How culturally competent care is a part of my role as an advanced practice nurse, particularly as it relates to interviewing and assessing patients. https://cccm.thinkculturalhealth.hhs.gov/default.asp Sample 1 • The theme I chose to complete was “Fundamentals of Culturally and Linguistically Appropriate Services (CLAS)”. Two case studies were looked at in this module.The first case was that of a young boy who presented to the ER from an apparent suicide attempt. As the doctor recounted his last visit with the boy he recalled a few things that stood out as worry some. He remembers changing the boys antidepressant and advising the mother to give the boy one pill, once daily; he even remembers writing this information down for her. As he thinks about the situation further he realizes that there is a high probability that the boy’s mother cannot read English, being that she knows very little English. He realizes that the word “once” in Spanish means eleven not one, and begins to question whether or not the mother had accidentally given the boy too many pills. This situation could easily happen to anyone, which is why it is so important to consider cultural differences prior to sending our patients on their way. Communication barriers, whether due to language differences or intellectual differences, can have a negative effect on patient care- “Language and communication problems may also lead to patient dissatisfaction, poor comprehension and adherence, and lower quality of care,” (Georgetown University, 2004). In the example given above, a language barrier may have almost cost a boy his life. The second case example looked at was that of an older American-Indian woman who has uncontrolled type 2 diabetes. As opposed to following western medicine to control her ailments the woman was seeking alternative treatments. She admits to feeling better after spending time in Arizona, taking herbs and praying. The doctor is getting frustrated with her for not following his treatment recommendations, which includes hospitalization to get her diabetes under control. During their discussion the woman states that she does not want to go to the hospital out of fear of her condition worsening, ultimately leading to death. It is obvious that she sees the hospital not as a place of healing, but as a place that will lead to her demise. In this situation it is important that the doctor try and understand the patient’s cultural beliefs, so he can better educate her on the importance of western medicine. It is not unrealistic to say that we have a high chance of encountering different cultural beliefs on a regular basis when we get into our respective practices. In order to provide the best level of care to our patients it is important that we educate ourselves on cultural diversity. It is unrealistic to say that we can be proficient in all of the different cultures we may run into, but it is not unrealistic to say that we need to keep cultural differences in mind with every patient seen. One way we can better care for our culturally diverse patients is to establish relationships with community leaders, such as shaman. “Collaboration, whether internal or external, may provide new avenues for hospitals currently undertaking cultural competence initiatives. Building active relationships with cultural brokers, traditional healers, chaplains, religious leaders, and other individuals may enhance and extend the hospital’s existing C&L services,” (Wilson-Stronks, Lee, Cordero, Kopp, and Galvez, 2008). I think it is important to assess our patients cultural needs as quickly as possible, so that they feel safe and comfortable being in our care.
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