Overcome My Mind

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            Growing up in Vietnam, I was taught various aspects of my Asian culture, including the importance of treating older adults with dignity and respect. When I came to the U.S., there were many cultural conflicts with my own beliefs. Learning to adapt to the new environment and culture was a challenge for me in the beginning. However, I recognized that I do not need to neglect my culture to adopt the new one. On the other hand, I have merged them to create my own identity and values. Understanding the different values between my culture and American culture helps me find solutions to overcome cultural conflict; it helps me enhance my nursing practice in the future and helps me during my research process. 

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           Through my Mental Health Nursing class (NURS 411), I learned about therapeutic communication with patients. I also learned that it is important to understand patients' backgrounds and culture; it will improve patient care and effective communication, which is essential to my work as a nurse and researcher. My idea for the smart lightbulb research came from effective therapeutic communication with older adult participants, which consolidated my communication skills.

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             In my culture, I was taught not to look directly into the person's eyes that I am talking to because this brings out a non-verbal message of threatening and challenging the other person. Most of the time, this action limits their willingness to share and to converse effectively. For example, if I look directly into my older adult relative’s eyes during the conversation, she or he will feel that I am disrespectful to him or her. Therefore, I avoided eye contact with Asian friends and family members because I thought that would make the other person feel uncomfortable. However, in NURS 411, eye contact shows trustworthiness and confidence and connects two people during conversations.

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            In this course, I learned about using motivational techniques such as using silence to encourage others to talk, using clarifying questions, paraphrasing, considering cultural differences, and respecting personal space. This course also emphasized how important eye contact is in making connections with patients. However, it was still so hard for me to make eye contact during conversations.

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           During my junior year as a research assistant, I had the opportunity to visit one of my participants. The research that I was working on with Dr. Corbett was about using a device called Alexa to support the geriatric population. We tried to identify Alexa’s function to help the aging process and identify older adults’ perceptions about using technology. During my visit, I sat down and had a conversation with this participant, an older adult. Unintentionally, I looked away whenever she tried to make eye contact with me. The conversation did not go as well as I anticipated. At that moment, I remembered about therapeutic communication note that I learned in NURS 411. I used the silence technique to encourage her to talk more as it is one of the first recommendations to force the other person to talk.

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           However, it was an awkward, silent moment. I was nervous, and my heart started racing with the question, “what should I do next?” The idea of looking into her eyes crossed my mind as a last result. I hesitated for a couple of seconds because I had to get out of my comfort zone. I lifted my head after looking at the ground for a while. I saw her, an elderly woman who just wanted to talk, but she did not know if I was interested in talking with her. I started to look into her eyes and share with her my struggle that I have a hard time making eye contact. She laughed and said, “I thought you did not want to talk with me.” The ice was broken; we had an outstanding conversation in which I found out that she was afraid at night because her vision was getting worse. I asked her why she did not go to an ophthalmologist. She explained her insurance does not cover that. What she said made me think a lot about the healthcare disparity in our country. This experience changed 180 degrees in my perspective about making eye contact. I started to feel more confident to make eye contact with my patients and my participants.

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           Her concern motivated me to further research on insurance costs and coverage for older adults. With the support of my research mentor, Dr. Cynthia Corbett and her team, I started to write a paper about fall risks in older adults who live at home and the potential of improving insurance coverage to reduce fall risks (Reducing Fall Risk among Visual Impairment Older Adult artifact.) Many factors lead to fall risks, and visual impairment contributes to that. However, insurance coverage for older adults' visual care is complicated and does not cover everything (Zabeck, Lam, Randall, Field, & Brinks, 2020.) For example, insurance will cover the frame of glasses but not the refraction unless the older adults have some specific comorbidity. Even though the consequences of falling because of visual impairment/visual loss has a huge impact on healthcare costs, insurance companies do not cover annual eye exams or treatment in the early stages of visual impairment to prevent vision loss.

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           Overall, the knowledge about the therapeutic communication strategy I learn from NURS 411 helps me effectively communicate. My research experience allowed me to practice effective communication with older adults and overcome my fear about making eye contact, which is important for me to become a better future healthcare worker and researcher who can connect with his patients and participants personally. Also, I now understand how important culture sensitivity is in healthcare, so it is important that I ask my patients what matters to them or what makes them uncomfortable related to their culture, religion, or beliefs that they want me to know. Therefore, I can adjust myself to bring out the best quality of care for my patients due to this experience.

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Reference:

Zaback, T., Lam, S., Randall, J., Field, T., Brinks, M. (2020). Access to Eye Care Before and After Vision Loss: A Qualitative Study Investigating Eye Care Among Persons Who Have Become Blind. The Qualitative Report, 25(6)(4): 1473-1488. https://search.proquest.com/openview/901d2a72a702d45bd13e2dd1a553bc5c/1?pq-origsite=gscholar&cbl=55152.