So we recently admitted a male patient who identifies himself as female. We don't get many patients like her. A nurse in particular let's his political views get in the way of work and has been calling this patient "it".
Now, let's fast forward to the dilemma. During medication pass, he addressed the patient as "it" out loud and other staff and patients started laughing; next thing you know, we had a behavioral emergency on our hands.
I filled out an incident report because several other nurses and I have spoken to this nurse prior to the event happening. One nurse even brought it up the chain of command. Not only is it unprofessional but it's endangering the safety of others - clearly, it's one of her triggers. Has anyone ever dealt with this type of conduct?
So the complete definition of a person goes no further than how they express their sexuality? Who they are is based on with whom they have sex? Nothing more? Because that's what you're saying.
It cannot be reduced to sexual or gender expression, but it certainly includes it in no small measure. People have built thriving, culturally-rich communities heavily informed by those parts of themselves. Watch Paris is Burning, read Stone Butch Blues or Funhouse or Gay New York. Gender and sexuality are very, very important parts of our experiences. Straight and/or cis people don't have to think about it as much because they're accepted as a cultural norm, but really think about how many milestones and important events have to do with gender and sex for us: weddings, our first dates, first kiss, girl's or boy's nights out, greek life, etc.
edit: not that LGBT people don't participate in those things, but when we think of them we generally default to the straight/cis - implicit bias and all that
Asking gay people to be okay with nurses believing that homosexuality is a mental disorder is asking an awful lot.
I don't ask any patient to be okay with it because the workplace and their venue of care is not an appropriate place for any such discussion. They'll never know what I think unless they ask, and why would they ever ask? If they did, though, I'd probably say that my personal beliefs aren't relevant to providing their care.
Tolerance is about letting people have the freedom to hold their beliefs and live on them, as long as they're not harming anyone else, even when we disagree. I can't stop people from hating the Catholic church, I just expect them not to take their hatred out on me. If an anti-zionist Muslim nurse provides excellent care to an Israeli patient regardless of her beliefs, the patient has no complaint. Same with say, an ethnically Korean nurse raised in south Los Angeles to hate black people, but who takes good care of her black patients and keeps her views to herself.
If you want to disagree with someone's personal beliefs, do it in a personal venue like this. But you don't have the right to try and deny employment to someone who fulfills the requirements of their job just because you disagree with a personal belief they hold. Some of you think people who think differently from you shouldn't be allowed to work as nurses. That makes *you* the bigots, not the people you're trying to ban.
And holding a personal belief that homosexuality and transgender are disordered in no way means that a person cannot remain professional and provide compassionate care. After all, as nurses we deal with people who have disordered things going on all the time. That's kind of the job. Being a nurse means you care for the person AS PERSON and the rest is details. Keeping human dignity and compassion as your guiding compass in patient interactions will always serve you well.
You know, I've read enough of your posts on AN to believe that you genuinely care for and advocate for your patients and that you believe in treating all your patients ethically.
What I don't personally understand is how it's possible to have the belief that the way a person lives their life is abnormal and not at all have that affect the way you interact with that person. I'm not saying that it's impossible to do or that you personally are unable to do this, but it's hard for me to understand how it can be done without the other person noticing/sensing something.
So the complete definition of a person goes no further than how they express their sexuality? Who they are is based on with whom they have sex? Nothing more? Because that's what you're saying.
Of course there's much more to a person than who they're attracted to, who they fall in love with and who they have sex with but still, it's a part of our personalities and has a large impact on our lives.
My partner isn't just a convenient way to save on the cost of batteries
Sex/sexuality is a part of the relationship but he's also my friend. He's a person who challenges/stimulates me intellectually, who makes me laugh, who supports me during rough times. He's someone I share my joys and disappointments with.
I do the same for him.
I'm straight, so most folks don't have a problem with the way I live my life. But I imagine that it would be very hurtful if people around me thought that I was somehow not normal for sharing all these things with the man I love. If people thought what we share is diseased, it would genuinely hurt. I would think that's a feeling shared by most people, regardless of sexual orientation or gender identity.
