Clinical Communication Narrative Report

Language is one social and cultural barriers that may have made it difficult for the doctors to communicate with Jessica’s family. It creates the trust that exists between a patient and a doctor and their guardians. When using a translator, meanings may change and the desired communication result may not be achieved. The trust that should exist between the doctor and the patient and the guardians

When he came into the examination room he was different, I had his medication record and a record of his vital signs and blood glucose checks but had not looked at them. He started to talk before I had a chance, he told me that when he left from the previous visit that he went back to his room and prayed the entire night. He said that God told him that he needed to start following his treatment plan. I than looked at his records and saw that he had been taking all of his medications and that blood pressure and blood glucose numbers were decreasing. I could not believe it, I just looked at him dumbfounded. The patient told me he felt great and that I needed to keep continue what I was doing because I really did make a difference and had changed his life. I must have looked so silly because I was crying and smiling at the same time. He said that he just could not believe that someone cared that much about what happened to him. I continued to see that patient for several more months, and he would tell me how he had started to repair all of the relationships in his life through understanding, forgiveness and god.

One of the most moving characters in the 20th century American Literature is Atticus Finch. Because of his significant intelligence, calm wisdom, and admirable behavior, Atticus was respected by everyone in Maycomb, even the poor. Atticus Finch is one of the most authentic and noble characters in To Kill a Mockingbird by Harper Lee and his character remains, constant throughout To Kill a Mockingbird. He began as a honorable citizen who was admired and respected by his neighbors and even when he lost the trial, but still in the end, he was still looked up to, both of his children and all levels of the community.

In the novel To Kill a Mockingbird, by Harper Lee, there are several examples of courage between each of the characters. Harper Lee has shown throughout the novel, that many people have demons they’re fighting, in or out of the bodies or mind. By showing the characters conflicts between themselves and other people, Lee has proven that being courageous is not only physical but mentally too. Some examples of both ways is when Scout decides that she will not fight any more, Scout realising that Atticus is a lot more courageous than she thinks, and Atticus throughout the Tom Robinson case.

The most effective method of communicating with patients with limited English is the use of a certified translator. When using this method, it is important to speak to the patient, not the translator. Eye contact should be utilized in the appropriate manner for the patient’s culture. The same terminology used with English-speaking patients

At today's visit he is awake, alert and oriented. He complains of generalized pain. He states “I have pain all over today, my head, my back, my feet" I have not felt good for the last few days”. He rates his pain as 6/10 in severity; he describes his pain as shooting pain in different places. His pain does

The patient faces various cultural, economic and lifestyle challenges based on the analysis. It also indicates that language barrier is a key factor that prevents the formation of a collaborative relationship with health experts. Therefore, medical specialists should seek to address the patient in simple language. The specialist should also focus on the patient’s feelings and attitudes. This will enable him to provide credible data that will facilitate a comprehensive treatment plan.

Since the hospital was huge, some patients came from other countries, and they could not speak English. So, I needed an interpreter to translate English to their language. First time, I went with Jake, and we had a hard time to give direction to patient’s mother how to use the medication. Second time, I watched a pharmacist gave counseling to the patient’s grandfather. The pharmacist made the grandfather could find the right medication and drew the right dose for the patient. She said I needed to make sure that they understood everything correctly, and I needed to spend more time with them for

My second patient of the day was D.B.. He was a four year old male admitted to the hospital for pneumonia, bronchiolitis, and respiratory syncytial virus (RSV). On top of being admitted to the hospital for these issues, D.B. also suffered from cerebral palsy and had a thorough medical and surgical history. D.B. was a premature fetus at 34 weeks. When I first walked into the room, I thought that I was in the wrong room or had the wrong patient in the crib since D.B. was said to be four years old but looked like he was about two years old.

TS has not been tolerating his hemodialysis, and has been hypotensive. During my shift, midodrine was given prior to going to his hemodialysis to increase his blood pressure. TS’s diabetes is not well controlled; he had capillary blood glucose of 178 on March 22. He is currently receiving a sliding scale injection of Humalog. TS is not able to ambulate, stating, “they use hoyer lift to transfer me.” During his swallowing evaluation, I noticed that he was not able to lift up his right hand, and both of his upper and lower extremities were swollen. I also noticed that he had healing ulcers to his left and right second toes, and on the plantar surface of his fourth toe. He also had abrasion on his right shoulder, and a blister on his right elbow, covered with a dressing. After his session with the occupational therapist, we helped him reposition to reduce excessive pressure on his bony prominences. When I peeked at TS’s room after we documented his swallowing evaluation, he was staring at the window. He has depression, and a history of suicidal attempt. It would have been helpful to have a therapeutic communication with him, to help him express his feelings about his situation.

Patient, G.V, is a seventy-two-year-old male, of Hispanic origin, whom was born and raised in a small town called Jutiapa located in Guatemala, Central America. He migrated to the United States in the late 90’s, leaving behind his wife of forty plus years and his four sons. He came to reside in VA in a small town where he resides with his only sister and her daughter and two grandchildren. G.V. has lived in the United States for more than a decade, he has not mastered the main language spoken, English, but has a good comprehension of the language although he struggles to speak it. For the purpose of this assignment, everything obtained from the patient was through his native language, Spanish, and translated into English by the student nurse.

2. Patient is experiencing acute pain r/t coughing and deep breathing aeb wheezing in the right and left upper lobes of the lungs.

Causal Factor 2: Communication between the clinical staff and patient is recognized to be important for the diagnosis and has therapeutic benefits. Barriers such as cultural or language can present health disparities which have potential cost to both patient and the organization (Dotson & Nuru-Jeter, 2012). Jacobs, Lauderdale, Meltzer, Shorey, Levinson and Thisted (2001) indicate relying on family, friend or nonclinical interpreters can lead to reduced physician trust, lower patient satisfaction, breach patient confidentially, deliver inadequate or inaccurate treatment, and reduce quality of care. Interpreters can improve patient satisfaction, perceived understanding of disease and increase patient compliance with care and follow up appointment (Jacobs, Lauderdale, Meltzer, Shorey, Levinson and Thisted, 2001). Management may look into contracting with translation companies to ensure communication is clear between patient and clinical staff.

“Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help” (Asnani, MR. 2009). Effective communication plays a big role in healthcare and contributes to the quality of patient care and teamwork.

Censorship is a highly controversial topic regarding the arts, controlling the freedom of expression of artists to convey what is deemed acceptable within society. Ai Weiwei falls victim under the power of the regime and the influence of censorship guidelines within China, limiting the display of his art due to the important messages he raises. Andres Serrano has experienced attempted censorship on his provocative image, Piss Christ, and has been attacked for producing offensive art. Censorship aims to conceal certain artworks which clash with the viewpoints of others; however, it should not be enforced as they are confrontational, challenging audiences and act in response to political, social and cultural contexts.