The ability to communicate fully and completely is a vital aspect of all healthcare.  Before we can even begin to ask open-ended questions.  We as healthcare providers need to suppress our ethnocentricity and bias that everyone living in this country has even a basic grasp of the English language.  Prior to entering the exam room or patient room is to determine how to effectively communicate with the patient and family.  In the primary care setting the healthcare provider has the opportunity to review the patient record to become familiar with the patient (Bickley, 2017).  Healthcare facilities have secured interpretation services, most often via telephone.  Larger hospitals have entire departments dedicated to providing interpretation services.  In the case of having an interpreter in the examination, they should stand behind the provider so that eye contact can be maintained between that provider and the patient (Bickley, 2017).  If using the telephonic service, that telephone, on speaker, can be placed between the provider and the patient to allow that eye contact.  Azam and Watson (2017) noted that even those patients that are bilingual, in times of stress they often prefer to communicate in their native language.  Shadow Health discussed how to communicate with the virtual patient so that each question is in context to the specific aspect being discussed.

N522PE-20A Module 1 Assignment 1 Implementing Clinical Reasoning in Practice References

Azam P. Watson R. (2017) Language barriers and their impact on provisions of care to patients with limited English proficiency: Nurses’ perspectives.  Journal of Clinical Nursing.

Bickley, L. S. (2017). Bate’s guide to physical examination and history taking (12th ed.). Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins.

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In reply to James Rhinehart

Re: D1

by Dona Clarin – 
Well done. Discuss another culture and how cultural practices may impact health.

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In reply to Dona Clarin

N522PE-20A Module 1 Assignment 1 Implementing Clinical Reasoning in Practice Re: D1

by James Rhinehart – 
Dr. C,
I have been intrigued by the Hmong peoples and culture for quite some time, so I decided to concentrate on their cultural differences concerning healthcare. The Hmong were recruited by the Central Intelligence Agency during the Vietnam war to assist in Laos. After that war was over many Hmong became refugees in this country, bringing with them their unique culture. At present, it is estimated that there are more than 260,000 (Fang and Stewart, 2018). The traditional religion for the Hmong is Animism and Shamanism (Her-Xiong and Schropfer, 2018). Animism is defined as the belief that everything has a soul ( For the Hmong, this means that good health is an equilibrium between themselves and the universe (Her-Xiong and Schropfer, 2018). For those times when healing is needed the Hmong turns to a shaman. The Hmong are fearful of Western medicine and a very paternalistic culture, and deferring all decisions to tribal elders (Fang and Stewart, 2018). These cultural differences are in addition to a language barrier between their native language and the English language. Without taking all of this into account, the healthcare provider is doing a disservice to the patient and family, along with wasting time, energy, and resources.
N522PE-20A Module 1 Assignment 1 Implementing Clinical Reasoning in Practice References
Fang D. Stewart S. ( 2018) Social-cultural, traditional beliefs, and health systems barriers of hepatitis b screening among Hmong-Americans:
a case study. Cancer 124(Suppl 7) p 1576-1582. doi: 10.1002/cncr.31096
Her-Xiong Y. Schroepfer T. (2019) Walking in two worlds: Hmong end-of-life beliefs and rituals. Journal of Social Work in End-of-life & Palliative Care 14(4) p 291-314. doi: 10.1080/15524256.2018.1522288

265 words N522PE-20A Module 1 Assignment 1 Implementing Clinical Reasoning in Practice