As Alice Randall (2012) showed, there are many different cultures, populations, and groups with a wide variety of beliefs that must all be taken into account when attempting to treat individuals within the field of health care. While not all of the issues are similar to that which Randall discussed, i.e. that they wish to remain overweight because it is considered culturally beautiful (2012), the fact of the matter is that many different cultural groups have different perceptions, ranging from everything to a distrust of medical personnel to a belief in spiritual options over medicine, to a desire for DNRs (do not resuscitate orders); while not all concerns are this extreme, it is imperative for an individual to take care and realize that there are other factors that weigh on the patient’s decision making abilities beyond that of medical advice.
In my time as a nurse, I have seen many different individuals experience many different issues or conflicts as they relate to the medical advice they have been given. Taking for example many of the Hispanic patients who would rather visit a bodega and obtain a “natural” remedy as opposed to filling a prescription, or taking a prescription in conjunction with a natural remedy from a bodega, potentially causing issues and drug interactions (Varney, 2013). An individual who is taking blood thinners should not drink willow bark tea, for example.
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Looking to the different patient profiles provided, the case of the 40 year old Hispanic male on Prozac working 60+ hours per week who wishes to explore alternative and complementary modalities to assist in his sleep, we find a similar situation as that with the bodegas. In order to work to assist this patient, one must first obtain an appropriate health history from the patient, taking care to keep the patient’s background, lifestyle, and culture in mind. The five questions that I would ask the patient to build his health history, while remaining sensitive to those areas and still determining his health risks would be:
How long have you been experiencing issues sleeping?
Have you tried any non-prescription remedies to assist you in getting sleep? Any herbs?
What foods and beverages are you consuming within the last three hours before you are attempting to lie down?
Are there any issues that you would like to discuss that may be preventing you from getting sleep, or preventing your sleep being restful?
What is the environment like in your house when you are attempting to get to sleep?
In working to phrase each of these questions in this manner, the nurse is able to obtain a host of information from the patient that may not otherwise have been received. The first question allows for the nurse to find out the duration of the sleeping issue, while the second works to cover all potential items that the individual could be taking, including cultural remedies, over the counter sleep aids, and various natural remedies. In asking what foods and drinks the individual is consuming before attempting to sleep, the nurse can find out if there is any caffeine or other stimulants present that may be causing the patient issues, and in phrasing the question in such a manner it does not assume that the patient is on a night time sleep schedule. Question four works to determine if there are any outside factors such as relationship trouble, family trouble, job trouble, or the like, that may be causing them to be unable to sleep. The last question allows the patient to provide their sleep schedule to the nurse, indicating when they sleep and whether or not there are others around that may be causing a disruption during that time, (such as if the patient is attempting to sleep during the day in the middle of summer in a house with multiple children playing). In this manner, the nurse can work to get a full history without worrying about causing any offense to the patient in regard to their lifestyle choices or factors associated with their lifestyle.
- Randall, A. (2012). Black Women and Fat. Nytimes.com. Retrieved 11 June 2014, from http://www.nytimes.com/2012/05/06/opinion/sunday/why-black-women-are-fat.html?_r=0
- Varney, S. (2013). As ‘Bodega Clinicas’ Fill Void, Health Officials Are Torn. Nytimes.com. Retrieved 11 June 2014, from http://www.nytimes.com/2013/01/13/health/bodega-clinicas-draw-interest-of-health-officials.html
