Renew the Nursing Profession to Attract New Forces and Be Increasingly Inclusive and Attentive to Diversity

Abstract

We greatly appreciated the work by Nicoletta Dasso et al. on the experience, perspectives and feelings of transgender people during hospitalisation recently published in the Journal (Dasso et al. 2024).

The authors confirm the disparities and suffering that trans or gender diverse people endure when they have to face a treatment path. Health professionals cannot accept this state of affairs, and we should put all our efforts into overturning this situation. These aspects cannot be overlooked in the search for new perspectives and a renewal of the nursing profession. These are issues that should rightfully become part of the sociocultural baggage of the nurse. Interest in the person, attention to care, availability towards those who are in difficulty and are seeking support and attention and long for a helping hand, are the sensibilities of all we health professionals. However, these sensibilities clash with reality, with our social and cultural backgrounds, with the structures that surround us and the interactions we find in the environments we frequent and where we work.

The stress and dissatisfaction that nurses often experience at work today (Ginaldi et al. 2024) reduce sensitivity and sometimes amplify deafness and blindness to the needs and attention-seeking demands of the people we have to take care of.

We should also recognise that inclusion and acceptance of diversity is sometimes a problem that is also found within our teams. Furthermore, trainers themselves are often not adequately educated on the issues of diversity and inclusion (Ginaldi and De Martinis 2024a). How can we expect that all this, if not reported and addressed, does not substantially impede the harm caused by our structures and in our welfare processes towards minoritized and marginalized populations?

The authors certainly have not underestimated these aspects, which also concern the nursing profession within the multiprofessional teams responsible for care processes and their call to action appeals precisely to the sensitivity of nurses and probably to the fact that the latter are, in the process of team, the closest and most intimate link with the patient. These are therefore the professionals who, better and sooner than others, can make themselves welcoming, break down any type of barrier and approach anyone who needs listening, care and support.

But other team members should not exempt themselves from this responsibility, we should all feel like protagonists in this call to action.

The idea of health equity translates into providing safe care to all people, regardless of sexual preference, orientation or identity, and requires creating a safe and nonthreatening environment for all patients, including transgender patients (Ginaldi and De Martinis 2024b). Nurses have a key role in rebuilding a healthcare system where transgender patients do not have to worry about being treated as special cases.

We should be able to reshape systems and social conditioning at broader levels to include the trans and gender nonconforming experience as part of the normal, rather than always the exception.

These requests addressed to nursing staff should not be seen as an additional burden in this moment of crisis for the profession but as a stimulus to renewal, the search for new models, the affirmation of new roles and new responsibilities in our healthcare systems.

Nurses who are unaware of how care can be influenced by explicit or implicit bias may inadvertently engage in stereotypical transphobic behaviours or engage in microaggressions. In contrast, self-awareness can enable a nurse to exercise greater empathy and sensitivity in their role, being welcoming and engaging with the patient to support them in their care journey.

The renewal of the profession must involve study courses that should be promoters of this new vision of nursing (Ginaldi et al. 2024; Sirufo et al. 2022): more autonomous, more responsible, more involved in decision-making and organisational processes, more specialised but always welcoming, inclusive, close and sensitive to the needs of all citizens.

The authors declare no conflicts of interest.