Cultural Competency Training

[Cmatt13, BSN, MSN]

Hi everyone. I'm currently working on a program through an LGBT (lesbian gay bisexual transgender) health care center to provide cultural competency training to LGBT older adults. We are federally funded and our program provides CEU's to nurses who complete the program, which is a 6 module (6 hour) educational offering that provides information about LGBT needs, HIV and aging, legal concerns, sex and sexuality and transgender health issues. It's offered free of charge to interested facilities.

My question is this: what populations do you think are most in need of this kind of training, if any? Would you take a course of this kind? What would be your motivation?

At the moment we are targeting both staff nurses at local hospitals and LTC facilities, public health nurses and clinic nurses. We piloted the program with nursing students initially, and the feedback was overwhelmingly positive. Our main barriers to getting it more widely disbursed have been mostly having to do with staff time.

Any feedback on interest would be greatly appreciated.

[mentalhealthRN]

Well I guess I can answer this question both as an RN as well as a member of the LGBT community myself. I think it could benefit any nurse, doctor, CNA/Patient care tech, PT/OT......in any and every setting. I say this because gay and lesbian individuals are no different then any straight patient in the needs they may have medically, mentally,etc for the most part. Yeah there are maybe a few little things here and there, but for the most part its the same. I find the biggest thing is really something simple. All medical staff should get in the habit of never making assumptions. They should ask if a person has a significant other, keeping it general. This includes in the OB/GYN setting for female patients. Sexual Orientation is asked about in most histories reported by the patient and I,over and over, get healthcare providers who don't read this and walk in and ask things like "what are you using to protect against pregnancy?" ---ummm really? LOL and I have delivered babies of lesbian couples. So really all healthcare providers--docs, nurses, etc-- could use some training, in every setting. And that can start with the basic practice of never assuming a patient they care for is straight (regardless of appearance).....there are more, a lot more, of us out there then most people realize.

And last thing I want to say is KUDOS to you for seeing the importance of what you are doing and doing it!!!!!!!!! THANK YOU!!!

[carolmaccas66, BSN, RN]

I think this is a fantastic way to get info out there re LBGT people. There have been too many prejudices against people like this (I just watched the DVD 'Milk' on the weekend, couldn't believe some gay guy got stabbed 15 times and killed JUST WALKING DOWN THE STREET! and no-one did anything about it! Just awful).

I'm not in the US, but you also need to be targeting the universities/colleges, as well as hospitals, clinics and high schools, so kids get a better understanding of all this and that you can't discriminate against LBGT people. They are people just like anyone else.

[heartflutter, ADN, BSN]

My wife is transgender and I am bisexual. I feel it is extremely important that ALL healthcare staff are well-informed of the correct terminologies and questions to ask trans-patients. One of the most frequent debates I hear come up is individuals who have transitioned from one sex to the correct sex and insist they don't need a prostate exam (for a male to female trans-person), etc. They still have parts they were born with that must be taken care of, but we need to be sensitive in how we approach them about this.

While the LGB community is making leaps and bounds lately in terms of civil rights and recognition, the trans community is still facing overwhelming discrimination. I see stories pop up on the news about trans-individuals being refused care and being called (deliberately) the wrong pronoun. This is unacceptable behavior from people who have committed themselves to helping others and the psychological effects of these incidents discourage trans-individuals from seeking medical care.

And to second MentalhealthRN, never, ever assume someone's orientation. Significant other is a great term to use and never be afraid to ask what someone's preferred pronoun is if you are not comfortable (or do not feel it is possible to guess). It may even help your patient open up about trans-related health issues that they may have not otherwise felt safe discussing. Exam rooms and hospital settings should be SAFE places.

As for who to target, I'd suggest ER nurses, doctor offices, and clinics, because these are places trans-patients likely show up most and will need the greatest amount of support from healthcare professionals to feel safe and comfortable.

Great topic!

[birthrevolution]

Awesome! I ran a similar program almost ten years ago (!) except we did 3 hour in person trainings. We could never really get the time to train clinical staff like RNs and MDs, and focused mostly on LTC facilities, senior service providers (adult day health, in home health, etc.) If you're focusing on older adults I think that geriatric/rehab floors would be a good place to start, but honestly, I think every nurse needs this kind of training. You might try getting buy in from nurse managers on any floor. Start with the low hanging fruit (an LGBT workers group at the hospital, etc.) and use those connections to get in with nurse managers on different floors, etc.

PM me if you want to chat more about it.