‘He’s a Gay, He’s Going to Go to Hell.': Negative Nurse Attitudes Towards LGBTQ People on a UK Hospital Ward: A Single Case Study Analysed in Regulatory Contexts

ABSTRACT

Lesbian, gay, bisexual, trans and/or queer (LGBTQ) people experience profound health and social care inequalities. Research suggests that staff with negative attitudes towards LGBTQ people, are more likely to hold strong, traditional, religious beliefs. This article reports on a single case study with a newly qualified UK nurse who has since left the National Health Service. This is based on a single interview taken from a larger dataset derived from a funded scoping research study exploring religious freedoms, sexual orientation and gender identity rights in older age care spaces. The interviewee described a toxic nursing culture on a hospital ward for older people. She recounted various incidents involving homophobic and transphobic practice and LGBTQ microaggressions which reportedly impacted the quality of nursing care. The findings are considered in relation to standards for anti-oppressive practice in nursing care, and how nursing students and staff can be supported in addressing practice relating to equality and diversity issues, specifically LGBTQ issues. They confirm the direct significance of addressing the needs and circumstances of LGBTQ people in nursing curricula and ongoing professional practice, and the need to further research, evaluate and progress translation of learning into improved quality care for diverse populations.

KEYWORDS:

• LGBTQ
• nurse attitudes
• religion
• prejudice
• discrimination

Acknowledgements

Our sincere thanks to Rhiannon Griffiths for her excellent research assistance, and to the anonymous reviewers for their helpful comments on an earlier draft of this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

This project was granted ethical approval by the University of York’s Economics, Law, Management, Politics and Sociology Ethics Committee (ELMPS).

Additional information

Funding

This article is funded by a small pump-priming research grant from C & JB Morrell Trust Priming Funds (2019/2020), via the University of York.

Notes on contributors

Sue Westwood

Dr Sue Westwood is Senior Lecturer at York Law School, University of York, UK. She has previously been a research fellow/research associate at several universities, including the University of Oxford, UK, and the University of Surrey, UK, where she was a member of the Centre for Research on Ageing and Gender (CRAG). Sue was previously a Visiting Scholar at the Vulnerability and the Human Condition Initiative, Emory University School of Law, Atlanta, US. She has also taught law at Keele University, UK and Coventry University, UK, and the Chinese University of Hong Kong. Sue's research interests relate to LGBTQ ageing and equality in regulatory contexts. She has published extensively in the field, including in relation to health and social care provision, and has recently co-authored the following good practice guide: Westwood, S. and Price, E. (2023) LGBTQ People and Dementia: A good practice guide. Good Practice Guides in Dementia Care series, University of Bradford and Jessica Kingsley.

Jemma James

Jemma James is a qualified nurse and a PhD candidate in the Department of Nursing Midwifery and Health, Northumbria University, UK. Her professional interests include older peoples' nursing, care home nursing, integrated care, community and social care. Jemma has a background in project management and service design and delivery. She is passionate about research, particularly its implementation, and is a keen campaigner on nursing & older peoples' issues, from grassroots to government level.

Trish Hafford-Letchfield

Professor Trish Hafford-Letchfield is a qualified nurse and social worker with 18 years practice experience in social work. She is Head of the School of Social Work and Social Policy at the University of Strathclyde, UK. Prior to joining Strathclyde, Trish was Professor of Social Care at Middlesex University, London, UK. Trish has a strong interest in the rights of LGBT+ communities and is a founder member of the international LGBTQI social work network. She has over 100 publications including 19 key books covering a range of topics on leadership, management, organisational development, feminism, sexual and gender identities, values and ethics, gerontology, social work supervision. Trish has been involved in a wide range of funded research and knowledge exchange. She has recently co-authored a learning framework, produced for Skills for Care, the strategic workforce development and planning body for adult social care in England: Hafford-Letchfield, T., & Roberts, L. (2023). (LGBTQ+) Care in Later Life: A Learning Framework for Knowledge, Skills and Values for Working Affirmatively with LGBTQ+ People in Later Life. https://strathprints.strath.ac.uk/84379/