grandmother of two young boys, arrived in the emergency room (ER) of a busy metropolitan trauma center complaining of a severe headache with increasing pain,

grandmother of two young boys, arrived in the emergency room (ER) of a busy metropolitan trauma center complaining of a severe headache with increasing pain, dizziness, and nausea with movement. After the physical examination, the physician ordered a CT scan, which revealed a left occipital mass. Ms. Talsford was admitted with a brain tumor. During the next few days, MRI studies, a PET scan, and other tests revealed that Ms. Talsford had lung cancer with metastases to her brain. A friend of the family was with the patient when the doctor spoke with her. He asked Ms. T, as everyone called her, if it was okay with the patient to speak about her situation while the visitor was present. Ms. T said that was okay with her. The doctor spoke encouragingly and told Ms. T that everything would be done to remove the tumor from her brain. Over several days, Ms. T made a slow neurological recovery from the surgery, but became more despondent after being told about the severity of her illness. She was starting to eat less each day and lost 20 pounds in a short period. Ms. T was well liked and had a room full of visitors each day. The nurses on the unit were confused about how to best care for Ms. T. They were not sure if she appreciated the significance of her diagnosis. One day Karen, one of the staff nurses, asked Ms. T if she would like to see a minister or other clergymen during her hospitalization. Ms. T stated, “Well, I’m not really 132 II. Stepping Up to Cultural Competency the religious type.” Karen was stunned by Ms. T’s comments and replied, “Okay, I’ll be back in a little while.” She left the room perplexed about what to do next to assist Ms. T -What cultural information about the patient will you need to obtain culturally sensitive care during the EOL? -What kinds of psychological, emotional, and spiritual support would you need if given a similar diagnosis?

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