Homophobia and transphobia have historically informed abusive and unethical medical practice. Your personal beliefs, no matter how well controlled, ultimately trend towards dehumanizing trans people and sexual minorities. The issue is not that you are going to walk in an announce that you believe a trans or gay patient is disordered or deserving of mockery and abuse; it's that your implicit bias against patients will undermine your good intentions. How can you, for example, (and here I am guessing at political beliefs, so correct me if I'm wrong) stand against the right of someone to use the bathroom that aligns with their identified gender or the right of a same sex couple to marry or adopt and at the same time truly believe that those people are fully human and deserving of your respect? There's a dissonance there! There are no half measures! You cannot pick and choose when and where you treat trans and LGB people with respect to their full humanity! People will pick up on your prejudice, make no mistake. I would advise you to educate yourself about about gender and sexuality and what they mean to people who are outside "the norm." Seriously:
Thank you, macawake, I truly appreciate your post.
I understand why you find it hard to envision personal beliefs not impacting care. I haven't taken care of a transgender patient yet (that I know of), but have cared for several gay and lesbian ones and with it being hospice, of course partners and family members are always very much around. Regardless of my personal beliefs, I understand that for these couples, that person is to them what my husband is to me. I can respect the reality of the bond for them and act accordingly. Human dignity comes first. It's at times like those that I have renewed appreciation for the very good training I got from my hospice employer about putting aside my own personal ideas and focusing care on the patient as appropriate for *them*. I embrace that. Respecting where they are and meeting them there is fundamental to what I do. If my personal beliefs and experience are helpful to doing so, like recognizing the importance of scapulars to Catholic patients and families because I know what they are, then great. (Interesting aside, I live where there is a large LDS population, and find that because I'm Catholic and understand the value of the material in the spiritual, I show more respect for the importance of LDS temple garments than some of my peers who are less versed in that idea.) But when my personal background does not serve the patient, then it's not to be drawn upon. Regardless of what I think about toilet paper not being halal and a Muslim woman needing cups of water to rinse herself after using the toilet, my job is to respect her and provide the cups of water. Same with the patient I had who had a Buddhist-influenced belief system and needed several stained-glass circles on stands arranged in a certain way around her room. It's my job to do what *she needs*.
I know what it looks like when someone can't keep their personal beliefs out of their care. I work with a nurse who is a very outspoken Christian. As in, proselytizing to patients. I spoke to her once after she told a patient Jesus was waiting for them. I asked if she had checked the patient's religion before she said that. She hadn't. I did, and the patient turned out to be Lutheran, so I jokingly told her she was okay, but that she should be more careful next time. What followed was a fairly horrifying conversation where she told me that she will continue to talk the way she does regardless of the patient's religion, and that she purposely talks about Jesus to nonchristians! I was literally sick to my stomach at such disrespect. I'm trying to decide the best way to alert my leadership that this problem exists, anonymously or otherwise. She's mostly a nice person and I don't want destroy anyone's career, but what she's doing is just so wrong. I can believe that she is incapable of keeping her personal beliefs from affecting her care of a gay patient. Frankly, I think her behavior reflects insecurity. Those of us who really know our beliefs and are at peace do not constantly need to broadcast them.
Anyway, I appreciate those who are willing to consider that my beliefs don't necessarily make me a bigot unworthy of nursing. We are all complicated individuals with a tapestry of qualities, and we all bring different things to this profession. We probably all believe something that someone else would find distasteful. What matters is how we care for the patients entrusted to us.
Specializes in Float Pool-Med-Surg, Telemetry, IMCU.
If it makes me a bigot to be intolerant of people who believe that being transgender or gay is pathological I can live with that. The difference between my bigotry and yours is that mine doesn't affect YOUR right to marry or adopt children.
yowheez
32 Posts
You reject people based on who they are. I reject people based on the way they treat people. They don't have a choice; you do.