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NURS 3020 Reflection 1 Melissa Jenkins

TITLE Identification Another student and I answered a call bell of a patient. The patient was an older Indian woman that had had a total knee replacement. Her husband was in the room with her, and was answering all of our questions for her. It was then evident that she had a limited understanding of English. It was also clear that her husband had limited understanding of English from the way he was responding to our questions. My initial reaction was frustration. What had seemed like a simple task of helping a patient pivot from the chair to the bed has just gotten more complicated. Description After answering the call bell and establishing that the patient wanted to be put back into bed, we left the room to check the weight bearing status of the patient in the kardex. During this time the patient might have felt like we were stalling or not willing to help her. Once we returned to the room we had to look for the walker and transfer belt. While I gathered supplied, the other student adjusted the chair to make it easier for the patient to stand. It was at this time that it started to become clear that the patient might not understand our requests. It also started to become clear that though the husband spoke English, he only had a slight understanding what we wanted. We would as the patient to do something and her husband would repeat it to her either in English or in Hindi, but he would have misinterpreted what we said. As we were giving her instructions to help her get up, like moving forward in the chair to get her foot on the ground, the husband stepped in to assist, I think in frustration that it was taking so long. I think this whole process was frustrating for everyone involved. For the patient though it must have been especially frustrating because she was in pain and she just wanted to get back into bed.
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NURS 3020 Reflection 1 Melissa Jenkins

Esthetic Knowing In this situation the patients facial expressions and groans indicated to me that she was experiencing pain in this situation. Her behaviour in getting up was also something I had seen in other patients when helping them out of the chairs and back into bed. The chairs seem to be challenging to everyone because they have to slide forward so much in order to get their feet just touching the floor, and then even more to get their bad foot in the right position to stand. Once I knew that the patient didnt really understand English I started trying to use hand gestures to try and help her and her husband understand what I wanted her to do. This still did not ease the transition. Personal Knowing I was definitely frustrated in this situation. I was frustrated with the husband for trying to help as he was not really helping, he was more hindering. I was frustrated because answering call bells is normally a fairly simple task especially when the patient just wants to get back into bed from a chair. I was also trying my best to find a way to successfully communicate with the patient, to help facilitate the process. Ethical Knowing All patients deserve to receive competent care regardless of language and culture, and I think given the situation we were able to provide the same care to the patient as we would to other patients. It just may have taken longer than we intended. In this situation we treated the patient like any other patient. We made sure that she was safe by getting the walker and attaching the transfer belt. We also tried to communicate to her in the best way we could what we needed

NURS 3020 Reflection 1 Melissa Jenkins

to do to protect her joint and her. And we were able to successfully able to transfer her from the bed to the chair. Empirical Knowing Nurses in acute care settings experience language barriers while providing care and perceive them to be barriers to providing quality care and increases work related stress (Bernard et al., 2006). This differs from physicians who perceive language barriers to be less of an impairment to providing care than nurses (Bernard et al., 2006). And though interpreters exist in many hospitals, the use by nurses varies considerably (Gerrish et al., 2004). Nurses who have had training in the use of interprets and have control of when patient visits occur are more likely to use them (Gerrish et al., 2004). In this situation, an interpreter would have been useful, but not practical. When answering call bells you cant first request an interpreter, if one exists, you need to respond quickly. The husband acted as an informal interpreter in this situation I did not find it very helpful as he could not fully comprehend what we were asking. This contributed to the stress and frustration felt in the moment. It also acted as a barrier to providing care that was timely. Implications This was my first experience dealing with a patient that had a limited understanding of English and could not communicate in English at all. It has caused me to rethink the way I communicate with patients and strategize new ways of communicating to patients in a way that is clear regardless of their understanding, such as miming actions that I desire patients to do. It has also made me more aware of how patients may feel.

NURS 3020 Reflection 1 Melissa Jenkins

References Bernard, A., Whitaker, M., Ray, M., & Kearney, P. (2006). Impact of language barrier on acute care medical professionals is dependent on role. Journal of Professional Nursing, 22(6), 335-358. doi:10.1016/j.profnurs.2006.09.001 Gerrish, K., Chau, R., Sobowale, A., & Birks, E. (2004). Bridging the language barrier: the use of interpreters in primary care nursing. Health and Social Care in the Community, 12(5), 407413.