January 24, 2009, 1:20 pm

Health Care for Lesbian/Bisexual Women: Did You Know?

Why is a nurse talking about dentists and tooth decay?

Nice cap, but I’ve never had an RN talk to me about tooth decay.

Wouldn’t an “ammoniated dentifrice” taste like, yuck?

3 out of 4 dentists recommend it?

I’ve had two dentists in my lifetime and neither one of them ever even said the word “Amurol” to me.  They must have been in the other 25%.

“Minty taste”? Try ammonia breath.

And, um, isn’t Amurol something that you put on your tires?

Oh, wait that’s Armor All.

Ah, tires!

Only 21 days until the Daytona 500.

You knew I was going to fit that in somehow, didn’t ya?


Editrix Jenni of ChronicBabe.com is hosting Grand Rounds this week and her theme/topic is Totally Babelicious: A Focus on Women’s Health Care Issues.”

I wanted to look at women’s health from a different angle.

There are great blogs out there on living with chronic illness, breast health, heart health and women’s sexuality.

What I don’t see are a lot of blogs about health care for lesbian/bisexual women.

So I went to the Gay Lesbian Medical Association. And I downloaded their pdf: “Guidelines for care of Lesbian, Gay, Bisexual and Transgender Patients”.


I honestly thought there was no big deal between the health of lesbian women and heterosexual women. We all face breast, uterine and ovarian cancer. We all face heart disease.

We are all women, after all.

But unlike those of us who are heterosexual, our lesbian sisters, relatives, friends, colleagues and partners have risk factors and face barriers to health care you may not realize.

And what I am about to tell you is pulled right from the GLMA pamphlet.


Did you know…

  • Lesbian/bisexual women are at higher risk for chronic stress, depression, anxiety and other mental health issues because of the stigma, harassment and discrimination (or fear of same) associated with being homosexual. Fear of being judged or discriminated against often prevents a lesbian or bisexual women from seeking health care.

Did you know….

  • A lack of appropriate health care education could cause a lesbian/bisexual woman to forgo necessary screening, perhaps believing that pap smears and other tests are not required for homosexual women. Problems like cancer might not be caught in the early stages. If you don’t access health care personnel, you miss out on health-related education and information.

Did you know…

  • Lesbians have lower health insurance rates than their heterosexual counterparts? Why? Marriage and employment are the two primary routes to healthcare in the United States. (Some states recognize domestic partnerships, some do not). Your patient’s partner is less likely to be insured.  Less insurance means less money for follow-up visits or expensive medications.

Did you know…

  • Lesbian women are more likely to be overweight than heterosexual women. Let me quote directly from page 26 of the pamphlet because the studies behind why this is are interesting (italics mine): “There is evidence that lesbians are more likely to be overweight than their heterosexual counterparts, possibly because of cultural norms within the lesbian community and because lesbians may relate differently to, not accept or not internalize mainstream notions of ideal beauty and thinness. While lesbians as a group tend to have better body image than heterosexual women—a positive health characteristic—they may consequently be  less motivated to avoid being overweight.”

Did you know?

  • That smoking and substance abuse are found more often in lesbian populations, not only because of stress, but because of the “prominent role that bars and clubs have played in lesbian subcultures and as “women-only” spaces.


So what can we do to make it easier for our lesbian/bisexual patients?

  • Understand that there is no “unique” lesbian patient; that lesbians are as diverse as the rest of the     patients we care for in race, language, appearance.
  • Be accepting and non-judgmental in your care. An accepting health care environment is likely to lead to willingness to access further health care, leading to further health education. Discussing sexuality is never easy, but don’t be afraid to ask the right questions or just assume that your female patient is heterosexual.
  • Make sure your patients have options – remember that like any patient population, it is possible the lesbian patient may not have insurance. Access to many options is appreciated.
  • Education is key. Lesbian women need to know they are just as likely to develop heart disease, diabetes, COPD, and STDs as any other patient population.

If you provide a warm, welcoming and open environment for your lesbian/bisexual patients you
help promote not only sexual health, but their entire physical health. When they need information, they will gravitate to the health care environment that is most accepting.

And information is power.

The power to make the appropriate decisions for your health care.

Gee.  Maybe we aren’t so different after all.


If you work in a practice with gay, lesbian, bisexual or transgendered patients, I really suggest you download the GLMA pamphlet. It’s full of good information for caregivers on how we can support  our GLBT community.

January 21, 2009, 8:44 pm

Change of Shift: Vol. 3, Number Fifteen

Welcome back to Emergiblog, for the post-inaugural edition of Change of Shift!

If you didn’t get a chance to check out this week’s Grand Rounds, hosted by Dr. Val of Getting Better With Dr. Val and presented at MedPage Today, be sure to do so!

As is the custom on Emergiblog, since the “theme” is nursing, I’ll present the submissions themselves as the theme of the edition.

Also, the schedule for Change of Shift is now posted through 2009, so if you would like to host an edition, please shoot me an email (see Contact button above) and I’ll be happy to schedule you in!

Note: An important message follows this week’s submissions.


