Posted at 09.10.2018
This essay is going to focus on my connection with caring for an individual who was admitted over a forensic ward with regards to culture variety and the impact this had on my ability to connect and employ effectively with them. Because of confidentiality NMC (2008) will make reference to this patient as Mr Kay. Mr Kay is a 50 time old Caucasian man who was admitted over a forensic after being transferred from jail and was detained under section 37/41 of the Mental Health Act 1983 under the legal group of mental illness with a diagnoses of schizophrenia. Corresponding to his family background Mr Kay's parents were alcoholics and separated when his was eleven and he changed to Glasgow along with his mother in 1972and was located in a group home. He is the eldest of four siblings' two sisters and a brother and has been diagnosed with schizophrenia. At time fifteen he was considered beyond control by his family and was given into the care of local power. Records indicate that he had experienced various flats and hostels around London. He has a brief history of heavy drinking alcohol and polydrug use (including cocaine, LSD and cannabis). He has already established 33 convictions between age range 14 and 25yearsoffences including theft, deception, ABH, indecent assault burglary and different assaults on police. He has delusional perception that the police officer he bites in the neck of the guitar died from bleeding and this lead to him being demitted in hospital. He has been instutionalised for nearly 25 years.
Mr Kay experienced very little interaction with personnel and other service users and would only approach personnel when definitely a need which was due to the fact that he didn't approve of him being looked after by a dark-colored person. During his ward round he indicated that he had not been happy that his sisters possessed black children and this acquired made him bitter towards any black person hence the negative attitudes towards personnel.
It is important to recognise and acknowledge cultural variations and needs because recognition is critical in health care delivery and practice (Joe, 2006). Knowing of cultural diversity affects diagnoses, diagnosis, and intervention approaches for patients. Communication is a essential part of cultural interaction that occurs between healthcare providers and client. Patters of communication are inspired by culture and not only include language differences but verbal and non-verbal behaviours as well (Warren, 1997). Matching to (Prunell& Matters, 1998) nurses must culturally examine each patient separately while keeping in mind that differences can occur not only between cultures but also within cultures which culture impacts how mental condition may be exhibited. Cultural competence encourages the nurse to proficiently develop social recognition, knowledge, skill for use in areas of medical education, practice and research in order to promote effective and quality health care delivery patients (Campinnha-Bacote, 1997). This also encourages nurse to recognize, value and agree to a patient's ethnic belief. Ethnical incompetence creates patient non-compliance and insufficient interventions since it negates the value of culture (Spector, 1998).
The patient social needs were met I communicated with the other staff on the ward and it was made a decision that initially the patient had a one to one treatment with the primary nurse. Through the reaching Mr Kay looked guarded and did not say a lot of his views on the problem but only were able to say that he had not been comfortable working with staff of black origins hence he was reluctant to take part in any therapeutic interventions if they was a dark person mixed up in activity. Matching to (Peplau, 1952) nurse and patients commence as strangers and work collaboratively in providing attention. Providing a composition decreases the withdrawal and isolation of tranquil and non-participating patients to diminish or stop dysfunctional behaviours. The primary nurse and me agreed with the individual that people were going to improve the problem in the ward round to others customers of the multidisciplinary team, he was missing out on the activities that could help them in their rehabilitation process and this would prolong their stay static in hospital. I recorded the conference that had occurred in the patients notes to ensure that information would be handed down over to other staff which if they would start to see the patient behaving using way would having a knowledge of that which was happening. |As explained by Springhouse (1995) records is an efficient communication of clients status between health care providers and helps in providing quality attention and minimises errors. During the ward round I offered to other members of the multidisciplinary team what the individual thought and it was reviewed that it would be helpful may to try and gain trust from the patient and could encourage and remind them when they have sessions to attend and try to explain how this would be helpful in their rehabilitation process Mr Kay was also known as expressing how he sensed and the team informed him that that they well known how he sensed but it might be helpful if he would try and use the staff as they were there to help him in his recovery and non involvement would only decrease he rehabilitation process and long term stay static in hospital or being sent back to jail for him to complete his word. Matching to (Joe, 2003) responding effectively means being sensitive to individual cultures in its broadest dynamic sense not only a patient ethnicity but also their socio-economic track record education, prior health activities, religious beliefs and also the value of structural influences on healthcare experience, such as racism and interpersonal inequality. He expressed that he believed he would make an attempt to work with the staff which it would take time for him to engage fully with the personnel.
Due to Mr Kay's values he missed the majority of his session, that have been supposed, to help him towards he rehabilitation process and this business lead to him being regarded as someone who did not want participate. The patient's negative attitude towards me managed to get very difficult to engage with him as sometimes he would never react to anything I was saying and was difficult to learn whether he understood what I was expressing. This managed to get quite difficult for other staff and sometimes other personnel would avoid any connection with him, that was not good for the individual. I sensed that although Mr Kay was urged expressing his cultural views he only agreed to build relationships the staff because they were very few options for him, but he had quite strong views of dealing with black people. The way the team handled the situation revealed that discrimination is not suitable and that it's important to encourage to patients to express their view and if they lose control it's important to give a structure taking temporary control (Forchuck, 1992).
I have discovered that everything we consider just as cultural minorities or people from other backgrounds is different from the quantity on patients in psychiatric nursing homes. As mostly the individual are from an Afro-Caribbean track record and patients from white backgrounds are minority. Typically these patients believe that their needs are not being met as they believe that too much emphasis is placed on trying to meet up with the cultural minorities needs and feel that they are simply being neglected. As mentioned by (Worthing 1992) that patients tend to be complaint with the healthcare programmes and effects are more successful if patients' ethnical needs are contained into assessments, screening, interventions and protocols. Culture is a crucial component of someone's and influences one's healthcare attitudes and activities in relationship to one's potential to comprehend and utilize the interventions. Corresponding to (Stewart, 1998) culture impacts how mental health problems may be exhibited and behaviours may be misinterpreted as pathological if the nurse is not aware of the patient's cultural beliefs and norms as they relate to health care actions. The psychiatric patient maybe labelled, to be noncompliant may have never frequently received appropriate or culturally experienced nursing care. The new mental health culture has seen the role of the patients modified and their privileges have been evidently described and patients have greater understanding of their illness. These are active participants in the development and implementation of these treatment process and learn about themselves, medical health care system and management of their illness. It's important to note that therapeutic communication targets the patient but is planned and aimed by the professional and that the professional is obligated to share information within the treatment team. The nurse is a patient's advocate rather than a patient's good friend (Kemper 1999).
The broader conditions that arise out of this situation are that although there is a clear plan on that patients have to be active individuals in mental health service development and delivery, however research demonstrates negative behaviour of medical researchers to patients has been a significant barrier to the realisation of the policy goal (Roper&Hapel, 2007). Additionally it is important to note patient's record is essential as this helps to relate to some of the issues that may arise as they may be conditions that may have occurred in the past and start to surface because of a current or similar situation.