Briefly introduce a person you have recently cared for in your nursing practice that was diagnosed with COVID-19

Culturally Competent

Vixony Vixamar

St. Thomas University

Prof. Kathleen Price

NUR 417

October 28, 2021

Culturally Competent

The COVID-19 has affected over 45 million in the United States and has led to over seven hundred and forty thousand deaths across the United States. The pandemic has increasingly affected all individuals and has led to various economic as well as social changes. However, there have been some health disparities identified with people of color being among the most affected individuals (Reyes, 2020).  Nurses are at the frontline of providing health care services to individuals that have been infected by the virus. Therefore, as a nurse, I have come across various COVID-19 cases where the patient needed to be observed or there was a need to manage the condition.

One case was that of a middle-aged pregnant woman that had contracted the virus. The symptoms started as headaches and feeling tired. She stated that she initially assumed these symptoms as normal pregnancy symptoms as she had earlier on in the week engaged in some intensive exercises as she went shopping with some family members. However, one evening she had some challenges breathing and her family members rushed her to the hospital. She had to be put on oxygen as she needed support breathing. She was given a PCR test that turned out to be negative. However, the fact that she needed to be on oxygen necessitated another test which also read negative. At this point, it was crucial that a chest scan be done to help with the diagnosis. Upon the scan, the physician diagnosed the patient with COVID-19. Her condition quickly deteriorated and she had to be put in intensive care. It was especially challenging caring for her given that she was seven months pregnant at the time. At one point, the family had contemplated terminating the pregnancy to increase her chances of surviving given that fetal movements had subsided for a while. However, after a few weeks in the intensive care unit, she made a full recovery and was able to deliver her baby full-term. She remained on oxygen and under observation until her due date.

The patient was a patient of color, with a university education and is from a middle-income family. Her family, the mother, and three sisters, played an important role as they helped with the health care decision making. The patient’s health literacy was high and, therefore, she would ensure that she had information on all possible alternatives before making a decision relating to her health. The education level of individuals is highly linked to their health literacy with individuals with higher education being perceived as being health literate (Bayati, et al., 2018). As a person of color, it was important to provide culturally competent care to meet her needs. A quick self-assessment was important to ensure that I do not hold any subtle biases that might affect the delivery of care. It was especially important to recognize that a majority of Black Americans do not trust the health care system due to past historical injustices. Therefore, creating a conducive therapeutic environment was important for helping build a mutually trusting relationship. The relationship was especially crucial in educating the patient and family about the importance of getting vaccinated. According to Kricorian & Turner (2021), the acceptance of the COVID-19 vaccine is low among Black Americans. Therefore, it was important to address all their concerns about the vaccine and understand the impact of culture on the same.  The efforts made were not in vain as the family was fully vaccinated with the patient receiving the vaccine a few months after giving birth.

References

Bayati, T., Dehghan, A., Bonyadi, F., & Bazrafkan, L. (2018). Investigating the effect of education on health literacy and its relation to health-promoting behaviors in health center. Journal of Education and Health Promotion, 7, 127. doi: 10.4103/jehp.jehp_65_18

Kricorian, K., & Turner, K. (2021). COVID-19 Vaccine Acceptance and Beliefs among Black and Hispanic Americans. PloS One, 16(8), e0256122. https://doi.org/10.1371/journal.pone.0256122

Reyes, M. V. (2020). The disproportional impact of COVID-19 on African Americans. Health and Human Rights, 22(2), 299. PMID: 33390715

Providing Culturally Competent Care 

Andrea Lyn-Bell

St Thomas University

NUR 421: Nursing Practice in a Multicultural Society

Professor Price

October 28, 2021

Providing Culturally Competent Care 

I have been involved in the care of many people in the Emergency setting since the beginning of the COVID-19 pandemic from early 2020 until now. This pandemic has been challenging for all. The fear of contracting the virus and the havoc it can wreak inside ones body, the social isolation in an effort to contain the spread, the financial challenges as many people’s livelihood has been affected and not knowing how long our lives will be altered by this new normal has affected everyone in various ways, most of which are negative. Mental health crises are at an all-time high as people struggle to navigate this difficult period. A Kaiser Foundation health tracking poll from July 2020 found many adults reporting sleep disturbances, increases in alcohol consumption or substance abuse, and worsening chronic conditions due to stress or worry ( Panchal et al, 2021).

I remember having a patient earlier on in the pandemic who had a difficult time accepting that she had contracted the virus and providing care for her became quite an ordeal. She was an older Caucasian woman who appeared to be very affluent and knew many people who donated generously to various local healthcare organizations. She presented to the emergency department experiencing fever, cough, chest discomfort and loss of taste and smell. After being examined by the emergency room Physician she was informed that as a part of her work up she would be tested for COVID-19. She made is clear that it was not necessary as she was tested three days prior and had a negative result. It was explained to her that she is now presenting to the hospital with worsening symptoms and she would more than likely need to be admitted as she was now requiring oxygen to address her low oxygen saturation readings. The patient continued to get upset and after speaking with her husband she agreed to be tested again. Upon receipt of her positive result and her chest x-ray showing ground glass opacities consistent with viral pneumonia that patient became even more disgruntled. The patient let us know that she did not believe the results and we were not carrying out the testing properly. It was explained to the patient that she is in droplet isolation and should not leave her room especially to use shared facilities. The patient disregarded all the isolation precautions and continued to walk around the unit. It was explained to her that she was putting other patients and staff at risk and security would be called if she continued to disregard the protocols. The patient started to drop names of the influential people that she knew and stated that she would be contacting various board members to tell them how horribly she was treated by the staff. As her nurse I explained to her that we are trying to provide her with the best care possible and that I understood that due to the fear surrounding the pandemic this diagnosis may be hard to accept. With her permission I went head and contacted her family and explained the details of what happened since their loved one came into the hospital. Her husband and children were afraid but did not approve of the way in which the patient had handled the situation. After much discussion, they convinced her to stay for treatment and monitoring.

It is our responsibility to do what is best for our patients and sometimes we are faced with challenging situations that we must navigate as healthcare providers. I tried my best to provide care for this patient is the most respectful way possible while advocating for the safety of the other patients and staff on the unit. I realized that getting her family involved was best and collaborated with them to de-escalate the situation and get the patient admitted to the hospital. According The Chicago School, cultural competence prepares Nurses to empathize and attend to patients needs on a deeper level through bridging gaps and personalizing care (2021).

References