Diversity is exhibited in many ways, including a multiplicity of upbringing, dress, thought, lifestyle, values, food preferences, family relationships, and in gender, ethnicity, and age. These factors exist throughout the gamut of health care patients and the interactions designed with the nurses who care for them. Diversity in healthcare refers to the cultural setting in how the patient lives and in some measure defining their connection to healing, health, and their own role in the nurse to patient relationship (University of Phoenix, 2012). In many ways, the United States landscape is changing, especially in the health care field. The Baby Boomers are reaching an age where they are going to need and use more health care assistance, Generation Y and the Nexters are entering into the ages to begin working careers, and are bringing different behaviors and value sets with them. In the middle of all of these changes are the nurses and their care. Factors that play an influential role in the delivery of nursing care to the ever changing landscape are not only the diversity of the patient but the ability of the nurse to provide effective and culturally competent care (University of Phoenix, 2012). Standards of Cultural Competence
American nurses are predominately made of white females and does not honestly indicate the diverse population they serve. The push for more minority students to be recruited into the schools of nursing is big, but because of the culture of the profession being made up of middle class, white values, the minority nursing students are facing a barrier; racism. In nursing education, there is an emphasis on cultural competence. Being culturally competent means having the ability to care for patients with different cultures and backgrounds competently. This is otherwise known as transcultural nursing. An essential part of the nursing syllabus, transcultural nursing eliminates the racism shadow that has been portrayed all these years as normal. Transcultural nursing emphasizes nursing capabilities in providing culturally specific care to a diverse patient population. Cultural competence refers to studying and practicing nursing, focusing on the similarities and differences among the cultures with respect to nursing care and patient health.
Cultural competence can also be defined as “the ability to provide effective clinical care for a particular ethnic or racial group and is seldom seen as the ability to reach a culturally diverse student population with varying perspectives on health and illness and female roles” (Wilby, 2009, p. 58). Culturally competent standards in healthcare are set as ethnic or racial differences in the quality of care not discriminated against. There are two levels of non-discrimination. The first is within the operation of the healthcare system and the way the system functions following regulatory and legal pathways. The second is at the provider-patient level, or the individual’s levels. Discrimination is described as the way care is given based on prejudices, biases, and stereotyping. Another type of discrimination is on the patient level with the provider. An example, a minority patient refuses service recommendations based on the result of a cultural mismatch between the patient and the care provider.
This type of behavior can also result from misuse of clinical services such as when a test is not clinically indicated but given anyway (a pregnancy test on all females over the age of 12 regardless) (Institute of Medicine of the National Academies, 2003). Culturally Competent Care within Memorial Hermann Healthcare Systems Memorial Hermann Healthcare System (MHHS) is dedicated to the purpose of assisting the communities, patients, employees, and physicians they serve in a responsible, legal, and ethical fashion. Furthermore, they are loyal in rendering aid to their community, staying in full conformity with appropriate guidelines, laws, and regulations, in addition to their own procedures, policies, and processes. They are especially aware of the obligations appropriate to federal programs and correct billings submission. MHHS provides culturally competent, holistic care that directs with due respect, the physical, psychological, spiritual and social needs of their patients.
The system has high ethical values and expects respect, integrity, and fairness in all their relationships, employer, employee, and patient. MHHS provides culturally competent care with respect to the individual dignity of the patient, responding to needs, questions, and concerns in a sensitive and timely fashion. They evaluate and monitor on a continuing basis, the way care and any other similar services is being delivered to make sure that their mandated and customary set standards are being met. They take pride in the non-discrimination of the patient for any basis regardless of their ethnicity, race, upbringing, dress, lifestyle, values, gender, disability, or age. These same standards are upheld for the employees also. There is no discrimination when it comes to training, promotion or compensation, and employees are encouraged to frequently evaluate their current methods of care delivery in hopes of learning more effective ways of providing patient care and showing support (Memorial Hermann Healthcare System, 2012).
Populations: Served and Vulnerability
Cultural minorities have more of a tendency to get an inferior quality of care than the non-minorities, even with controlled access-related factors, such as income and insurance status. There are many sources to this disparity; contemporary and historic inequities, and involving many players; health care systems along with their bureaucratic and administrative processes, case managers or utilization reviewers, the healthcare professional, and the patients themselves.
Studies have shown that uncertainty, biases, and stereotyping done by the professional contributes to this unequal treatment. Minorities also experience other barriers to accessing care, even if they carry the same level of insurance as whites, including cultural familiarity, geography, and language barriers. Furthermore, the hospital and clinic financial arrangements of a health care system, as well as the regulatory, policy, and legal environment in which the system operates, may have a negative effect on these vulnerable populations’ ability to acquire quality health care (Institute of Medicine of the National Academies, 2003).
