Assignment: Considerations for Culturally and Linguistically Appropriate Service and Care for the Terminally Ill

Assignment: Considerations for Culturally and Linguistically Appropriate Service and Care for the Terminally Ill

Assignment: Considerations for Culturally and Linguistically Appropriate Service and Care for the Terminally Ill

Info: I am a 60 years old black male protestant who speaks English only. I have been a nurse since 1985

FINDING YOUR PLACE ON THE STAIRCASE

Step 1. Nurses at Step 1 fail to recognize the significance of cultural influences when planning care. They may have completed nursing school before cultural content was introduced and/or have limited exposure to culturally diverse patients.

Step 2. Nurses at Step 2 have a growing awareness of the influence that culture has on health, but limited cultural self-awareness. They may be in denial about the role culture plays in their lives and have limited knowledge about other cultural groups.

Step 3. These nurses have begun to develop cultural self-awareness, acquire cultural knowledge about one or two culturally diverse groups, and attempt to include cultural information in care planning.

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Step 4. Nurses in this category have a strong cultural self-awareness and an expanded social network from which to derive cultural information about diverse groups. These nurses consistently incorporate that knowledge into their care planning.

Step 5. Nurses at Step 5 are highly aware and readily apply cultural knowledge to care planning. They also anticipate potential culturally related patient problems or staff issues. They may serve as mentors and role models.

Step 6. Nurses at this level have a high level of self-awareness, a wide knowledge of another or multiple cultures that differ from their own, and an ability to problem solve across cultural groups and to teach other nurses through mentoring, publication, and/or research.

For this assignment, please review the Case Scenario on page 112 and Case Scenario 1 on page 131 (Kersey-Matusiak, 2019). Reflect on your attitudes, beliefs, and practices as they apply to each case scenario. This assignment requires you to address your personal feelings about culturally and linguistically appropriate service and care for the terminally ill. Remember, answer these questions from your unique perspective, so there is no right or wrong response. You must address each problem.

For this assignment, create a 1250-1500-word essay based on the following case studies.

Read the following two Case Studies and answer the questions presented below.

1. Case Scenario: Mrs. Garcia is located in Chapter 6 on page 112.

Mrs. Garcia is a 67-year-old woman who is visiting her daughter from Puerto Rico. She suddenly experiences an episode of severe chest pain. Her daughter, who recently delivered a healthy 8-pound newborn, calls for an ambulance but is unable to accompany her mother to the hospital. Although the daughter speaks English fluently, Mrs. Garcia speaks only Spanish and can understand only a little English. She is rushed to the nearest hospital, where the staff struggles to communicate with her as best they can. In the emergency room (ER), Mrs. Garcia holds her hand over her chest and grimaces as the pain seems to grow more severe.

One of the ER nurses grabs Mr. Rodriguez, a staff member in environmental services, and asks him to assist by translating for the nurses and doctors caring for Mrs. Garcia because it is 8 a.m. and the only Spanish-speaking medical interpreter, Mr. Sanchez, is not due in until 10 a.m. Based on the ECG findings and first lab results, the staff believes that Mrs. Garcia is experiencing a myocardial infarction (MI). They ask that Mr. Rodriguez explain to her that they are awaiting the results of other laboratory studies to confirm the medical diagnosis, but believe that she probably had a heart attack and will need further testing to confirm the medical staff’s suspicion. Mrs. Garcia becomes extremely anxious and begins to cry. The staff is baffled about what to do next.

Questions:

• Where are you on the Cultural Competency Staircase regarding this patient’s language and culture? How will you progress to the next level? (Review Chapter 1 and the Staircase Model).

• What knowledge do you need to have about this patient, including cultural/language needs, to provide this patient with culturally sensitive care?

• What would you personally do to address the needs of this patient?

• What resources do you need, and how would you obtain them?

• What cultural assessment model would you plan to use to assess this patient?

Ms. Vera Talsford, a 65-year-old widow, mother of two daughters, and grandmother of two young boys, arrived in the emergency room (ER) of a busy metropolitan trauma center complaining of a severe headache with increasing pain, dizziness, and nausea with movement. After the physical examination, the physician ordered a CT scan, which revealed a left occipital mass. Ms. Talsford was admitted with a brain tumor. During the next few days, MRI studies, a PET scan, and other tests revealed that Ms. Talsford had lung cancer with metastases to her brain. A friend of the family was with the patient when the doctor spoke with her. He asked Ms. T, as everyone called her, if it was okay with the patient to speak about her situation while the visitor was present. Ms. T said that was okay with her. The doctor spoke encouragingly and told Ms. T that everything would be done to remove the tumor from her brain. Over several days, Ms. T made a slow neurological recovery from the surgery, but became more despondent after being told about the severity of her illness. She was starting to eat less each day and lost 20 pounds in a short period. Ms. T was well liked and had a room full of visitors each day. The nurses on the unit were confused about how to best care for Ms. T. They were not sure if she appreciated the significance of her diagnosis. One day Karen, one of the staff nurses, asked Ms. T if she would like to see a minister or other clergymen during her hospitalization. Ms. T stated, “Well, I’m not really the religious type.” Karen was stunned by Ms. T’s comments and replied, “Okay, I’ll be back in a little while.” She left the room perplexed about what to do next to assist Ms. T.

Questions:

• Have you considered the significance of your death?

• Do you believe in life after death?

• Where are you on the Cultural Competency Staircase when caring for patients who are terminally ill? How will you progress to the next level?

• How comfortable are you caring for this patient and discussing issues related to her and her family’s death and dying process?

• What cultural information about the patient will you need to obtain culturally sensitive care during the EOL?

• What kinds of psychological, emotional, and spiritual support would you need if given a similar diagnosis?