Culturally Competent Organisations - Essay Example

Culturally Competent Organisations September 2008 Introduction In this world of globalization, political boundaries are fast getting blurred and soare the geographical distances which earlier used to be almost insurmountable barriers keeping people and cultures far apart from one another. Today we have a world which is often lovingly referred as “global village” where free movement of capital and labour across oceans and check posts have become commonplace. So, global entities are now facing a challenge which was not there earlier – the challenge of seamlessly mingling with local culture so as to service customers hailing from diverse cultural backgrounds without the slightest hitch. This is more relevant in service sectors, especially the health care industry. One must appreciate the uniqueness of health care industry before proceeding further. A healthcare professional needs to strike an equation with the patient before any meaningful healthcare can take place since, matching of frequency in thought, feelings and culture is essential for the patient to really start trusting a professional nurse. Unless this trust is developed and nurtured, any hope of speedy recovery can be safely forgotten. The only way such trust can take roots is through cultural compatibility. The patient must feel completely “at home” for medicines to start taking effect. (Sue, D.W. & Sue, D, 1990) Cultural Competency and Healthcare A culturally competent healthcare institution accepts the difference that exists among different cultures and races and not only respects that difference but also adapts itself to serve all those who come from diverse cultures. The first step towards becoming a culturally competent healthcare organisation is to engage in deep research about different cultures and taking professional assistance from persons who are experts in the nuances of these cultures and ethnic groups. The results and findings of these researches need to be circulated in an easily intelligible format among all the healthcare professionals in the organisation so that each one of them gets the opportunity of equipping themselves to face challenges of cultural diversity. But a culturally competent organisation not only tries to adapt itself to diverse cultures of those whom they serve. They also induct such cultural diversity within their ranks by employing people from diverse cultures so that it becomes almost natural for the organisation to automatically adapt to practices prevalent in far off countries. (Cross, T.L., B.J. Bazron, K.W. Dennis, and M.R. Isaccs, 1983) Such a constructive approach towards overcoming the barrier of cultural diversity will not only improve the standards of healthcare but also will go a long way towards improving relations between diverse ethnic groups. It is needless to emphasise such an improved level of mutual relation and interaction will go far beyond the realms of healthcare – it will enrich and strengthen the social fabric and help build a nation which truly becomes a symbol of unity in diversity which has been the hallmark of all great civilisations throughout human history. Becoming aware of the ethnic groups which are to be served In order to be really effective, a healthcare institution needs to identify the ethnic groups which fall under its area of operation. As already mentioned globalisation has led to a massive movement of human beings and institutions now span oceans and have footprints across continents. It is only natural that a culturally competent organisation as a matter of policy carries on the process of monitoring the changing demographics of the population it has to serve and take appropriate steps to maintain its efficiency. (Ponterotto, J.G. & Casas, J.M., 1991) But a simple statistical record keeping of the number of persons belonging to each ethnic group and being aware of the basics of each of their cultures would not be of much help. The involvement needs to be deeper and more sincere than that. Details about educational levels, employment levels and extent of criminalisation in the group, substance abuse, teenage pregnancy and infant mortality are parameters which will help an institution to be really prepared to help these ethnic groups. Health is inextricably related to stress and unless all these details are researched in depth, no healthcare institution will be in a position to effectively deal with the challenges faced when dealing with such ethnic groups. There is a very dangerous pitfall which every healthcare institution must avoid while it remains abreast of demographic changes which continually take place within its ambit of operations. It must always adopt a collaborative approach while interacting with these groups. There should not be any hint of a patronising attitude, this will ruin any possibility whatsoever of striking a chord with these groups and in its place will generate an apathy which, if it sets in, will be very hard to dispel. How necessary is it to be aware of demographic details Various studies have highlighted the extent of sea changes which are taking place in the demographic structure of western countries. A recent study has concluded that by the year 2017 almost half the population in the area in and around Toronto will comprise of “minorities” and close to eight million Canadians will have a mother tongue which is neither English nor French. This has led someone to comment whether the word “native” will really make any sense a few decades from now. (Statistics Canada Study: Canadas Visible Minority Population in 2017, 2005) So, healthcare workers now need to know not only about nutrition but also about the fasting month of Ramadan or Eid which marks the end of it. While treating a Muslim patient, if a nurse does not show respect to the religious leanings of the patient and insists on feeding at intervals prescribed by the doctor during the month of Ramadan, the results will not be encouraging, to say the least. While there is no denying the good intentions of the nurse in insisting that the patient takes food at regular intervals one must also appreciate that the ultimate aim of any form of healthcare is to treat the person as whole and not removal of an ailment. The well-being of the patient is of utmost concern and any step taken in contravention of long held beliefs and age old customs of a particular ethnic group will most certainly not yield the desired results. More instances of miscommunication owing to cultural divides In a convention held by a foundation dealing with child health two queer instances have been quoted to highlight how even the best of intentions tend to create the worst impressions simply due to lack of awareness of diverse cultures. A young mother who had only recently emigrated from Guatemala was more than irritated when she came to collect her one and a half year old daughter from an infant