How Would Patient Care Change If Doctors, Nurses, And, Providers Failed to Take in a Person

How would patient care change if Doctors, Nurses, and, Providers Failed to take in a person’s religious, cultural, and personal preferences? Would patients be less likely to seek care if they knew they would not be treated as they think they should? How would claims rise if patients disagreed with the care they were given or how it was administered. Even today with the practices in use by providers, you will be hard pressed to find someone who feels they were mistreated by someone in the hospital staff.
“Health care providers take many different approaches to bridge barriers to communication and understanding that stem from racial, ethnic, cultural and linguistic differences. In recent years, the notion of "cultural competence" has come to encompass both interpersonal and organizational interventions and strategies that seek to facilitate achievement of clinical and public health goals when those differences come into play” (U.S. Department of Health and Human Services, 2007).
Everyone on this planet even though they may be the same race as another, was raised differently. Each person has their own customs, values, morals, religions and cultural views. Every person deserves to have those ideals respected when seeking care for themselves or their families. The breaking of these ideals by hospital staff can be a very troubling and traumatic experience for the individual and that same person is unlikely to seek care again due to it. Some of these ideals may sound crazy, hurtful, or insane to anyone with a different set of ideals, but in most cases they are not harmful and are appropriate for that person. This of course changes region by region, but with America being a melting pot of many regions, religions, beliefs, and cultures, a provider is bound to find themselves in a situation where they do not necessarily believe in what the patient or their family are requesting. Communication in these instances is crucial so that there will be no instances of inappropriateness or hurt feelings while caring for a patient.
I went with scenario number one, which involves a South Asian girl, Lena, who was brought into the emergency room because she fainted in her class. Lena had no history of fainting or any other complications that would attribute to her passing out in the middle of class. Lena was taken to seek medical attention at the emergency room by her best friend Susie. Susie had taken this task upon herself while Lena was still passed out, for going to the emergency room was against Lena’s wishes. Although Lena and her family have lived in America for the past 10 years, her and her family still followed and held true to the customs and beliefs of their native country. They lived their lives accordingly to how they did at home with very few expectations. Lena is upset and angry because she thinks hospitals and even worse emergency rooms are for weak people, and Lena is not a weak person. Lena is directing her anger mainly at Susie for bringing her to the hospital in the first place; she probably feels her best friend should know her better. Lena does not attempt to hide her anger when the medical assistant came into the room, and the medical assistant escalates the situation when he informs Lena that she is ill beyond what she was brought in for and that a doctor will be in shortly to discuss the findings with her. When the doctor comes into the room Lena is so upset and angry at what has happened and frightened that something worse might happen, she cannot focus on what the doctor is saying. When the doctor leaves the room Lena is more afraid and angry than she was when she discovered that she had been taken to the emergency room.
I am in agreement with Susie’s decision. To care about someone enough to feel the danger of a situation and seek help so that the person you care about is no longer in pain is a strong feeling. Taking Lena to the emergency room was really the only choice Susie, who was probably scared stiff seeing her friend lying seemingly lifeless on the floor, could make. I can however see Lena’s anger and even resentment at the situation. Her beliefs were probably known to her friend and Lena might feel a sense of betrayal at her best friend ignoring her wishes. The feelings of anger were made worse once in an exam room when the medical assistant stated, “Listen girl, I don’t have time to deal with this today! You need to stay here, you are sick!” This medical assistant is no Doctor, who is he to tell the patient anything other than, “Please if you wait here I will have a Doctor come in and discuss things with you.” This statement would have made anyone angry at the level of rudeness that the medical assistant displayed, yet he was speaking to someone who did not want to be there in the first place. Hospitals are not prisons, people are not held there against their wills, people can leave the hospital on their own at any time and for the medical assistant to be so rash and scare her when she was already scared and angry was unacceptable and inappropriate. Lena had not seen a Doctor yet and it was not the medical assistants place to determine if the patient was sick or not, Lena had no idea what was going on except for that she was brought into the hospital by her friend because she passed out. To be told there is something wrong with you or you are sick and need medical attention without having been diagnosed or even seen by the doctor is a very frightening experience, and in this situation just made matters worse. The medical assistant made a critical mistake by telling Lena she was sick, a Doctor is the only person who can diagnose and only after a diagnosis has been made can a medical assistant comment on the situation. In this case before Lena had even been diagnosed she was told she was ill.
