to the Editor


A vast amount of information is available to both the LGBT community and nurses—in print, online, and in various support groups. All patients should be treated as people first, with individual needs requiring individual care plans. Reading “Addressing Health Care Disparities in the Lesbian, Gay, Bisexual, and Transgender Population: A Review of Best Practices” (June) made me think that when the patient’s sexual orientation is turned into a primary need, this may override the concerns for which the patient is being seen. Sexual orientation doesn’t matter when the patient is having a laparoscopic cholecystectomy, for example, and it doesn’t make a difference when a patient with diabetes is hospitalized for a blood sugar level of 800. During my hospitalizations, no one asked about my sexual orientation, nor did I expect them to. Unless it is a necessary part of my care, or I bring up the subject, it’s not the business of my nurses. Vicki Nesbitt, RN Cleveland, GA

Authors Fidelindo A. Lim, Donald V. Brown Jr., and Sung Min Justin Kim respond: Patient-centered and culturally sensitive care can only be delivered when the provider takes into consideration the patient’s enduring values, identity, and sexual orientation. Otherwise, how can we individualize the care plan? Similarly, providers must understand why it’s difficult for LGBT patients to come out (some may even refuse) to their providers, and how this impacts health care outcomes. Sexual orientation is not a need but a sense of being that is closely tied to a person’s identity—and ultimately to her or his health. When providers fail to acknowledge this, we run the risk of perpetuating the health disparities referred to in our article. While it’s true that “a vast amount of information is available 12

AJN ▼ September 2014

Vol. 114, No. 9

to both the LGBT community and nurses,” the nursing profession has been slow to join discussions about LGBT health. From 2005 to 2009, only eight out of almost 5,000 articles published in the top 10 nursing journals addressed LGBT health issues.1 It’s our aim to contribute to the ongoing efforts by nurses to ensure LGBT health equality. REFERENCE 1. Eliason MJ, et al. Nursing’s silence on lesbian, gay, bisexual, and transgender issues: the need for emancipatory efforts. ANS Adv Nurs Sci 2010;33(3):206-18.


I enjoyed “Invite an Adversary to Lunch” (Editorial, May). I’ve had similar experiences and I’m happy the problem was finally resolved. However, I would never counsel anyone to schedule meetings with someone who continually doesn’t show up. A failure to require responsible behavior from our counterparts is poor nursing administration. That this colleague’s childish behavior may come from some previous slights and bad treatment by nurses is no excuse. If he and the author were required to work together, then a well-planned sit-down in his office (a location that might give him a sense of safety), during which he explained his rationale for this unacceptable behavior, would have been in order. Some senior administrative leaders exhibit an almost inveterate dislike for all things nursing and, in particular, nurse admin­ istrators. Their frequent power plays, complaints that they aren’t listened to, and failure to command the respect they think they deserve build an almost impregnable wall around them. They are a serious liability to an organization. No lunch, however sumptuous, will change them. Richard Flynn, PhD, RN Seminole, FL


I graduated with an associate’s degree six months ago, but so far I’ve been unable to secure my first nursing position (“Changing Trends in Newly Licensed RNs,” February). During my job search, I’ve had several interviews and the opportunity to speak with many managers and nurses. The managers tell me they receive 200 or more applications for one or two positions and that I’ve been lucky to even schedule interviews. One hospital in my area pays for relocation fees and hires nurses from all over the country. The desire for nurses who have a bachelor of science in nursing (BSN) is very strong here, just as it is nationally: a survey of 501 schools of nursing found that 39.1% of hospitals are requiring nurses they hire to have a BSN, whereas 77.4% strongly prefer nurses who’ve graduated from BSN programs.1 The community college I graduated from recently expanded its nursing facility and has increased the number of students allowed in the program. How many of these graduates will also struggle to find a job? At what point will there be a reduction in associate’s degree programs? More attention must be given to this issue to assist new graduates in becoming working nurses. Laura Miller, RN Apex, NC

REFERENCE 1. American Association of Colleges of Nursing. Employment of new nurse graduates and employer preferences for baccalaureate-prepared nurses. Washington, DC; 2012 Oct. Research brief; http://www.aacn.nche.edu/leading_initiatives_news/news/2012/employment12.


I currently hold a position of leadership and can attest to many of the points made by Beverly Hancock in “Developing New Nursing Leaders” (Perspectives on Leadership, June). ajnonline.com

I didn’t see myself as a leader or management material until I was asked to take on this role. I had so many doubts and feared failure. At the time, I was new to the organization and the area and hadn’t yet built relationships with the staff. Plus, I still had so many questions about being a staff nurse that I wondered if it was right to move to the next professional level. Now I’m all too aware of the lack of nurses willing to step up and take on leadership roles. There are only a few who can take my place if I need to be out, making it difficult to staff the unit adequately. It’s important that nurses realize they don’t have to go into management to be leaders. On our unit, the nurses involved in the shared governance committee provide valuable leadership to the rest of the staff by introducing information and helping to implement new practices.

Many times, when nurses take one step toward leadership, they will take another. I hope this article inspires them to take this first step, because it will benefit them both personally and professionally. It will also strengthen the units on which these nurses work and the nursing profession overall. Ingrid Butler, RN Charlotte, NC

regard to this role, and her encouragement boosted my confidence and contributed to my belief in my leadership potential. With her support and that of other senior leaders in my organization, I accepted the management position and now feel inspired, responsible, and accountable for the care received by the patients recovering on my unit. The encouragement and guidance I received leading up to and following this decision have been crucial in my development as a nurse leader. We must identify employees with management potential, embrace teachable moments, and, above all, set an example in the workplace. The success of any organization is largely dependent on the selection and development of its future managers and leaders.

About two years ago, I was approached by my manager to take on a leadership role as the clinical nurse supervisor of a 42-bed medical–surgical unit.The reasons for my hesitation in accepting this position included all of those discussed in Dr. Hancock’s article: lack of experience, less time with patients, and work–life imbalance, among others. My manager at the time (now LaurenLippincott Porter,Williams BSN,& Wilkins RN-BC my mentor) made a point of idenThe Health Career Authority San Francisco ▼ tifying my strengths and assets in


Nurse leaders.

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