Recognition of the need for important patient information for adjusting the care provided by nurses has been receiving more attention as a strategy to improve patient outcomes.
The Institute of Medicine issued a report in 2011 recognizing the lack of information about LGBT people and its adverse effects on the health of these populations. Health care has been reluctant to ask controversial questions even when there is evidence that certain information will result in better patient outcomes. More specifically, information regarding a patient’s sexual orientation and gender identity is essential to adequately plan for their care.
Many health care organizations do not even collect this information because of a lack of strategic planning or due to religious affiliations. Evidence has supported that patients have specialized needs based on their gender identity and sexual orientation. For example, men who have sex with men are at higher risk for becoming HIV positive and transgender people are more likely to need mental health services.
Before issues such as accessibility and stigmatization of LGBT people can be addressed, we need to mandate that essential information be collected when health services are provided. Not only do we need to collect this information, we need to adjust patient care based on this information. Barriers to collecting this information may be reluctance because of the sensitive nature of the information.
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Nurses typically ask personal questions ranging from menstruation to the frequency and characteristics of bowel movements and thus may be able to advocate for change. Two additional questions asking the patient to identify their sexual orientation and gender identity would not be any more invasive.
As nurses we have been called upon to battle the pandemic during the last year so asking nurses to advocate for further change is difficult to justify. If this pandemic has taught us anything it is that nurses have shown a resiliency to adapt to a dynamic rapidly changing environment.
Health care administrators have been reluctant to create an infrastructure to allow nurses to collect information on sexual orientation and identity. A grassroots movement led by nurses may be the best strategy to demand changes for collecting information on sexual orientation. A revision of the nursing curriculum to include information on sexual orientation and identity as an essential component of an effective patient assessment.
The American Nurses Association (ANA) states, "Nurse educators that will help fill the void in knowledge by incorporating the issues of the LGBTQ+ populations as part of nursing curriculum" (ANA position statement,2018).
Changing the nursing curriculum to include questions about sexual orientation and identity needs to be taught as an essential part of an assessment. I advocate that nursing curriculums include assessment of sexual orientation and identity. Once the curriculum has been revised nurses will demand that the tools such as the electronic health record gather information that gives nurses the resources to improve patient outcomes.
O. Erin Reitz is a board member of the Prairie Pride Coalition.