Hi! I'm new on the boards and after reading a bit, thought I'd jump in and see if what I'm experiencing is only happening to me, and if not, if anyone has any advice.
I'm a FNP in CA and work in a rural, community clinic. Most of my patients speak Spanish and are farm labor workers. I find that when offering education regarding viral vs bacterial, DM diet education, diet and exercise, my patients are extremely resistent. They only want an antibiotic for whatever ails them. They don't want education. They simply want a pill to make it better. I've been here for awhile and am becoming discouraged. Is it simply the patient population I work with, or are most people simply wanting medication and don't care about learning about their health?
Wow! Thanks guys! YES, you all understand the plight...which I guess we're all facing together.
Scottaprn, coast2coast and BCgradnurse-exactly. Everything you said is 100% spot on.
I speak enough Spanish to get me through a basic URI/viral issue. However, half the time when I speak Spanish, I am completely ignored until my MA repeats exactly what I said. I have asked if my accent is too much so they can't understand me and have been told no, that my Spanish and accent aren't bad. So, maybe they don't want to speak to me. I understand a lot and am usually able to catch something my MA misses or doesn't quite interpret the way I need it to come across. I'm working on my Spanish so I can communicate with them directly, and I definitely keep their education level in mind. My spiel typically is, "You have a virus. Viruses won't go away with abx. They typically last 3-5 days with the cough being the last thing to go. I can give you (mortin, sudafed, claritin, etc), lots of handwashing, vapo-rub, humidified air". They talk around town about the docotora who doesn't give medicine, so I've tried to reassure them that I DO give medicine if they need it. I always make sure to have them come back in 5-7 days if there is no improvement. They don't return.
As far as DM education, you're right. I will scroll it back. Their culture is so ingrained with tortillas with every meal that asking them to cut back is like cutting off their leg.
I feel like I'm spinning my wheels and am losing heart because for every 100 patients I see, 1-2 really care and ask questions. I feel I'm very thorough (though simplified) with them and when our surveys come out, I'm reported to not allowing enough time with them, not asking if they understand everything, not allowing them to ask questions. I believe this goes back to what coast2coast said, I think, about them not asking questions and being accommodating. I end every visit with "Do you understand what we talked about? Do you have any questions?", am routinely told, "Yes, I understand. No, no questions".
You all offered some great advice and encouragement! Thank you!
I choose my battles. I won't prescribe antibiotics qMonth, and we agree not to talk about how often they go get random penicillin shots in Tijuana. And yes you get a reputation. Just make sure it's for other (good) things.
...and we agree not to talk about how often they go get random penicillin shots in Tijuana.
HAHA! this is literally my childhood! If my parents don't get abx, they drive down to TJ and get them there. Penicillin for days! So bad. I've tried educating them about it myself, but they love to take antibiotics. It's hard to explain the difference between virus and bacteria.
amberusky
9 Posts
Wow! Thanks guys! YES, you all understand the plight...which I guess we're all facing together.
Scottaprn, coast2coast and BCgradnurse-exactly. Everything you said is 100% spot on.
I speak enough Spanish to get me through a basic URI/viral issue. However, half the time when I speak Spanish, I am completely ignored until my MA repeats exactly what I said. I have asked if my accent is too much so they can't understand me and have been told no, that my Spanish and accent aren't bad. So, maybe they don't want to speak to me. I understand a lot and am usually able to catch something my MA misses or doesn't quite interpret the way I need it to come across. I'm working on my Spanish so I can communicate with them directly, and I definitely keep their education level in mind. My spiel typically is, "You have a virus. Viruses won't go away with abx. They typically last 3-5 days with the cough being the last thing to go. I can give you (mortin, sudafed, claritin, etc), lots of handwashing, vapo-rub, humidified air". They talk around town about the docotora who doesn't give medicine, so I've tried to reassure them that I DO give medicine if they need it. I always make sure to have them come back in 5-7 days if there is no improvement. They don't return.
As far as DM education, you're right. I will scroll it back. Their culture is so ingrained with tortillas with every meal that asking them to cut back is like cutting off their leg.
I feel like I'm spinning my wheels and am losing heart because for every 100 patients I see, 1-2 really care and ask questions. I feel I'm very thorough (though simplified) with them and when our surveys come out, I'm reported to not allowing enough time with them, not asking if they understand everything, not allowing them to ask questions. I believe this goes back to what coast2coast said, I think, about them not asking questions and being accommodating. I end every visit with "Do you understand what we talked about? Do you have any questions?", am routinely told, "Yes, I understand. No, no questions".
You all offered some great advice and encouragement! Thank you!