Below are several case studies for you to think about and respond to on the bulletin board. Once you have gathered your thoughts, please post your responses on the bulletin board prior to our on-line sessions scheduled for Thursday, February 5, 1998 from 4-6 PM. During that time you can react to other students' responses.

Case Study #1: Lupe Verde, a twenty-four year old mother-to-be from the Dominican Republic, has just had a tooth extraction performed by Dr. Rita Blank at the clinic. Senora Verde becomes visibly upset when she see Dr. Blank throw the tooth away and demands to be given the tooth instead.  Which of the following should occur and why do you feel that way?

1. Dr. Blank can say, "I am sorry.  It is too late to retrieve the tooth now. You should have asked me before I pulled the tooth."
2. Dr. Blank should give Senora Verde the tooth if that is possible. Otherwise, she can offer to save the next tooth she extracts for Senora Verde.
3. Dr. Blank should refuse, explaining that it is not hygienic to have a bloody tooth around where anybody can get hold of it.
4. If possible, Dr. Blank should give Senora Verde her tooth without comment.

Case Study #2: Giesele King has been working at Paisley Hospital for two weeks, having moved here from a small town in Montana. During a coffee break shared with Pamela Drake, who has been at Paisley for five years, Giesele mentions that she cannot get Mr. Park, the middle-aged Korean patient in Room 349, to call her by her first name. "I am worried that I have offended him somehow," she confides. "What do you suggest I do?" Which of the following should occur and why do you feel that way?

1. Pamela thinks that Giesele will be a liability on the floor and makes a mental note to bring the matter up discreetly with the head nurse at the earliest opportunity. (In the meantime, she changes the subject with Giesele.)
2. Pamela reassures Giesele that Mr. Park is only showing his respect for nurses avoiding the possibility that someone would think he is making improper sexual advances.  She suggests that Giesele not push for a first-name basis, adding that Mr. Park should continue to be addressed by his last name as well.
3. Pamela answers that Mr. Park is probably not very comfortable in English and can most likely neither remember nor pronounce "Giesele."
4. Pamela should remind Giesele that hospital policy forbids the use of first names.  Mr. Park probably knows and honors the rule.

Case Study #3: Marie Louise and Jean-Claude Poitier, who are political refugees from Haiti, take their eight year old son to a private family physician for acute earache. After the doctor examines the boy, he instructs the family to see the nurse in the reception area. The nurse reviews the doctor's instructions and extends a bill for services and a prescription to Mrs. Poitier, who accepts the prescription but tries to return the bill to the nurse. Why? Which of the following is the reason?

1. Mrs. Poitier thought the nurse gave her the bill by accident, because she assumed that medical care would be free for them as political refugees.
2. Mrs. Poitier does not work, and so she has no money of her own.
3. Mrs. Poitier is trying to convey to the nurse that one should always defer to the man as the head of the family.
4. The Poitiers do not agree with the physician's diagnosis.

Reference: Gropper, Rena C. (1996). Culture and the Clinical Encounter. Intercultural Press, Inc. Yarmouth, Maine.

Class discussion/bulletin board

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