Research has identified the need for improved cultural competence of health care providers regarding the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community’s needs. This article articulates the teaching approach and methodology of an unfolding LGBTQ family case study for undergraduate nursing students. This method provided a forum for exploration of personal biases and gender-affirming techniques, and addressed the challenges of aging for a transgender woman and family within the context of societal stigma and discrimination. Students gained knowledge concerning shifts in family structures and understanding of the nurses’ role encouraging inclusiveness and equitable access in health care settings, advocating for vulnerable populations, and addressing specific health concerns for transgender older adults. Student responses demonstrated increased knowledge of family diversity, and critical thought regarding the intersectionality of discrimination and aging. The findings revealed the case study methodology facilitated student understanding of the unique health and social issues for LGBTQ older adults within a family context.

Background Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) people experience significant health inequities with well-documented negative health impacts due to their status as a sexual and gender minority population. Insensitive or discriminatory attitudes toward LGBTQ people within the health care system have negatively impacted access to health services and the overall physical and mental health and well-being of this at risk population. Few studies of LGBTQ populations in rural areas have been conducted, with even fewer in the Canadian context. Rural areas often create greater visibility for LGBTQ persons, contain fewer supports and alternatives in the face of discrimination, and are often are less accepting of LGBTQ populations due to increased stigma and social isolation. Objective The purpose of this study is to examine the lived experiences of LGBTQ people utilizing health care services in rural Manitoba. Method 12 individuals who self-identified as LGBTQ who had accessed health care services in Manitoba were recruited. Using qualitative methodology, interviews were recorded and analyzed for themes. Results Analysis revealed themes including stigma and discrimination, judgments and assumptions, gender identities, lack of knowledge, limited access/systemic barriers, rural considerations, and recommendations for changes to address the gaps in health care services and barriers to access. Conclusions This study of the LGBTQ community provides an expression of their opinions and experiences, but also provides a voice to this underserved population. The findings of this study provide a better understanding of the unique health needs and experiences of LGBTQ people in rural Manitoba, creating opportunities for meaningful change in health care delivery

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Aim To investigate the role stressors, and how coping strategies cultivated nurse managers’ resilience in rural workplaces. Background A stressful workplace can impair the mental and physical health of nurse managers leading to poor performance. Building and sustaining manager resilience in complex and stressful practice environments is necessary to attract and maintain competent and skilled managers. Method In this qualitative exploratory inquiry, a purposive sampling method was used to recruit 16 nurse managers in rural western Canada. Results Coping strategies fostered manager's resilience that made their work meaningful, and included putting out fires, psychologically reframing a situation, serving others and receiving support. Conclusions Managers brought expertise, knowledge and skill to make their work meaningful and central to ongoing health service delivery in these rural communities. Nurse manager resilience can be strengthened by using evidence‐based strategies in an increasingly complex health care environment. Implications for Nursing Management Managers need to be supported and encouraged to develop awareness of their own protective factors as they cope with challenging situations. Building resilience through formal education, social support and meaningful recognition is an important focus for nurse leaders in establishing a healthy work environment and maintaining a stable nursing workforce.