Cultural competence care is borrowed from the aspects of cultural competence in any other work or personal environment. Cultural competence refers to the aspect of developing awareness of the personal existence, thought, sensation as well as the environment, without letting this knowledge have any form of influence on other people’s backgrounds, thoughts and opinions (Murphy, 2011). This means that one has to respect the cultural aspects of those around them, by accepting and appreciating their differences without any form of prejudice. When this element of cultural awareness is introduced in the nursing field, cultural competence care thus can be said to refer to the ability of the registered nurse to offer highly specialized care, with complete knowledge and appreciation of the patient’s cultural beliefs and attitudes in mind, with respect to disease, pain, healing, diet, religion, communication and death among others (Douglas et al., 2014).
Due to our society consisting of people from many diverse backgrounds, the registered nurse is always faced with new challenges as they meet and interact with patients from differing backgrounds (Taylor, 2011). The most important aspect of health care delivery that is centered on the patient is that the nurse needs to respect the decision of the patient (Douglas et al., 2011). This aspect is due to the fact that, the patients are supposed to be incorporated in every other decision that the nurse and other members of the health care team have to make over the life and treatment of the patient. With close reference to the aspect of cultural differences, there are patients that will be particularly cautious of their cultural beliefs and in most of the cases will want these beliefs to be respected and maintained at all times.
As mentioned earlier, these beliefs may range from, diets, clothing, gender of the attendant, religious observations to matters relating to pain, healing and death (Peterson-Iyer, 2014). As such the nurse has to work with the patient and the family to come to an understanding and agreement on the best way forward. In an example, it is common for registered nurses to be faced with patients who do not want to be attended by nurses of the opposite sex. It is important that the nurses understand that this is not the patient’s way of saying that they do not need help. They just want help that coincides with their cultural beliefs, which they are entitled to at all time (Murphy, 2011).
Guidelines for Registered Nurses
For the registered nurse to be in a position to offer the best care on the ground of cultural competence there are a few guidelines that can help them achieve their goals with much ease. It is important, that guidelines are implemented across the board, such that all the nurses from the different sections integrate them into their practices (Douglas et al., 2014). This way there will be uniformity in the provision of care among all the nurses and thus streamline the nursing practice culture in the health care facility involved.
a. Personal Reflection
For a nurse to understand the beliefs of the patient that come their way, they would have to first evaluate their own beliefs. The term cultural self-awareness comes to mind in which one objectively examines their own beliefs, values, practices and family experiences (Taylor, 2011.) Cultural self-awareness is important, that way the nurse can create the same level of self awareness that the patient has. Much like the nurses have their own preferences that are culturally related, the patients too have the same and would want to be understood and respected not judged on these grounds (Peterson-Iyer, 2014). This is the first step towards enhancing the nurse’s ability to provide culturally competent care.
b. Gaining Knowledge of the Cultures
Ideally this means that the nurse should take their time to gain understanding of the cultures of the patients that they are attending. The registered nurse should take interest in learning the traditions, perspective, values, family systems and practices among other culturally relevant material of the patient (Douglas et al., 2011). Different patients will have different beliefs that they observe and it is important for the nurse to stay ahead of the curve, by familiarizing themselves with the different cultures around them.
c. Involve the Patient
Patient empowerment and advocacy is one of the crucial pillars of any health care practices that put the patients at the center of their practices (Douglas et al., 2014). When treating the patients, registered nurses should make sure that they include the patient, family and friends in the decision-making circle (Murphy, 2011). Making health decisions is crucial to the patient, and it has to be done in manner that, the patient is actually involved in the process.
d. Communicating Cross-Culturally
Communication is very important in any relationship, but it is particularly important in the patient/nurse relationship. In this case, it is crucial that the registered nurse learns how to communicate with the patients. Communication is defined as the process of exchanging information and generating and transmitting meanings between two or more individuals (Taylor, 2011). Communication is not limited to verbal but also spreads to the ability to interpret nonverbal language cues (Murphy, 2011). This is essential as it indicates that the nurse actually respects and dignifies the patient. Miscommunication between nurse and patient much like in general conversation between any two strangers can cause a lot of controversies. It is important that the nurse understands the information being transmitted and looks at their patient’s response before making a rushed judgment. Incorporating culturally competent care in nursing practices Self-awareness is the initial step that every registered nurse should take before trying to understand their patients.