Delivery of Nursing Care
Nurses need be aware of how barriers such as racial, ethnicity, and gender can be related to health care access, and problems with underutilization are present causing disparities and affecting the communities in which they serve (University of Phoenix, 2012). Transcultural nursing has become a lead role player in the delivery of healthcare and is a necessity for the nurses of today because of the steadily increasing multicultural trend happening within the American population. One out of three people in the United States make up a portion of various ethnicities other than the average White. Because of this swift growth of the multicultural society, transcultural nursing is vital to nursing care, requiring that nurses are practicing cultural competence in their day-to-day patient care areas.
Culturally competent nurses are knowledgeable about other cultural beliefs and ideas and are trained in being able to identify particular patterns in order to formulate a personalized care plan that meets all the needs and goals of the patient. Culturally competent nurses also provide holistic care. This approach focuses on the spiritual, emotional, social, psychological, and physical needs of the patient. Being able to provide holistic care to the individual patient also means that the nurse can also relate to the patient’s cultural differences. In other words, in order for the nurse to perform care for their patient at the optimal level, the nurse must be culturally competent (Maier-Lorentz, 2008).
Multi-level and comprehensive strategies are needed to eliminate barriers of cultural competence. The gap between ethnic and racial groups and healthcare (providers, payors, patients, insurance plans, and society as a whole) must be made known in order to reach a solution. The healthcare workers and their competence to provide superior care to ethnic and racial minorities can be enhanced significantly by expanding the ratio of ethnic and racial minorities among healthcare professionals. Also, both the providers and their patients can profit from education. Patients can profit from culturally and customarily suitable instructional programs to enhance their knowledge of how to obtain competent health care and their capacity to share in their outcome and making decisions. The providers, however, carry the larger educational burden.
Cultural competence courses should be incorporated from the beginning of their career, for any upcoming healthcare professional, and case-based, realistic, and meticulously assessed training exercises be offered through continuing education courses. Lastly, monitoring, collecting, and reporting of core measure and meaningful use data to health insurers and state and/or federal entities should be supported as a way to evaluate improvement in eradicating disparities, to assess mediation attempts, and to gauge conceivable civil rights breaches (Institute of Medicine of the National Academies, 2003).
Implementing the Solutions
The health care professional who develops a detailed viewpoint of the association between health and culture; values respect for inclusiveness, social justice, equity, and differences; and uses their ability to authorize these standards in their areas of influence, personally and professionally, are capable of improving care for patient diversity (Getzlaf & Osborne, 2010). Studies such as the “Sullivan Commission’s Report on the Diversity in the Healthcare Workforce suggests that increasing the diversity of healthcare professionals” will rally healthcare equality and quality for racial and ethnic minorities who go through the most disparities in health results (Edwards, 2009, para. 3). As the number of non-white people increase in the United States, the workforce of professional nurses needs to reflect its persons to strengthen quality and access of healthcare for people from culturally diverse upbringings (Edwards, 2009).
Diversity in healthcare refers to the cultural setting of how the patient lives and in some measure defining their connection to healing, health, and their own role in the nurse to patient relationship. Most nurses are performing in multicultural settings where the patient brings his or her own set of values and beliefs. Being able to understand the nurse’s individual cultural viewpoint of the community, the client, and one’s self is central to giving culturally and suitable care (University of Phoenix, 2012). In collaboration with others, MHHS is committed to assessing and creating health care solutions that meets the needs of the individuals in their diverse communities.
This healthcare system believes in treating everyone with the respect and dignity as they themselves want, creating an environment that is unique to each individual who enters their doors, making each patient feel special and well-cared for, no matter what (Memorial Hermann Healthcare System, 2012). Nurses must continue to practice cultural competence daily in their practice in order to impart in each patient the feeling of being cared for and known of as an individual in a multifaceted healthcare system and the culturally diverse society (Maier-Lorentz, 2008).
Edwards, K. (2009, Summer). Promoting quality care by increasing the diversity of the professional nursing workforce. Journal of Cultural Diversity, 16(2), 39. Retrieved December 4, 2012 from University of Phoenix Library, CINAHL Plus with Full Text. Getzlaf, B.A., & Osborne, M. (2010). A journey of critical consciousness: an educational strategy for health care leaders. International Journal of Nursing Education Scholarship, 7(34), 1-15. Retrieved December 4, 2012 from University of Phoenix Library, MEDLINE with Full Text. Institute of Medicine of the National Academies. (2003). Unequal Treatment. Confronting racial and ethnic disparities in health care. Washington, D.C. The National Academies Press. Maier-Lorentz, M.M. (2008, Spring). Transcultural nursing: its importance in nursing practice. Journal of Cultural Diversity, 15(1), 37-43. Retrieved December 4, 2012 from University of Phoenix Library, MEDLINE with Full Text. Memorial Hermann Healthcare System. (2012). Standards of conduct. Retrieved December 4, 2012 from http://www.memorialhermann.org University of Phoenix. (2012). Read me first. Retrieved November 6, 2012 from University of Phoenix, NUR/531 website. Wilby, M.L. (2009). When the world was white. International Journal for Human Caring, 13(4), 57-61. Retrieved December 4, 2012 from University of Phoenix Library, CINAHL Plus with Full Text.
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