Substandard health care for minorities?

live4today, RN · Mar 22, 2002

:chuckle :roll :chuckle Oh Brownie! :blushkiss

Brownms46 · Mar 22, 2002

heeheee..:chuckle

donmurray · Mar 22, 2002

The National Health Service in the UK has its critics, but the bottom line is healthcare provision depending on need, and not ability to pay, free at the point of use, and funded from taxation. Our Chancellor of the Exchequer gave a speech recently along those lines. Insurance based schemes are unfair, inefficient, and hugely expensive, not to say overcomplicated.

According to him, 26% of American families have forgone health care in the last year because they cannot afford it, and 40m. have no insurance. Medicare and Medicaid, together with the tax relief allowed to those with insurance, totals 500bn. dollars, or 7% of GNP. this is about the same as the UK spend, but for our total system. The overall US healthcare budget is 14% of GNP.

eldernurse · Mar 23, 2002

Is it socio-economics or stupidity? If you get medical advice and don't follow it, whose fault is it? If you use the ER as your primary physician, whose fault is it? If you are transported to the ER more than twice a year for cold symptoms, who is misusing the medical resources of this country?

I work in a large city ER and we don't even roll our eyes (where you can see) when these people come in. We do the best we can to take care of the problem that we can and direct them to agencies or clinics that will help them. It is not our job to follow up. People have to be responsible for their choices.

Minorities who don't get care don't seek care. It is there.

Q. · Mar 23, 2002

Originally posted by eldernurse
Minorities who don't get care don't seek care. It is there.

This is a tricky statement, and I will warn you in advance that you will pay for that statement by some BB members here.

I feel as you do; the care is there, even if inappropriately used, such as the ED. But studies have identified factors that decrease care: some is cultural (ie some Hispanics don't believe in primary care) some is mistrust of physicians (for primary care only, certainly not under extreme situations - which is contradictory, but whatever) some is lack of transportation, some is knowledge deficit. Studies have shown (and I am not commenting on the validity of the study here) that the American way of educating people isn't "culturally sensitive" therefore, if we educate a patient in the ED about signs and symptoms of an infection, we do in an Americanized way so there is a high probability that they won't understand, or follow the instructions. Thereby, increasing acuity and no follow-up.

I see it as no win situation. I realize there are cultural differences that should impact care, but there are too many subcultures of subcultures of subcultures that we can't keep up with what is right for that subculture, and we offend someone or miss someone. There needs to be more personal accountability on the part of the patient, as well as culturally sensitive care givers, to increase access to care.

fergus51 · Mar 23, 2002

Have any of you ever had any inservices on culturally sensitive care? I work L&D, (which is fulll of cultural beliefs and traditions!!!) and we had a woman from our town's immigrant services come to talk to us about different cultural groups traditions and preferences regarding childbearing. Things like how some cultures think colostrum is bad for the baby, some refuse to shower right after birth, some believe a new mother should not do any work for at least a month after birth, etc. It was really interesting and helpful for us to be able to understand why some people are so confusing to us and how we can work with them.

Q. · Mar 23, 2002

We haven't had an inservice at the hospital, but rather, this information was presented in my BSN curriculum (imagine that!)

We do have handbooks on the unit as well. But it has been my experience that the inservices and handbooks don't cut it. We've offended many individuals by lumping them in any category. It's impossible to keep up.

live4today, RN · Mar 23, 2002

Originally posted by fergus51
Have any of you ever had any inservices on culturally sensitive care? I work L&D, (which is fulll of cultural beliefs and traditions!!!) and we had a woman from our town's immigrant services come to talk to us about different cultural groups traditions and preferences regarding childbearing. Things like how some cultures think colostrum is bad for the baby, some refuse to shower right after birth, some believe a new mother should not do any work for at least a month after birth, etc. It was really interesting and helpful for us to be able to understand why some people are so confusing to us and how we can work with them.