There are so many nurse blogs I am discovering for the first time. Although Shrtstormtrooper (gotta watch the spelling on that one!) has been blogging for over a year, I have just discovered this great blog from a blogger with “no verbal filter”. The Diving Bell and the Butterfly is a post written by our colleague after reading the book of the same name. The post will give you a lump in your throat, and is found at New Nurse Insanity: Fundus Chop!

Keith at Digital Doorway is concer. A new television show. “The United States of Tara” follows a main character with Dissociative Identity Disorder (aka: Multiple Personality Disorder). Will it lead to understanding or be used solely for humor? Keith muses over how mental health has been treated in the media and he doesn’t sound too optimistic about this latest foray into the arena.

Marijked is a nurse of many talents, and this week she is wondering Do You Have a Living Will? The post can be found on her Senior Support blog, along with a link to a survey she would love to have you complete. It takes less than a few minutes – I took it today!


Long time Emergiblog supporter/sponsor (thanks, guys!), NurseConnect has submitted three posts for Change of Shift this week.

In Career Transitions and Other Nurse Topics, Nurse Laura takes on Ratios and Reform. Are ratios enough to keep nurses at the bedside? Are there other aspects of care that need to be addressed? A though provoking post; weigh in with how you feel about ratios.

Nurse Kathy, in Nursing Dynamics and Clinical Issues, discusses The New Generation of Nurse. I have only one thing to say: I LOVE THIS POST! Being at the age I am now, I am so into giving back to the profession and my daughter will be one of the new generation in 3 1/2 years. Thanks Kathy, you have great insight into what the future of nursing needs, people like YOU!

NurseConnect also invites guest bloggers to weigh in on nursing issues, and this time the Nursing Guest Blog is written by Karen Siroky, the Director of RN.com. Karen asks What Does Specialization Mean to Nursing? It is a great post and has given me an idea for a post of my own. So, what do you think?


Now for the important announcement.

Or, more like an important discussion.

These were the only nurse related posts I received.

Oh, there were about 2/3 more. All from Blog Carnival, and not a single one from a true blogger let alone  nurse-related in any way. I try to be inclusive of everyone I can but enough is enough.

I was going to go out and find great nursing posts and include them in this edition (and I KNOW you are all out there!) but I wanted to get some feedback. What do you think should happen in a case where the majority of submissions have nothing to do with nursing?

  • If nursing-related posts are few, should the host go “looking” for some great posts by or about nurses?
  • If you run across a great post on another blog, would you be comfortable submitting it for the blogger?
  • If you are a blogger yourself, would you be comfortable having your blog post included in Change of Shift?  Would you prefer the post-er ask your permission?


I’ll be honest. I see “Change of Shift” as our (nurses) “baby”. Well, our “baby” has reached adolescence and is having an identity crisis.

IMO, we need to keep CoS as nurse-focused as possible.

That means we need as many nurses as possible to submit their posts, or have their posts submitted.


I need your ideas.

Do we need more aggressive marketing? Should we issue personal invites to submit? Should hosts be able to just “put in” posts that they think are great? Should we have a “Blog of the Week” selection, by the host?


Don’t MAKE me come OUT there…

Just kidding.

Change of Shift will be as good as the nurses who contribute. Nurse bloggers rock, ergo “Change of Shift” should rock.

So, all comments welcome!

Hit me with your best shot!

January 19, 2009, 9:08 pm

Medblogger Meet-Up: Making Progress

Well, I am one happy camper today, let me tell you!

That is The King himself, Richard Petty!

And Petty Enterprises has merged with Gillette/Evernham Motorsports to become….

Richard Petty Motorsports!

The reason I’m so happy? Kasey Kahne is now driving for the team that bears Richard Petty’s name.

It’s hard to explain how totally cool this is to someone who is not into Nascar, but everyone knows the Petty name!

(This great picture was taken for NASCAR Scene by David Griffin)


This photo of my daughter Lillian and our cat Mork was taken in 1981.

I thought catching the smile on both of them was priceless.

I sent the photo into the “I Can Haz Cheezeburger” site with this caption, and it made the regular site!

I nearly fell over.

Between talking to Richard Simmons this week and then having Lillian’s photo show up online, what’s next? Is Ty Pennington going to tell them to “Move that bus!” in front of my house?


The work-behind-the-scenes of our first Medblogger Meet-Up is progressing.

First of all, there were six topics in our medblogger poll that stood out from the others.   After a total of 83 votes, these are the six topics rose to the surface, in order of popularity:

1.  Blogging for Change: Blogging as Vehicle for Change/Activism in Healthcare (55.4%)

2.  Blogger’s Block: Keep the Passion in Your Posting (55.4%)

3.  The Danger Zone: Staying on the Good Side of HIPAA (54.2%)

4.  Let’s See How Far We’ve Come: The State of the Medical/Health Blogosphere (50.6%)

5.  Healthcare Blogger Code of Ethics:  Why You Want to Wear the Widget (48.2%)

6.  Blogging for a Living: Leveraging Your Expertise (45.8%)

So sponsors are now coming on board (Johnson and Johnson there from the start!), and the big decision is where we are going to hold the meet-up and how we can keep it affordable for our bloggers (us!).

The exciting thing is, it is no longer an idea and is quickly becoming a reality.

I promise to post more info as things become finalized.

I am stoked!

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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