JOGNN
IN FOCUS EDITORIAL
Improving the Care of Lesbian, Bisexual, and Transgender Populations Holly Harner
Correspondence Holly Harner, PhD, MBA, MPH, CRNP, WHNP-BC La Salle School of Nursing and Health Sciences St. Benilde Tower – Office 3333 1900 W. Olney Ave., Philadelphia, PA 19141. [email protected] Holly Harner, PhD, MPH, CRNP, WHNP-BC, is an assistant professor and director of the Master of Public Health (MPH) Program, La Salle School of Nursing and Health Sciences, Philadelphia, PA 19141
fter reading the three articles in this In Focus series, I am reminded of a famous quote attributed to Maya Angelou: “Do the best you can until you know better. Then when you know better, do better.” Most if not all nurses I have worked with in my career strive to provide safe, effective, timely, and respectful care to their patients. Furthermore, they seek opportunities to “know better” so that they can “do better” for their patients. In order to “know better,” nurses listen to and learn from patients and their families. They review the scientific literature, attend professional conferences, and may complete advanced certifications or degrees. They may even contribute to the state of the science by generating their own research. The articles in this series add to the literature and provide tangible recommendations that have the potential to improve the care of lesbian, bisexual, and transgendered (LBT) populations.
A
In the first article, Alexander and Fannin explored factors that influence the sexual safety and sexual security of young Black women who have sex with women and men (WSWM). Findings generated from this investigation provided insight into the sexual decision-making processes used by this often invisible population of women. Using qualitative analysis with five participants, the authors identified three factors that influenced sexual safety and sexual security among Black WSWM: institutional expectations, emotional connectedness, and sexual behaviors. In addition to exploring these themes through participant narratives, the authors provided concrete clinical recommendations that nurses and other health care providers can swiftly implement to improve the care of this vulnerable population.
The author reports no conflict of interest or relevant financial relationships.
http://jognn.awhonn.org
In the second article, Zuzelo examines nursing care of LBT women through then lenses of nursing education, practice, certification, and licensure. She argues that although there have been positive and incremental changes in health care for LBT women, the gap in deliberate nursing education related to LBT health needs may
contribute to the heterosexism and homophobia experienced by LBT populations. Zuzelo examines the current practice environment and identifies important organizations and recommendations that support nurses attending to and reducing LGBT related health disparities. She describes missed opportunities for nurses to be deliberately exposed to LGBT health concerns and called on nurses and other health care providers to examine their own personal views, biases, and stereotypes relevant to providing care to LGBT populations. Finally, Zuzelo provides a beginning roadmap for improving the care of LBT women, including developing clinical expertise and improving outcomes, assessing work environment factors, and enhancing nursing students’ learning experiences. In the last article, Brennan and Sell explore the effect of written and spoken language on maternal role attainment in a population of lesbian, social (nonbirth) mothers living in a large urban city. In this in-depth qualitative investigation, the authors focused on 20 women who became mothers through donor insemination with their female partners. Findings from this investigation, which are presented using an ecological framework, revealed that language, particularly language used to describe the maternal role (mommy, mama, mather, etc.), can profoundly influence the social mother’s transition into motherhood. Participants indicated that terms that negated their maternal roles (social mother, for example) often left them feeling excluded, invisible, and neglected. Participants described experiencing heterosexism within the health care setting and felt frustrated and exhausted by having to educate others about their family systems. Brennan and Sell use the women’s accounts to identify opportunities for nurses and other health care providers to provide quality care that respectful and inclusive of all prospective and new parents. These articles offer an in-depth examination of the provision of quality care to LGBT populations
C 2014 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
507
IN FOCUS EDITORIAL
508
Improving the Care of Lesbian, Bisexual, and Transgender Population
and the gap in nursing education, practice, certification, and licensure related to LGBT health needs and concerns. Together, they provide immediate and long-term recommendations for improving the care of LGBT populations. These rec-
ommendations offer opportunities for healthcare providers working in maternal and child health and women’s health to “know better” to “do better” when caring for this underserved, vulnerable population.