It appears the Doctor saw firsthand the situation that went on between the medical assistant and Lena, as when the Doctor enters he instructs the medical assistant to leave the room. One would assume that the Doctor would show more understanding and maybe even apologize for the brass attitude and behavior that the medical assistant showed, however this assumption proved to be wrong. A doctor with years of schooling and having taken courses on relations and communications with patients should show more understanding, care, and sympathy for a patient’s worries and beliefs. The Doctor was almost as bad as the medical assistant in his treatment of Lena. When the Doctor spoke to Lena and informed her rather coldly that, “Fine, you are not going to respond? I have many other patients to attend to who actually want to get better,” when Lena did not respond to his questions, then he promptly left the room without trying again or giving any more information. This in my opinion shows a poorly run hospital, when you have one bad experience that is one thing, but repeatedly being treated unfairly by different members of staff shows a poorly run hospital. To have both the Doctor and the medical assistant show poor communication and rudeness shows a lack of experience no matter how much schooling one has obtained.
“Improvement in physician-patient communication can result in better patient care and help patients adapt to illness and treatment. In addition, knowledge of communication strategies may decrease stress on physicians because delivering bad news, dealing with patients’ emotions, and sharing decision making, particularly around issues of informed consent or when medical information is extremely complex, have been recognized by physicians as communication challenges” (Back, 2002, Enhancing Physician-Patient Communication).
The Doctor could have shown some compassion and patience for this young frightened girl in front of him. Lena was obviously distressed, unset, afraid, and angry. At the very least he could have told her he would be back in 15 minutes to give her a chance to calm down and revaluate if she wanted help or not. This is however a difficult situation because there are two sides to this story not just Lena’s. Perhaps the Doctor was overworked and having this child, who was being difficult in an exam room while there were 30 other patients to see to, was probably frustrating to the Doctor. Lena remained silent and most likely sulking while the Doctor was speaking to her, and at this he probably felt ignored, which would further frustrate someone. Physicians normally are not ignored or treated this way as they usually consider themselves very up class, financially and socially, and the doctor probably did not like patient’s behavior. However this person is a Doctor, he or she went to school, took an oath, and made the decision to practice medical care in an emergency room setting, so this Doctor should, regardless of the situation, provide medical care to the patient, unless of course the patient refuses care and leaves the hospital. When making the decision to become a Doctor people understand that they may have to deal with crying kids, patients refusing care, and people with different beliefs and customs from them. If the Doctor did not want to support the patient then they should choose another career.
In my opinion Lena was experiencing an emotional reaction that caused her to “shut down” in a way.
“In traditional Chinese medicine, emotions and physical health are intimately connected. Sadness, nervous tension and anger, worry, fear, and overwork are each associated with a particular organ in the body” (Wong, 2008, Understanding Emotions in Traditional Chinese Medicine).
Some providers see tolerance levels of patient pain fluctuate between races or genders. This causes some patients to believe, falsely, that the whole race or gender is the same way. A persons religious and cultural beliefs or the way they were brought up, play a major role on how the patient is handling pain or discomfort. There are cultures and religions which absolutely prohibit screaming, crying and other signs of pain, some believe that it is a shame to show weakness, and of course, there are cultures which do not believe in traditional medicine, rather natural herbal healing.
In this instance Lena most likely came from a society that looked at receiving medical assistance as a sign of weakness and or shameful.
“The Asian American/Pacific Islander population in the U.S. is mostly foreign-born. Therefore, these families continue to hold on to traditional views of health and illness,” (Cantore, 2008, Modern Nursing Traditional Beliefs).
Communication between the patient and provider is very important; the patient should feel free to communicate any and all issues with their provider. Good communication on both sides ensures effective, successful, and proper treatment of the patient. The patient must be assured that the provider knows what they are doing and the provider must know for a fact that the patient will do everything possible to speed or help the treatment and recovery. Having proper communication between the patient and provider will make the patient more relaxed, secure, and, trusting and less anxious and irritable.
