Introduction: Reflective practice forms an integral aspect of the nursing profession, as it allows the professionals to introspect about a specific clinical scenario and undertake a thorough self- assessment. Reflective learning helps in appropriate identification of strengths and weaknesses which are appropriately groomed with the use of effective measures. This paper intends to evaluate the case study of the patient Rosa in order to identify the challenges that could affect the communication quality and accordingly adapt measures to mitigate the identified issues. Description: As per the provided case scenario of the patient, it can be said that the patient, Rosa Calapari is 80 years old and is Italian in origin. Further, the patient has a long medical history which suggests that she has been suffering from a number of chronic illnesses. Further, the patient has a history of a fractured hip which has increasingly made her anxious and has limited her abilities to address activities that she liked such as gardening or talking to her neighbor. Identification of two health related topics that would impact the quality of interaction with Rosa: Upon analyzing the patient history, I feel that caring for Rosa would be critical and would require appropriate support from her end so as to facilitate the recovery process. In this context, I feel that the two most challenging aspects that would impact the quality of my communication with Rosa would comprise of the cultural diversity and her reduced awareness about the health conditions. As has already been mentioned in the case study, Rosa had been extremely anxious and worried while she was placed in the Austin healthcare facility. The primary reason accountable for the same was the cultural diversity and her reduced comfort in comprehending
the English language. Further, the patient case study also mentions that Rosa failed to comply with the exercise routine and other recommendations that were given to her by the GP for managing the symptoms of Diabetes, Obesity and Deep vein thrombosis. Reflecting on the challenge the chosen topics pose: As I am not of the similar cultural background as that of Rosa, it would be extremely difficult to build rapport and establish a positive therapeutic relationship. As I belong to a different cultural background, I would make use of the official language English to converse and impart instructions to the patient. This might result in triggering anxiety and the patient might not feel comfortable with me. Also, as a nurse I would ask her to follow instructions such as take medication, control her diet and alcohol intake and comply with the exercise routine so as to promote recovery. Rosa might refuse to act according to my instructions as she is not aware about complying with the instructions could help her recover at a rapid pace. Measures adapted to mitigate the identified challenges: In order to build a positive therapeutic relationship with Rosa, I would first make sure that Rosa is comfortable in my presence. I would specifically ask her as well as her husband about their culture specific preferences so that I can devise a care plan accordingly to suit the need of Rosa and she is able to positively cooperate with the care process. Further, I could arrange a referral to an Italian RN so that Rosa feels comfortable in her presence and is able to express better. The Italian RN could specifically take into consideration the spiritual preferences of the patient and her food preferences and accordingly create a diet plan which would be easier for Rosa to follow. In addition to this, in order to make her aware about her disease conditions, health literacy would be provided by me using proper educational tools such as audio and visual
aid. This would help Rosa and her husband to relate better to her medical condition and this would help in imparting awareness and motivation so that Rosa complies with the devised care plan. Conclusion: Therefore, to conclude, it can be mentioned that dealing with culturally diverse patients who are also aged can be extremely challenging. This is because a major linguistic barrier interrupts the flow of smooth communication between the nurses and the patient. As in this case, Rosa was extremely frustrated with the care professionals at the Austin Repatriation Hospital. Also, poor memory is a common sign with advancing age and lack of awareness about the disorders leads to reluctance to comply with the interventions and as a result patients often turn out to be aggressive and rude. The same has been the case with Rosa and along with lack of awareness she is also facing the ego integrity versus despair crisis which is bringing out the worst version of her. Action Plan: The action plan would comprise of browsing through scholarly journals about effective communication and cultural safety while dealing with culturally diverse patients. This would ensure that a strong rapport is build with Rosa which would ensure a smooth recovery process.