Soon-to-be pharmacy graduate ready for challenge of providing care in culturally sensitive manner

April 24, 2009 | Features
By Jim Winkler

Tyler Campbell believes considering patients’ cultural background is an important part of providing good pharmacist care.

Tyler Campbell, left, talked with Dr. Martin Ohlinger during a break at the recent program in the Student Union, where pharmacy students gave research presentations.

Tyler Campbell, left, talked with Dr. Martin Ohlinger during a break at a recent program in the Student Union, where pharmacy students gave research presentations.

It’s an approach that will serve the May pharmacy doctoral graduate well when he begins a one-year ambulatory care residency training program in July at the 39-bed Santa Fe Indian Hospital, a primary treatment center for American Indians in northwestern New Mexico.

Campbell is one of 14 students who will begin first-year residency positions after graduation, according to Dr. Martin Ohlinger, clinical assistant professor of pharmacy practice and critical-care residency program director in the College of Pharmacy.

Of the 14 students beginning residency training — most are staying in Ohio and other Midwestern states to train in big-city hospitals — Campbell might face the biggest challenge because he will have to incorporate cultural competency in his daily activities and understand that Native Americans respond to medical providers and Western medicine in different ways.

Many American Indians maintain strong historic, social, cultural and spiritual beliefs and practices that influence their encounters with physicians, nurses, pharmacists and other health-care professionals. Medicine men who offer prayers and blessings, natural remedies such as herbs, roots and plants, and meditation, chanting and even tobacco, play an important part in the healing process.

Native Americans from 11 area Pueblos benefit from services provided by the hospital, which is part of the Indian Health Service, an agency of the U.S. Department of Health and Human Services. The hospital has a staff of 320 employees that cares for 30,000 patients, many of whom have diabetes, high blood pressure, obesity, chronic kidney disease and cardiovascular disease.

“As far as challenges dealing with cultural differences, there will surely be some,” Campbell said. “I did an experiential rotation at a reservation hospital in Arizona in February, so I got exposed to a small portion of it. The main thing to remember is to respect the individual’s beliefs because they are noticeably different in certain areas. Their beliefs tend to be different in terms of causes of disease states as well as best methods of treatment. Individuals also are very protective of their family, and often times you deal with more than one individual in a counseling session. Learning as I go is definitely going to be a major part of crossing these barriers. However, the individuals I spoke with in Arizona were all very friendly and willing to share with you their views and willing to listen to what you had to say. Cultural competence is without a doubt very important in this area of pharmacy. It also allows for new learning experiences and broadens one’s horizons.”

Campbell, a native of small-town Carrollton in east central Ohio, said he appreciates the need to understand patients’ cultural backgrounds. In practical terms, what that means is health-care providers need to take time with patients to understand their cultural attitudes and beliefs.

“There is a lot of patient interaction at the hospital,” he explained. “All Indian Health Service sites require that patients be counseled on every medication when they are picked up. This particular site is set up so that the patient is in an individual room with the pharmacist during their his or her visit to the pharmacy. It allows for maximum patient-pharmacist interaction.”

“The changing demographic makeup of the U.S. has brought to the forefront the need for culturally competent health-care providers, including pharmacists,” said Dr. Monica Holiday-Goodman, associate professor of pharmacy practice, who teaches a required course for pharmacy doctoral students titled Human Interaction in Health Care that contains a major component on cultural competence. “Cultural competence is said to be as important as clinical competence in ensuring positive outcomes for patients. Much of what we and our patients do regarding health care is culturally based. Cultural competence takes into account the patient’s attitudes, beliefs and practices regarding health care. Oftentimes, these beliefs and practices may differ from those of the health-care provider. Those health-care providers that learn to work within the cultural framework of the patient can more easily establish a relationship of trust with the patient, thereby enhancing the likelihood of positive health-care outcomes.”

Campbell will participate in three of the hospital’s specialized, pharmacist-run clinics for patients interested in stopping smoking or needing anti-coagulation or hepatitis-C treatment.

He said ambulatory pharmacy practice is attractive because “it allows you to use your knowledge to a greater degree than a community setting and offers more patient interaction than your typical inpatient pharmacy job.”

Campbell also will travel to five satellite clinics in the greater Santa Fe area, allowing him to care for patients from a wide variety of backgrounds. After residency, Campbell has a two-year obligation with the Public Health Service; he said he is considering a career with the organization.

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