Brynn Strawderman
October 2023
Brynn
Strawderman
,
BSN
7 East HOPE
Medical University of South Carolina - Charleston
Charleston
,
SC
United States
The combination of Brynn's assessment skills with the reassuring presence of a friend from the same culture created an environment where Brynn knew that culturally sensitive care needed to be delivered.
This is one of many examples of why Brynn is deserving of the DAISY. In this example, she provided culturally sensitive care to a young patient with cancer that ultimately prevented limb amputation. This patient is able to walk on both legs solely because of Brynn’s unwavering commitment to advocate for our patients.
Recently, a 19-year-old Indigenous Mayan from Guatemala who primarily speaks K'ichi and limited Spanish presented to Hollings Cancer Center for care for osteosarcoma. He was treated with neoadjuvant MAP chemotherapy and surgery in 2022. His sole support person was a friend since his only family member living in the United States was his father. The relationship with his father was complicated by cultural influences after his diagnosis and he ultimately abandoned him. His father believed the mass was caused by "witchcraft" and because the patient had "sinned". The patient's treatment regimen required recurrent outpatient appointments as well as multiple inpatient admissions. Transportation was an obstacle to care exacerbated by the language barrier.
The patient presented to Hollings Cancer Center with intermittent pain, femoral swelling, and difficulty weight bearing. He was readmitted for recurrent prosthetic joint infection. Communication was facilitated through a Spanish interpreter, and he was assessed as having poor health literacy by his clinical nurse, Brynn. During one of the patient's multiple admissions for recurrent leg infections, providers began to discuss the possibility of amputation and consented to the patient for the surgery. After the consent for surgery was obtained, and the patient was being prepped for the amputation, Brynn probed further discovering that he really did not understand this terminology. Through conversations with the patient’s friend, Brynn identified that in the patient's culture amputations were not accepted. Amputations in his culture meant that he would be considered worthless because it would make it difficult to send money back to his mother, making him a burden on his family. Brynn also learned that the patient's noncompliance with prior antibiotics was caused by his lack of knowledge about their importance. This misunderstanding of medicine is influenced partly by his culture, which has an understanding that is considerably different from modern medicine’s.
The combination of Brynn's assessment skills with the reassuring presence of a friend from the same culture created an environment where Brynn knew that culturally sensitive care needed to be delivered. Because of this cultural sensitivity, providers explored other treatment options including an antibiotic-coated tibiofemoral nail spacer with hopes of limb preservation. Later during the patient's long hospitalization, Brynn connected with the patient about his lack of nutritional intake. With the help of an interpreter, Brynn discovered that the patient did not like "American food" but could not afford alternatives. Brynn educated the patient on the importance and connection between eating and wound healing. With limited resources, Brynn purchased food from Chipotle and the patient's intake greatly improved. In addition to making sure he ate; Brynn personally went shopping and purchased clothing for him.
Recently, a 19-year-old Indigenous Mayan from Guatemala who primarily speaks K'ichi and limited Spanish presented to Hollings Cancer Center for care for osteosarcoma. He was treated with neoadjuvant MAP chemotherapy and surgery in 2022. His sole support person was a friend since his only family member living in the United States was his father. The relationship with his father was complicated by cultural influences after his diagnosis and he ultimately abandoned him. His father believed the mass was caused by "witchcraft" and because the patient had "sinned". The patient's treatment regimen required recurrent outpatient appointments as well as multiple inpatient admissions. Transportation was an obstacle to care exacerbated by the language barrier.
The patient presented to Hollings Cancer Center with intermittent pain, femoral swelling, and difficulty weight bearing. He was readmitted for recurrent prosthetic joint infection. Communication was facilitated through a Spanish interpreter, and he was assessed as having poor health literacy by his clinical nurse, Brynn. During one of the patient's multiple admissions for recurrent leg infections, providers began to discuss the possibility of amputation and consented to the patient for the surgery. After the consent for surgery was obtained, and the patient was being prepped for the amputation, Brynn probed further discovering that he really did not understand this terminology. Through conversations with the patient’s friend, Brynn identified that in the patient's culture amputations were not accepted. Amputations in his culture meant that he would be considered worthless because it would make it difficult to send money back to his mother, making him a burden on his family. Brynn also learned that the patient's noncompliance with prior antibiotics was caused by his lack of knowledge about their importance. This misunderstanding of medicine is influenced partly by his culture, which has an understanding that is considerably different from modern medicine’s.
The combination of Brynn's assessment skills with the reassuring presence of a friend from the same culture created an environment where Brynn knew that culturally sensitive care needed to be delivered. Because of this cultural sensitivity, providers explored other treatment options including an antibiotic-coated tibiofemoral nail spacer with hopes of limb preservation. Later during the patient's long hospitalization, Brynn connected with the patient about his lack of nutritional intake. With the help of an interpreter, Brynn discovered that the patient did not like "American food" but could not afford alternatives. Brynn educated the patient on the importance and connection between eating and wound healing. With limited resources, Brynn purchased food from Chipotle and the patient's intake greatly improved. In addition to making sure he ate; Brynn personally went shopping and purchased clothing for him.