DiversityNursing Blog

As nurses we are taught that we are professionals and we must maintain a certain emotional distance with our patients. It’s a boundary that encompasses the therapeutic relationship: nurses as caregivers, patients as the recipients of the care. But now, working as a nurse, I have found that while most of my professional boundaries are well defined, sometimes the line between a professional and personal relationship with a patient can become blurred.

I work on an orthopedic surgical unit where most patients are coming in and going out very frequently. That makes it hard to get to know anyone too well. But there are some patients that we never forget, for good or bad reasons. Most of the time these patients stay with us because, for whatever reason, one of us crossed the invisible boundary nurses set for themselves.

Recently, I cared for two patients who touched me so deeply it was impossible to maintain a professional distance. My grandfather had recently passed away, and both of these men reminded me of him. My grandfather, or “Grand-Daddy” as we all called him, was one-of-a-kind, and one of the kindest and most generous people I’ve ever met. He was hard of hearing but constantly fiddled around with his hearing aids, so it was wise to always be prepared to repeat yourself once or twice. He had an extraordinary memory until the day he died, and was one of the funniest people I’ve ever known.

One day at work, an older man arrived on my floor after a total hip replacement. As I worked to admit him to our care, his room was crowded with half a dozen family members who surrounded him with love. I asked him about his family, and he told me about his eight children, 30 grandchildren, and a couple of great-grandchildren too. It was uncanny how much this man reminded me of my grandfather, who also had a large family of six children, 28 grandchildren and three great grandchildren.

I smiled as I watched my patient fiddle with his hearing aids, and tears welled up in my eyes as he answered all of my questions with a familiar, “What did you say?” I didn’t mind repeating myself, and for a moment, it was as if I was speaking with my grandfather again.

After I was finished admitting him and settling him in, I found myself constantly peeking back into his room asking if he was O.K. and if he needed anything. He was pretty low-maintenance and never really needed much, and eventually, he was gone. I never told him that he reminded me of my grandfather, or how he tugged at my heartstrings, and I often wonder if I should have. But I worried that in showing this man a little extra attention, I had somehow breached the therapeutic relationship.

Not long after that, another patient came up to the floor. The report said he was an older man who was in “comfort care.” This essentially means that no lifesaving efforts would be made on his behalf; we were there to keep him comfortable during his final days. When this patient came up to the floor, I was quite taken by him. His gruff, Irish exterior belied his sweet nature. Medically, he had a lot of issues, but when he came up to the floor, the only thing he wanted was a bowl of oatmeal. When his tray came, he found cream of wheat instead. He was so disappointed, but I was determined to find him a bowl of oatmeal.

Miraculously, after a search through our floor kitchen, I found oatmeal and delivered it to him. He was delighted and blew me a kiss and gave me a wink. His chart said he needed assistance to eat, but he dug right in. Sure, he made a mess, but he managed just fine on his own.

Watching him eat that oatmeal reminded me of some of my last meals with Grand-Daddy. Grand-Daddy never was the neatest eater, and we would always laugh about what a mess he made. But he didn’t care — at his age, he just wanted what he wanted when he wanted it. My patient’s personality was strikingly similar to that of my grandfather. As he lay curled up in the bed, I thought about the strong man he must have been a long time ago.

When his wife and children came to the room, I felt a pang of familiarity. His wife remained so graciously composed during her visits. It brought back memories of my grandmother during my grandfather’s last days. Despite her deep sadness and fear of what was to come, my grandmother kept full composure and took care of not only him but also everyone around her. I still am amazed by how strong and selfless she was during that time: a true role model for unconditional love, and I saw these saintly qualities in this man’s wife.

The following day, the man was sent back to a nursing home where comfort care would be resumed. When the transporters came to get him, I started to feel emotional, like someone I loved was going to leave me. Even though I knew he was going to a nice and comfortable facility, I didn’t want him to go. We transferred him onto the stretcher and I made him cozy in his blankets. His family was sincerely thankful, and I remember telling them with tears in my eyes how much we enjoyed taking care of him, and how much we would miss him.

The tears continued to well up as I watched his stretcher go around the corner and out of sight, because I knew I would never see him again. I felt like I was saying goodbye not only to him, but also to my grandfather all over again. But once again, I stopped myself from sharing these feelings with my patient or his family. They knew I cared, but they never knew how much caring for him meant to me personally.

