Bell, Johnson Publish Case Study in Geriatric Nursing

Lacrecia Bell, clinical nurse educator, and Ragan Johnson, assistant professor, published the case study “Deep vein thrombosis in an aging transgender patient: Care and cultural considerations" in Geriatric Nursing. 

Abstract

This case highlights the importance of recognizing specific needs of aging sexual and gender diverse adults. Nurse practitioners often provide care with a heteronormative, cis-gendered frame of reference. “The term transgender is part of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) acronym, an acronym that represents both sexual orientation (LGBQ) and gender identity (T)”.1 Transgender adults identify variance between the sex that they were assigned at birth and how they identify their gender. The transgender older adult may demonstrate limited health seeking behaviors and acknowledge barriers to care, inclusive of discrimination and lack of honesty with providers. To help mitigate these barriers, the authors suggest the use of cultural humility when nurse practitioners are caring for sexual and gender minorities. Cultural competence suggests that there is a static knowledge that clinicians purport to know about patients’ varying race, ethnic, gender, sexual and socioeconomic identity. Care is often predicated on the assumption that the provider can obtain a level of “knowledge mastery” when caring for diverse populations.2 However, this concept of mastery can be discriminatory because inherent in the definition of “cultural competence” is the failure to recognize the dynamic and evolving nature and understanding of culture. Cultural humility prompts the provider to become a learner as it pertains to a patient's culture and expression of self.3 Employing cultural humility when caring for diverse populations negates the idea of knowledge mastery but encourages care providers to use techniques of inquiry, listening and self-reflection to provide individual care and facilitate trusting patient- provider relationships.4 This open shared communication facilitates mutual respect, and influences patients’ health seeking behaviors and patient outcomes. This case study will demonstrate the imperative that nurse practitioners must respond to in dually addressing the physiological and psychosocial needs of aging adult sexual and gender diverse patients.