The Last Tango of Tristan and Isolde
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Stellar Undergraduate Research Journal Oklahoma City University Volume 10, 2016 2 Stellar Oklahoma City University’s Undergraduate Research Journal This academic journal is a compilation of research that represents the many disciplines of Oklahoma City University, ranging from nursing, literature and religion, to education and the sciences. This diversity makes Stellar representative of all the exceptional undergraduate research at Oklahoma City University. Editors: Meaghan McEwen Sunsinee Parker Faculty Sponsor: Dr. Terry Phelps Stellar is published annually by Oklahoma City University. Opinions and beliefs herein do not necessarily reflect those of the university. Submissions are accepted from undergraduate students from all schools within the university. Please address all correspondence to: Stellar c/o Terry Phelps, English Department Oklahoma City University 2501 N. Blackwelder Ave. Oklahoma City, OK 73106. All submissions are subject to editing. 3 Contents Health Care Disparities Related to Race Jean-Nicole Black ................................................................... 4 The Greatest Story Ever Told: From Harry Potter to Jesus Christ Brandie McAllister .................................................................. 13 Man, Woman, Medea Sylvia Hayes ........................................................................... 24 Bombs Not Food: The Role of Women in Religious Terrorism Rebecca LaVictoire ................................................................. 31 Social Media and Patient Confidentiality in Nursing Dixie L. Cook.......................................................................... 43 Heuristic Learning: The Nature of Knowledge 0-3 Hope Wiggs ............................................................................ 52 Prions: Understanding Proteins Role in Neurodegenerative Diseases Angela Clifton ......................................................................... 60 The Concept of Freedom: Post-Emancipation Proclamation How this newly-found freedom fails to remove the veil separating blacks from it Patience Williams ................................................................... 72 QSEN Problem: Antibiotic-Resistant Organisms and Infection in Nursing Practices Holly N. McCabe .................................................................... 81 A New Challenger Approaches: Video Games Being Used as an Educational Tool Dustin Bielich ......................................................................... 89 Credits and Thanks ............................................................................ 98 4 Health Care Disparities Related to Race Jean-Nicole Black Health disparities related to race continue to plague our nation’s healthcare system. Despite decades of research and advances in health care technology, the problem of unequal treatment still exists. African Americans are disproportionately affected by disease, chronic health condition, and mortality, facing a 20% higher mortality rate amounting to a deficit of four years of life than that of whites (Kronebusch, Gray, & Schlesinger, 2014; Peck & Denney, 2012; (Penner, Blair, Albrecht, & Dovidio, 2014; Samuel, Landrum, McNeil, Bozeman, Williams, & Keating 2014). All competencies of QSEN are adversely affected by race related disparities. Patient centered care is obstructed by the implicit biases of some health care providers (Penner, Blair, Albrecht, & Dovidio, 2014). Informatics and technology is shown to be lacking in facilities that serve minorities the most (Samuel et al., 2014). Evidence based practice would suggest that across the board standards in specific disease treatment be utilized to prevent minorities from receiving less than adequate care, yet it is highly controversial to suggest it. The argument is that although this approach would ensure quality improvement, this method would lessen patient centered care, which can be interpreted as different care for different groups of people (Penner, Blair, Albrecht, & Dovidio, 2014). Safety is also found to be compromised. When minorities are referred for surgery, they are often sent to hospitals that perform a low volume of the specified surgery, leaving the client at risk for mortality (Kronebusch, Gray, & Schlesinger, 2014). Team work and collaboration between clients, providers, nurses, and support staff is needed to monitor, research, and reduce race related health disparities. Every client should be considered a unique individual with special needs. Although their ethnic background should not be ignored, it also should not impede 5 needed health interventions based on cultural stereotypes (Penner, Blair, Albrecht, & Dovidio, 2014). Assessment/Analysis In my clinical experience, I have seen a different standard of care on a few memorable instances. One was an African American female who was in the hospital for sepsis, and she also had difficile colitis, and chronic anemia. The client’s lab work was far out of range for her white blood cell count, hematocrit, and hemoglobin. I was assigned to this client, and talking with her I discovered that she was unaware that she was anemic and she did not know what kind of anemia she had. At the time, we were studying some cancers that could cause the symptoms she had, yet she said her doctor did not tell her very much information. She was not receiving treatment for anemia. She had shown to have lost weight and gained difficile colitis during her stay at Mercy hospital. The client did not have control over her health, and she lacked information and patient centered care from her provider. Her nurse did not have many answers for me either. The technology available was her chart in epic which was vague in regard to anemia. There were labs but no further examination of the possibility of more serious health conditions. This was not the last time I encountered questionable care in minority clients. In another instance, a First Nations (Indigenous Canadian) male with type two diabetes was in recovery on the med-surg floor from having an operation to remove a cyst. After assessing my client’s needs, I asked for the social service person to assist my client in seeking a way to get needed medications and diabetes equipment once discharged. The attitude at the nurse’s station was that it was silly to help the client because he knew what he had, and that he did not care. To validate this judgement, I witnessed the same group of nurses referring a homeless white man to social services, and that is how I knew that it was available to assist clients. I witnessed the nurses celebrate that they were able to help a homeless man. I believe the underlying cause of the differential treatment in those instances was complex. I hypothesize that because both of these clients were poor, had little control over their health, and were admitted by the emergency department, they were 6 a part of a systematic health disparity. Any impoverished person might experience the same situation. The difference is, in the homeless white male client, the nurses and support staff showed concern and care. In the cases with the African American female and the First Nations male, the nurses showed no concern or question of how they could help the clients. This behavior was maladaptive of the nurses because although the system and physicians perpetuated systematic discrimination, it was the job of the registered nurses to care for all clients despite personal biases. As nurses, we might be the only person to show care to a person. That ability to show concern is what distinguishes a nurse from anyone else. When nurses ignore differential treatment and participate in treating minorities poorly, this jeopardizes the profession of nursing. Planning/Literature Review According to (Penner et al., 2014), racial disparities in health have three routes of causation. Discrimination, persistent discrimination leads to physiological stress leading to racial disparities in health. Physician-Decision, physician implicit bias leads to disparities in physician decision making leading to racial healthcare disparities. Physician-patient relationship, physician implicit bias leading to disparities in clinical communication leading to negative patient outcomes, and racial healthcare disparities. Explicit racial bias is unacceptable in medical care, and providers and support staff do not generally engage in blatant racism. Implicit bias is automatic and mostly unconscious. A widely used measurement tool for implicit bias is the Implicit Association test (IAT), which tests the individual by measuring their response to white and black people. The responses are so quick that the person is unable to control their unconscious thoughts being quickly fired off in negative or positive responses about white or black people. Eighty percent of non-black physicians show to have biases toward African Americans, meaning they associate them in a negative form. Suggestions for 7 improvement include standardizing healthcare treatments for all people, despite cultural differences, and responses taught in medical school. The data suggests that providers will not respond well to being asked to confront their own implicit biases (Penner et al., 2014). In 2012, Peck and Denney explored how health disparities are present in meetings between African American clients and their providers. Data were coded from 221 audiotapes of physician- client meetings. Seventeen physicians and 221 clients participated in the study over 11 months. There were consistent differences based on race, and this