Looking back, I still don’t know if I did the right thing, keeping my feelings to myself. I now realize that both of these patients were helping me heal, even as I was helping them. Watching them leave was like letting go of my grandfather again, but they also gave me the gifts of laughter and reminiscence, right when I needed them most.

I know that, ultimately, I am still just the nurse, and they are still just my patients. But I think it’s better for both the patients and myself if we both sometimes allow ourselves to feel something more than a professional bond. Nurses and patients move in and out of each others’ lives so quickly, but we are nonetheless changed by every encounter.

I became a nurse because I want to care for people and make a difference. Being touched in return is an added bonus.

Source: The New York Times

The seriousness surrounding the problem of elder abuse in our society is often ignored or underrated. People have a tendency to put discussions of elder abuse on the backburner, in favor of more shocking stories that tend to grab the media spotlight.

Despite the lack of attention paid to the phenomenon of elder abuse, the American Psychological Association estimates that “4 million older Americans are victims of physical, psychological or other forms of abuse and neglect” every year. For every reported instance of abuse, experts estimate that 23 more go unreported.

There are many different types of elder abuse, but they can be broken into three categories:

1. Physical Abuse

Some of the most common signs of physical abuse include unexplained marks or injuries, such as bruises, pressure marks, welts, cuts, burns or broken bones. If the caregiver refuses to let you be alone with your loved one, this could also be an indicator of physical abuse. Other possible signs include broken glasses, ripped clothing and signs of restraint (such as rope marks around the wrist).

Remember, neglect is also a form of physical abuse. Some of the most common signs that an older adult is being neglected by a caretaker include sudden weight loss, malnutrition and dehydration. Unsanitary living conditions (like dirty sheets or bed bugs) are also indicators of neglect, as are untreated physical problems, like bed sores.

2. Emotional Abuse

The signs of emotional abuse include characteristics of depression, like uncharacteristic silence, loss of appetite and unexplained withdrawal from normal activities. Likewise, if you witness a caregiver acting in a way that is threatening, belittling or condescending, there’s a possibility that the person they’re charged with taking care of is experiencing emotional abuse. 

There are many people who don’t recognize emotional abuse or don’t think of it as a serious mistake. These individuals operate under the false assumption that emotional scars are somehow less violent or harmful than the physical ones. This is one of the characteristics of emotional abuse that makes it so dangerous—if you don’t recognize a problem as a problem, you can’t take steps to solve it.

3.       Sexual Abuse

                The most common signs of sexual abuse include an unexplained venereal disease or genital infection, unexplained vaginal or anal bleeding and bruises around the breast or genitals. Torn, stained or bloody underwear can also be an indicator of sexual abuse. 

                There are many reasons that sexual abuse can be difficult for many older adults to talk about. For some, it’s an issue of pride—they would rather suffer in silence than face the humiliation of admitting helplessness. Others are afraid of retaliation, and worry that they’ll be punished for speaking up. Whatever the specifics of the situation, it’s important to remember that the subject of sexual abuse is complicated and needs to be handled with sensitivity.

Conclusion:

                The most important thing to remember when you suspect that someone you know is being abused is that speaking out is half the battle. The invisibility of elder abuse is what makes it difficult to prevent and punish. By calling attention to the situation, you’ve already laid a foundation for preventing future instances of elder abuse.

Linda Bright is a staff writer and a public relations coordinator for MyNursingDegree.com. Given her experience as a former hospital administrator, she writes primarily about healthcare reform, patient rights and other issues related to the healthcare industry. In her free time, she enjoys Sudoku, spending time with her family, and playing with her poodle, Max.

By Melissa Assink, RN, BSN

I was in med/surg for 13 years before moving to hospice, where I have been privileged to work for almost 24 years. At age 5, I was telling people I wanted to be a nurse. I believe it was a vocational passion that God placed in my heart those many years ago. 

A recent loss in my personal life, followed by a visit from a former patient, brought my passion into even clearer focus. 

I had received a phone call from my brother, telling me that moments before our father had suffered a massive heart attack and died. Even though he had been in declining health in recent years, the news felt like it hit me completely out of left field. 

The day of Dad’s memorial service arrived. While the presence of those in attendance was a comfort, it was also overwhelming to greet the many people who joined us to celebrate his life. Some we had not seen for many years, and it seemed they all had stories to share about him. 