day-care home in Santa Clara and found the child was not wearing shoes. The young mother insisted that the child should always have her feet covered by her shoes. The day-care counsellor tried to reason with the mother about the necessity of the child to remain barefoot while she is learning to walk since she will be able to master easily the intricacies of standing on her feet and shifting balance from one foot to the other as she toddles. But all the efforts of the counsellor went in vain. The young mother was adamant that her child should always wear shoes whenever she sets foot on the ground. The counsellor was frustrated at the ignorance and intransigence of this Guatemalan lady. But little did the counsellor know (or perhaps tried to know) why was the lady so insistent on such a trivial issue. In rural Guatemala there are dangerous parasites teeming in the soil and it is a very common practice to cover the feet of babies to protect them from parasitic infections which often turn deadly due to poor medical infrastructural facilities in that country. The point which needs to be emphasised at this juncture is the best of intentions often seem to get lost in the maze of cultural incomprehension. It might not be out of place to mention that the biggest sufferers of this cultural conflict are often the children who are often completely at a loss about which culture and practices they adopt as their own – the one imparted at day-care centres or the one followed by the family. If this divide is dissolved through a little bit of understanding and compassion; these children will be able to bloom to their fullest potential. (Day, M & Parlakian, R., 2003) Let us now see the other instance of the apparently insurmountable culture divide which prevents willing partners to come together and reap the benefits of a developmental initiative. There was this trainer in a neighbourhood school who was interacting with parents and trying to impress upon them the necessity of a calm and quiet place in the house where children might sit down to do their homework. None seemed to disagree (there was nothing to disagree as it were) but when it came to signing a paper where parents are supposed to declare their agreement in writing, two of them went away from the meeting and never returned. Predictably enough, the trainer felt crestfallen and formed her own opinion about these parents which was, most obviously, far from being good. But what she did not realise was one of them was ashamed of the fact that nine members of her family stayed in a small apartment where minimum privacy is a distant dream. The other was completely illiterate when she landed in United Sates and has just started learning how to read and has not yet mastered the technique of writing. (Laurie Olsen, Jhumpa Bhattacharya & Amy Scharf, 2006) What it requires to be culturally competent A lot is being said these days about improving cultural competency in health care but one needs to go into a little more detail to be able to clearly lay down the do’s and don’ts necessary to achieve this competence. Before even a beginning is made, one needs to understand that it is a continuous process where one continually keeps learning and imbibing new aspects every day. As Julie Edwards so very succinctly states if she had waited till she mastered all the intricacies of cultural diversity she would never have been able to get on with the actual act of bridging the divide between diverse cultures. The basic qualities necessary in an individual to become culturally competent is to be able to listen carefully and be completely non-judgemental. The basic acceptance of the fact that there is no one best way of doing a thing and an empathetic attitude is most required in an individual who wishes to be culturally competent. This empathy obviously makes an individual realise that everyone has a culture which might or might not be similar to the one in which the individual is brought up. Another very crucial realisation in this regard is a person need not stick to the culture imbibed upon birth; it might change if there is a change social, economic or societal environment. This realisation prevents a culturally competent healthcare professional or institution from stereotyping an ethnic community or group and fosters a more flexible approach towards providing effective healthcare. (Ms. Foundation, 2006) Though there is no such uniform strait- jacketed norms which an organisation must fulfil to be considered to be culturally competent there are some broad indicators which must be prevalent in the policies of the organisation for it to be termed culturally competent. The organisation should actively follow a policy of weeding out cultural prejudices against a particular community or ethnic group. The healthcare institutions should be really strict in this matter as it has wide ranging social ramifications. It should have in place a proper programme through which it imparts the qualities necessary for its employees to become culturally competent and capable of serving diverse groups. This programme must be adequately funded and should never be relegated to the level of a chore which needs to be completed for upward movement in individual careers. Proper methods of rewarding those who perform well in these programmes must be in place and it would be ideal if the institution promotes only those prove their competence in these courses. The organisation must be committed towards improving cultural competence and all its policies and procedures must have this facet interwoven in such a fashion that only the culturally competent prosper and progress through the organisational hierarchy. (Randall-David, E, 1989) Works Cited Cross, T.L., B.J. Bazron, K.W. Dennis, and M.R. Isaccs. (1983). “The Cultural Competence Continuum.” Toward a Culturally Competent System of Care; A Monograph on Effective Services for Minority Children Who are Severely Emotionally Disturbed. Georgetown University Child Development Center. Day, M & Parlakian, R. (2003). How Culture Shapes Social-Emotional Development: Implications for Practice in Infant-Family Programs. Washington, DC: Zero To Three. Laurie Olsen, Jhumpa Bhattacharya & Amy Scharf. (2006). Cultural Competency: What it is and why it matters. Lucile Packard Foundation for Childrens Health. Ms. Foundation. (2006). Culture and Context. New York: Ms. Foundation. Ponterotto, J.G. & Casas, J.M. (1991). Handbook of racial/ethnic minority counseling research. Illinois: Charles C. Thomas. Randall-David, E. (1989). Strategies for working with culturally diverse communities and clients. Washington, DC: Association for the Care of Childrens Health . (2005). Statistics Canada Study: Canadas Visible Minority Population in 2017. Department of Canadian Heritage. Sue, D.W. & Sue, D. (1990). Counseling the culturally different: Theory and practice (2nd edition). New York: John Wiley & Sons, Inc. . Read More