An Approach to Manage Agitation

Le résumé fourni par la source

Have we overlooked our Filipino nurses? As a clinical nurse specialist, I oversee nurses from diverse cultures and backgrounds, many of whom, like me, are Filipino. These nurses provide postoperative care for transgender and gender-nonconforming (TGNC) patients who have undergone gender-affirming surgeries. It is a wonderful, enriching environment to work in. Yet, despite this progress, misgendering remains a persistent issue—especially among my Filipino colleagues—and I have yet to see training opportunities that address the unique challenges Filipino nurses face when adopting gender-inclusive language.Misgendering of TGNC patients by Filipino nurses is not intentional. Tagalog, the official language of the Philippines, is a primarily gender-neutral language. The challenges lie in the linguistic similarities between Tagalog and English, particularly with pronouns.In Tagalog, the pronoun siya, (pronounced as “shah”) is used for both “he” and “she.” Although technically gender neutral, it sounds feminine to the North American ear. As a result, many Filipino nurses, particularly first generation, may default to using “she” when speaking in English, regardless of the patient’s gender identity. This linguistic carryover is unintentional but still problematic, especially in a health care setting where accuracy and respect for language are vital.Misgendering is harmful to both TGNC patients and Filipino nurses. For TGNC individuals, misgendering can exacerbate the discrimination they already face in health care, contributing to mistrust and fear of medical professionals. This fear, in turn, can delay care seeking and negatively impact patient outcomes. A history of marginalization has made many in the TGNC community wary of health care systems, and frequent misgendering further entrenches these barriers to care.For Filipino nurses, the consequences are equally serious. Consistently misgendering patients can lead to disciplinary actions, legal repercussions, and damage to professional reputations. The stress of such consequences can contribute to burnout, depression, and other mental health challenges. When nurses feel unsupported in their professional development, it not only affects their well-being but also the quality of care they provide.At this critical juncture, it is more important than ever to bridge the gaps between diverse cultural practices and the expectations of modern health care. The World Professional Association for Transgender Health has acknowledged the limitations of their standards of care when applied outside Western cultural contexts. However, as long as the United States continues to rely on internationally trained nurses to address the national nursing shortage, we must ensure that cultural competency training is provided to these nurses—particularly when it comes to gender-inclusive language.Future revisions of World Professional Association for Transgender Health standards of care should include guidance on how health care systems can support immigrant nurses in becoming culturally competent in using gender-inclusive language. This approach will not only benefit TGNC patients but also contribute to a more inclusive and effective health care environment for everyone.The ancient Greek poet Archilochus once said, “We don’t rise to the level of our expectations, we fall to the level of our training.” It is time we provide the necessary training for Filipino nurses—and all health care providers—so they can meet the expectations of their patients and offer the compassionate, respectful care that every individual deserves.

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