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What can student nurses to do to combat stigma and discrimination?

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When I first started training to be a nurse two years ago now, I was fresh-faced and ready for the challenge.

When I first started training to be a nurse, I couldn’t quite believe or comprehend how often people are stigmatised or discriminated against. I don’t think I realised the extent of the problem. 

I have had the privilege to treat everyone – from those who come from privileged sections of society (think Made in Chelsea) to those who have nothing, those who have addictions to opioids and alcohol and those whose lives seem to be in a constant downward spiral.

During my career so far, I have made a point of giving everyone the same high-quality care they deserve, and I endeavour to always do so. Because everyone deserves to be treated with respect, compassion and dignity. This is what is expected of a nurse. I thought everyone thought that – how naïve of me.

“On this placement, I was shocked to find people still hiding their condition”

I was lucky enough to go on a HIV community placement, which changed my life. It sounds dramatic but it’s true. My mentor was everything I hoped to be as a nurse and I truly respected her for the difference she made to people’s lives. I am also lucky in that I get to train in one of the biggest and busiest trusts in London.

London itself continues to have the highest prevalence of HIV in the country. On this placement, I was shocked to find people still hiding their condition away from their communities – from their own family and friends for fear of retribution.

Before this, I hadn’t really come into contact with anyone who had HIV, therefore I didn’t know what to expect. It shocked me how isolated and alone some people with the condition were, and how often they suffered from mental health issues which only made them more stigmatised. Instead of just having one label to contend with, they had two.

HIV can be managed so well that it no longer poses a significant threat to life as it once did. HIV is not transmitted through touch or saliva as so many people still believe and yet, despite advances in science and medicine, people are still ignorant of these facts. Just like asthma or chronic obstructive pulmonary disease, it is a condition that can be treated with regular medication.

This placement made me realise how important it is that nurses go beyond the clinical aspects of the job. That we assess how a patient is doing psychologically as well as physically. It doesn’t matter if you are training to be an adult, child, learning disability or mental health nurse – mental health always matters.

As it is 2018, I thought people were becoming more accepting, and I still think this is true, but we have a long way to go to truly help those people who have been marginalised by society. 

Whether it be those with HIV, sex workers, people who misuse drugs and alcohol, the transgender community or any other minority groups, these individuals often experience high levels of discrimination in healthcare settings – so much so it has been recognised as a problem by the World Health Organization.

Similarly, why is there such a shaming culture with giving young people access to contraception, especially the morning-after pill? It seems scary to me that there are potentially health professionals practising out there that would rather shame someone for wanting to have contraception than praise them for their proactivity.

While most of the healthcare workers I have worked alongside have been nothing short of wonderful to these people – there are still those who are not. Access to good healthcare and treatment is a basic human right, but why are there still people who actively try to stop this?

It is not acceptable to make comments about a patient or treat a patient differently just off what is written on a handover sheet. Just because a patient is an injecting drug user does not mean they are going to cause trouble. Just because a patient may live with schizophrenia does not mean they are going to be challenging.

“It can be hard to speak up”

So what can student nurses to do to combat stigma and discrimination? It can be hard to speak up, especially as we can often feel inferior and challenging our superiors feels like the end of the world. But it is so important.

Being an advocate for our patients is integral to the nursing profession, so why not try and conquer our own fears for the wellbeing of our patients? Our own fears and worries are minimal in comparison to what others face on a daily basis.

We can also help by listening. A problem shared is a problem halved, and often helping others to discuss their issues makes them more forthcoming with adhering to treatment and allowing professionals to help when necessary.

It has been found that stigmatising attitudes are more abundant in those communities and individuals who are less educated. So let’s begin by starting the conversation. Educate ourselves fully and educate other people when we get the chance - after all, it is part of our job description.

It does not matter when we qualify, but that when we do, we make sure that we are the voice our patients need and deserve.

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