By becoming self-aware, it is much easier for the nurse to understand the beliefs and the values of their patients (Peterson-Iyer, 2014). To integrate this aspect in their practices, registered nurses need to get in touch with their inner values and reflect on them, before making any assumption on the part of the patient. By doing this the nurse will be in a position to challenge their assumptions and personal believes as they dispense personal practices and professional ones. It is also important to note that this is a practice that should start at the student nurse level and go into the professional levels.
Building on one’s cultural knowledge, can help the nurse go along way into the aspect of understanding the patients and their needs. Registered nurses should never make assumptions and generalize the patients and their beliefs. Different patients will have different sets of beliefs and it crucial to understand the specific details, creating the differences. Nurses should use their knowledge of the cultural differences to understand the impacts they will have on values, behavior and attitudes of each patient. They will also use this knowledge to establish the impact they will have on the health care policies and the resources at the hospital (Douglas et al., 2014).
At the center of the cultural awareness and health care provision is the ability of the nurse to communicate with patients and other medical team members. One of the basic aspects of integrating proper communication skills in their work, registered nurses should understand the essence of quality communication (Douglas et al., 2011). This means that they need to value the basic rules of communication. At the same time they also need to have a wealth of understanding with reference to the verbal and nonverbal communication elements. It is advisable that the nurse try and pick up some of the common phrases used by the patient’s culture. In the example, when a nurse asks their patient whether they are having any pain, in the patient’s language, there is the element of the patient feeling appreciated.
While it may be taken as a light gesture, it is actually very strong and creates a strong between the patient and the nurse (Murphy, 2011). The idea of having patient-centered care that is culturally nourished cannot happen if the patient is not actually involved in their own care (Peterson-Iyer, 2014). In the implementation of the patient-centered care, the registered nurse needs to understand that, whether all the other guidelines are observed, if the patient is not involved in their health care decisions, the program is doomed to fail. Understanding the patient’s language, values, practices and preferences are not enough if these are not recognized in creating a platform where the patient is involved in the decision-making process.
The Importance of Incorporating Patient’s Cultural Needs
Health care has made some very, major leaps since the 60s. It is no longer a practice associated with helping the patient heal and go back to their lives, but it is much more complex and patient-centered. In the past, the doctors and the nurses made the decision and told the patient when they felt the need to inform (Douglas et al., 2011). Due to the level of globalization, nurses now get to treat patients from across the globe while at the same time they also get a chance to work in different areas of the world. Learning to interact with the different cultures across the globe is crucial to the development of the patient-centered health care services. For nurses, it is very crucial to ensure that they understand the various cultures to deliver quality care. By understanding the various communications cues in a certain language, whether verbal or nonverbal, it reduces friction between the nurse and the patient.
This means that the nurse is able to establish a cordial relationship with the patient and their families. At the same time the nurse also understands the barriers that can inhibit their delivery of care and avoid them or work to refine their skills. When a registered nurse incorporates cultural awareness in their care, they give the indication that they are respectful to the patients. Patients recovering in a hospital are not only battling with physical illness, rather they are also having social and emotional difficulties to deal with. When the nurse shows that they understand, it makes the patient feel much better and this increases the chances of recovery, physically and mentally. For a nurse, incorporating the cultural awareness aspect into their care delivery ensures that they are liberated from social stereotypes (Douglas et al., 2014).
By learning the different cultures across the cultural divide, the nurse is skilled with the right knowledge to work anywhere in the world. It is not possible to work across borders if one is still affected by cultural prejudice and preferences (Murphy, 2011). By making sure that one understands their culture, they adapt an open mind, where they are able to relate to the different cultures. It also means that the nurse is able to work with different nurses from varying backgrounds. Cross cultural skills are not limited to the nurse-patient relations, due to the fact that the workplaces are now multicultural.
