Free Essay: The Clinical Situation

The following intersectionality clinical case is about a 25-year-old pre-op African American transgender male who legally changed his name to Charles Smith. Mr. Smith was born female and lives in Cincinnati, Ohio. He is attracted to females and only responds to male gender acknowledgment. Additionally, he has not been in contact with his family since they threw him out of the house at the age of sixteen. He has never graduated high school, is unemployed, homeless, has no support system, and has an addiction to both alcohol and OxyContin; hence, he survives through prostitution. He became addicted to alcohol and narcotics abuse to numb pain of discrimination, body image issues, depression, and due to lack of LGTBQ community resources. Because of a hate crime, Mr. Smith has been admitted to a local hospital for his injuries. He is also receiving holistic care, and for the first time, he is acknowledging feelings of depression, substance abuse addiction and is seeking transgender outreach support because he feels many staff members have treated him with insensitivity and bias.

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The Interprofessional Team

In the hospital, a sexual assault response team (SART) has been created to respond to Smith's case to ensure he receives the best medical and legal care. The team is comprised of forensic nurses, police officers, psychologists, and forensic scientists. The team's primary goal is to ensure proper healthcare and recovery of the victim, arrest the perpetrators, and promote public safety. Notably, different professionals have various dependent roles that contribute to the attainment of their primary goals. The psychologist is responsible for Smith's emotional and psychological recovery, nurses undertake medical interventions, forensics will aid in matching evidence with potential suspects, and police are tasked with the arrest of the crime perpetrators.

Analysis of the Situation from an Intersectional Perspective

Mr. Smith's situation is an example of an intersectionality case, which his economic, sexual orientation, and ethnicity contribute to his adverse predicaments. According to Dhillon & Lyon (2014), intersectionality is a process by which an individual's class, gender, sexual orientation, and race contribute to their inferior social status. As a result, individuals are exposed to social injustices, marginalization, vulnerability, and social inequity in societal aspects such as health care. Nevertheless, feminist intersectionality lobby groups exist, which try to eliminate powers structures and complex dimensions that facilitate social injustices (Dhillon & Lyon, 2014; Rogers & Kelly, 2011). Unluckily, most of these feminist institutions are predominately focused on white females' interests as opposed to those of women of color. Therefore, many LGBTQ persons of color, evident in the case of Mr. Smith, may have faced discrimination and hate crimes due to their inferior social status since no one cared to defend their plight

Nursing Perspective

Nurses can utilize King Imogene's theory of goal attainment (TGA) to facilitate the provision of holistic medical care, which is client-centered. The TGA theory provides a humanistic system that enhances mutual relationships between nurses and patients to allow achievement of shared therapeutic goals (Caceres, 2015). In this case, nurses can develop interpersonal relationships with patients to enable proper communication, interaction, transactions, accountability, and elimination of stress to facilitate social justice in the attainment of health goals. For instance, nurses can engage Mr. Smith in the formulation of health goals, choosing an appropriate medical intervention, and eliminating the stress that may lead to his dissatisfaction (Caceres, 2015). Moreover, the approach ensures that nurses do not discriminate based on gender or sexuality and are compassionate towards clients since they can create a reasonable perception of them. The TGA framework is one of the best approaches to enhance nursing service delivery in a diverse society.

Analysis of the Situation from a Perspective of Interprofessional Collaborative Practice

Mr. Smith's medical situation is a complex one that requires interprofessional collaboration to ensure his recovery and creation of an environment where he can be safe despite his sexuality, gender, and race. The interprofessional team, in this case, includes nurses, forensic scientists, psychologists, and law enforcement agencies. In interprofessional collaborative practice, experts' roles are clear with power hierarchies efficiently maintained to avoid professional conflict (Kusnoor et al., 2019). Firstly, the psychologist is responsible for Mr. Smith's mental recovery. Hate crimes such as rape affect an individual's self-perception; thus the need for expert psychological assistance to achieve a relatively normal mental and functional state. Nurses are responsible for Smith's physical recovery from his injuries to facilitate him to achieve a functional body state. Thirdly, Forensic scientists are tasked with conducting laboratory tests and analysis to establish any relationship between evidence sample collected from the victim's body and potential suspects. Fourthly, police officers are tasked with finding and arresting the crime perpetrators. They depend on information from forensics and Smith's revelation.

