A nurse is caring for a female patient from an unfamiliar culture. The nurse has planned extensive discharge teaching, but the patient seems uninterested, deferring all questions to an older adult male relative. The best action by the nurse is to

Question

a. ask the male relative to assist with discharge teaching.
b. include the male relative and revise the teaching plan.
c. remind the patient that her condition is confidential.
d. try to do the teaching when the male relative is absent.

Answer 1

B
For many cultures, the nurse must recognize the importance of family (or others) in health care decision making and in health care behavior. The nurse should reconsider the discharge teaching plan and include the male relative in creating a new one. This demonstrates sensitivity by following the patient's cultural cues.
The relative may not have the expertise or skill to actually assist with the teaching. Plus, without including him when planning the teaching, the patient has a high risk of not following through with the plan.
Confidentiality is an important concept in health care, but as nurses work with patients from increasingly diverse cultures, the implementation of confidentiality may need revision. This patient clearly wants her male relative included in her health care, and the nurse should follow the patient's lead.
Trying to teach the patient when the relative is absent will most likely create a conflict between patient and nurse with the end result being "noncompliance" on the patient's part. The nurse needs to follow the patient's cultural cues and include the relative.