Vignette

Mrs. Khairallah is a 32-year old pregnant woman who arrives at the delivery suite with contractions. While the nurse are getting Mrs. Khairallah to her bed, her husband calls the nurse and tells her that he demands that no man be allowed to enter his wife’s room. He insists that all nurses, doctors, and other staff be female. He also does not want any male person to enter the room during the night because his wife will have her veil remove while she is sleeping.

The nurse is conflicted because the doctor the doctor in the delivery suite is a male, and Mrs. Khairallah is fully dilated and ready to deliver at any time.

The nurse puts a note next to the Khairallah family’s room saying no males are allowed in the room based on patient preference. 1) Assuming this patient either did not have any prenatal care or was not being followed by this hospital, how might a nurse handle this unforeseen situation effectively? Explain to the husband what can be reasonably be done and the limits.

Your wife is in active labor and the doctor here is male, what we can do, make sure the patient always have a women present at all times, she can wear her own clothing , along with her hijab, carefully drape her and completely cover her legs.

After the deliver we can put a sign to knock before enter and wait on permission to enter the room. If a male have to enter the room to provide care, he will wear gloves and always a female would be present.

2) If you were in charge of this patient prenatal care, how would you have managed this case to prevent awkward situation described above? Doing the assessment find out what the patient expectation at deliver, ask about religious concerns, values and possible refer her to a female obstetrician. Mrs. Cheng brought her 4-year-old son, Justin to the emergency department early one morning.

She stated that her son has had a high fever for 4 days. Her mother-in-law used traditional herbal medicine, but it was ineffective. The advanced practice nurse diagnosed a pulmonary infection and prescribed antibiotics. 1) Discuss whether or not the traditional herbal treatment could be safely continued while antibiotics are being given. I feel it could be continue, if you find out what herbal medicine they are using and not contradicted to the antibiotics that is being prescribed. Also being part of their culture, it may be continue without your knowledge anyway. ) Discuss strategies you might use to teach this mom how to correctly administer one teaspoon of Amoxicillin three times per day. Mrs. Cheng has a limited command of English. I would draw a clock and mark in red the times she would give the medication, then I would draw up in a syringe the amount to give at the times in red and ask her to demonstrated back understanding. 3) Describe from the perspective of the traditional Chinese adult the ideal American health care provider. Purnell (2013) noted, “The Chinese may distrust Western health-care providers because of the pain and invasiveness of their treatments” (p. 194).