Observations of homophobia in the trenches

[fantasty]

So, I recently changed practice settings. I'm now working in nursing homes, and it's been quite a culture shock (clinically). But, aside from that, I definitely have a different level of ... psychiatric acuity... than I'm used to. To be clear, there's a lot of long-term care in my facilities that are dementia patients and aren't the best in communicating at all. But, at least in this area, there's a whole lot of younger folks who need nursing home care due to a lifelong history of abusing their bodies (substance abuse is part, but also obesity / diabetes, as well as just about anything you might correlate with low SES, low education, lifetimes living in a depressed economy, and often homelessness).

As I just started in these places, I haven't come in with a blazing rainbow flag or "queer pride" tattoo on my forehead. But, I don't hide that I'm married with husband. I do have HRC stickers on some of my clipboards. And, we clearly have "family" in the staff (including some folks that I feel that I can safely assume are trans-* even though I haven't specifically talked to them about it yet).

I was in-house late on Thursday signing paperwork and finishing up notes for the day [at my newest site, so the one I've only been at a few times]. I wouldn't say I was "hiding" from this resident, but she had made it clear earlier in the day that she was upset about news that my NP gave her, and I explained that I would not be able to address her concerns until the next day (when my NP and I could talk; and to be clear, it wasn't a medical issue that she was mad about - it was more in the realm of the social workers).

So, the residents at this place due tend to sit out in the hallways with the staff while they are passing meds and what-not. The evening nurse (who happens to be an older male, and I wouldn't be surprised if he was family, but that's irrelevant) was keeping her occupied when she decided that she needed to talk about the gays. In her keen observation, she noted that one of our employees is very effeminate and probably one of the gays. She then clarified that she doesn't have "a problem" with the gays as long as they don't touch her. And, mentioned her obligatory gay friend. Then said the phrase that I used to hear all of the time but not some much anymore... "It's just, when I think about them kissing and stuff, I want to puke.". I used to hear that a lot at my old hometown, well before I came out. And, even sometimes when I had the awkward coming out conversation with my .... less enlightened family and acquaintances.

Part of me wishes that I had stepped out of my office with some perfectly worded phrase about her gay doctor who's going to be spending a fair chunk of his day doing her a favor... But, I didn't do so. And, I know that I'm professional enough that I won't let that interaction (which went on for a while but you get the overall tone) affect my care. And, even if I wasn't confrontation about it, I'm sure if I had the energy I could have made it a teachable moment and also done a better job ensuring that we all work in a safe, inclusive environment.

I also don't want to make it sound like I'm defeated already. But, at the facility that I've been at the longest, we have some dementia patients that are calling staff racial slurs on a daily basis. So, I'm going to have to pick my battles.

Thanks for listening

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[fantasty]

(Oh yeah - I forgot to order her zofran for her nausea)

 

[DokterMom]

The times, they are a changin' -- But not fast enough, it seems.

It's likely that when this resident was young (and forming her mindset) that gays were either closeted or imprisoned. If picturing homosexual sex makes her queasy, I'd suggest she imagine her parents at it instead. Doubt she'll make the mental leap, but it could conceivably get through to her that not picturing anyone doing it is the better way to go...

 

[Goro]

So, I recently changed practice settings. I'm now working in nursing homes, and it's been quite a culture shock (clinically). But, aside from that, I definitely have a different level of ... psychiatric acuity... than I'm used to. To be clear, there's a lot of long-term care in my facilities that are dementia patients and aren't the best in communicating at all. But, at least in this area, there's a whole lot of younger folks who need nursing home care due to a lifelong history of abusing their bodies (substance abuse is part, but also obesity / diabetes, as well as just about anything you might correlate with low SES, low education, lifetimes living in a depressed economy, and often homelessness).

As I just started in these places, I haven't come in with a blazing rainbow flag or "queer pride" tattoo on my forehead. But, I don't hide that I'm married with husband. I do have HRC stickers on some of my clipboards. And, we clearly have "family" in the staff (including some folks that I feel that I can safely assume are trans-* even though I haven't specifically talked to them about it yet).

I was in-house late on Thursday signing paperwork and finishing up notes for the day [at my newest site, so the one I've only been at a few times]. I wouldn't say I was "hiding" from this resident, but she had made it clear earlier in the day that she was upset about news that my NP gave her, and I explained that I would not be able to address her concerns until the next day (when my NP and I could talk; and to be clear, it wasn't a medical issue that she was mad about - it was more in the realm of the social workers).

So, the residents at this place due tend to sit out in the hallways with the staff while they are passing meds and what-not. The evening nurse (who happens to be an older male, and I wouldn't be surprised if he was family, but that's irrelevant) was keeping her occupied when she decided that she needed to talk about the gays. In her keen observation, she noted that one of our employees is very effeminate and probably one of the gays. She then clarified that she doesn't have "a problem" with the gays as long as they don't touch her. And, mentioned her obligatory gay friend. Then said the phrase that I used to hear all of the time but not some much anymore... "It's just, when I think about them kissing and stuff, I want to puke.". I used to hear that a lot at my old hometown, well before I came out. And, even sometimes when I had the awkward coming out conversation with my .... less enlightened family and acquaintances.

