and Betty is afraid that she might as well have cancer.
Working with Betty is a special case because she is depressed and her situation has numerous factors to consider. First of all, physiologically, the woman thinks of herself as a lesbian, however, in fact, she had sexual interactions with both men and women within the past three years. It might also witness that she is somewhat deviant from the behavioral perspective. As of sociocultural factors, Betty has four children, was married three times, and was involved in many relationships. She has the experience of death caused by cancer in her family because she lost her husband and mother within the past five years. The fact that her mom died of cancer is the additional psychological factor because Betty is afraid that she might also be in the risk group. Moreover, being involved in relationships with another woman might also be a matter of concern. As of the health system factors, the patient does not have the health insurance, so, she may have limited access to the healthcare system (Holden et al., 2012). These factors, if considered together, may help understand the roots of Betty’s depressive condition.
The patient’s case is special, so, it needs special actions to be taken. In fact, Betty is bisexual, but because currently she is involved in sexual relations with another woman, the option is to treat her as a lesbian. First of all, in the case of these special patients, it is vital to create a welcoming environment so that they are willing to share their health concerns (Ard & Makadon, 2012). The point here is to make the patient believe that she is accepted the way she is and not judged. Another specific action is to guarantee Betty’s confidentiality, so she is sure that she can share her story. Another necessary step is trying to detect whether she had ever been a victim of abuse and whether surrounding people judge her for being different (Gay and Lesbian Medical Association, n.d.). These actions are necessary because they will help determine whether Betty’s depressed condition is caused solely by her concerns with possible cancer or by psychological factors as well. Moreover, it is crucial to use sensible language, ideally, the terms used by the patient when she told about her relationships.
Even though Betty is afraid she might have cancer, the primary health concern is depression. The community nurse’s role in this case is crucial because the patient’s decision to open up and undergo treatment fully depends on the nurse’s actions. What is necessary to remember is that Betty’s case might not necessarily be caused by the fact that her family members died of cancer. The nurse should remember that LGBT patients often suffer from depression because of discrimination and bias in their everyday life and that they strive for seeing people whom they can trust in caregivers. In addition to that, because of the same fear of being suppressed, they fall upon the medical aid as the last resort (Kane-Lee & Bayer, 2012).
Bearing in mind everything that was told about the possible causes of Betty’s health concerns and about treating special patients, the community nurse should demonstrate tolerance and sensibility and make Betty trust her because the way the nurse treats her might influence further treatment and quality of life.
References
Ard, K. L., & Makadon, H. J. (2012). Improving the health care of lesbian, gay, bisexual, and transgender (LGBT) people: Understanding and eliminating health disparities.Web.
Gay and Lesbian Medical Association. (n.d.). Guidelines for care of lesbian, gay, bisexual, and transgender patients.
Holden, K. B., Hall, S. P., Robinson, M., Triplett, S., Babalola, D., Plummer, V.,… L. DiAnne Bradford. (2012). Psychosocial and sociocultural correlates of depressive symptoms among diverse African American women. Journal of the National Medical Association, 104(11-12), 493-504.
Kane-Lee, E., & Bayer, C. R. (2012). Meeting the needs of LGBT patients and families. Nursing Management, 43(2), 42-46.