Question - E.S. is a 23-year-old female from El Salvador who migrated to the United States with her sister (now 17) in 2011. They fled El Salvador due to crime and gang violence. E.S is being admitted to the hospital on a 72-hour-hold.
E.S. was referred to a psychiatrist by her primary physician for an evaluation of possible Post Traumatic Stress Disorder (PTSD). The symptoms she was experiencing at the time included: trouble falling asleep, frequent awakening, nightmares, awakening in cold sweats, and crying out in the middle of the night that someone was trying to kill her. Her appointment was set for next month. Since the referral, she has become increasingly agitated. She was brought to the ER after trying to run in front of a car. She is accompanied by her sister and 25-year-old boyfriend.
Her boyfriend speaks and interprets for the sisters. E.S. and her sister do not speak English. Her brother reports that E.S. has had frequent lapses of memory, that she does not "make sense", that the house is a mess and that she has wandered off and gotten lost three times in the last few months. The brother says that he feels that E.S. should be taken care of by his family when he leaves the hospital.
In the first 24 hours of hospitalizations, E.S. is pacing the room frequently and often looks out the window. Bruises were noted on her back and arms. When meals are served, E.S. will ignore it or throw the tray on the floor. She refuses to take any medications. She has had three incidents of self-injurious behavior. Her boyfriend would like her restrained during visits and meals for safety. Her boyfriend has requested that she be discharged to the care of an espirista and her boyfriend's family tomorrow.
- Describe the information the nurse should seek in order to provide culturally competent care for this client.
- How might the family's traditional medicine be incorporated into the treatment she receives at the hospital?
- What steps are necessary for the client's safety regardless of culture?