Hi fergus! :)

In the college I attended, our nursing program had a separate nursing class on teaching cultural diversity and sensitivity to various ethnic differences. Nurses should have this training long before they begin working as nurses, and be updated on any changes during their nursing days in the way of CEU classes within the hospitals.

I've worked with more ethnic groups than most of the nurses I personally know, and this is a subject matter that is so real and so necessary to be educated in -- and not just through reading about statistics because by the time those statistics hit public print, it's old news anyway. The best way to learn about ethnic and cultural diversity is by observing and asking questions from those IN THOSE ETHNIC GROUPS, and not just the ones who have studied about them.

There were so man UNTRUTHS written in the nursing textbooks that I studied in college about certain ethnic groups I know that I reported those 'falsities' to the College Dean. That particular textbook in question was removed from the program and replaced with a more recent up to date textbook that at least presented the various ethnic groups more truthfully.

fergus51 · Mar 23, 2002

We had it in school too. They called it transcultural nursing, but it is impossible to fit in the groups that you need because you won't know who you'll be working with. That's why inservices are great. We have nurses from as far away as Australia and South Africa, who didn't get to learn about the cultures that make up our community.

The presentation was by someone from the ethnic group we were interested in, not an outsider. I used to volunteer there and asked one of my classes if anyone would be interested in speaking to a group of nurses. The lady that volunteered was "honored" to be asked to speak to a group of "sisterly nurses":)

I have found I avoid offense by saying right away "I like to ask all my patients to tell me how they see their birth proceeding and any beliefs you think I should know about to be a better caregiver" or something like that. I have never had anyone get mad offended, most people are very tolerant if you just explain you don't have a lot of knowlege about them and are interested in learning.

live4today, RN · Mar 23, 2002

Originally posted by fergus51
We had it in school too. They called it transcultural nursing, but it is impossible to fit in the groups that you need because you won't know who you'll be working with. That's why inservices are great. We have nurses from as far away as Australia and South Africa, who didn't get to learn about the cultures that make up our community.

The presentation was by someone from the ethnic group we were interested in, not an outsider. I used to volunteer there and asked one of my classes if anyone would be interested in speaking to a group of nurses. The lady that volunteered was "honored" to be asked to speak to a group of "sisterly nurses":)

I have found I avoid offense by saying right away "I like to ask all my patients to tell me how they see their birth proceeding and any beliefs you think I should know about to be a better caregiver" or something like that. I have never had anyone get mad offended, most people are very tolerant if you just explain you don't have a lot of knowlege about them and are interested in learning.

You sound like an excellent caring and compassionate nurse, fergus! I like your comments above! :kiss

fergus51 · Mar 23, 2002

Aw...shucks...:imbar you too....:kiss

Peeps Mcarthur · Mar 23, 2002

Blacks uderserved? I think patients getting hosed by thier HMO's is a statistic that knows no skin color. If you think about it can you REALLY believe that a hospital(corporation) cares what skin color the person with the billable insurance has?

Pollsters have been skewing data to show anything they want since........well, since there were polls to skew.

The Democratic vote seems connected to the next election somehow.........Huuuumm......I wonder if party afilliations have anything to do with such an inflammatory, sensational piece of "reporting"? The supplement industry has been enduring this kind of attack for years. There are no credible facts yet the tall tales about heart conditions, cancer, kidney and liver damage and so on plague my conversations with almost every customer.

I've looked, but there's never a source. There's never any clinical data. It's always "could be connected" or "you might be at risk" and the ever popular "we reviewed the numbers or the "incidents"and this is what we found" Gee.....thanks for thinking for me since I can't do that for myself. I think I'll just go shoot myself in the head now and get it over with. Thanks to fine reporting and your thirst for the truth you've saved me many years of suffering.

There's no honor in jounalism. There hasn't been for a long time.

A new era of discrimination lawsuits has begun. Let he who is without a conscience throw the first stone.