Western medicine is a system that using health care professionals (nurses, doctors, pharmacist, therapist) to treat disease and symptoms by using medications, test, and surgery. This practice of medicine has been evolving in the United States for decades and continues to change based on new research. New medications, equipment, and practices are based almost solely on this research being done. Its success is often measures by the outcomes of these practices. With western medicine being the dominate system in place in healthcare, what happens when you combine that the melting pot of cultures, races, and ethnicity that this country is made up of? You can find yourself in situations where what you learned and practice, isn’t what the patient believes and accepts. Two main components of western medicine are standardization (such as objective measurements to ensure treatment is meeting the standard of care) and therapeutic aggression (such as drug therapy for treatment of symptoms of a disease or disorder). These components can be a source of conflict with patients who believe in a healthcare system that does the exact opposite.
Western medicine is often based on objective information that tells the practitioner if the current plan of care is effective or not. This information is composed of labs, scans, and vitals recorded. Another part of western medicine is drug therapy, which aims often to manage the symptoms of a diseases. This can be a problem when you have patients who practice medicine a different way in their culture but are seeking help in the United States. For example, I’ve had a patient who practices Chinese medicine come to the hospital for acute medical concern. The medical team wanted to run test and do scans to determine what exactly was going on and start treating the symptoms right away. The patient agreed for baseline testing but did not understand why the team would want to treat something they weren’t sure of yet or mask symptoms of a problem. This causes a lot of tension between the patient and their family with the medical team. They often felt like their values and right to make decisions for themselves were ignored. This resulted in non-compliance from the patient and lack of respect of the health care team. This led to a longer stay in the hospital and more complications for the patient. More teams got involved which created more miscommunication and frustrations to the patient and their family.
Being the nurse in the situation, I felt conflicted on what I should do. There was the legal aspect of providing safe and competent care while following orders. There was also the concern for respecting the patient’s rights and wishes for their own care. It wasn’t understood well why the patient was refusing care at times. If the patient wanted to feel better, why not do these interventions that have been proven to help? While it was understood that the patient had differing cultural practices, the health care team often did not understand why the patient didn’t want the same outcome with their practices. Looking back, I realize that no one thought to ask the patients perception of their disease and understanding of it. The patient wanted to go home feeling better and healthy like everyone else, but they wanted their beliefs and practices involved in the care. As the nurse there was a concern about protecting the patient’s rights and staying neutral in the situation to not offend anyone. Things that were overlooked were treatment plans that the patient would have been comfortable with that involved their cultural practices. Those plans could have integrated holistic medicine such as herbal components, spiritual guiding, and mediating. Allowing the patient to know what alternatives they had and reinforce that they had the freedom to choose what was best would have been helpful. It would have made the patient feel less forced into a solution that they had little input in. These are things that weren’t explored during this situation because of lack of understanding. Trying to stay neutral on a situation doesn’t mean there shouldn’t be interest in understanding the patients concerns and wants. These are things that will apply next time this situation comes about.
Most of the learning done for health care professional has often focused on the western way to treat health concern. This is understandable when practicing in a place where that is dominate but should not be the only method focused on. The United States is a mix of all types of diverse people from dozens of backgrounds. Living in this country does not mean they have to ignore their cultural practices to get treated at our facilities. The same goes for health care professionals. Integrating what was taught and currently being practice with a patient’s own perceptions and values can be obtained when health care teams have taken the time to understand the patients reasoning. Doing this can endure that proper, ethical treatment is achieved without compromising the patients beliefs.