Immersion of distinct cultures is basically about the interaction and attitude of people. Moreover, the increasing diversity of the nation nowadays can provide health care staffs chances to work hard to fulfil a quality of care and improved health outcomes. As a result, there is a growing number of healthcare workers from different cultural backgrounds due to the increasing diversity of the patient population. Besides, multicultural society has needs that health care professionals must be aware of. In order to prevent health care discrepancies that negatively affect both the physical and emotional aspects of patients, culturally-based competent care must be provided. As a nurse, it is pivotal to be cautious in superimposing own beliefs and practices onto the patient, hence, making sure to consider every patient as an individual, taking each individual’s cultural upbringing into account when rendering care. Additionally, health care professionals must also recognize their own beliefs and cultural values and how those principles and values modify their functioning and behaviour apart from recognizing the patient’s cultural influences. The patient’s principles and behaviour may be affected by race, gender, ethnicity, language, education level, physical cognitive or emotional disabilities, occupation, religion, age, sexual orientation, marital and parental status, family structure, or geographic location. Also, safety culture has been proposed as a means to keep patients safe. Thus, the cultural needs of the patient must be properly assessed (Lippincott Procedures 2019). In light of this, one of the most common health issues in a long-term care facility such as a nursing home is the continuous, irritating pain felt by elderly residents. Furthermore, there are several barriers, namely patient’s behaviours and beliefs, age-related reaction to drugs and disorders and diseases that alter perception and communication such as dementia, that cause challenges in regards to the management of pain in all facilities. Hence, familiarising the pain management procedures for old-aged people by health care workers is crucial (Fitzgerald, Tripp & Smith 2017). By following Rolfe’s reflective model, I would like to share my current experience regarding pain management of elders with mixed cultures.Recently, I was assigned to a facility that looks after elderly clients. These individuals mostly have dementia and other diseases that need physical assistance from health care workers. When I, together with my supervising RN did the medication rounds, I noticed that all residents at that day have 2 doses of paracetamol. I thought initially that it was only on that day that most of them were about to take analgesic all together. However, during the consecutive medication administration rounds, they were still taking the same doses. So I checked the charts of the residents and found out that they all have daily orders of pain medications eversince when they were admitted in the facility. Suddenly, I was curious about the excessive dossage and long term use of paracetamol among elderly clients. I knew for certain that pain medication even if it is just a paracetamol, still must be ordered as a PRN or as needed. Moreover, I was a bit worried as well about its side effects in the long run. So, when I asked my supervising RN, she then explained that aged-related beliefs and attitudes from a well cognitive, functional elderly as well as with dementia are considered obstacles to specifically report the pain being experienced. Thus, to prevent discomfort and distress related to consistent untreated pain and possible physical deterioration, the physician has ordered daily dose of paracetamol to almost all the residents. Nevertheless, I am still reflecting on that specific management until now since there are pain assessment tools nowadays that must be considered for geriatric settings such as Abbey Pain Scale for those who cannot verbalise, PAINAD, DOLOPLUS-2, NOPPAIN and PACSLAC. Consequently, the formation of different pain assessment tools and identifiers lately can be used to aid in educating and encouraging awareness regarding pain management as most of the old-aged patients have a hard time to verbalise their pain experience due to many reasons. This wide range of suitable pain assessment tools are beneficial to properly alleviate different types of pain and can be categorised as observational behaviour tools, sensory testing mechanism and self-reporting scales. Therefore, an extensive assessment regarding pain is vital to be able to make a successful pain management strategy. As a result, a fuller comprehension of clinical signs and symptoms of pain, better techniques of assessment, and use of both pharmacologic and non-pharmacologic therapies can lead to a more beneficial results in managing the pain of elderly people (Savvas & Gibson 2015).
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