NUR 504- Reply to ANN

  case 1 

• 76-year-old Black/African-American male with disabilities living in an urban setting.


• Adolescent Hispanic/Latino boy living in a middle-class suburb

Week 1 Discussion, Case Study 1

There are a few different interpersonal barriers to effective communication.  The first being a language barrier, English is a very complex language, we have many words that have multiple meanings, and many slang words.  This can be very confusing for patients that English is not their first language.  Psychological barriers can include being embarrassed, shy, cognitive issues, and mental disabilities.  Cultural barriers between patient and provider can cause strained relationships.  Some cultures find it offensive to maintain eye contact, while some find the simple touch as being offensive.  Environmental barriers should also be considered, these include noise, lack of privacy, and room being too hot or too cold.  Taking into consideration the physiological barriers that patient may have including hearing deficits and potential stress the patient may be under that would cause a patient to not understand what we are asking or teaching them.

Taking these barriers into consideration while caring for our 76 year old African-American man with disabilities living in an urban setting, we would be considering the type of disability the patient has.  The case study does not define this disability as physical or mental.  If the patient has a mental disability we would be up against the psychological barriers and would need to be cognizant of our approach with trying to navigate this barrier.  There is also a potential for a language barrier with this patient, while most African-Americans speak English, there is still the aspect of the slang words that can have different meanings based on culture, and there is a potential for cultural barriers to be present as the patient may have beliefs that differ from my own.

In caring for this patient, I would first explain to the patient exactly what I am going to be doing, and would show him the equipment that I will be using and explain what each item is for.  If the patient has mental disabilities, I would also demonstrate for him either on myself or another family member of the patients the procedures.  Building trust with the patient is the first item that needs to happen in order to provide this patient with the best possible care.

Caring for an adolescent Hispanic boy, we also have the potential for a language barrier.  This child may speak English as a second language and may have difficulty in interpreting what is being stated to him.  There may be psychological barriers, due to the patient being an adolescent male and myself being female.  The patient may be shy or uncomfortable speaking with a female healthcare professional.  There may be cultural barriers as well,  Hispanics are very tight-knit families, and can tend to be over-emotional.  Hispanics also tend to be more "touchy-feely". 

In caring for this patient, I would also explain to him exactly what I am going to be doing.  I would also show him the equipment and would explain what each item is for.  I would allow him to hold the equipment, to allow him to see how it works.  Should this patient need a demonstration on another person, or a stuffed animal, I would provide this demonstration prior to performing the procedure on him.

"The most common approach for documenting a history and physical is the subjective data, objective data, assessment, and plan (SOAP) format" (Rhodes & Petersen, 2021). The subjective data includes patient identifiers, the chief complaint, history of present illness, past medical history, family history, social history, and the review of system.  The objective date includes the physical examination, and any diagnostic tests results that were completed.  The assessment portion has three categories, new diagnoses and any preexisting diagnoses, differential diagnoses, and a problem list.  The plan section is the final section, in this section the healthcare practitioner would lay out what the treatment plan is for the patient.  This would include: nonpharmacological interventions, pharmacological inerventions, educational needs, follow-up, and referrals.

References

Rhoads, J., & Wiggins Petersen, S. (2021). Advanced Health Assessment and Diagnostic Reasoning. Burlington, MA: Jones and Bartlett Learning.

Wainwright, N. (2017).  Barriers to Effective Interpersonal Communication.  https://bizfluent.com/list-7422303-barriers-effective-interpersonal-communication.html