One of the first people to approach me after the service was a man who appeared to be maybe 85. He had white hair, was hunched over and used a walker. He came up to me and stood there, staring at me, as if willing me to remember who he was. I drew a blank and asked, "How do I know you?"

His response was amazing: "You were my nurse 30 years ago, when I was in the hospital for five days to have my gall bladder taken out." He said it very matter-of-factly, as though I should remember him out of probably thousands of patients I have cared for over the years. 

Rather flabbergasted, I asked, "Did you know my dad?" He indicated he did not, that he had simply seen the obituary in the paper and wanted to come to the service as a tribute to me, his former nurse.

My mind raced. This dear man had connected me with Dad by recognizing me as a listed survivor in his obituary. It meant that he had to remember my first name and my maiden name from a brief hospital stay more than 30 years ago. 

I wanted to sit down and talk with him about his memories, but he promptly turned, walked out the door and was gone as suddenly as he had appeared. It seemed as if he knew he had accomplished his mission. I was engulfed with people wanting my attention, and it became impossible to follow him.

I have been reflecting on this former patient and his sudden reappearance in my life for several months. It was almost like he was an angel of sorts, sent to remind me how we, as nurses, touch the lives of people in our care at every turn. We sometimes are in good moods, sometimes not so good. We can become distracted by computerized charting, time management and policy and procedure manuals. 

It is easy to sometimes forget that we care for people when they are most vulnerable, sharing in their joys and sorrows in a way we might not always appreciate. We might forget their names by the next day, often as a coping mechanism, allowing us to go forth and care for the next person. We neglect to recognize they often do not forget us so easily. 

This former patient reminded me that we should never take any interaction for granted. We need to be caring and supportive, treating each of our patients with the respect and honor we’d like to experience if we were in their shoes. Our personal issues and circumstances are not important to them. They are watching us at every turn, looking for the light of our knowledge and support to see them through. A hug, a smile, a kind word, a moment of laughter or a shared tear — these are easy to give, but never forgotten. 

I pray I will always remember the responsibility I have to provide love, care and perhaps a moment of joy to the patients and families I interact with every time I put on my name badge. After all, we never know when a white-haired angel with a walker who received our care will cross our path and help us remember why we became nurses in the first place. 

Melissa Assink, RN, BSN, works for Providence Hospice and Home Care of Snohomish County in Everett, Wash. 

Source: Nurse.com

For years, nurse practitioners in Minnesota have been able to see patients only in association with a licensed doctor. But a governor's task force says it's time to let those nurses work independently -- in part, because of a coming shortage of primary care physicians.

The proposal, which has been opposed by physician groups, was endorsed Thursday in the final report of the state Task Force on Health Reform, headed by Human Services Commissioner Lucinda Jesson. The report is expected to set the stage for a debate in the Legislature, which must approve any changes.

The plan would lift restrictions on the state's more than 5,000 "advanced practice nurses," who get extra training to diagnose and treat many routine conditions, from strep throat to chronic illnesses.

Under current law, they must have a working agreement with a physician, although 17 other states have no such restrictions.

"The reality is that we've got a primary care shortage and you can't turn out doctors fast enough," said Dr. Therese Zink, a University of Minnesota physician who served on the task force. "We can't afford to wait. We need creative solutions."

Many advanced practice nurses already operate semi-independently, running clinics in drug stores, schools, rural areas and other locations, under "collaborative agreements" with physicians. The problem, said Zink, is that if the physician retires and no replacement is found, the nurse practitioner would have to close up shop. "It's probably, more than anything, a rural access issue," she said.

But the Minnesota Medical Association (MMA) says the physician oversight is necessary. "This is a patient safety issue," said Dr. Dave Thorson, a St. Paul physician and chairman of the MMA's board of trustees. "I think nurse practitioners ... do a wonderful job. They're a valuable member of the health care team. But they're not the same as a physician, so they shouldn't be given the same scope of practice as a physician."

The American Academy of Family Physicians also objects to the idea. "Substituting nurse practitioners for doctors cannot be the answer," it said in a report in September. It noted that doctors are required to go through twice as many years of training (11 years) as advanced-practice nurses (five to seven years).

But the trend has been spreading. Today, 17 states, including Iowa and North Dakota, permit advanced-practice nurses to diagnose and treat patients, as well as prescribe drugs and devices, without physician supervision, according to the task force.

One of the driving forces is the anticipated physician shortage, as large numbers of doctors retire and aging baby boomers need more care. National experts predict a shortage of 45,000 primary care doctors by 2020.

"We're trying to stay ahead of the curve," Zink said. "We've got to have solutions that are above and beyond and push the envelope."

The task force report, which includes a broad range of recommendations on quality and access to care, will be posted Friday on the Minnesota Health Reform website, mn.gov/health-reform.

By limiting our understanding of diversity in nursing to matters of race and religion, we risk excluding other cultural groups, warns Arabella Sinclair-Penwarden

Issues of diversity enjoy a high profile in nursing today, from the RCN’s continuing emphasis on the importance of valuing diversity, to training in this area in both pre- and post-graduate contexts. Defined as ‘the state or quality of being different or varied’ in Collins English Dictionary, the word has accumulated various different interpretations, not all true to the original.

I asked several colleagues what ‘diversity’ meant to them. ‘Respecting people of different races,’ said one. ‘Being aware of other people’s religions and faiths,’ said another. Still another commented that it was ‘to do with treating each patient as an individual’.

These are examples of applying the term constructively and, typically of nursing, in a wholly practical manner. Yet by restricting our definition to matters of race or creed, we risk isolating the term and omitting cultural groups that fall under neither heading.
When I was asked to take on the role of diversity link nurse in my department, I was intrigued by the potential of the role. You see, there was no precedent, no shoes to fill. The role was entirely new.

Our trust had a comprehensive policy relating to the different spiritual beliefs of patients, and I had no desire to replicate what had been written. But I had read about Deaf culture – and there did not seem to be a great deal of awareness about it.

Deaf people are not always perceived as a specific cultural group. Indeed, there is confusion about the terms related to an absence of hearing. What, for example, is the difference between a patient being deaf and Deaf? Between being deafened and hard of hearing? Information is both scarce and sparse. Terms may be used interchangeably and research can be confusing.

It is common practice to capitalise the ‘D’ in ‘Deaf’ when writing about the culture and the children and adults that make up its members. The term ‘deafened’, or ‘deaf’ with a small ‘d’, or ‘hard of hearing’ is frequently used to describe someone who has acquired hearing loss. This may also be referred to as being ‘post-lingually deaf’, meaning those whose loss developed after the acquisition of spoken language.

Anecdotally it has been noted that terms can be used inconsistently, and sometimes incorrectly, even by healthcare workers.

Yet, when such a lack of clarity exists, it is unsurprising that confusion regarding dealing with patients with hearing loss should follow.

The term ‘Deaf community’ has demographic, linguistic, psychological and sociological dimensions, and this is underlined by the description of sign language as ‘a minority language’. It therefore seems wholly appropriate to include the needs of people who identify themselves as culturally Deaf when discussing diversity issues.

As nurses and midwives we are bound by the code of conduct set down by the NMC. Thus, we are – or should be – aware not only of the need to respect each person within our care as an individual but also to be wary of discriminating against them. Yet discrimination can take many forms. Direct discrimination is defined by the government as when a person is treated ‘less favourably because of, for example, their gender or race’. Indirect discrimination is when ‘a condition that disadvantages one group more than another is applied’.

By being ignorant of the discrete needs of culturally Deaf patients we risk indirectly discriminating against our own patients, whether by not providing an interpreter when one is required, or by assuming that a pre-lingually Deaf patient will be able to lip-read fluently.

We are not expected to be fluent in British sign language, nor to be fully au fait with the finer nuances of Deaf culture. But, in view of a 2004 RNID statistic suggesting that 35% of Deaf and hard of hearing people have been left unclear about their condition because of communication problems with a GP or nurse, neither can we afford to be lackadaisical. Awareness of these issues is the key to individualising care – and that is something that we are required to do.

11:10AM EDT October 5. 2012 -From USAtoday.com

As Baby Boomers age into retirement by the millions each year, their growing health care needs require more people to administer that care.

That makes fields such as nursing one of the fastest-growing occupations, and hospitals are hiring now to prepare for what's to come.

Central Florida Health Alliance has 140 to 170 open positions a week, and almost 90% of them are for jobs that include registered nurses, pharmacists, physical therapists and pharmacy technicians, says Holly Kolozsvary, human resources director.

The two-hospital system based in Leesburg and The Villages is hiring for its peak season from January to April, when many retirees seek winter refuge in the Florida sun. But it's also managing a trend that requires it to employ more people year-round: More retirees aren't leaving at the end of spring, Kolozsvary says.

