HSS 261 Unit 4 – Individual Project CTU

Based on your understanding of diversity, equity, and inclusion, describe a situation or experience that you have witnessed in a healthcare setting that relates to how diversity, equity, or inclusion impact patient care or the healthcare workforce positively or negatively.

I had a patient that came into the ER yesterday morning. He was severely intoxicated but asked for medical clearance to enter an alcohol rehab program. During the exam, he complained of rib pain after a fall before arriving by ambulance. He was not homeless but very poor. He was in his 60s, disheveled, and had smoked most of his life. The Dr ordered basic lab work, IV fluid, a chest x-ray, and a cat scan of his chest. He was placed in a wheelchair and parked in the hallway to sober up. Hours later, the Dr flagged him for discharge and said, “the homeless drunk guy can leave now that he is sober.” The discharge diagnosis was alcohol intoxication.

I reviewed his labs and radiology results and noticed the cat scan showed several nodules in multiple lobes of his lungs. The patient stated he had no prior history of this and was only here for the clearance. The Dr did not document any such clearance nor mention the newly found nodules or suggest a consult, just general alcohol abuse information, and he had left for the day. The patient was agitated that the Dr left without informing him of the findings. I explained his results and the need for follow-up with his primary physician for a plan of care. I sympathized with him over the fact that he did not get what he needed from the Dr, and I had to be the bearer of bad news regarding the lung nodules. I understood being an alcoholic will play a big part in his treatment and recovery if he has cancer.  I suggested a plan to see his Dr to address the nodules and decide the appropriate actions to take with an alcohol program. I made copies of all his lab and radiology reports to take to his Dr. He then stated he did not have a ride home. I requested a taxi voucher from the house supervisor. It took over an hour to receive it, but I filled it out and wheeled him teary-eyed into the lobby where he was waiting for the taxi. He was grateful that I took so much time explaining his diagnosis and helping him with a plan to address it.

How did the healthcare professional or the organization demonstrate DEI or cultural competence? What could have been done differently?

People with mental health disabilities and lower socioeconomic status often don’t receive the care they need because they take more time. Every patient cannot be treated with the same expectations of understanding. Just as a patient with a language or cultural barrier would take extra time to retrieve the translator computer, these patients need more time having things explained to them and assuring they understand the next steps to take. It is our duty to provide patients with optimal care, demonstrating cultural competence in healthcare. A provider should follow through with caring for the patient, explain the diagnosis, and make suggestions for follow-up regardless of their cultural status. For this patient to be disregarded as a homeless drunk and not be provided the results of possible cancer does not meet the standards of cultural competence in healthcare.