Illness Narrative Essay
by Marie Jimenez, SPN
Chinese. There are several countries that represent Asia
including Japan, Korea, Vietnam, Malaysia, Indonesia, and the
Philippines.
Part A – As a future licensed practical nurse, living in
New York City, it is important to develop cultural awareness in
getting to know our future patients. After reading excerpts of
More Than a Case by Professor Ting Man Tsao, I was
disappointed at the way the healthcare providers failed to
provide optimum healthcare to the patient, baby Ann. It made
me realize how important therapeutic communication,
transcultural communication, and cultural awareness are vital
in the nursing profession.
Culture & Language – Baby Ann’s mother is from
Vietnam although, according to More Than a Case, “she spoke
Cantonese, Vietnamese, and some simple English…[She] was
not able to deal with complicated situations that demanded
difficult English.” Regardless of the amount of English that
baby Ann’s mother used, there are ways to therapeutically
communicate with patients and their family members.
Since baby Ann’s mother is Vietnamese and spoke
Development of Self-Esteem – Throughout the story,
the self-esteem of baby Ann’s mother gradually declined. In
the beginning of the story when baby Ann had some rashes, her
mother was always attentive and brought her to the Emergency
Room. Regardless of the cultural and ethnic backgrounds of
potential patients and their family members, the hospital
represents a place where healthcare providers help people get
better and recover from their illness.
Towards the end of the story, baby Ann’s mother was
in despair. According to More Than a Case, baby Ann’s
mother was “aggrieved over how the hospital” treated baby
Ann. Despite the mother’s anger at the healthcare system, she
persisted through obstacles against her.
Strengths & Weaknesses –The strengths of baby Ann’s
mother was that she was very willing, determined, and had a
lot of integrity. From More Than a Case, baby Ann’s mother
persisted to tell the nurse to wait and “explain the possibility of
Cantonese, she could have been mistaken for someone who is
an allergy to the doctor.” Despite the language barrier, the
Chinese. That is an issue that should be addressed because I
mother’s strength contrasts the ‘stoic’ perception of Asian
believe that we should not stereotype Asians as only being
women. Baby Ann’s mother is not indifferent to her emotions.
the habit of making sure that our patients understand the
The weaknesses of baby Ann’s mother was that she was
rationales behind procedures and medications that are given to
unassertive, powerless, and had a self-defeating attitude. Baby
them. Failure on one or both sides to communicate effectively
Ann’s mother should have questioned the switch of
leads to miscommunication and legal issues.
medications from Amoxicillin to Ampicillin. From More Than
If I was one of the nurses taking care of Baby Ann from
a Case, baby Ann’s mother did not question the doctor as the
May 23 to May 27, I would have done things a little differently
doctor explained that “the same medication had been applied to
to better address the concerns of the mother and the needs of
[baby Ann] in the last hospital stay and everything had been
baby Ann.
OK.” Baby Ann’s mother should have been more assertive and
May 23 – First, based on More Than a Case, on May
asked more questions to the doctor instead of being intimidated
23, I would have reported baby Ann’s condition immediately to
by authority.
the doctor when she turned “purplish black.” For a baby to
Part B – According to Catalano, “Nurses who work
abnormally turn to this color should be an immediate sign that
with non-English-speaking clients need to develop alternative
something is wrong. Second, on May 23 when the doctor
ways to measure a client’s understanding rather than depending
concluded that baby Ann’s condition was not an emergency,
only on a verbal response” (Catalano, 2006, p. 423).
baby Ann’s mother cried. According to More Than a Case, the
Communication co-exists both verbally and non-verbally. As
doctor “didn’t do anything. Nothing. No special care was
future nurses, we should be able to utilize the ways in which a
given…The nurse talked to the same doctor, who repeated
patient expresses themselves and the message that they are
what he had told baby Ann’s mother.” If I were the nurse, I
trying to send. The goal is to understand the patient by
would not have repeated what the doctor said to baby Ann’s
gathering all sources of information and clues the patient might
mother. Instead, I would have spent time to listen and comfort
be sending. In addition, as future nurses, we should also get in
the mother with open-ended questions such as “I see that you
are upset and bothered. Can you tell me what is bothering
way that she does not feel any more distressed and threatened.
you?" From asking open-ended questions, I believe that would
I would not give her false reassurance. Instead, I would use
have reduced the mother’s anxiety and would prevent her from
therapeutic communication and tell her that we are trying the
crying.
best we can to alleviate baby Ann’s symptoms.
In nursing, the profession calls for an interactive and
The difficulties faced by the nurse was when baby
collaborative effort between all healthcare professionals in
Ann’s pediatrician wanted to speak to the doctors in the
achieving one goal: to effectively provide the best possible care
Emergency Room. According to More Than a Case, “The
for the patient.
nurse was upset, arguing it was not appropriate for an outside
May 27 – Baby Ann’s mother became concerned about
doctor to ask their doctors to call back.” Most likely, the nurse
her daughter when she was in the ICU. She was desperate for
wanted to intervene and allow the pediatrician to talk with the
her daughter to see a doctor promptly. When baby Ann’s
ER doctor, but was uncertain of her role as a nurse to allow that
mother saw the doctor, the doctor dismissed baby Ann’s
to happen because in every hospital there are certain protocols
mother and baby Ann’s symptoms. According to More Than a
and procedures that have to be maintained. Deviation from
Case, “the nurses nearby were shaking their heads though they
those protocols and procedures leads to further complications
didn’t say anything audible.” If I were the nurse, I would have
and legal issues.
pulled the doctor aside and suggest that he should find other
Overall, it is important to think about how culture has a
ways to explain to the mother what is going on with her
definite impact on healthcare and the nursing profession. It is
daughter in a polite manner. As a collaborative team, we
always encouraging to read at the back of some of my
should have open communication with our colleagues about the
textbooks how to say medical terms and questions in several
things that should be more appropriate to do in certain
languages such as Spanish and Cantonese. This is important
situations. Secondly, I would approach baby Ann’s mother in a
because it should serve as a catalyst to better understand our
patients.
References
Catalano, T. J. (2006). Nursing Now! Today’s Issues,
Tomorrow’s Trends. Philadelphia: F.A. Davis
Company, 423.
Tsao, M. T. More Than a Case. LaGuardia Community
College.