Case study 2

Respond to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.

Post #1

Ruth

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 medications.

People of color have been regarded as a minority group which makes up a bigger percentage of people with chronic conditions, uninsured, and living in poverty which has contributed to their poor health. In the case study, the patient comes from a minority community and has several health conditions. As a nurse, when attending to this patient, it is important to take into consideration his socioeconomic, spiritual, lifestyle, and other cultural factors which might have impacted his health. Culture affects health in many ways and can be linked to people’s health behaviors and their perception of diseases. The perceptions of illness vary among cultures, something considered normal in one country may be perceived as an illness in a foreign country (Rosen, 2015).

 Due to his frequent visits to a health facility, the nurses have labeled him “frequent flyer”. In my view, this label might have a significant negative impact on the quality of services the nurses might provide to him since it attracts negative connotations. A Frequent flyer is a patient who seeks medical service for any minor illness they experience. As a nurse, exploring his medical history shows that he has several health conditions which might be related to other external factors. Therefore, to ensure that he is given quality services, the nurses should start by examining his socioeconomic factors. For example, the issue of health disparity in the US has been a major contributor to poor health which is manifested caused by poor access to healthcare, discrimination, language barrier, environmental factors since many lives in polluted areas, and inadequate access to proper nutrition (Ball et al., 2021). Since the patient is of African American race, the nurses should be willing to offer him quality care without thinking about his race. Secondly, another cultural factor that needs to be taken into consideration is the language barrier. Effective communication is paramount in providing quality healthcare services since it allows the patient and the nurse to communicate and understand each other. In a situation where there is a language barrier, nurses should look for interpreters or family members to accompany them. When dealing with this patient, communication was effective since he was also accompanied by his father who helped with developing the patient’s medical history. Another factor is cultural beliefs and practices. Each culture has different and special beliefs about health. For example, in African American culture, people prefer home remedies to treat their illnesses before they can think about going to the facility. Hence, during the interview, the nurse is supposed to ask the patient if he has been using any homemade medication to relieve the situation. This information is important when developing a treatment plan (Chun et al., 2005). It is important for nurses to be informed about the impact of some cultural factors on the patients and the healthcare system. They should be informed on how these factors impact the patient’s perception of his health and learn how to make clinical decisions without validation from the patients. Nurses need to be informed about the impact of health beliefs, diet, language, and family relations have on patient’s health

As a nurse, there are some sensitive things that need to be addressed when interacting with the patient. For example, all medical providers should be sensitive when addressing issues related to patients’ level of education, employment, family structure, nutrition, and religion. This is because integrating cultural sensitivity in the medical profession will have a positive impact on patients’ health, hence improving outcomes, and reducing health disparity. Besides, since the patient had come accompanied by his father, he should be accorded privacy as this will enable him to talk freely about questions regarding sexual partners, family planning, and undertaking other reproduction tests. Promoting privacy and confidentiality is an important progress that will produce enough information needed to develop his medical health history.

Targeted Questions for the Patient

1.    Have you been using any recreational drugs?

2.    What kind of job do you do that is physically demanding?

3.    Have you had any surgery?

4.    What is your smoking, alcohol, and illicit drug use history?

5.    Have you been mentally assessed before?

Post #2

Wilda

Main Post

Shawn Billings, a 28-year-old African American, is the patient in the case study. He is called a “frequent traveler” by the clinic personnel. Shawn is agitated and suffering from a severe headache, and he has come to the clinic with his father, who is also anxious that they will not be given medication. Shawn looks to have a low socioeconomic position, which may limit his access to healthcare services.

 Furthermore, as an African American patient, his cultural background may contribute to disparities in healthcare, such as underutilization of resources and lower quality of care (Rahman et al., 2022). These problems may be caused by a lack of culturally appropriate health information and treatments and a lack of faith in the healthcare system. Shawn’s lifestyle also appears to be unhealthy, as indicated by his frequent visits to the clinic. Overall, the patient’s circumstance demonstrates the systemic elements that might contribute to socioeconomic and cultural differences in health.

While working with patients, it is critical to consider factors such as race, education, religion, family history, and socioeconomic level. It encourages cultural and socioeconomic sensitivity in the medical industry, improving service delivery to a diverse population while minimizing biases (Wong et al., 2021). The patient interview is critical for providing complete patient-centered treatment. Active listening and empathy are essential for developing rapport and confidence with the patient. Nodding and open-ended questions allow patients to disclose detailed information about their illnesses and emotions (Vandewalle et al., 2019).

The following are five targeted questions that can be asked while employing a combination of open and closed questions at appropriate times to develop the patient’s health history and identify health risks:

1.    How long have you had this condition, and how serious is it?

2.    Could you describe the type of discomfort you are experiencing? Is it a throbbing sensation, a dull ache, or a sharp or shooting pain?

3.    Have you observed other symptoms, such as light or sound sensitivity, dizziness, or difficulty concentrating?

4.    Do you have any vision issues such as hazy vision, tunnel vision, or double vision?

5.    Would you rather snooze in a calm, dark place during the episode or go about your everyday business?

6.    What is your emotional state? Do you have any anxiety, depression, or stress due to your condition?

My patient

John Green, 33 year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining.