Question

"They told us this might happen, but we were hoping this day would never come.” Kim Hoang and her siblings crowded into the tiny conference room and were shaken to hear the news that their grandmother, Anh Hoang, a 74-year-old Vietnamese woman, was in end-stage renal failure. "My grandmother is old world. We don't know how she will cope with all of this.” The nurse and physician explained the treatment plan. Dialysis is required three times each week and the schedule is rigid. Mrs. Hoang's diet restrictions are also significant. New medications will be added, and Mrs. Hoang needs to learn to care for her dialysis site. She will feel better once dialysis starts, but she might be fatigued and will probably require periodic blood transfusions. Kim asked to be present when her grandmother's teaching takes place. "My grandmother's English is not very good and I can help explain things to her. She doesn't respond well to strangers.” Discuss: 1: How would you respond to Kim's request to serve as the interpreter for her grandmother? 2: Which areas are most important for you to assess when completing Mrs. Hoang's cultural assessment? 3: If during your assessment you discover conflicts between Mrs. Hoang's cultural beliefs and the treatment protocols, how will you handle them?

Answer 1

1. My response to Kim's request to serve as the interpreter for her grandmother will be not to proceed with that since there are certain rules and regulations for allowing someone to serve as an interpreter. Interpreters are expected to know and adhere to the 'Code of ethics for interpreters in healthcare' while interpreting and they should be certified. Since the hospital has Vietnamese-English trained certified interpreters, Kim's grandmother, Anh Hoang, can have one of them as her interpreter.

2. Most important areas to assess when completing Mrs. Hoang's cultural assessment are sensitivity, diversity, congruent care, safety, competent care, data, skill, knowledge, awareness, patterns, flexibility, values and immigration/emigration.

3. Handling conflicts between Mrs. Hoang's cultural beliefs and the treatment protocols, if any, during the assessment:

• Long term medications should be accompanied by culturally sensitive patient education.
• Injections should be given instead of oral medicines if possible.
• Patient education and assurance should be provided regarding the dosage.
• Culturally sensitive patient education should be given about all laboratory tests and procedures.