WK 1 Discussion – 40-year-old black recent immigrant from Africa without health insurance

WK 1 Discussion – 40-year-old black recent immigrant from Africa without health insurance

Main Post

The patient I’m addressing is a 40-year-old black recent immigrant from Africa who does not have health insurance. The primary challenge in this situation is the uncertainty about the patient’s English fluency. To initiate the interview, I would start by warmly welcoming the patient with a smile and introducing myself. I’d then ask some basic questions like their name, age, and place of residence to assess their language proficiency. If it becomes evident that they do not speak English fluently, I would consider utilizing an interpreter, possibly a language translation software tool if an interpreter is unavailable. It’s essential to note that not all African nations use English as their primary language, so a language assessment is crucial for obtaining a comprehensive health history.

Once any communication barriers are addressed, I would proceed to gather basic information such as age, gender, marital status, and occupation. Following this, I would delve into a comprehensive health assessment by asking specific questions. Obtaining a thorough patient health history is a powerful tool for identifying symptoms that may indicate various health issues (Diamond-Fox, 2021).

I would focus on asking these five fundamental questions:

1. What is the reason for your visit today? This question aims to assess the patient’s unspoken concerns or fears.
2. When did you first start experiencing these symptoms? This helps establish a timeline of events and assesses the patient’s recent health status.
3. Can you describe your symptoms in terms of location, duration, factors that worsen or alleviate them, when they began, and how long they’ve persisted? This inquiry is crucial for symptom analysis.
4. Do you have any existing medical conditions or are you currently taking any medications? Additionally, I might inquire about any childhood illnesses or injuries relevant to the patient’s chief complaint. Understanding the patient’s medical history aids in assessing the current issue and assessing their overall health risks.
5. Towards the end of the interview, I would summarize the information collected and ask, “Is there anything else I should know?” or “Is the information accurate?” This step ensures accuracy and completeness in the patient’s health history, which will be recorded in their medical chart or profile.

Cultural Sensitivity and Empathy:
As a healthcare provider, it’s crucial to be culturally sensitive to avoid any potential misunderstandings or misinterpretations. Immigrants from Africa, in particular, often face challenges in the US healthcare system, including a lack of culturally sensitive care and encounters with providers who may not understand their unique needs (Omenka et al., 2020). To address this, I would prioritize empathy, courtesy, and ensuring the patient’s comfort to build trust. The I.C.E. (Ideas, Concerns, Expectations) tool can be valuable in active listening, maintaining proper body language, empathizing with the patient, and addressing their thoughts, concerns, and healthcare expectations directly (Desai, MD, 2018).

Mental Health Assessment:
Given the patient’s immigrant status and potential challenges associated with migration, such as culture shock, socioeconomic stressors, and a lack of emotional support, I would also include a mental health component in the interview. I’d look for signs of depression, anxiety, trauma, sleep disturbances, eating disorders, or substance abuse. Utilizing mental health assessment tools like the PTSD checklist for DSM-5 or anxiety checklists can provide insight into the patient’s mental well-being.

Comprehensive Care Plan:
Taking into account all these factors, I would develop a comprehensive care plan for the patient. It’s essential to be extra empathetic and understanding as this patient is in a foreign country, facing culture shock, language barriers, and the absence of health insurance. This assessment might be more time-consuming than usual due to these factors, and I would refer the patient to a social worker for assistance in accessing appropriate care despite their lack of insurance. Ultimately, my goal would be to provide comfort, empathy, and establish trust with the patient while delivering appropriate medical care.

References

Adu-Boahene, MPH;, A. B., Laws, PhD, MA, M. B., & Dapaah-Afriyie, MD, MBA, K. (2017, January). Health-Needs Assessment for West African Immigrants in Greater Providence, RI. Rhode Island Medical Journal. https://www.rimed.org/rimedicaljournal/2017/01/2017-01-47-cont-adu-boahene.pdf

Desai, MD, R. (2018, October 19). Clinician’s Corner: Taking a good patient history [Video]. Osmosis. https://www.youtube.com/watch?v=4wfjSfoHwl4

Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing, 30(4), 238-243. https://doi.org/10.12968/bjon.2021.30.4.238

Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: A scoping review. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-019-8127-9

Discussion: Creating a Patient Health Record

In the medical field, it’s crucial to communicate effectively to gather a patient’s history accurately. Several factors like age, gender, ethnicity, and surroundings influence a patient’s health. As an advanced practice nurse, you need to be aware of these factors and adjust your communication accordingly. This will not only help you connect with your patients but also gather the necessary information to assess their health risks.

For this discussion, imagine you are a clinician responsible for building a health record for a 40-year-old recent African immigrant without health insurance.

Preparation:

1. Your instructor will assign you a new patient profile.
2. Think about how your communication and interview techniques would differ for each patient.
3. Consider tailoring your questions based on the patient’s social determinants of health.
4. Identify potential health-related risks based on age, gender, ethnicity, and environment.
5. Choose a risk assessment tool suitable for your patient.
6. Develop at least five targeted questions to assess your patient’s health risks.

By Day 3 of Week 1:

1. Share a summary of the interview and the communication techniques you would employ.
2. Explain why you chose these techniques.
3. Justify your selection of a risk assessment instrument.
4. Provide at least five specific questions you would ask the patient.

By Day 6 of Week 1:

1. Respond to two colleagues who selected different patients.
2. Share additional effective interview and communication techniques.
3. Suggest more health-related risks to consider.
4. Validate ideas with personal experience and additional research.

Thank you for sharing your insightful discussion post. I agree with your approach of starting with a friendly smile to put the patient at ease and introducing yourself to establish a connection. African immigrants often face significant health vulnerabilities upon arrival in the United States, making it essential to assess their needs and create an appropriate treatment plan by gathering information through history collection and physical examination (Ball et al., 2019).

Communication is a two-way process, and as clinicians, we must consider various factors such as language skills, cultural beliefs, and body language to build a therapeutic alliance (Isasi et al., 2016). In the case of immigrants, it’s crucial to focus on chronic illness, migratory trauma, and socioeconomics in communication. Language barriers should also be addressed, considering that many African countries use languages other than English (Omenka et al., 2020).

Verbal and Nonverbal Communication in Nursing

Structuring a health history is indeed critical, and evaluating the patient’s English proficiency and using language interpreters when needed is a thoughtful approach to overcome language barriers. Cultural sensitivity is key, as this immigrant’s values and views may differ from those in the United States. Additionally, assessing the patient’s emotional and psychological well-being due to the challenges of adaptation is important (Isasi et al., 2016).

Using the “I.C.E.” (ideas, concerns, expectations) approach is a valuable tool in providing excellent care. Incorporating cultural sensitivity into practice can enhance outreach and provide non-biased care to diverse patient groups (Ball et al., 2019).

References:

– Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). Mosby.

– Isasi, C. R., Rastogi, D., & Molina, K. (2016). Health Issues in Hispanic/Latino Youth. Journal of Latina/o psychology, 4(2), 67–82. https://doi.org/10.1037/lat0000054

– Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review. BMC public health, 20(1), 27. https://doi.org/10.1186/s12889-019-8127-9