"It's kind of a domino effect," she says. "They move here, they're well, they get sick, they're left here through their cancer or heart disease, and we have to take care of them."

Job postings on Monster.com for positions including registered nurses, physical therapists and physician assistants rose 13% from June 2011 through June 2012, according to a 2012 health occupational report by the job site.

The additional demand could be due partly to hospitals preparing for the retirements of many older nurses as the economy gets better, increasing the need for new skilled workers. Scripps Health, a group of five hospitals and 23 outpatient facilities in San Diego, plans to hire about 400 nurses a year over the next three years but might need to increase that by 200 annually because of retirements, says Vic Buzachero, senior vice president for human resources. About 30% of the hospitals' nurses are older than 50.

Jamie Malneritch applied for a part-time job as a registered nurse with Scripps in March and heard from the hospital the same day she submitted her application. She started working a month later.

The 31-year-old, who has worked as a nurse for four years, says the job security and growth opportunities were primary drivers in her decision to go to nursing school in 2006.

"It seems like we always need more hands," she says. "Nursing is flourishing."

With an average salary of $64,690 a year, according to 2010 data from the Bureau of Labor Statistics, registered nursing may be the more desired profession, but lower-paid home health aides are actually in higher demand.

An industry shift that puts more emphasis on outpatient care and home health services makes home health and personal care aides two of the fastest-growing occupations in the country. Employment in both positions, which have an average salary of about $20,000 a year, is expected to grow by about 70% by 2020, BLS data show. Registered nursing is expected to grow 26%.

ResCare HomeCare, a national provider and employer of home health and personal care aides, who work primarily with seniors with chronic illnesses or disabilities, has received 32,000 applications this year, a 23.3% jump from last year, and it hired 6,000 of the people who applied, about 5% more than in 2011, says Shelle Womble, senior director of sales.

Home health and personal care aides are generally the same, providing services such as checking vitals, prepping meals and bathing and grooming the patient. But home health aides are funded by Medicare and, in some states, require more training, while personal care aides are funded privately and may require less training, Womble says.

ResCare, where aides make $22,000 to $30,000 a year, is anticipating the need for more workers in the near future.

"Right now, one of our key positions is that we are hiring the talent before we even get the clients so we can be prepared and have the staff available," Womble says of home health and personal care aides. "There's a lot more competition for that type of employee."

By Christina Orlovsky, senior writer, and Karen Siroky, RN, MSN, contributor

As the nation’s population becomes more diverse, so do the needs of the patient population that enters U.S. hospitals. As caregivers with direct contact with patients from a wide spectrum of races, ethnicities and religions, nurses need to be aware and respectful of the varying needs and beliefs of all of their patients.

In its position statement on cultural diversity in nursing practice, the American Nurses Association (ANA) states that: “Knowledge of cultural diversity is vital at all levels of nursing practice…nurses need to understand: how cultural groups understand life processes; how cultural groups define health and illness; what cultural groups do to maintain wellness; what cultural groups believe to be the causes of illness; how healers cure and care for members of cultural groups; and how the cultural background of the nurse influences the way in which care is delivered.”

Additionally, the Joint Commission requires that all patients have the right to care that is sensitive to, respectful of and responsive to their cultural and religious/spiritual beliefs and values. Assessment of patients includes cultural and religious practices in order to provide appropriate care to meet their special needs and to assist in determining their response to illness, treatment and participation in their health care.

There are a number of ways to comply with the requirements for providing culturally diverse care.

First, be self-aware; know how your views and behavior is affected by culture. Appreciate the dynamics of cultural differences to anticipate and respond to miscommunications. Seek understanding of your patients cultural and religious beliefs and values systems. Determine their degree of compliance with their religion/culture, and do not assume.

Furthermore, respond to patients’ special needs, which may include food preferences, visitors, gender of health care workers, medical care preferences, rituals, gender roles, eye contact and communication style, authority and decision making, alternative therapies, prayer practices and beliefs about organ or tissue donation.

Kathleen Hanson, Ph.D., MN, associate professor and interim executive associate dean for academic affairs at the University of Iowa, summarized the importance of learning cultural diversity in nursing education.

