When Cultures Are Different

When Nurse Navigator Vicky Fliman, RN, steps into the exam room, she is prepared to talk with the patient in one of the five languages she speaks. What she must also be prepared for is the many cultural differences that exist. With patients hailing from more than 35 different countries, BVMI’s patient base is a microcosm of Bergen County.

Raul’s experience speaks for many.

Nurse Navigator Vicky Fliman, RN with Certified Diabetes Educator Holly Homa

Raul works in a restaurant and knew that he had diabetes. When he came to BVMI for help, the diabetes team prescribed insulin injections.

On a follow-up visit, Vicky noticed that his numbers had not improved. “He began to shake when I asked him about his insulin,” Vicky recalled. Raul was not taking the life-saving medication as prescribed.

He told her that his niece in Mexico had taken insulin injections and was now in a vegetative state. “In the village where I come from, we believe that you will die if you take insulin,” explained Raul. Knowing that she could not persuade Raul to change his mind, Vicky instead recommended that his prescription be changed to an oral medication. Certified Diabetes Educator Holly Homa then worked with Raul to teach him how to monitor his blood sugar levels and improve his diet.

When Raul returned for his next visit, his tests showed improvement. His wife said that he was careful about what he ate, monitored his blood sugar levels and took his medication. Equally important is what Raul said, “Thank you for respecting my beliefs. I truly appreciate that I was not judged.”