Affirmative Palliative Care for Transgender and Gender Nonconforming Individuals.

ABSTRACT: Nurses have a professional and ethical responsibility to provide inclusive, affirmative palliative care to transgender and gender nonconforming (TGNC) individuals experiencing life-limiting illness or injury. In accordance with standards for professional nursing and health organizations, nurses must continue to take tangible steps to achieve a level of care that is affirming, holistic, nonprejudicial, and collaborative. Providing quality care for TGNC individuals requires informed, competent integration of palliative nursing care, gender-affirmative care, and trans-person-centered health care within nursing practice. An interdisciplinary national team of experts collaborated to identify ways nurses could better uphold their professional responsibilities to TGNC individuals with serious illness. The purposes of this article are to: 1) describe elements of TGNC-inclusive palliative nursing care; and 2) present eight concrete recommendations to achieve affirmative clinical practice for TGNC patients living with life-limiting illness and their family of origin and/or family of choice. These recommendations address professional development, communication, medication reconciliation, mental health, dignity and meaning, social support and caregivers, spiritual beliefs and religion, and bereavement care.

Improving Attitudes and Perceived Competence in Caring for Dying Patients: An End-of-Life Simulation.

AIM: The aim of this study was to assess learning outcomes from a simulation on providing care to a critically ill patient from whom care is ultimately withdrawn. BACKGROUND: Nursing students have anxiety and low perceived competence for caring for dying patients. Effective strategies for teaching communication, assessment, and basic nursing skills are needed. METHOD: A pretest-posttest design compared perceived competence and attitudes in caring for dying patients with three separate cohorts of undergraduate nursing students performing the simulation. RESULTS: The cohorts had significantly improved scores on the perceived competence (p < .001) and attitude (p < .01) measures following the simulation. Reliability for a new instrument to assess perceived competence in caring for dying patients was also established. CONCLUSION: This study's simulation offers a robust teaching strategy for improving nursing students' attitudes and perceived competence in caring for dying patients.