JOGNN, 43, 507-508; 2014. DOI: 10.1111/1552-6909.12465
http://jognn.awhonn.org
IN FOCUS EDITORIAL
Improving the Care of Lesbian, Bisexual, and Transgender Populations Holly Harner
Correspondence Holly Harner, PhD, MBA, MPH, CRNP, WHNP-BC La Salle School of Nursing and Health Sciences St. Benilde Tower – Office 3333 1900 W. Olney Ave., Philadelphia, PA 19141. [email protected] Holly Harner, PhD, MPH, CRNP, WHNP-BC, is an assistant professor and director of the Master of Public Health (MPH) Program, La Salle School of Nursing and Health Sciences, Philadelphia, PA 19141
fter reading the three articles in this In Focus series, I am reminded of a famous quote attributed to Maya Angelou: “Do the best you can until you know better. Then when you know better, do better.” Most if not all nurses I have worked with in my career strive to provide safe, effective, timely, and respectful care to their patients. Furthermore, they seek opportunities to “know better” so that they can “do better” for their patients. In order to “know better,” nurses listen to and learn from patients and their families. They review the scientific literature, attend professional conferences, and may complete advanced certifications or degrees. They may even contribute to the state of the science by generating their own research. The articles in this series add to the literature and provide tangible recommendations that have the potential to improve the care of lesbian, bisexual, and transgendered (LBT) populations.
A
In the first article, Alexander and Fannin explored factors that influence the sexual safety and sexual security of young Black women who have sex with women and men (WSWM). Findings generated from this investigation provided insight into the sexual decision-making processes used by this often invisible population of women. Using qualitative analysis with five participants, the authors identified three factors that influenced sexual safety and sexual security among Black WSWM: institutional expectations, emotional connectedness, and sexual behaviors. In addition to exploring these themes through participant narratives, the authors provided concrete clinical recommendations that nurses and other health care providers can swiftly implement to improve the care of this vulnerable population.
The author reports no conflict of interest or relevant financial relationships.
http://jognn.awhonn.org
In the second article, Zuzelo examines nursing care of LBT women through then lenses of nursing education, practice, certification, and licensure. She argues that although there have been positive and incremental changes in health care for LBT women, the gap in deliberate nursing education related to LBT health needs may
contribute to the heterosexism and homophobia experienced by LBT populations. Zuzelo examines the current practice environment and identifies important organizations and recommendations that support nurses attending to and reducing LGBT related health disparities. She describes missed opportunities for nurses to be deliberately exposed to LGBT health concerns and called on nurses and other health care providers to examine their own personal views, biases, and stereotypes relevant to providing care to LGBT populations. Finally, Zuzelo provides a beginning roadmap for improving the care of LBT women, including developing clinical expertise and improving outcomes, assessing work environment factors, and enhancing nursing students’ learning experiences. In the last article, Brennan and Sell explore the effect of written and spoken language on maternal role attainment in a population of lesbian, social (nonbirth) mothers living in a large urban city. In this in-depth qualitative investigation, the authors focused on 20 women who became mothers through donor insemination with their female partners. Findings from this investigation, which are presented using an ecological framework, revealed that language, particularly language used to describe the maternal role (mommy, mama, mather, etc.), can profoundly influence the social mother’s transition into motherhood. Participants indicated that terms that negated their maternal roles (social mother, for example) often left them feeling excluded, invisible, and neglected. Participants described experiencing heterosexism within the health care setting and felt frustrated and exhausted by having to educate others about their family systems. Brennan and Sell use the women’s accounts to identify opportunities for nurses and other health care providers to provide quality care that respectful and inclusive of all prospective and new parents. These articles offer an in-depth examination of the provision of quality care to LGBT populations
C 2014 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
507
IN FOCUS EDITORIAL
508
Improving the Care of Lesbian, Bisexual, and Transgender Population
and the gap in nursing education, practice, certification, and licensure related to LGBT health needs and concerns. Together, they provide immediate and long-term recommendations for improving the care of LGBT populations. These rec-
ommendations offer opportunities for healthcare providers working in maternal and child health and women’s health to “know better” to “do better” when caring for this underserved, vulnerable population.
JOGNN, 43, 507-508; 2014. DOI: 10.1111/1552-6909.12465
http://jognn.awhonn.org