Part of me wishes that I had stepped out of my office with some perfectly worded phrase about her gay doctor who's going to be spending a fair chunk of his day doing her a favor... But, I didn't do so. And, I know that I'm professional enough that I won't let that interaction (which went on for a while but you get the overall tone) affect my care. And, even if I wasn't confrontation about it, I'm sure if I had the energy I could have made it a teachable moment and also done a better job ensuring that we all work in a safe, inclusive environment.

I also don't want to make it sound like I'm defeated already. But, at the facility that I've been at the longest, we have some dementia patients that are calling staff racial slurs on a daily basis. So, I'm going to have to pick my battles.

Thanks for listening

I have to laud you for not reacting. Being a New Yorker, I do not suffer fools lightly, and would have had a hard time NOT jumping down her throat.

I suppose educating one person at a time is the way to go.

 

[12glaucoma34]

So, I recently changed practice settings. I'm now working in nursing homes, and it's been quite a culture shock (clinically). But, aside from that, I definitely have a different level of ... psychiatric acuity... than I'm used to. To be clear, there's a lot of long-term care in my facilities that are dementia patients and aren't the best in communicating at all. But, at least in this area, there's a whole lot of younger folks who need nursing home care due to a lifelong history of abusing their bodies (substance abuse is part, but also obesity / diabetes, as well as just about anything you might correlate with low SES, low education, lifetimes living in a depressed economy, and often homelessness).

As I just started in these places, I haven't come in with a blazing rainbow flag or "queer pride" tattoo on my forehead. But, I don't hide that I'm married with husband. I do have HRC stickers on some of my clipboards. And, we clearly have "family" in the staff (including some folks that I feel that I can safely assume are trans-* even though I haven't specifically talked to them about it yet).

I was in-house late on Thursday signing paperwork and finishing up notes for the day [at my newest site, so the one I've only been at a few times]. I wouldn't say I was "hiding" from this resident, but she had made it clear earlier in the day that she was upset about news that my NP gave her, and I explained that I would not be able to address her concerns until the next day (when my NP and I could talk; and to be clear, it wasn't a medical issue that she was mad about - it was more in the realm of the social workers).

So, the residents at this place due tend to sit out in the hallways with the staff while they are passing meds and what-not. The evening nurse (who happens to be an older male, and I wouldn't be surprised if he was family, but that's irrelevant) was keeping her occupied when she decided that she needed to talk about the gays. In her keen observation, she noted that one of our employees is very effeminate and probably one of the gays. She then clarified that she doesn't have "a problem" with the gays as long as they don't touch her. And, mentioned her obligatory gay friend. Then said the phrase that I used to hear all of the time but not some much anymore... "It's just, when I think about them kissing and stuff, I want to puke.". I used to hear that a lot at my old hometown, well before I came out. And, even sometimes when I had the awkward coming out conversation with my .... less enlightened family and acquaintances.

Part of me wishes that I had stepped out of my office with some perfectly worded phrase about her gay doctor who's going to be spending a fair chunk of his day doing her a favor... But, I didn't do so. And, I know that I'm professional enough that I won't let that interaction (which went on for a while but you get the overall tone) affect my care. And, even if I wasn't confrontation about it, I'm sure if I had the energy I could have made it a teachable moment and also done a better job ensuring that we all work in a safe, inclusive environment.

I also don't want to make it sound like I'm defeated already. But, at the facility that I've been at the longest, we have some dementia patients that are calling staff racial slurs on a daily basis. So, I'm going to have to pick my battles.

Thanks for listening

The best thing you can do is provide her exceptional medical care and form a good doctor-patient relationship with her. After this is established, her position on how she treats and thinks about gay people will most likely change.

 

[12glaucoma34]

I have to laud you for not reacting. Being a New Yorker, I do not suffer fools lightly, and would have had a hard time NOT jumping down her throat.

I suppose educating one person at a time is the way to go.

Or you could disagree with her position, but not be an intolerant jerk. "Jumping down her throat" will not solve anything and make you look like a *****. Tolerating others perspectives and trying to understand them is far more effective.

Something more effective would be to acknowledge you are gay and then be the best possible doctor you can be for her. Bend over backwards to do everything to help her and she will change her tune.

 

[BonsaiClouds]

Good that you kept your composure... Must be very tough, but I suppose a little thanklessness is sadly part of the job.

 

[clinicalpresentations]

It's probably extremely wrong to think this way, but whenever I think about elderly patients who have the classic bigoted attitudes of their age group, I comfort myself that they will eventually die and their bigotry with them - I just have to outlive them.

Then I have to go away and cleanse my soul by giving pediatric patients lollipops because that's so wrong...

 

[24blue8]

It's probably extremely wrong to think this way, but whenever I think about elderly patients who have the classic bigoted attitudes of their age group, I comfort myself that they will eventually die and their bigotry with them - I just have to outlive them.