Obstructions to culturally competent medical care - Research Paper Example

INTRODUCTION The discrepancy in the existing health system and admittance to medical care facilities that subsist amid the minority sections of the population of United States has been accepted as a familiar problem by the government since the early 1970s. Due to its effect, there has been a lot of research done on this issue and it has been documented in reports that the American minority section is suffering from poorer health due to lack of cultural competency in medical care. For a majority of the ethnic groups, the debate on the cultural equation of health care cannot take place without giving ample consideration to the variety of ways in which traditions crisscross with matters of poverty and impartiality, access to health care, individual and community discrimination, and a deficit of cultural proficiency on the part of health care providers. Even though some system-wide obstructions to a proper health care system are well thought-out elsewhere, they also require extraordinary thoughtfulness with the majority of the ethnic minority sections because the concerns are elevated by the cultural dynamics. The urgent requirement to reflect on the cultural and traditional factors that impediment the medical care of the minorities has been identified by many countries around the globe. Yet most of these governments are not at all close to solving the problem of cultural incompetency of medical providers, (Shortell, Hull, 1996) The main reason is that most of the time, a patient’s tradition is habitually perceived as a setback, which ultimately creates a barricade to providing effective medical care. Marginalization of traditions and culture of the minority groups of the ethnic patients diminishes the accountability of the medical care providers. The medical care could be more efficient in dealing with this; the problem should be seen in a different light and screening the obstructions as ensuing not from the cultures of the minority groups but from the values that exist in the medical community, inadequate proficient training, and other barriers. Some experts of the field also argue that the medical community has been highly unsuccessful in this case, and has not been able to identify their own responsibilities of effectively attending to providing competent service to their ethic and other minority clients and patients, (Gordon, 1995). 2. OBSTRUCTIONS TO CULTURALLY COMPETENT MEDICAL CARE This section of the paper identifies some known barriers amid the patients and the medical care providers that have made a high influence on the quality of the service provided and at the same time supplement to added racial and ethnic disparities in the medical health care system. 1. Lack of Diversity amongst the Medical Care Providers and Workforce Experts on the issue concerning lack of a culturally competent medical care have often stated their worries about the lack of a diverse leadership potential in the health care sector. The minority population holds up an effectual 29% of the total population percentage of United States but fare poorer in the employment sector. Not more than 3 percent of the minority communities hold positions in medical school faculties; approximately only 12 percent hold positions in a community health school, and 18 percent in all metropolis and province health executives. Moreover, 98 percent of the senior executives in health care management belong to the white community. These figures exercise major concern because if there would have been a higher percentage of minority health care professional in the system, they would be able to identify, recognize and take into account the socio-cultural factors that adversely affect the medical acre treatment being given to the minorities and could have better organized health care delivery decisions to meet the requirements of minority populations, (Reese, Ahern, Nair, et al., 1999). 2. Poor and inefficient medical care systems for Ethnically Diverse Patients Many experts have pointed out on the lack of proper medical care systems that are being offered to a racially diverse set of patients / population. These systems are not found to be very responsive to the needs and desires of the ethnically varied patients. The concern of language discordance connecting the medical care provider and the minority patient was the most important issue. Such systems which cannot take care of their patients who are ethnically diverse in traditions or are in minority, tend to experience patient disappointment, poor understanding and devotion, and lower-quality care, according to various studies (Leon, Cheng, and Dunbar, 2002). 3. Reduced Cross-Cultural communique Between Providers and Patients In this case, when the medical care providers do not understand socio-cultural dissimilarity between themselves and their minority grouped patients, the results of the health care may suffer. This is a result of less and diminished communication of needs and confidence between the two parties. This in turn may lead to patient unhappiness, deprived obedience to prescription and health encouragement approach, and this results in poor health in the society. In addition, when the medical care providers fail to consider socio-cultural issues, they may route to stereotype, which can influence their performance and clinical decision-making. 4. Lack of Interpreters For minority patients who are not able to understand English or the native language, the lack of a trained medical interpreter may increase the concern. Most of the times, the medical facilities are of such degree that they are not able to provide trained interpreters to their ethnically diverse clients and patients. Even if an interpreter in available, he/she is not properly versed in verbal assessment or medical education to help the patient in the best possible manner. In such cases where language barriers become huge, the patients tend to stop the treatment from the medical care provider, and mishandling of the patients health is a direct result. 3. SOLUTIONS TO THE ABOVE MENTIONED PROBLEMS This section recounts the requirement for culturally proficient nurses who can end the health care differences that exist in the wake of racial and cultural contexts. With the support of culturally competent trained nurses, it may be possible to provide better quality to minority patients who experience reduced care, and therefore, this may result in better patient outcomes. Nurses: the frontiers of health care - The United States has repeatedly identified the profession of nursing as one of the most respectable of all. More often, American citizens feel that nurses are more easily accessible as compared to other medical health care providers like physicians. The call for providing an ongoing cultural proficiency teaching to the medical fraternity is in particular significant to the nursing occupation since nurses devote their time for a patient’s care and well-being by coming in direct contact with the patient and his family. However, the diversity of culture and religion that exists within the nursing profession is far less than that of the community they serve, as a result of which there has been an increasing demand for culturally competent nurses, (Salsberg, Forte, 2002). As an obvious solution to this problem, various health care organizations are looking to recruit foreign nurses or nurses from diverse cultures in view of supplementing the deficiency and enhancing the health care results that seem to have gone down with the minorities. Due to the limitations of finding nurses from the minority communities within the local area, the