Our readings about health literacy and the imperative
barriers to it has given me a lot of food for thought. It’s made me quite reflective of my work and responsibilities
as a healthcare provider in respects to making sure my patients are fully aware
of their health status.
The most recent epiphany occurred to me last week that there
is still a very real and strong cultural barrier and resistance to healthcare,
especially in my own culture, the Hmong.
This particular story is of a
relative who was hospitalized for a stroke.
His blood pressures were normal with some mild elevation in his LDL,
nothing too alarming. He was started on
a statin, ASA and Plavix. However, on a
routine transthoracic ECHO prior to discharge there was a small patent foramen
ovale (PFO) found that could possibly have been a contributing factor to his stroke. Naturally, the attending neuro team was
concerned and subsequently ordered a transesophageal echocardiogram (TEE) and
Cardiology consult, to be done the next day.
Nonetheless, there was quite some
resistance with going forward with more testing. The reasoning being fear and annoyance of the
medical staff finding more issues with the patient. Also, stating that the hospital was purposely
finding more tests to do, to keep them in the hospital longer in order to
collect more money. He even stated that
health care providers “don’t know what they’re doing”.
…So, I have to take a step back and
hold my breath because now I’m getting a little offended by their comments. And
yes, they know I’m a nurse. The NP
discussed her concerns utilizing an interpreter and myself to re-explain their concerns
and the reasons for their recommendations for further testing. Initially, the patient and his son was
adamant about refusing further testing and resolute on being discharged home. However, they did become agreeable to waiting
for Cardiology’s input about the PFO.
Cardiology was luckily on the floor and was able to review his chart and
see him. They weren’t too concerned and
was okay with him going home but recommended following up for an outpatient
TEE.
The Asian culture, like all other cultures, is unique and has their own philosophy on
healing. As described in our text, there
are four common values that are strongly reflected in the Asian culture as a
whole, that being: “male authority and dominance, saving face, strong family
ties and respect for parents, elders, teachers and other authority figures”
(Kitchie, 2014).
As a Hmong nurse, I hope to use my medical knowledge to
teach the Hmong people of the necessity of healthcare maintenance and prevention
and to seek out professional help earlier rather than waiting until a person is
acutely ill or septic. As I read the
book, even my own experiences within my family concurs with the books statement that
medical intervention is usually sought out in an emergency or dire situations, often almost being too late for the patient.
I live these issues everyday with
my elder mother-in-law with her herbal medication cures and non-DEA approved
medications that she purchases at Asian markets. Even tonight, I received a message from my
siblings that my mom is very sick and has been having fevers, chills, weakness
and vomiting since last week Friday. I
called my Dad right away for an update and learned that my Mom has not improved,
she probably had a UTI that’s now pyelonephritis, but they were going to wait
until tomorrow to go to the ER. Oh boy, luckily I was able to iterate the
severity of her condition and need for IV hydration and IV antibiotics before
things got worse and that things were only going to get worse without medical intervention. Thank goodness my dad
took her to the ER tonight and she is still currently receiving treatment.
This is why it is so important to bridge the gap between
healthcare literacy and different cultures.
An easy UTI could have been treated when minimum symptoms were present. And truth be told, with a much smaller medical bill too.
