Nursing Alum Puts LGBTQ+ Patient Care Policy into Practice

Envisioning an American healthcare system that welcomes its LGBTQ+ patients with the dignity and respect that all patients should be given, Jonathan Gurrola (Nursing, ’18; MA, Psychology, ’19) has long been working to make that dream come true.

“Most hospitals don’t have a real internal source of how to provide care for LGBTQ+ patients, and there are historical fears—the AIDS epidemic, for example—that cause LGBTQ+ people to not feel safe in a hospital,” he said. “Patients are afraid of being misgendered or being referred to by a dead name, and many patients aren’t even aware that their partners can visit.”

After decades of discriminatory treatment, lack of access to care, and awkward, disrespectful interactions with doctors, nurses, and other hospital staff, change is long overdue, Gurrola said, adding that it’s critical to establish policy and procedures that ensure at least a basic level of inclusive care.

He’s doing what he can to move the needle. An advanced clinician at Sharp Memorial Hospital in San Diego, he volunteered countless hours working with healthcare leaders in recent years to establish the first-of-its-kind LGBTQ+, nonbinary, and gender-nonconforming patient care guidelines to guarantee all patients the standard of care they deserve.

In return, all seven Sharp Healthcare hospitals received a perfect score of 100 from the 2022 Healthcare Equality Index (HEI), an LGBTQ+ benchmarking tool developed by the Human Rights Campaign Foundation, for their policies related to the equity and inclusion of LGBTQ+ patients, visitors, and employees. But perhaps more importantly, Gurrola said, patient care is truly changing as a result.

“We go by policy and procedure for how our hospital does everything—how long we should keep food in the refrigerator, how we should take out an IV,” said Gurrola. “Now, if you’re new and have never had an interaction with a transgender patient, you could type that into a search bar and find out how to give respectful care at the most basic level.”

His evolution as a leader advocating for equity began at Chico State. As a first-generation, historically underrepresented student, he knew early on that he wanted to study nursing.

“I asked myself, what’s one of the most stable jobs in the world? I saw how my family struggled, and I sensed that learning could change my life,” said Gurrola. “I got this opportunity to go to Chico State to study and be mentored by incredible professors, so I treated it with great value and was able to really take what I learned and run with it.”

A community project assigned during his nursing program first illuminated his concerns about the bias, oversights, and missteps in LGBTQ+ healthcare and motivated him to do something about it. Gurrola and another student decided to design an LGBTQ+ training course for Chico State nursing students and faculty, which grew to include participation from nurses at Enloe Medical Center. The training advised participants on everything from defining sexual orientation and gender identity and what LGBTQ+ represents to patients’ rights and the trauma of misgendering.

“The nursing program at Chico State is really community-focused, and my passion for health helped me see what was needed,” Gurrola said.

Upon his hiring at Sharp Medical Center, Gurrola approached his nurse residency manager and offered to do the same training for staff, and before he knew it, he was providing training sessions throughout the hospital. These trainings have since been converted into a learning module that has been shared systemwide within Sharp Healthcare.

One of the big takeaways of the training is to never assume, Gurrola said, adding that although nurses often use first impressions with patients to spark communication, it’s important to erase those preconceptions and let the patient lead.

While he’s pleased by the progress so far, he says his work isn’t done. What started as a ground-level fight for equity in LGBTQ+ patient care has become a national movement, and he hopes to forward the cause by expanding the policies and practices he helped establish throughout the San Diego area.

“We’re actively seeking more opportunities to teach and educate, because when you have a policy, it brings awareness, and then suddenly people start asking, ‘How do I interact in my department with registration? How do I interact in the pre-surgical department? How can I be respectful?’” Gurrola said.

After watching his growth in Chico State’s nursing program over several years, associate professor Holly Kralj isn’t surprised at what Gurrola has accomplished. Standing out in his courses as articulate and smart, it was clear he would go on to do good things in the world, she said.

“We’re in the midst of a pandemic, our healthcare workers are swamped, and what I’m seeing around me is that no one’s doing anything extra—we are all just trying to hold on,’” she said. “I think it’s pretty remarkable that despite all this, Jonathan is still pushing things forward and moving the dial in terms of providing evidence-based practice and best care.”

His efforts are not going unnoticed. In 2020, he received the Center of Recognized Excellence (C.O.R.E.) Award for his service and commitment to Sharp Healthcare, and he was recently nominated for the 2022 “Excellence in Nursing” award for Sharp Metropolitan Medical Campus and “Nurse of the Year” at Sharp Memorial Hospital.

“I’m very proud of the work that I’ve done, especially as an LGBTQ+ person,” said Gurrola. “My voice has value within the healthcare system, and I’m creating the change I want to see.”