Part 1 The Calos-Clark Family
1.3 Calos-Clark family case study 2: Ethics and inclusion
Jennene Greenhill and Anna Foster
Introduction to case study
Learning Objectives
By the end of this case study, you should be able to:
- Align your personal and professional ethics in nursing.
- Identify core ethical principles that apply to practice.
- Appreciate the importance of inclusion and equity in nursing.
- Reflect on how to advocate for communities and individuals under your care.
Scenario
Following Giani’s operation, Jay was with Giani most of the afternoon. They had 2 visitors in the evening, their friends Teal and Harper, one non-binary and the other trans. They are fellow performers, both flamboyant and funny. When they arrived with a large basket of snacks and a bunch of rainbow balloons, they said, ‘Hey girl, how are you feeling? Ready to “partaay” yet?’ They laughed and joked to cheer up Giani. He was a bit tearful when they left.
After they left, Jay went to the kitchen to make he and Giani a cup of tea. While there, he overheard 3 nurses talking in the nurses’ station, 2 senior RNs and one 20-year-old graduate RN. One of the senior RNs said, ’Did you see those visitors in room 3? I’m not saying I don’t accept them, but I just wish they would be a bit quieter’. The other senior RN chuckled and agreed, saying, ’I’m glad I’m not on that side of the ward tonight. I don’t know why they need to be so overt?’ The graduate nurse was silent for some time during this conversation, until Jay heard her say to the other nurses, very quietly, that those comments weren’t appropriate. She said, ’I don’t want to upset you both, but are you aware those kinds of comments are now illegal, as they are homophobic?’ One of the senior nurses replied, ‘Ahh come on, if they didn’t want to be discussed they wouldn’t be so out and loud. They must want the attention to behave like that’. She laughed with the other senior nurse. Jay could hear the nervousness in the young nurse’s voice. As she walked past him in the tea room, he could see she was close to tears.
Jay and Giani grew up during a time when being gay was a criminal offence. Jay had heard these kinds of comments for years and couldn’t believe it was the responsibility of a 20-year-old to educate fellow colleagues on inclusive language. The following morning, he complained to the nurse unit manager (NUM) who was shocked. She apologised to both Jay and Giani. She took a considerable amount of time to listen and talk with Jay about the incident, took many notes and later completed an incident report on the situation. She then contacted HR, who advised her to inform the assistant director of nursing in writing, including an action plan. The action plan covered individual counselling for the 2 nurses and broader education for the whole interprofessional team.
The NUM went back to Jay after the counselling session and closed the loop by informing Jay of the outcome of the incident reporting and process. When she told Jay about the education session coming up, he offered to come back as a volunteer to help educate the staff on how to care for LGBTIQ+ patients and about discrimination, inclusion and equity. The NUM was grateful for Jay’s offer, however the hospital employed an academic from a nearby university who had undertaken research in this field, and Jay assisted to deliver a series of staff education sessions.
Case study questions
- How would you feel in this situation, overhearing commentary like this about the people you love?
- How could such behaviours and attitudes impact on the quality and safety of patient care?
- What does the legislation say regarding legal rights and anti-discrimination for LGBTIQ+ peoples?
- What escalation tools are available for junior staff to interact with senior staff in difficult situations?
- What do the Registered Nurse Standards for Practice say about how the rights of LGBTIQ+ individuals can be protected?
- In what ways does this case study shape your own future professional identity?
- How would you demonstrate professionalism in this type of scenario?
Key information and links to other resources
- LGBTIQ+ Health Australia
- Rainbow Health Australia: Research & resources: This website has resources to help individuals and organisations to develop services that are inclusive for LGBTIQ+ staff and clients.
Thinking Point
Think about how we communicate with each other as health professionals in the clinical environment. We are often guilty of discussing patients in a less than professional way when we think we are alone with other healthcare practitioners. If this were your family member you overheard being discussed in this way in an environment that should be safe for all patients and families, what would you do after hearing these comments? Would you feel safe leaving your loved one receiving care from a health professional after they expressed opinions like these? What could they (or you) do differently to ensure they were providing safe responsive care to their patient, and their patient’s families and friends?
Case study 2 summary
While Giani and Jay are extremely disappointed that this had happened at all, they appreciate the way the nurse unit manager took their concerns seriously and dealt so promptly with the issue. Jay returned to the ward 2 weeks later to help provide education on the history of healthcare in the gay community by sharing his personal experiences. The education sessions provided insights about what the community has overcome to get to this point of greater equality and what needs to happen to continue this journey towards respect for LGBTIQ+ patients, families and friends. The 2 nurses involved approached Jay and Giani at a later point after the counselling they received. Each separately apologised for their role in distressing Jay and Giani. Jay approached the graduate nurse on a later shift when she was again caring for Giani to thank her for her attempt to intervene and stop the cycle.