LAUSR

International Journal of Palliative Nursing 2017, Vol 23, No 5 © 2 01 7 M A H ea lth ca re L td The month of May is a significant one for nurses: 12 May International Nurse’s Day, an event that commemorates the day Florence Nightingale was born almost 200 years ago. Less than a week later, on 17 May, is the International Day Against Homophobia, Biphobia, and Transphobia. These two events may seem to have little in common with one another but for nurses they are inextricably intertwined—or at least they should be. Florence Nightingale lived her life in ways that were markedly different from those of her female contemporaries. Referred to as ‘a man of action’ by biographer Sir Edward Tyas Cook three years after her death (Cook, 1913), Nightingale radically defied society’s expectations of what a person who was assigned female at birth should do or think. In short, Nightingale was gender non-conforming—or at least that’s what it looks like to me almost two centuries after her death. As to whether Nightingale was a lesbian, it’s impossible to know without asking her. If Nightingale were alive today, I would ask her for the words that best describe how she identifies. Who knows how she would have answered? In every part of the world where nurses practise, there are people who identify as lesbian, gay, bisexual, transgender, gender nonconforming, queer and/or questioning (LGBTQ). The words they use to describe themselves may vary, as may their willingness to speak these words out loud. When LGBTQ people are reluctant to share who they are with the nurses who care for them, that reluctance needs to be understood in context: being ‘out’ can cost an LGBTQ person their job, their housing, their family, or even their life. Under the Nightingale Pledge, nurses promise to ‘... hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling’ (McBurney and Filoromo, 1994), but do you really follow this pledge in practice by protecting LGBTQ people from having the most personal aspects of their lives made public beyond the confines of the nurse-patient relationship? When a patient tells you they are having sex with both men and women and you write this in their chart, who has access to that information? If a patient tells you that the sex they were assigned at birth does not align with their current gender identity and you note that in their chart, who has access to that information? Depending on the country where you practise and the laws in place regarding patient privacy, that information may be seen by the patient’s health insurance company, their employer, or even their government. Given that LGBTQ people face stigma, oppression, and even violence in the communities where they live, what are you doing as a nurse to ensure your LGBTQ patients’ information remains private? In honour of Florence Nightingale and the pledge that bears her name, I call upon nurses worldwide to do everything in their power to ensure that LGBTQ people feel—and are—safe in seeking healthcare from them. This requires a radical shift in the way you approach your care of all patients. When you meet a new patient, ask them what pronouns they use (e.g. she/her/hers, they/them/their, zie/zir) and whether you may use those pronouns in their chart, then use those pronouns consistently in al l of your documentation about that patient. Before you write information in a patient’s chart about their gender identity, sexual orientation, or sexual behavior, ask the patient whether they are comfortable with this information being documented in writing. Follow these two simple practices with all of the patients you care for— whether they identify as LGBTQ or not—and you will have taken an important step toward making the care you provide LGBTQ people inclusive. Your patients deserve no less.