Cultures

I've noticed a big cultural difference between two of my patients. One of them has a godmother who is an emergency department nurse. As a result, the family members are very assertive about what they want. They know how the hospital works and bring deficiencies to our attention. For example, when the patient was not getting pain medication in a timely manner, the legal guardians were adamant about improving her care. This is entirely appropriate, but it is sometimes hard to negotiate with them; their attitude is to demand what they think is owed to them.

On the other hand, I'm taking care of a child whose family recently immigrated to the U.S. Culturally, they are very passive when it comes to interactions with doctors. They grew up in a place where patients never argue with a physician and rarely speak up to ask questions or request clarifications. Through my entire interactions with them, they have treated me with quiet respect; they're always thanking me for my time and for my help. But I feel uneasy. They don't speak English, and though we use a translator, I wonder how much comprehension they have. Every time, I let them know that they can take control of their medical decisions, but I worry that their passive nature, while easy for physicians, will ultimately detract from the care they receive.