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Problem or potential problem
The main problem in this case study is that patients from different cultural backgrounds respond differently to pain due to different beliefs of pain management prevalent in their cultures (Narayan, 2010, p. 38-47). This means that nurses are faced with diverse problems when caring for patients from different cultural backgrounds especially when such patients regard the expression of pain as a demonstration of weakness or a taboo. From the case, both the Chinese and the Dominican Republican patients receive the same treatment yet their level of pain management or pain expression is different.
The individuals in this case study include the two patients drawn from different backgrounds, Mr. Ramirez, a middle-aged man from the Dominican Republic, and Mr. Yu Hee, a middle-aged Chinese patient, the nurse, and the doctor. The nurse and the Chinese patient do not interact favorably because the Chinese patient has no skills for pain management and he doesn’t ask for help from the nurse. However, the interaction level between the nurse and the Dominican Republican patient is favorable because the patient expresses his pain openly thus calling for the attention of the nurse regularly.
The level of interaction between the nurse and the doctor is high and favorable since the doctor responds positively and quickly to the calls from the nurse. The context within which the situation is unfolding is that patients are drawn from different cultural backgrounds and the nurse and the doctor must respond to different calls from the patients without considering the patient’s cultural background.
One of the conflicts evident in the case study is that the Chinese patient does not give the nurse a hard time and this makes it difficult for the nurse to determine whether the patient is in pain. This makes it difficult for the nurse to administer the care required by such a patient even though the patient might be in great pain. The Dominican patient gives the nurse a hard time through constant shouts of agony which makes it possible for the nurse to administer the nursing care required by such a patient to help him manage the pain.
Madeleine Leininger’s theory
Madeleine’s theory involves the discussion of the methods of care through the transcultural nursing concept. This includes integrating cultural factors in the practice of nursing to arrive at the best methods which can be used to attend to the patients in need of care. From Madeleine Leininger’s theoretical orientations and assumptions, care is assumed to be a distinct, unifying, and dominant focus in nursing even when the people involved come from different cultural backgrounds (McEwen and Wills, 2007).
It is evident from the above theory that patients who encounter nursing care that fall short of their values, beliefs, and lifeway caring always show signs of cultural conflicts such as stresses, noncompliance, moral or ethical concerns which make them respond differently to the treatment administered to them (Madeleine, 1991, p. 44). From the above case study, it is evident that the Dominican Republican patient has encountered nursing care that falls short of his values, beliefs, and lifeway caring which makes him uncomfortable with his present treatment.
According to Madeleine Leininger’s theory, culturally fitting nursing aims at providing supportive, cognitively based, enabling decisions or acts as well as facilitative decisions which fit with group’s, individuals, beliefs, cultural values, and lifeways of different patients drawn from different cultural backgrounds (Madeleine, 1991, p. 45). According to Madeleine’s theory, the overview of the background of the patient involves an overview of language and communication, considerations of gender, disability and ability, sexual orientation, occupation, socioeconomic status, and age of the patient. Through the lens of this theory, the holistic overview of the patient’s cultural background is the most important avenue through which effective transcultural nursing is achieved.
Reference list
Madeleine L, M. (1991). The theory of culture care diversity and universality. New York: Sage Publishers, pp.44-45.
McEwen, M., & Wills, E. (2007). Theoretical basis for nursing (3nd ed.), Philadelphia, PA: Lippincott, Williams & Wilkins.
Narayan, M. (2010). Culture’s Effects on Pain Assessment and Management. AJN, American Journal of Nursing, 110 (4), 38-47.
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