2023 Topic 2 T Identify an experience where you had to assess the needs interests and goals of a patient

 

Topic 2/T

Identify an experience where you had to assess the needs, interests, and goals of a patient with an ethnic background, different from yours, that resulted in a positive learning experience. How did you turn the situation into a positive learning experience? Did you personally have to deal with any stereotypical beliefs?

When I was working in SICU (Surgical Intensive Care Unit), I was assigned to a patient who was admitted to ICU after an episode of bradycardia and loss of consciousness on the medical surgical floor. A rapid response was initiated and she was intubated and brought to our unit. She was Haitian and came from a very different ethnic background. At the time I was not familiar with their culture or beliefs nor did I know her health history and what originally brought her to the hospital or the reason for her admission.

After a couple days of being assigned to her and taking care of her and her family, I began to understand a little more. She had been diagnosed with breast cancer the previous year and had undergone chemotherapy which unfortunately was unsuccessful. The cancer had spread throughout her body including her esophagus which was later found out to be the reason for the intubation. A tumor had attached itself to her airway and she was unable to breath on her own. 

I instantly became attached to the patient and family and enjoyed learning about their culture and belief system. Many people including doctors, nurses and other medical professionals couldn’t understand why a patient who was terminal would want everything done and continue aggressive treatment. Many gave up on her and the family which is why I believe they requested that I take care of her every shift I worked. Special arrangements were made between the family and my director to accommodate their wishes. 

Each shift I worked, I took care of her. Her daughter and her husband never left her side other than for bathing or other emergent matters that couldn’t be handled without them. Eventually the primary physicians would stop rounding on her daily and healthcare professional started discussing her prognosis, treatment and plan of care. No one understood why we were continuing to treat this individual as they called the treatment “futile”. 

As time went on, the hospital decided to call in Risk Management as they had a different belief and understanding regarding by patient’s wishes and medical management. This is when I realized I did, I understood her and her family and knew I needed to be her patient advocate and her voice. I fought for her treatment and plan of care which was aggressive not palliative. She expressed to me she wanted to live, even if it meant her last days were spent in the hospital. She would lay there and listen to her children laugh and tell stories about their day and her husband’s voice telling her how much he loved her. She was a mother of 10 and had the most beautiful family I had ever met. 

Before I met her, I may have had the same thoughts and comments as the other healthcare professionals. However, once I got to know her and her family as well as their cultural beliefs and background, I understood her. This was more than a positive learning experience it changed my life, my outlook and opened my eyes to cultural diversity and understanding.