Nursing Perspective

According to the TGA nursing approach, communication serves as a vehicle that develops all other relationships in a nurse-patient dyad. Proper interpersonal communication and interaction between the professionals will ensure that they reduce medical maleficence that may undermine Smiths safety (Ourkouta & Papathanasiou, 2014). Furthermore, cultural competency is essential in such a setting to allow the creation of useful patient perception. Notably, the team can improve their interpersonal relationships with the client. Mr. Smith had complained of poor treatment from some medical staff leading to his depressive state. Alongside physical wellness, emotional and mental recoveries are critical parts of healthcare (Ourkouta & Papathanasiou, 2014). Therefore, the team members should create an active environment where the patient is comfortable and free of stress. They can achieve this by being culturally accommodative.

Reflections

Lessons Learned

Discrimination and prejudice are the primary causes of social injustice in health care. With adequate improvements on nurse-client relationships, the attainment of healthcare goals will become easier. From the above situation, one can learn that dysfunctional interpersonal relationships between patients and nursing staff can lead to client dissatisfaction. For instance, Mr. Smith was depressed since the hospital staff treated him insensitively and with bias. Additionally, proper communication in a health care setting allows the elimination of poor perception towards a client and improvement in the dissemination of primary care in hospital clinical microsystems and response teams (Ourkouta & Papathanasiou, 2014). Imogene elucidated that perception aids in determining how nurses and patients perceive each other and share information.

Secondly, it is evident that inequality in the distribution of social resources can lead to poor living standards and discrimination in a community. In this case, individuals engage in life-threatening activities, such as prostitution, to earn a living. Moreover, female intersectionality has been a significant burden to many underprivileged individuals such as the transgender and lesbians (Rogers & Kelly, 2011). Communities should invest more to improve social justice and inclusivity.

Planning for Systemic Quality Improvement in Practice

Sexual assault response teams may systematically improve performance by conducting various routine activities. Firstly, team members should undertake adequate training concerning interpersonal communication to harness their competences. The event will enable members to improve their social skills to avoid injuring patients emotionally in the future to facilitate the creation of an active nurse-client dyad (Caceres, 2015). Secondly, the team should introduce basic guidelines and checkpoints that obligate all members to adhere to a professional code of ethics to avoid cases of discrimination and bias in dissemination support services. The phenomenon is essential to facilitate goal attainment in the current global trend of social diversification concerning all societal elements.

Thirdly, the interprofessional team should develop a culture that is family and client-centered to increases efficiency in the dissemination of their services. In this light, they can be able to update the client on the treatment progress and ensure that all their behaviors are bona fide to the client. Moreover, patient-centered services will allow all team members to involve the client in shared decision-making processes concerning his health progress.

References

Caceres, B. A. (2015). King's Theory of Goal Attainment: exploring functional status. Nursing Science Quarterly, 28(2), 151-155. DOI: 10.1177/0894318415571601

Dhillon, M., & Lyon, K. (2014). Intersectionality. In S. Thompson (Ed.), Encyclopedia of diversity and social justice. Lanham, MD: Rowman & Littlefield Publishers. Retrieved from http://vlib.excelsior.edu/login? url=https://search.credoreference.com/content/entry/rowmandasj/intersectionality/0?institutionId=1649

Kusnoor, A. V., Gill, A. C., Hatfield, C. L., Ordonez, N., Stritto, R. D., Landrum, P., ... & Ismail, N. (2019). An Interprofessional Standardized Patient Case for Improving Collaboration, Shared Accountability, and Respect in Team-Based Family Discussions. Mededportal: The Journal of Teaching and Learning Resources, 15. doi: 10.15766/mep_2374-8265.10791Ourkouta, L., & Papathanasiou, I. V. (2014).

Communication in nursing practice. Materia Socio-Medica, 26(1), 65-67. doi: 10.5455/msm.2014.26.65-67Rogers, J., & Kelly, U. A. (2011). Feminist intersectionality: Bringing social justice to health disparities research. Nursing Ethics, 18(3), 397-407. https://doi.org/10.1177/0969733011398094