Editorial Update – June 2022: Recently named one of New York’s notable 2022 LGBTQ leaders by Crain’s New York Business, Kevin Moore remains a key advocate for LGBTQIA+ patients at NYU Langone Health. In the last year, his work to bring affirming care to patients has expanded, including the development of cancer screenings specific to LGBTQIA+ patients and the collection of sexual orientation and gender identity info at the Perlmutter Cancer Center, as well as innovative efforts to deliver LGBTQIA+ education through High Reliability Organization (HRO) shift huddles.
The role of the nurse has evolved greatly over the past century, but nurses’ innovative and compassionate nature has remained a constant—from Florence Nightingale, the founder of modern nursing, to the nurses of today working tirelessly to fight COVID-19. The rapport nurses develop with patients can transcend healthcare—which no doubt contributes to why nurses have been the most trusted healthcare professionals for years. Nurses are innate advocates for all patients, including marginalized and underserved groups, from caring for the homeless, working with immigrant populations, working in public health, or working in rural or urban areas alike where healthcare is scarce. The LGBTQIA+ community, which comprises approximately 10 million U.S. adults, represents another community where disparities are often widespread. It is also an area where a new role is developing for nurses who are dedicated to stepping in to advocate and help tackle the challenges of the LGBTQIA+ community. The LGBTQIA+ community itself is at greater risk for suicide and suicidal thoughts, mood disorders, substance abuse, and certain diseases and infections—and, critically, they are more likely to be refused healthcare services.
Nurses like Kevin Moore, BSN, RN, Assistant Director of LGBTQ+ Clinical Services at NYU Langone Health in New York City/Manhattan, NY, are changing the game for what it means to be an advocate for patients and health equity. His professional role is a rarity, because it is centered around improving the patient experience for the LGBTQIA+ community, whether by setting them up with the right healthcare provider or educating staff on the importance of affirming a patient’s gender identity and pronouns. His efforts are rooted in compassion and bringing gender-affirming care to patients who have dealt with significant barriers within their own healthcare.
In recognition of Pride Month 2021, the Johnson & Johnson Notes on Nursing team sat down with Kevin to learn more about how his role is addressing the health disparities of the LGBTQIA+ community, and how he is encouraging his colleagues at NYU Langone Health to continue being progressive, inclusive and intentional about providing equitable healthcare for marginalized groups.
Johnson & Johnson: What inspired you to become a nurse? Can you walk us through your story?
Kevin: When I was 13 years old, there was an incredibly kind male Operating Room (OR) nurse who lived down the street from me and would share stories with me about his job. I found his tales from the OR and his dedication to his patients so inspiring that I decided that nursing and healthcare was what I wanted to do for a living. But that dream came crashing down after I shared it with my mother—she wasn’t supportive. I didn’t understand at the time that several stereotypes existed, and the common belief was that nursing was a woman’s job. Despite not being able to make that connection, I chose to put nursing on the backburner. I didn’t want to disappoint my mom.
So, my first career path was acting, and I truly believe that I wouldn’t be the nurse I am today without that experience. It was incredibly hard, but I learned several fundamental nursing skills, like how to trust my instincts, knowing when to speak and when to listen. Although acting was exciting and fulfilling, I felt there was something missing. It put me at a turning point in my life where I needed to decide whether I wanted to stick with it for the years to come. I was 41 and thought I needed to feel passion for my career and that was no longer happening for me as an actor.
While I was in career limbo, I took up a job at the American Girl Café developing allergy-safe menus. There, I came across a child with Phenylketonuria (PKU), which is basically when you can’t eat protein. Constantly learning of new or different challenges that people face each and every day was a vivid reminder that our individuality is something to be embraced, protected, and looked after. I look back at moments like these in my life as parts of the impetus that drove me back towards the idea of being a caretaker, and ultimately towards the field of nursing.
When I made the career switch, I went back to school around the same time my mother got sick with ovarian cancer. I remember her sharing how she was so proud of me for becoming a nurse, a complete 180 from my childhood. She would brag to all her nurses and doctors about it, and my father did too. She passed away only a month after her diagnosis, but the experience was enough to show me the difference between good and bad nursing. I could see that technical skills were important, but they mean so much more when they are accompanied by instinct and compassion. I knew I had to do everything in my power to combine those skills to be a great nurse.
