Introduction
Most of the medical needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) people mirror those of the general population and can be met by following usual standards of good practice. However, studies have shown that LGBTQ people face specific health disparities (Elertson & McNiel, 2020). These people encounter significant difficulties in accessing appropriate care. Despite this, sexual orientation and gender identity are still very rarely discussed in medical consultations and largely continue not to be considered as variables of interest in health surveys carried out among the population. Even in developed nations, this issue is only addressed sporadically in the training of doctors and primary care staff. Therefore, one of the policies that should be adopted is making it mandatory for all nurses and nursing schools to incorporate LQBTQ care courses in their learning institutions.
The reiteration of the right to humanized care and free from discrimination because of sexual orientation and gender identity is a concrete advance that must be widely publicized. It is a legal instrument in the fight for the realization of the right to health of LGBTQ (lesbians, gays, bisexuals, transvestites, and transsexuals), having as recognition the effects of discrimination and prejudice in the health-disease process of this population. This is an important milestone in verifying the health needs of these segments and the complexity and diversity of health problems that affect them, more so their emotional and mental needs. Unfortunately, many nurses are not educated on how they should provide care for LGBTQ patients.
The proposed policy encompasses key components that will lead to improved outcomes and quality of care for LGBTQ patients. Nursing management in a hospital has many different areas of responsibility. Sexual orientation is important for care professions because it accompanies and cares for people in exceptional situations and thus intervenes in a very intimate personal situation. The foundations for good care to an individual of non-compliant gender are constituted by a welcoming care climate and to achieve this goal it will be necessary to pay attention: to communication, clinical documentation, the assessment phase, and the protection of privacy.
The proposed policy will help colleagues, nurses, and stakeholders in the health industry know-how to provide care for LGBTQ patients. It is important to emphasize that nurses have a fundamental role in the concept of caring, working, educating, and guiding concerning sexuality, diversities, and clarifying the population regarding sexual orientation and gender identity as a holder of health education within the dissemination of public health policies.
These policies and guidelines are realistic in the context of the nursing organization and they are also realistic in the context of the existing environmental factors. Regarding the current state of relevant outcomes related to the proposed policy, there is a universal need for care. Inseparable from care is respect for human rights, including cultural rights, the right to life, and freedom of choice to dignity and to be treated with respect (Traister, 2020). Care is given with respect and regardless of age, skin color, belief, culture, disability or illness, gender, sexual orientation, nationality, political views, ethnicity or social status exercised.
Although it is clearly stated that patients should not be discriminated against in any way, LGBTQ patients are still discriminated against. It is important to work towards improvements in outcomes and quality of care since this will ensure that all patients, irrespective of their sexual orientation, will receive care in a way that they do not feel discriminated against (Englund et al., 2020). The policy will help ensure that improvements are achieved in several ways. Nurses will know how to take care of LGBTQ patients. From the very first contact, it is necessary to address the individual in need of assistance using appropriate language. It is necessary to get used to using the patient's preferred name and to decline the masculine or feminine phrases without relying on biological sex, since the behavior of this type implies respect, openness towards the other, recognition and acceptance, nourishing a relationship based on mutual trust.
To successfully implement the proposed policy, nurses should go through that course and participate in practical courses. For example, the nurse may find her/himself examining clinical records that do not take gender variance into account. For this reason, during the first contact, the patient's gender identity should not be taken for granted by deducing it from the physical appearance or clothing (Stewart & O'Reilly, 2017). Addressing the patient with the title of gentleman or lady without him recognizing himself can be offensive, cause discomfort, communicate disrespect, or even disqualify the care received. The interlocutor may think that he/she is not receiving the best care, that it can allow him/her to align the body image with the perceived gender identity if not even a health professional recognizes this identity. In these cases, the patient can be asked politely what he/she prefers to be called and add the “desired” name to the documentation. The chosen name can be inserted in quotation marks next to the official name respecting the will of the user without compromising the clinical documentation.
During the initial interview, if necessary, the person who accompanied the user to the facility can be allowed to attend the interview to provide moral support to the patient and ease the tension. It is recommended to ask only for clinically relevant information and to avoid being guided by curiosity by administering invasive questions that are not useful for diagnostic purposes. If the nursing assessment is conducted with sensitivity and respect, the user himself will tell his/her story in detail, since he/she will feel that he/she is in a safe environment free from judgments.
During the physical exam, it is necessary to explain to the patient what the nurse is doing and why the nurse is doing it, guaranteeing privacy and examining only the anatomical parts that are clinically relevant. Moreover, if the patient will have to undergo instrumental examinations or visits that require undressing, it is up to the nurse to avoid uncomfortable situations. According to Kuzma et al. (2019), it must never be assumed that the patient has told everyone that he/she is LGBTQ and in this regard, it may be necessary to reassure the patient of the confidentiality of the information provided and that it will not be mentioned to relatives, family members or other visitors without the patient’s explicit consent.
The LGBT policy is based on a set of guidelines whose function requires plans and goals for its execution, and nurses must do their part in guaranteeing the right to health, in the sense of equity, taking actions to avoid discrimination against the LGBTQ audience. According to Margolies and Brown (2019), the greatest role of nursing for the LGBTQ public is the guarantee of dignified and humanized care from primary health care, perpetuating at medium and high complexity levels, respecting differences, and providing humanized and quality care.
Conclusion
Through the proposed policy, nurses will be aware and equipped with all the knowledge needed to provide equitable care to all LGBTQ patients. Non-compliance in the health sector with the typical needs of the LGBTQ population translates into estrangement and distrust on the part of the patients. Few people declare their sexual orientation in the medical field, this risks limiting the treatment process, and promotes the appearance of misunderstandings and discomforts, undermining trust in the professional. This distrust present in the patients allows the removal from care, negatively interfering with the person's overall well-being. The proposed policy will thus eliminate all these problems.
