Tailoring education for a lost Somali patient

Goal was teaching diabetes control

When a Somali man found wandering the streets of Columbus, OH, was brought to Doctors Hospital, medical staff determined that he had quite a few medical problems. He had a stroke and new diabetes was identified. The man spoke very little English, so interpreters were used for the assessment of his condition.

Because there is a large Somali population in Columbus, staff at the hospital had classes on this culture. "From our understanding, they don’t do any preventive care; and if they do get into the health care system, they expect to stay until they are better. That is pretty much what happened. He was here two months with no insurance and no documentation. We couldn’t turn him out on the streets," says Cindy Wagner, RNC, MS, CNS, a geriatrics clinical nurse specialist at Doctors.

Although the Somali man was put on lots of medications, the pharmacist worked closely with the nurses to make the regimen easy to understand. It worked out that the man was able to take each medication either once a day or twice a day, and the nurses put a sun on the bottles if he was to take the medicine in the morning and a moon on the bottle if the medication was to be taken at night.

To help reinforce teaching of nutrition, the patient was given meal tickets to the cafeteria and allowed to get up and get dressed during the day so he could pick out his own food. The staff got together and brought in clothing and purchased him a winter coat, shoes, and a wallet.

Because most of the information staff had learned about Somalia was health-related, Wagner went on the Internet and typed Somalia into the search engine. She downloaded a map of Somalia and information on the people’s customs. "These were more conversational topics that people could try to talk to him about," says Wagner.

She also downloaded a newspaper for the Somali man to read and it proved to be a good tool to assess his literacy. He did read a few of the articles to Wagner.

Eventually, some friends of his came forward, and the nurses completed several educational sessions teaching them about the Somali man’s disease and the medications he was taking.

The nursing staff set up an appointment for the Somali man at the outpatient clinic after discharge, but he never showed up. "Not following through on things is typical," said Wagner.

She had typed up a simple record of what had been done in the hospital, including a list of the man’s medications so he would at least have that information no matter where he went.