A 37-year-old Black woman who was recently diagnosed as having hypertension is admitted for a medical work-up examination. Her history reveals that she has recently moved from New Orleans to New York. The nurse is having difficulty communicating with the client because she not only speaks in Black English but also has a heavy Southern drawl and tends to speak in pidgin English. Another factor complicating the development of the nurse–client relationship is that not only does the client not understand the hospital jargon and medical terms, but also word meanings for the nurse and the client vary. For example, when the nurse asks if the client likes her physician, she responds, “He’s bad.” Only later does the nurse discover that the client was speaking in an argot that is a special linguistic code for some Blacks. The client appears very fearful and anxious about being in the hospital. When questioning the client, the nurse finds that the fear and anxiety are related to the connotative and denotative meanings of the word “hospital.” In this case, the client believes that hospitals are associated with death and that she may not leave the hospital alive. When the nurse communicates with the client, she speaks very loudly and repeats the same words again and again.
Clinical Decision Making
1. Describe at least two problems encountered by the nurse when giving nursing care to persons who do not speak English as their primary language.
2. Describe four communication approaches that the nurse can use to give culturally appropriate care.
3. Describe approaches the nurse can use when relating to a client whose primary language is not English.
4. Describe at least two nonverbal indicators of anxiety the nurse may encounter when dealing with a client who does not speak English.
5. List at least two problems encountered by the nurse who assumes that speaking louder will improve communication.