“Park explains that for patients to begin to trust modern health care procedures, which can be quite different from the health care system of their country of origin, they must first trust their care providers” (Cantore, 2008, Modern Nursing Traditional Beliefs).
This entire scenario makes someone believe that this hospital is not working correctly, or is in such poor condition that they cannot hire or retain properly educated staff. The actions of the medical assistant and the Doctor suggest that they were not properly trained in communication skills. Both were rude to the point of being cold and showed no compassion, sympathy, or patience with Lena. If communication training was not available at the school that either the Doctor or the medical assistant went to then the hospital should consider sending all new employees and all existing employees every year. A cultural diversity class would not be a bad edition either, as it does not take much to learn the tolerance of other cultures and how to build a good rapport with everyone who enters the doors for care.
The way these situations should have been handled is for the medical assistant to greet the patient in a kind friendly manner, and then try to relax the patient by telling them “not to worry” and “I will go get the doctor.” Using comforting phrases can make the patient more relaxed and comfortable and works wonders against the statements like, “you are sick”, “don’t go anywhere” or simply saying nothing at all. The situation with the Doctor could have been fixed by the Doctor being a bit more professional in his approach to the patient. He could have also taken a second to try to find the root of the patient’s issues with being in the hospital. If he would have done a tad bit of digging he would have found a new way to approach her to get results. Sometimes by simply asking the right questions just to get the patient talking is a good way to get results in order to give the patient the correct care. According to Lena’s culture, she was probably ashamed of showing her weakness, so the doctor should have put some effort into helping the patient past this issue in order to give her the care she needed. Thankfully these providers’ approaches did not affect Lena’s health very much. Their approach did not do much for her emotional well being but as for a physical aspect it did not affect her. There are different situations where appropriate communication skills are essential. For example, often woman from Asian and Middle Eastern countries will refuse to see a gynecologist because they believe that it is inappropriate, or parents will refuse recommended treatment for their ill children because certain procedures are against their beliefs. There are many situations where cultural beliefs, religion, and background will interfere with necessary medical treatments. That is why it is very important for health care providers to respect patient’s choices and beliefs.
Poor communication skills may not only offend a patient, but also lead to improper diagnosis and treatment. If good communication eludes the provider on the first visit then they should be persistent in their pursuit for communication. Providers should always have a controlled, respectful, caring, and above all professional appearance when dealing with patients who are either unruly or uncooperative. If a provider is consistent and persistent then they will be rewarded with good communication and a patient for life. Patients may find some physicians too demanding or even annoying, which will also result in poor communication.
There are probably not very many medical offices and hospitals which will be able to survive without considering diversity and paying attention to patient’s individual needs. Health care providers should go through mandatory cultural training to be able to recognize cultural differences among patients. A physician should show so understanding and sensitivity to a patient’s cultural or religious beliefs. Physical comfort and emotional support help the patient to open up and feel secure.
“Communication is one of the foundations of health care. Every health care interaction depends on effective communication, from making an appointment and registering for a visit to describing symptoms, discussing risks and benefits of treatments, and understanding care instructions. Good communication is linked to improved patient satisfaction, adherence to medical recommendations, and health outcomes” (Wynia, 2006, Promising Practices for Patient-Centered Communication with Vulnerable Populations).
Reference:
Back, A. (2002). The American Society of Hematology. Enhancing Physician-Patient
Communication. Retrieved April 22, 2009, from
Cantore, A. (2008). Minority Nurse. Modern Nursing Traditional Beliefs. Retrieved April 20,
2009, from
Wong, C. (2008). Alternative Medicine. Understanding Emotions in Traditional
Chinese Medicine. Retrieved April 17, 2009, from
Wynia, M. (2006). The Common Wealth Fund. Promising Practices for Patient-Centered
Communication with Vulnerable Populations. Retrieved April 18, 2009, from

U.S. Department of Health and Human Services. (2007). Setting the Agenda for Research on
Cultural Competence in Health Care. Retrieved April 20, 2009, from