Native American Nursing Care Plan

Mr. Hiawatha is a 65 year old Native American who was brought to the hospital after being in a car accident. He has a deep cut on his thigh and is seeking immediate care due to heavy bleeding. He was accompanied by his wife Mrs. Hiawatha who was also in the car accident, but escaped unhurt with a few minor bruises. Mr. Hiawatha has difficulties with communication in English and the nurses are not able to attend to him unless they can get a medical history. His wife is also Native American and she can speak in English though not fluently.

Whether interpreters are required or not, the level of literacy should be assessed as well as skills in English language. According to “Health and Health Care of American Indians and Alaska Native Elders”, many Indian languages lack equivalent words in English especially when it comes to medical language. The pronunciation or the accent or a word in English could mean different things to a person who is not Native American. It is important for the nurse to note that some Indian communities do not speak of death or of a possibility of a negative outcome after a medical procedure. Speaking of a deceased person is prohibited because it may hold back their spirit preventing them from crossing over to the next life (Flowers, 2005).

As explored by Levanne, the patient should also be given ample time to consult with other Native Americans on the information given. Consultations may be sought from religious leaders, clan elders or medicine persons. The patient may want to seek clarification about the medical jargon and other written material with another source. Some medical procedures are only appropriately done at a certain time after consultations with traditional healers. After careful consideration, the elder may allow the nurses to commence treatment. The elder can also delay medical procedures or order that they are not performed on the patient. However, the ultimate decision lies with the patient and should be given time to decide whether they will accept the treatment or not.

When collecting the medical history from the patient, the nurse should be careful not to sound aggressive or use terms like “what is your problem.” this kind of an approach especially to an elderly man like Mr. Hiawatha may cause a bad relationship between the patient and the nurse. This may result to loss of trust and lack of co-operation by the patient.

When noting the general condition of the patient, it is important for the nurse to note that Mr. Hiawatha could not be giving valid information concerning his condition. This is because according to his culture; he is taught how to manage his pain at a tender age as a sign of strength. In case the patient is in a lot of pain, they will only call for the nurse once and if they are not available, then the patient will find a way of controlling the pain. In most cases, these patients are under treated for chronic and acute pain.

Mr. Hiawatha was admitted in hospital because he had a deep cut as a result of a car accident. He needs physical examination to determine the extent of the injury. The nurse should explain to the patient how the physical examination is done and its importance in a calm manner so as to seek consent from the patient. Loudness is considered as aggression which is not allowed in Native American culture. When performing the physical examination, the nurse should seek consent from the patient because Native American culture does not allow a stranger or any member of the family to touch the body of an elderly man. The nurse should also be keen to cover all parts of the body. Clothes are only removed if completely necessary (Flowers, 2005).

Mr. Hiawatha was badly injured with deep cuts and will require the doctor to attend to him so that the wounds can be stitched. However, he still has minor words and bruises that need to be cleaned and dressed. The nurse is required to dress the wounds in a private area. This is because Mr. Hiawatha is an elderly man and according to his culture, no parts of his body should be exposed in public.

The nurse is also required to advise the patient on the correct procedure of taking medication. This is because Native Americans have a history of sharing medication with other members of the community. They also stop taking the medication once they feel that they are well enough and begin to self-medicate when the symptoms recur. His primary caregiver which in this case is his wife should also be advised on the same to ensure that the complete dose is taken in a timely manner.

Conclusively, this nursing plan is designed to ensure that nurses give care to patients while considering their cultural backgrounds (Dennis & Small, 2003). All patients are different are require to be treated in a different manner and that is why the nurse should be familiar with the different cultures to ensure that they care for the patients without going against their cultures. The care given by nurses should be according to the guidelines in the position statement that seeks to promote and protect human rights, dignity and individual worth in nursing (“The Nurse’s Role in Ethics and Human Rights”).

References

Centre for Ethics and Human Rights Advisory Board. (2010). “The Nurse’s Role in Ethics and Human Rights.” Position Statement.

Dennis, B. & Small, E. (2003) “Incorporating Nursing Care: An Action Plan.” ABNF Journal. Jan-Feb 2003.

Flowers, D. (2005). “Culturally Competent Nursing Care for American Indian Clients in a Critical Care Setting” Critical Care Nurse. 25: 45-50.

Levanne, R. “Health and Health Care of American Indians and Alaska Native Elders.” Retrieved (December 02, 2010) from HYPERLINK “http://www.stanford.edu/group/ethnoger/americanindian.html” http://www.stanford.edu/group/ethnoger/americanindian.html