A student nurse is teaching a patient from an unfamiliar culture about diabetic self-care
The patient is willing and able to take blood glucose readings and give insulin injections but will not use the sliding scale insulin protocol the physician has ordered. Which action by the student would be most beneficial? a. Ask why the patient is unwilling to follow the scale.
b. Assess the patient's health-related value system.
c. Call the physician and ask for a simplified regimen.
d. Have someone else try to teach the sliding scale.
B
Because the patient is from an unfamiliar culture, it is possible that health-related values are interfering with the patient's adaptation of the desired behaviors. In a culture that is fatalistic, the patient may believe he or she does not have the same choices the nurse might have and so cannot make the kind of self-determination decisions required to use a sliding scale for insulin injections. Assessing the patient's health-related beliefs can shed light on this situation.
Asking "why" questions often puts people on the defensive and may not elicit helpful information.
A simplified regimen, in itself, is not what is important. The physician may need to abandon the idea of a sliding scale for this patient, but changes should not be made to the regimen without first gaining more information and assessing how culture is influencing the patient's actions.
Without understanding the patient's cultural influences, simply having someone else try the teaching will probably not be helpful.
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