Avoid gender assumptions
I was thrilled to see the article "Providing Culturally Proficient Care for Transgender Patients" (February 2015).* As a long-time transgender health advocate, I've witnessed how critical it is to treat transgender people with respect and compassion in healthcare settings. I'd like to correct a statement that reads, "Transgender men feel innately that they're truly female and transgender women believe they're genuinely male." In fact, it's the opposite. Transgender men were born female at birth and now identify as male or on the masculine spectrum. Transgender women were born male at birth and now identify as female or on the feminine spectrum.
Always refer to transgender people by the name and pronoun that corresponds with their gender identity. Use "she" for transgender women and "he" for transgender men, even if you aren't in the patient's presence. If you're unsure about a person's gender identity or how the person wishes to be addressed, ask politely for clarification. For instance, you can ask, "How would you like to be addressed?" or "What name would you like to be called?" To facilitate a good provider-patient relationship, be careful not to make assumptions about the identity, beliefs, concerns, or sexual orientation of transgender and gender nonconforming patients.
The EHR in the room
As an assistant CNO and former director of clinical applications, I've successfully implemented a number of informatics projects. The article on nursing informatics leadership offered an uplifting glimpse into the role but failed to emphasize one of the most important challenges nursing informatics leaders are facing ("Nursing Informatics Leadership: Helping Craft the Profession's Future," December 2014).* Nurses spend less than 50% of their time at the patient's bedside, leaving nursing informaticists the challenge of improving efficiency while maintaining necessary documentation.1
As nurse leaders, we must all acknowledge the Elephant Hiding in the Room: not all electronic health records (EHR) are created equal. EHR fatigue is on the rise; antiquated systems and excess requests for clinical decision support can decrease the quality of patient care.2
Nurse informatics leaders must work with nurses at the bedside to drive change to establish and improve systems to support high-quality patient care.3
-KARA DESIDERIO, BSN
Brooklyn, NY
-CHASE PENDERSEN, BSN, RN, CEN, HACP
Austin, Tex.
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