Johnson & Johnson: Can you tell us about your role as Assistant Director of LGBTQ+ Clinical Services at NYU Langone Health? How is it addressing health inequities among LGBTQIA+ and other marginalized communities?
Kevin: Nursing is a pivotal profession that is critical in helping tackle health disparities and advocating for marginalized groups. Many in the LGBTQIA+ community face discrimination throughout their entire lives, which can have a significant psychological impact and put them at a high risk for several conditions. They have reduced access to compassionate and preventative care, which may explain why there is a disproportionate risk for certain conditions, like HIV and cancer. NYU Langone Health recognized this disparity and the need to provide a welcoming, equitable environment, and so in 2017, my role was created. At first, it was focused on improving the holistic patient experience for members of the LGBTQIA+ community, in particular transgender and gender non-binary people who experience barriers to healthcare in the greatest numbers. Over time it has grown into something bigger and bolder. It became a system-wide initiative to advocate for and educate on the clinical and cultural needs of all LGBTQIA+ patients across the NYU Langone Health community.
I’ve taken on a nice mix of educational, clinical and administrative responsibilities, but the role itself has an ever-evolving, innovative scope. While I always had goals and benchmarks to meet, NYU Langone Health nursing leadership operates in a transformational leadership environment. This allowed for me to innovate and address the issues the LGBTQIA+ community often faces. They care so much about providing equitable care, and I’m beyond grateful they let me use my voice to advocate, educate, and call people into the conversation of clinical proficiency and cultural humility. For example, research shows that no matter the age, affirming and using a transgender and gender non-binary person’s chosen/preferred name and the pronouns they associate with their gender identity dramatically impacts the mental health of the patient by decreasing suicidal ideation. This is why one of our first initiatives we worked on establishing was the importance of not only using a patient’s chosen/preferred name and pronouns, but also how to ask those questions. The message is simple. Misgendering should be taken as seriously as a medication error. Recovering when you make a mistake is paramount.
If someone has cancer, we should be looking holistically at the whole patient profile. We should be seeing their medical and social history along with their social determinants of health as all contributing factors to the overall experience of healthcare to help us assess the best conditions and environments for healing. These same considerations should apply to any group of marginalized people. I encourage and educate nurses and doctors to be cognizant of the full range of obstacles a person may be dealing with, because the challenges faced outside the hospital absolutely affect and influence their health. As healthcare professionals, we can make small changes that have a big impact.
I didn’t realize it then, but nursing leadership was asking me to innovate—to identify the gaps and disparities and figure out a creative solution to fill them. Figuring out where to start on each project is always the hardest part, but I ask myself: What do patients need? What do nurses need? The answer is often better communication and education. Looking back, it’s so surreal how much I’ve been able to accomplish in the role, with the support of NYU Langone Health and my amazing colleagues. I could barely navigate the construction of an Excel spreadsheet when I started and now, I have completed monumental milestones and forward strides for my community by instilling guidelines and large-scale projects. My day-to-day responsibilities now often take place in the form of me acting as an intermediary between patients and proficient health providers and educating nurses and staff on LGBTQIA+ patient needs.
I’m very proud and feel privileged in helping to elevate the voices of the transgender and gender non-binary community in different ways, I was told early on by members of the trans community, “nothing for us, without us.” All too often it is non-transgender persons making decisions about transgender and gender non-binary people. We need to hire and place members of the community in decision-making positions of authority. For example, I was fortunate enough to write, in partnership with human resources and one of our leaders, a self-identified trans woman who was transitioning in our workplace, the NYU Langone Health’s Gender Transition Guidelines. This document establishes a pathway to support and inclusivity for all our NYU Langone Health community.
Another initiative, which I touched on earlier, was working with our nursing informaticist team in updating our electronic health record system to be much more prominent and inclusive of a patient’s assigned sex at birth, gender identity, pronouns, and chosen/preferred name, especially when the information on their legal documents may be different. After that was implemented, I remember visiting a patient in their room the next day and seeing their chosen name on their wristband. When I pointed out how exciting it was to see it, he said, “oh, yeah. That’s so cool.” I cherished the moment to the point of tears and realized that this was going to affect people I would never meet. Patients were going to come into the system and look down at their wrist band and see their chosen name on the label and not be triggered by another name that does not represent who they are. After that, I knew that we were going to continue changing the game by challenging the inequities that plague marginalized communities and prevent them from receiving the quality care they are entitled to.