Cultural Practices in Health Care
Cultural needs have to be incorporated in the delivery of quality health care where possible. The different aspects that demand patient needs are incorporated in the health care services. Diet is one of the major aspects that has to be incorporated in the health care services. Different cultures have different diets that they observe, and these have to be maintained even at the hospital (Peterson-Iyer, 2014). Patients that are of the Muslim faith do not eat pork and as such cannot eat meals containing the same in the hospital. Dietary teaching must be individualized according to cultural values (Taylor, 2011). Some cultures also do not allow nurses of the opposite sex to attend to them (Douglas et al., 2011).
It is also common that patients will have some form of preferential clothing that they would want to wear. At the time of death, some cultures have rituals that may involve the services of spiritual/religious leaders and traditional healers. Some of the most common rituals in the Hispanic culture include prayers, placing candles in the room, picture of saints in the room, cleansing the body and inviting priests. It is also common to find that some patients may not support some of the medical practices such as cloning, blood transfusion (Murphy, 2011).
Understanding these differences creates the balance between the nursing practices and the cultural practices. Incorporating the cultural practices in medical care is crucial for the benefit of the patient and their families. Where possible the nurse can try and suggest alternatives such electric candles for safety issues among others. It also streamlines the delivery of health care services with minimal friction among the patients and their nurses (Douglas et al., 2014).
Culturally Competent Nursing Care
The Hispanic community consists of very religious people and follow their culture quite closely. As such when providing care to Hispanic patients, it is crucial for the nurses to take note of their beliefs and respect their wishes. They place a lot of faith in the Virgin Guadalupe and place a lot of emphasis on the traditional means of healing (Peterson-Iyer, 2014). According to the Hispanic traditions that are borrowed from the Greeks, when one is sick, their balance of the four humors is out of place. The four humors include black bile, yellow bile, blood and the phlegm. Ideally when one is sick from any disease including the chronic diseases, they have a form of imbalance in these humors or they may have too much cold or heat (Taylor, 2011). Some parts of the Hispanic community also believe that there are supernatural powers responsible for diseases.
In some cases, chronic diseases are believed to be caused by the supernatural powers and cannot be cured using medicine. Sensory impairments, according to the Hispanics are sometimes caused by supernatural powers while witchcraft is also attributed to patients losing some of their senses (Murphy, 2011). During the end of life care, the Hispanic community believe that a death is just an extension of life. Many may perform cleansing rituals as they prepare their relatives for the next life after their death (Douglas et al., 2014).
Nursing care considerations
As a registered nurse, it is important to understand the cultural believes of the Hispanic patients and the community in general to make sure that the health care delivery is highly improved. In the case of the chronic diseases, most of the families are going to prefer the use of herbal medicine for treating patients at all ages (Peterson-Iyer, 2014). In the case of the children it is important to try and explain to the families with a lot of understanding, the benefits of the modern medical practices. This also means that, one has to be careful not to look like they are bashing their cultural beliefs. Families can be asked to try the modern medical practices while at the same time they may decide on the traditional practices they are comfortable with. This also goes for the elderly patients, given that like children they are more susceptible to injury or illness and may give in to the treatment or the disease (Murphy, 2011).
When it comes to the impairment of sensory organs, most of the time, the Hispanic community will take that the patient has been bewitched, or a supernatural power is responsible. This mostly cuts across the age divide, for the children, youngsters and the old (Douglas et al., 2011). Communicating the importance to the families or the patient to try the modern medical practices is important. This is due to the fact that it can be difficult to convince an asymptomatic patient that they are ill (Taylor, 2011). The end of life experience takes different shapes across the age divide. In the case of the children, the families may believe that their child has been bewitched and may require performing cleansing rituals. At the same time, the rituals are also directed at helping the diseased join their next life and find peace, whether old or young.
Nursing practices have been revolutionized over time, and delivery of care to the patient is no longer the mandate of the medical teams alone (Murphy, 2011). Patient-centered care is the baseline for most of the health care services across the globe. With reference to the globalization levels and the multicultural interactions, nurses have to develop cross-cultural competency skills. Culturally Competent Nursing Care skills are crucial for any one that wants to be a registered nurse (Douglas et al., 2011).
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