A Focused Ethnography of a 2S/LGBTQIA+ Liaison Nurse Role in Acute Care: Advancing Equity Through Relational Practice.

Abstract

Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other gender and sexual orientation diverse (2S/LGBTQIA + ) people experience profound interpersonal and structural discrimination in health care settings, contributing to poor health outcomes. This study reports on a novel Liaison Nurse role enacted in a Canadian acute care setting to support equitable care. A focused ethnography was conducted over 7 months, utilizing observations of the Liaison Nurse across two acute care hospitals. Field notes were analyzed using iterative coding and constant comparison to examine institutional considerations and practice dynamics. Three interrelated dimensions of practice were identified via analysis: being present, knowledge of physiologic considerations for 2S/LGBTQIA+ clients, and advocating for the needs of 2S/LGBTQIA+ clients in the health system. These dimensions of practice facilitated the Liaison Nurse's capacity to foster trust, inform clinical decision-making, and navigate institutional constraints to promote equitable care. The findings highlight that the integration of nursing knowledge and lived experience is central to addressing individual and structural inequities. The Liaison Nurse role functions as a relational, clinical, and systems-level intervention that advances equity for 2S/LGBTQIA+ people in acute care. Implementing such roles within health systems supports more responsive, inclusive, and equitable care practices.