I’m grateful that I was encouraged to take the reins and build the role the way I felt it needed to be built, and proud that my efforts are helping make forward strides. I am always relying on my nursing lens and asking myself if and how the needs of patients and nurses are being met. NYU Langone Health’s passion for improving the patient experience for marginalized groups like the LGBTQIA+ community is part of what makes my role so unique and important—and I believe similar roles should be implemented in health systems nationwide. Tackling health disparities is a challenging and ongoing process.
Johnson & Johnson: Why are nurses uniquely suited to be a changemaker and advocate for marginalized communities?
Kevin: Nurses are natural advocates, with the power to be incredibly transformational leaders. For example, think about the social determinants of health. That’s our lane, because those environmental conditions are extremely correlated with patient outcomes—COVID-19 really shined a light on it. The National Academy of Medicine’s Future of Nursing 2020-2030; Charting a Path to Health Equity speaks to the importance of nursing in creating a culture of health, reducing disparities, and improving our patient’s overall well-being. The proximity nurses have with patients, like recognizing who the patient is beyond their condition, where they come from and why they came for help make us a valuable voice and advocate for more than just the LGBTQIA+ community, but for all marginalized populations. I’m very proud to be able to use my nursing skills to be an ally and bring forth meaningful change and facilitate important conversations related to advocacy in my own workplace and community. I learned additional ways that this advocacy worked across marginalized and underserved people when I partnered with Meals on Wheels North Jersey and my Rutgers University graduate school nursing leadership practicum this last year to facilitate vaccinations for their volunteers and clients. Nurses that work in hospital systems are a treasure chest of information. We are all public health nurses to the extreme and have so much to offer.
At their core, nurses are altruistic and compassionate, which are the qualities of a true changemaker. I think with that being so innate, a great place we can start setting future nurses up for success in this department is by approaching their education multimodally—making sure they have a deep understanding of the disparities that come alongside concepts like misgendering and being a part of a marginalized community. It will make us all better nurses in the long run. There is still such a long way to go, but I hope that in the future we fill the gaps and create a more synchronized and inclusive experience for patients of all backgrounds and identities.
Editor’s Note: Outside of his day job, Kevin is pursuing his Doctoral of Nursing Practice degree at Rutgers University in the Post-Baccalaureate to DNP in Leadership track. An active member of his community, Kevin is working with Meals on Wheels North Jersey to empower his community by arming them with the latest evidence-based information about the COVID-19 vaccine—effectively combatting COVID-19 misinformation. His belief that nursing is a calling motivates him to work tirelessly to change the lives of those around him and beyond.
As part of Our Race to Health Equity initiative, Johnson & Johnson has committed $100 million over the next five years to address racial and social injustice as the critical public health issue that it is and by fostering health equity through championing and supporting greater diversity in the nursing workforce. Learn more.
Join Us June 24th! – An Evening with Billy Porter:
HIV/AIDS, COVID-19 and Nurses Tackling the Health Equity Gap
On the 40th anniversary of what would become the first AIDS diagnosis, at a time when a new health crisis has exacted a brutal and disproportionate toll on society’s at-risk communities, we invite you to join Billy Porter – actor, icon and LGBTQIA+ activist and Michael Sneed, Executive Vice President, Global Corporate Affairs at Johnson & Johnson for a special screening on June 24th at 6:00 – 8:30 PM ET of the award-winning documentary film ‘5B'.
‘5B’ tells the story of a multidisciplinary team, led by nurses working on the first AIDS ward at San Francisco General Hospital, who pushed through barriers and biases, and made it their priority to provide ground-breaking patient-centered care for an at-risk community; an approach that has been recognized and replicated world-wide.
Following the film, stay for an illuminating fireside chat with Billy Porter, Ward 5B nurse Alison Moëd Paolercio, RN MS; and nurse, entrepreneur, innovator and author Rebecca Love RN, MSN, FIEL, as they discuss the disproportionate toll that epidemics and pandemics take on at-risk communities, the parallels between the HIV/AIDS and COVID-19 crises, and the role of nurses in driving transformative healthcare change.
Register here.
Not able to join the event? Visit 5Bfilm.com to find out where to stream the movie and, after the event, view the fireside chat here.
