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This biggest barrier at this point is the language barrier. Because Bana does not speak much English, we are limited on the information we can give her. Many places have language services that you can call to translate. Language barriers can cause many problems including the patient being more likely to not have medical care. These clients have preventative services at lower rates and an increased risk for noncompliance (Flores, 2016). It is so important for medical providers to have expertise in cultural competence because it is the cornerstone in reducing ethnic and racial disparities (Flores, 2016). My priority action to take at this time is ensuring prenatal care and safety for mom and baby, in addition to finding a translator. I don’t know if I would truly believe Bana’s statements about her being assaulted a few weeks ago. Bruises don’t stay for a few weeks. It’s very important that she is given information and hotlines where she can call and get help. No one deserves to be battered and it could not only place her life in danger but also her children and unborn child. It’s most important to make sure mom and fetus are not in any imminent danger.
In regards to Bana and her family’s nutrition, there are many programs she can apply for that can help her financially pay for food. There are food stamps and the WIC program that is great in assisting with formula and food needs. These programs are government programs that assist low-income families to eat well and learn about nutrition.
Flores, G. (2016, July). Language Barriers to Health Care in the United States. Retrieved from The New England Journal of Medicine website: https://www.nejm.org/doi/full/10.1056/NEJMp058316
Barrier you face in providing care to Bana at this point?
The greatest barrier to care for Bana is the language barrier at this time. This should be addressed immediately so that she can get proper care. Navigating the health care system is difficult enough for those who are not familiar with it and for those from a different country who do not speak English can face many obstacles. The case worker does is not trained to interpret and is no an appropriate source for doing so. It has been found that when untrained individuals are used rather than bilingual trained professional that there is an increase in medical errors, poor communications, and poor follow-up along with poor adherence to treatment and recommendations (Regenstein, 2008).
What is the priority action for you to take at this time?
Priority for the care of Bana would require getting an interpreter for the patient so that proper communication and assessment can be done. The patient is reporting that she has bruises from an event that was several weeks ago but as a provider you can tell these are recent. The situation needs to be investigated further to determine when and how this woman developed bruises around her neck. It is important to determine if this woman and her children are in an unsafe situation that needs intervention. A professional interpreter is needed as this woman should be interviewed away from anyone close to her to determine who is causing the assault. Using an ad hoc interpreter such as someone who knows the language as well as English such as family or friends is not appropriate and should be avoided. Most of the health care facilities have computerized interpreter service that are available for several languages.
What action is most important for you to take to ensure the health and safety of the fetus?
Since the woman has not been getting prenatal care or had knowledge about the fetus. An ultra sound maybe warranted however most ultrasounds are not done until later unless there is concern. Interview the woman about her previous pregnancies and determine if there were any complications. Since she is so young with three children already determine how long ago was her last pregnancy. Determine what exposures to chemicals she might have come into contact with at her job. Determine any other hazards she has been exposed to such as alcohol, drugs, and tobacco. Determine if she has been injured other than the bruising by her neck. Has she had injury to her abdomen? It is important to acknowledge any religious or cultural considerations that the patient might have.
Since she is a Muslim woman from a Syrian refugee it is important to assess her for chronic health care disparities that are common among this population such as hypertension, diabetes, and cancer. Other health care disparities that should be assessed include communicable diseases, injuries, and mental illness. She should have her immunization status addressed (Centers for Disease Control and Prevention, 2017).
Given Bana’s financial situation, you are concerned about her and her family having adequate nutrition. Which intervention would best address this concern?
It is important that this pregnant woman and her young children get proper nutrition for development. Different resources are avaiable depending on where she lives. Here in Wisconsin she might qualify for Temporary Assistance for Needy Families (TANF) which is a federally funded program that is administered by the state. It is for low income families that have children and pregnant women in their last three months of pregnancy. It provides financial assistance while helping the family find jobs that will allow the family to support themselves (TANF Program, 2019).
Woman, Infants, and Children (WIC) is another option that could help this family. WIC provides supplemental foods, healthcare referrals, and nutritional education for low-income pregnant, breastfeeding, and no breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk (USDA, 2019).
Centers for Disease Control and Prevention. (2017, January 10). Healthcare Access and Health Concerns among Syrian Refugees Living in Camps or Urban Settings Overseas. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/immigrantrefugeehealth/profile…
Regenstein, M. (2008, September 1). Language Barriers in Health Care. Retrieved January 2019, from Robery Wood Johnson Foundation: https://www.rwjf.org/en/library/research/2008/09/l…
TANF Program. (2019). What is TANF. Retrieved from TANF Program: https://www.tanfprogram.com/what-is-tanf
USDA. (2019). United States Department of Agriculture: Food and Nutritional Service. Retrieved from Women, Infants, and Children (WIC): https://www.fns.usda.gov/wic/women-infants-and-chi…