discussion

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1-Critique your colleague’s targeted questions and explain how the patient might interpret these questions.

2- Explain whether any of the questions would apply to your patient and whoy (my patient was
Shawn Billings, a 28 year-old African American patient comes in to the clinic today. He has been deemed a “frequent flyer” by the staff at the clinic and was at the clinic last week and 4 days ago with a migraine, given a shot of Toradol and Ativan and sent home. He is here today again for an extreme headache. He is very agitated today. He is here with his father and worried that he will not get any medication.)

References at least 2-3 no more than 5 years ago.

do not make negative critique

For this week’s discussion post, I was given the case study about Paloma Hernandez, a 26-year-old, Spanish speaking patient. Paloma presents to the clinic for the last two days complaining of abdominal pain that is worsening. During the patient’s first visit, the staff relied solely on her younger bilingual daughter to translate, so she was treated with omeprazole and encourage to take OTC medication. Today she presents with the same problem, but her daughter states it is the same problem but was worse today. There are socioeconomic and cultural factors that can be hurting this patient’s care. “When language barriers arise, we must become aware of our resources and know how to effectively use interpreters. Use of medical interpreters has a positive impact on healthcare quality, but we continue to use suboptimal methods of communication, such as family members” (Ball et al, 2019, pg. 25). With our patient, we have not been able to develop a relationship and enhance our communication to build a strong health history. We are relying solely on the patient’s daughter who speaks English, instead of using an interpreter to give the patient a chance to tell us her concerns. Just because we have a family member able to interpret, that doesn’t mean we will also get an accurate picture of what is wrong with the patient. Also, some cultures vary based on their health beliefs and practices. Some cultures define ill or sick based on the individual’s belief system. This patient’s family reports that she is having pain that is worsening, but in their culture, we don’t know what a pain rating for them is like. “Migrant interviews clearly show that they do not seek professional health care until they experience a certain level of pain, which was stated as ‘unbearable pain.’ Minor pain is often ignored, and the absence of pain is considered an acceptable level of health. Moreover, Marshallese migrants place high value on the denial or tolerance of physical pain, leading subjects to accept their illness symptoms. They often ignore and tolerate illnesses for a long period of time and do not seek professional health care until the pain becomes unbearable” (Coleman, 2019, para. 13). Overall, we need to avoid assumptions about cultural beliefs and behaviors made without validation from the patient. Beliefs and Behaviors that can have an impact on the patient is: Modes of communication, health beliefs and practices that vary from our own, diet and nutritional practices, and nature of relationships within a family (Ball et al, 2019, pg. 27).

 

           Furthermore, there are also sensitive issues that would need to be addressed with this patient. When sensitive topics arise, this might be a time that the patient wants to answer the questions without a family member in the room. A patient should be given a right to health privacy for us to get a more accurate history. Based off the patients’ symptoms, there a multiple diagnosis that needs to be assessed for. Some sensitive topics that could be discussed are a possibility of pregnancy, multiple sex partners, possibility of sexually transmitted infections, and other diagnosis’s’. There needs to be a translator used for this patient, so she can freely communicate with us when trying to determine the best path of treatment. The patient may be too shy to tell us that she could possibly be pregnant in front of her daughter. “Much of the communication between doctor and patient is personal. To have a good partnership with your doctor, it is important to talk about sensitive subjects, like sex or memory problems, even if you are embarrassed or uncomfortable” (U.S. Department of Health & Human Services, 2020, para. 1).

Five Targeted Questions

1. Do you feel comfortable having your family speak for you or would you prefer a translator when discussing your health concerns?

2. What is the most effective form of communication for you?

3. How long have you been having this abdominal pain?

4. Are you sexually active? If so, have you had multiple sex partners?

5. Is there a possibility that you could be pregnant?

 
 

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversity. Journal of Hospital Librarianship, 19(4), 330-338. https://doi.org/10.1080/15323269.2019.1661734

U.S. Department of Health & Human Services. (2020, February 3). How to Talk with Your Doctor About Sensitive Issues. National Institute on Aging. Retrieved September 5, 2022, from https://www.nia.nih.gov/health/how-talk-your-doctor-about-sensitive-issues

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