A couple of months ago, I got an email that sent chills down my spine. And I mean the good kind of chills that you get when something you have hoped for and anticipated for a long time finally happens. The email was from a faculty member of a Midwestern College of Nursing announcing that their curriculum committee had approved a plan to integrate their entire undergraduate program with LGBTQ content. This was a unanimous decision by the committee, with only a little prompting from the one out lesbian faculty member on the committee. But as Fidel Lim found out when he surveyed nursing faculty about their willingness, comfort level, and knowledge about LGBTQ issues, willingness alone is not enough. The faculty needed training. I was invited to come to the school to present an LGBTQ basics lecture to faculty and students, and to talk to faculty about integrating their own courses. I gave the request a few moments of thought, but since I have been nagging nursing programs to do this for almost 30 years, how could I say no?
The experience raised a lot of questions for me. Thirty years ago, when I first began my career in nursing education, there was virtually no mention of LGBTQ issues in nursing journals. Happily, that is changing, but more slowly in nursing than in medicine and the social services and sciences. There is a vast body of literature about LGBTQ health disparities, but little of it in the nursing literature. Did we have a sufficient literature within nursing to guide our curricular integration? It’s time for a comprehensive bibliography of that work so we can take stock on what we know and where the gaps of knowledge are.
Secondly, in the course of developing the 3-hour basic training, I spent a lot of time agonizing about what to include. Some schools might only deliver a basic lecture, so it needs to be meaty enough to give students the essentials, but what are the essentials? I decided that it would be great to have an expert panel to develop this content, along with a bibliography of articles that could be used in specialized courses. This would need to be updated every few years. Perhaps the GLMA Nursing Section could do this, or the Expert Panel of AACN? I opted to focus primarily on the issues that cut across the subgroups of lesbians, gay men, bisexual people, and transgender people, with only a few slides on any specific group. I spent a lot of time on terminology, since nurses still seem to be unfamiliar with the labels and the differences between sexual and gender identities and expressions.
Thirdly, I brought along the Nurses’ Climate Scale developed by the GLMA Nursing Section last year. I discovered just how complex the issue of gathering this information was. Well-informed faculty and administrators were present, including highly renowned lesbian health researchers and local level activists within the healthcare system of the university, and no one could answer all the questions. I spent the plane ride home developing a worksheet to go with the one-page document, and plan to launch a study in the near future. Along with curricular changes, the climate of nursing schools and practice settings needs to change.
So my challenge to readers of this blog is this. We have reached a pivotal moment in nursing history, where schools/colleges of nursing have finally recognized the need for LGBTQ content and are willing and ready to start the integration. We need to provide the tools so that this effort does not stall in the implementation details. Are we ready?