“Cultural competency is threaded throughout the nursing school curriculum. We teach every course with the idea that there’s content that may need to be explained for a diverse student group,” Hanson said. “In nursing, cultural competency has been around for a long time. I think that’s probably something that the nursing profession recognized maybe a bit before some other disciplines. We’ve always worked in public health, so we have always seen the diversity of America.”

Hanson concluded: “We need to be able to care for diverse populations because our country is growing increasingly diverse. Oftentimes persons who are in minority groups or who are underrepresented have different health care needs. It’s important for us to have a student population that is as equally diverse as our client; we need to prepare a workforce that not only knows how to work with diverse peoples, but also represents them.”

From thestarpress.com By Michelle Kinsey

MUNCIE — Indiana University Health Ball Memorial Hospital wants to make sure that every person who walks through their doors gets equal treatment.

That commitment has landed the hospital at the top of a list, as the first in the state to be designated as lesbian, gay, bisexual, transgender (LGBT) friendly by the Human Rights Campaign, the nation’s largest LGBT civil rights organization.

The news came in the form of the HRC’s annual Healthcare Equality Index for 2012, which looks at how equitably healthcare facilities in the United States treat their lesbian, gay, bisexual and transgender patients and employees.

IU Health BMH was one of 234 nationwide — but the only one in the state — recognized as a “Leader in LGBT Healthcare Equality,” meeting all four core policy categories — patient non-discrimination; employment non-discrimination; equal visitation for same-sex partners and parents, and training in LGBT patient-centered care.

“We are proud of the recognition,” said IU Health BMH President and CEO Mike Haley. “It’s the result of a lot of hard work.”

That work began two years ago, after a transgender patient claimed she was mistreated in the hospital’s emergency room.

Transsexual Erin Vaught claimed she was called “it” and “he-she” and eventually denied treatment when she went to the ER on July 18, 2010, for a lung condition that was causing her to cough up blood.

Complaints were filed days later by Indiana Equality and Indiana Transgender Rights Advocacy Alliance and the incident went viral, with the hospital receiving criticism nationwide, and beyond.

Ball Memorial Hospital released a statement saying the hospital was conducting an internal review.

The result?

“We failed to meet their needs,” Haley said. “We acknowledged that openly.”

Then they went a step further.

“It’s one thing to apologize,” he said. “It’s another to say, ‘And furthermore, I want this hospital to be considered as a place anyone would want to go if they needed a hospital.’”

Haley issued a challenge to all physicians, employees and volunteers to meet every HRC key indicator.

Ann McGuire, vice president of human resources for IU Health BMH, led the hospital’s efforts. Members of the LGBT community were asked to help.

Jessica Wilch, board member and past president of Indiana Equality, an LGBT rights group, said she was a “believer in what (IU Health BMH was) trying to do” from the first meeting.

“When this went viral, my concern was that BMH would take the stand that this was an isolated incident and just pacify the process,” Wilch said. “Instead they saw it as a teachable moment.”

New policies were drafted and training was developed.

In addition to hospital leaders, anyone a patient would come in contact with was involved in the training, McGuire said, adding that it was about more than just a tutorial. It was about “eye-opening” conversations.

Wilch agreed, saying that face-to-face conversations with the LGBT community were essential.

“We could talk freely about the things we have encountered and then come up with ways, together, to handle it differently,” she said.

Overall, the HRC reports the number of American hospitals striving to treat lesbian, gay, bisexual, and transgender (LGBT) patients equally and respectfully is on the rise.

This year’s survey found a 40 percent increase in rated facilities.

Last year, IU Health BMH was short a few policy additions for the leadership HRC designation, but was still recognized for its efforts.

Wilch said she was not surprised the hospital “hit all of the marks” this year.

“They have become, essentially, one of the leading hospitals in the country, because it really started with them,” she said. “They were the ones who reached out to us and said ‘How can we make this better? How can we do the right thing?’”

Haley said he believed the training and policies developed at IU Health BMH will be used “across IU Health.”

IU Health BMH has also set out to look at other ways to expand their “best practices” when it comes to diversity, McGuire said. The hospital has been hosting Palettes of Diversity events, which have celebrated not only the LGBT community, but other cultures.

“We are making sure we are hard-wiring an environment recognizing and supporting diversity for all who come here,” Haley said.

McGuire agreed.

“It’s about relationships and dignity and respect,” she said. “It is uniqueness that each of us brings that makes us stronger as a community.”

And, McGuire would tell you, as a hospital.