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Shawn Billings, a 28 year-old African American patient

Shawn Billings, a 28 year-old African American patient

Shawn Billings, a 28-year-old African American patient, visits the clinic once more. Within a short span, he has gained the label of a “frequent flyer” among the clinic staff, having sought medical attention last week and just four days ago for a migraine. On those occasions, he received a combination of Toradol and Ativan and was then discharged. Today, he presents with another severe headache, exhibiting heightened agitation. Accompanied by his father, Shawn expresses concern about the possibility of not receiving medication during this visit. This recurrence of symptoms and the increased frequency of visits raise the need for a comprehensive assessment to understand the underlying causes and address Shawn’s health concerns effectively.

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  • Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
  • By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
  • Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
  • Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
  • Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Scott Becker shadow health Transcript

BY DAY 3 OF WEEK 2

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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“Frequent flyers,” defined as patients admitted at least four times in 12 months (Huang et al., 2020, para 7), often signify suboptimal mental, social, and physical living conditions. Addressing health disparities is crucial for enhancing patient outcomes and overall well-being, particularly among diverse populations. Persistent disparities, prevalent in individuals from low socioeconomic classes with limited healthcare resources, hinder access to quality healthcare. Research by O’Rourke and McDowell (2018) indicates that many African Americans face healthcare disparities, leading to restricted access, underutilization of services, suboptimal quality, and inadequate insurance coverage (para. 3). Similarly, Hostetter and Klein (2021) reveal that African Americans are frequently underrated for pain compared to white patients, emphasizing the impact of false beliefs on healthcare delivery (para. 3). These socioeconomic factors and health disparities offer insights into the concerns of Shawn Billings and his father regarding the adequacy of the medication he might receive.

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A non-biased approach is essential when dealing with patients from diverse backgrounds. In Shawn’s case, factors such as race consciousness, educational levels, health literacy, religious beliefs, and family history should be considered. Patients who feel heard and treated as equals are more likely to engage with healthcare resources and actively participate in their healthcare, contributing to better long-term health outcomes.

Five target questions that would be appropriate to ask are:

  1. What causative or environmental factors seem to initiate or exacerbate these migraines?
  2. Have you been diagnosed with any conditions previously?
  3. What is your day to day routine like?
  4. How has your mental health been recently? Any depression, anxiety, nervousness, or irritability?
  5. What is your usual diet like?

Citations

Hostetter, M., & Klein, S. (2021). Understanding and ameliorating medical mistrust among Black Americans. Commonwealth Fund. Retrieved March 8, 2023, from https://www.commonwealthfund.org/publications/newsletter-article/2021/jan/medical-mistrust-among-black-americansLinks to an external site.

Huang, M., Van der Borght, C., Leithaus, M., Flamaing, J., & Goderis, G. (2020, September 7). Patients’ perceptions of frequent hospital admissions: A qualitative interview study with older people above 65 years of age. BMC geriatrics. Retrieved March 8, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487888/#:~:text=These%20’frequent%20flyers’%20can%20be,%25)%20%5B7%2C%208%5DLinks to an external site..

O’Rourke, M., & McDowell, M. (2018). Providing culturally competent care for African Americans . AANA. Retrieved March 8, 2023, from https://www.aana.com/docs/default-source/about-us-aana.com-web-documents-(all)/providing-culturally-competent-care-to-african-americans-jan-2018.pdf?sfvrsn=54115cb1_2

 

Response

  • Hi xx

    Thank you for sharing valuable insights. The acknowledgment of health disparities among African Americans is indeed crucial. Mistrust plays a significant role in shaping their medical care experiences, contributing to racial disparities in health outcomes. Unfortunately, disparate care for various conditions often goes unnoticed by caregivers, resulting in the deprivation of essential medical treatments (Eiser & Ellis). This patient, concerned about receiving adequate medication, highlights the need for proactive measures.

    To address such concerns, healthcare providers can adopt strategies during history collection. Greeting patients respectfully through body language, maintaining appropriate professional boundaries while fostering friendly discourse, acknowledging emotions, and utilizing healthcare staff familiar with the patient’s ethnicity for communication and education can help mitigate apprehensions. Additionally, cultural competence training for healthcare providers is essential to enhance treatment outcomes for diverse populations (Eiser & Ellis). Recognizing that medications may have varying effects in different ethnic groups, special attention is crucial when prescribing to ensure optimal efficacy and safety.

    Your emphasis on target questions related to mental health, stress, anxiety, and irritability aligns with the understanding that mental health significantly influences headaches. Considering the role of serum serotonin levels in migraines and recognizing alcohol and smoking as triggers, gathering information about a patient’s history of alcoholism, smoking, and drug use becomes essential for comprehensive care (Dains et al.). Your comprehensive approach to addressing the patient’s concerns and considering various factors in the history collection process is commendable for providing patient-centered and culturally sensitive healthcare.

    Reference

    Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care. (5th ed.). St. Louis, MO:

    Elsevier Mosby

    Eiser, A. R., & Ellis, G. (2007). Viewpoint: Cultural competence and the African American experience with

    health care: The case for specific content in cross-cultural education. Academic Medicine, 82 (2),

    176-183. Doi:10.1097/ACM.0b013e31802d92ea

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