hospitals, and usually in cities are recruiting foreign nursing graduates who are to balance the vacuum. However, the presence of foreign-trained nurses with their non-immigration status may pose a problem. The subject of foreign nurses is not a source of cultural incompetence, but as another layer of diversity in the healthcare system. Without a doubt, the foreign nurses may be a more attractive option for hospitals located in a city with good business and at times, it may lead to job discrimination issues between the local and foreign nursing employees within an organization. Therefore, the obvious solutions seem to be introduction of new training modules related to cultural competency to the existing and future nursing workforce. Evidence-based nursing practice - Evidence-based nursing or EBN provides a supplementary answer to offering culturally competent health care services. The Evidence-based nursing technique is a combination of two aspects – the personal skill of nurses with the existing external evidence / data collected with the help of methodical nursing investigation. This combination of skill and advanced techniques helps the nurses to take the best core decisions for the patients. Evidence-based nursing is based on the fact that the nurses possess sufficient skills to analyze the data and perform some individual research on the patient data and are able to implement the fundamentals of Evidence-based nursing in a superior manner. Evidence-based nursing is different from evidence-based medicine for the reason that nurses believe in suitability to patients and cost efficacy in addition to healing efficiency in the Evidence-based nursing course. Evidence-based nursing makes use of the following tactics to solve the issues that are confronted by the nurses at the time of patient care. The nurses are encouraged to use these solutions in the form of steps rather using them randomly. (1) The first step involves the identification of the problem suffered by the patient / medical care client. (2) The second step involves the task of finding suitable solutions / previous research work with regards to the problem (3) Then evaluation of the above evidence with the help of conventional standards keeping in mind the various medical advantages and disadvantages and (4) deciding the interference with the majority of suitable substantiation or proof. Training and development - The hospitals and other medical care organizations employing the nurses are accountable for offering training and development to the nurses to be able to become culturally competent medical care professionals who support and implement the CLAS standards. The nurses should be taught to accomplish their medical duties along with offering understanding and patience towards the patients background. One way to move ahead towards cultural competency is to believe the provider as a cultural broker who realizes both the medical requirements and the patient’s background, (Gabrel, Jones, 2002). One successful method is known as “train-the-trainer” modules in which peer nurses train the nurses and discuss practical issues thus making things more interesting. Use of “drama” commonly known as “cultural bingo” techniques can also be applied to make a lively training environment. Another method of offering culturally competent training to nurses is through an immersion program where the nurses are sent to another country to experience the impact of varying cultural needs and attitude, at the same time realizing the need of being culturally competent in their profession. THE ROLE OF HHS/OMH IN CULTURAL COMPETENCE The U.S. Department of Health and Human Services (HHS) has been striving hard to enhance and upgrade the health facilities for the minority population of the country. During the recent times, the U.S. Department of Health and Human Services (HHS) has made a number of advanced initiatives to eradicate the cultural and tribal differences that exist within the health care system. The U.S. Department of Health and Human Services (HHS) agency has taken a uniform approach to tackle this issue and carefully address the needs of the minority and foreign-born populations. On the other hand, OMH has also been working for the same cause and has provided $7 million of funds to develop the lagging culturally competent health care system in the country. By the end of the nineties, OMH had already started paying attention towards the guidelines and investigating studies to sustain the practice of a culturally competent health care. The nationalized principles existing in this report comprise an essential component of OMH’s program to encourage culturally competent health care amongst the organizations and policymakers in the country (Shortell, Hull, 1996). The two agencies have been working together in co-ordination through a number of exhibition ventures, partnership agendas, teaching, training and technological support system, statistics collection, and the expansion of monographs and models. 4. REAL MEDICAL SOLUTIONS As more and more immigrants are entering into the United States every day, the country’s population is becoming more and more diverse in nature, and at the same time facing a number of racial issues of which health disparities is a major issue. Therefore, the need to eliminate this particular disparity within the boundaries of real medical solutions has become urgent, (National Center for Health Statistics, 2001). As already discussed above in this paper, nurses spend more time with the patients than any other medical health care professional and as a result possess a unique opportunity of reducing the disparities faced by the minorities and improving their health care results. In order to empower the nursing sector with the necessary tools for providing culturally competent health care services, the Office of Minority Health (OMH) and the U.S. Department of Health and Human Services have introduced Culturally Competent Nursing Modules (CCNMs) for the purpose. The Culturally Competent Nursing Modules (CCNMs) are a certified, online set of courses, which are set up according to the National Standards for culturally, and Linguistically Appropriate Services in Healthcare (CLAS) and are intended to augment nurses' skills to make available patient-centered health care, (Andersen, Aday, 1999). Learning objectives of CCNMs At the end of this continuing learning activity brought up by the CCNMs, the nurses’ should be able to: Identify concerns that are linked to cultural proficiency in the nursing profession. Classify approaches to promote self-awareness about thoughts, values, prejudices and behaviors that may manipulate the nursing care in an efficient manner. Invent tactics to improve ability in the direction of providing culturally capable treatment and care. Demonstrate the rewards of the implementation of the CLAS Standards as suitable in their treatment procedure. References Andersen R, Aday LA . Access to medical care in the U.S.: Realized and potential. Med Care 16(7):533–46. 1999 Gabrel C, Jones A. The National Nursing Home Survey: 1995 summary. National Center for Health Statistics. Vital Health Stat 13(146). 2000. Gabrel C, Jones A. The National Nursing Home Survey: 1997 summary. National Center for Health Statistics. Vital Health Stat 13(147). 2000. Gordon AK. Deterrents to access and service for blacks and Hispanics: The Medicare Hospice Benefit, healthcare utilization, and cultural barriers. Hosp J 10(2):65–83. 1995. 2002 Institute of Medicine. Primary care: America’s health in a new era. Washington DC: National Academy Press. 1996. Leon J, Cheng M, Dunbar , J. 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