Concept from a Specific Nursing Theory - Term Paper Example

Middle range theories focus on a narrow dimension of the nursing reality. There are composed of concepts whose relationships are able to be depicted in a model (McEwen and Willis, 2006). These theories grow and develop with research and practice in order to provide the much needed guidance in scholarly research and everyday practice in the nursing profession (Smith and Liehr, 2008). For a long time some significant aspects of society continue to be ignored in health care. This is especially to do with diversity of the nation. It is one of the many societal priorities that have a direct impact on the health of the nation. The continued growing in diversity due to immigration is a reality that cannot be ignored. Cultural marginality is a theory advanced by Choi is a bid to increase understanding with individual experiences and the provide care that is relevant to their cultures (Choi, 2001). This health care service being offered to immigrants can only progress with mutual understanding between patients from varied cultural background and the health care providers. This understanding can be fostered once the concept of across-culture conflict recognition is put into consideration. Across-culture conflict recognition is a concept that allows for identification of contradicting norms, cultures values, behaviors and customs. Conflict always emerges between people with different value systems which push them to compromise their positions and make difficult choices (Choi, 2001). The recognition of this concept has much significance in practice and research as it allow for acknowledgment of differences in perceptions among individuals. It recognizes the varied responses and the outcomes of mental health which are directly linked to cultural marginality (Choi, 2001). Application to Nursing Practice In the delivery of care it is important to put into consideration the background of the individual. In being able to understand and appreciate an individual’s unique background, it does a lot to influence how the illness is perceived by the professional. In the near future most of the US citizens will self-identify as members of varied ethnic and racial group (Jenko and Moffitt, 2006). In order to improve patient’s outcomes and increase patient’s satisfaction, practitioners are compelled to be culturally competent. In ethics there are a number of principles which are purely Western and may not apply to other ethnic and cultural communities. There are cultures whereby it is considered impolite and disrespectful to share bad news. Some like Asians consider sharing it cruel to share cancer diagnosis. This too applies to some Europeans who see it as rather inhumane (Jenko and Moffitt, 2006). On the other hand there are Chinese practitioners who observe the ethic of cheng which involves shouldering the patient’s burden as a result of illness and also ensuring they are kept away from harm. It is also important for the family members more so the seniors, that discussions relating to serious illnesses are shunned. In other cultures such as Bosnian, Filipino and Native American the spoken word is perceived with so much reverence. Therefore in times of sickness, people will endeavor not to speak negatives words. It is imperative for practitioners to understand most communities view sickness as a family affair. In dealing with a patient, the practitioner is also indirectly dealing with the entire family. In almost all cultures there are beliefs surrounding illness and death or dying. It is essential for practitioners to be aware of some of these beliefs which will aid understanding and tolerance of some behavior. For instance there are communities that wear particular garments for spiritual purposes. These may include red ribbons, rosaries, sacred threads etc. Also there are a number of symbolism which accompany dying and illnesses. These cultural and symbolic meanings must be understood in the context which they are being practiced. A practitioner who has been oriented in some of the practices has an advantage compared to the uninitiated one. Fit to Nursing Practice Care is one of the fundamental concepts in nursing. In fact nursing has been perceived to be synonymous to care. This means there need be a deeper understanding of care which addresses the individuality of a patient. In order to do this the background of the patient must be taken into account (Andersson, 1995). Sometimes a patient’s illness is related to the environment or context surrounding a patient. To attend to the illness the practitioner must also deal with the background of the patient. It is here that the concept of cultural marginality informs nursing practice. The practitioner aims at gaining confidence and trust from the patient and family. This cannot be achieved without first understanding their cultural, ethnic or racial background. Across-culture conflict recognition is important for professionals in the exploration of individual experiences of the many immigrant groups and marginalized communities (Choi, 2001). It is important for the promotion of mutual respect, acceptance and tolerance among professionals. This is achieved through a plan whereby professionals will have to promote acceptance by breaking down boundaries based on status. It is also ideal to ensure they communicate effectively and foster good relationship with those whom they are dedicated to serve. The theory provides an avenue for the professionals to celebrate differences (Andersson, 1995). This can be effectively employed to ensure healthcare advantage. It also opens up many opportunities in a sense that professions are not tied or specialized on some factions. Further, the nurses will be able to enjoy their individual work. This however, does not mean to alienate an individual from the colleagues. In fact the theory will foster collective approach to issues that may seem challenging to an individual nurse. Importance to Nursing A nursing professional deals on a daily basis with marginalized groups, trying to advocate and defend their interests. This has conflicted in many ways with discourses and ideas meant for profiteering in health care services, locally and internationally. Through nursing practice, narratives from marginalized communities can be collected and their voices amplified such that authorities can understand their plight. This is especially so in times of war or similar catastrophes whereby a certain community or group is being targeted. It is important under such circumstances, principles and values of nursing prevail despite pressure from authorities. The nursing autonomy will continue to suffer as long as institutional influence prevails. There are situations whereby the nurse is limited in acting morally just because the institution prescribes otherwise. For instance, considering a patient that has been discharged from a hospital at 8 PM. The patient has been given prescriptions which she has to wait until the next day in order to fill, reason being closure of the only pharmacy in the locality. Despite the med chart containing medication for the patient’s evening dose, hospital policy does not allow the nurse to hand over medication. It is even less significant considering that the full medication has already been paid for by the patient. There are similar examples of meaningless policies which must be abided by nurses. The most apparent use of the concept is in places where one expects to meet a diverse group of people (Smith and Liehr, 2008). In institutions of learning for instance it is required of the nurses to be well versed with the different ethnic and cultural backgrounds of the students. School nurses will be better able to avoid conflict if they are made aware of this disparity from the onset. Most of the behaviors of the students can be traced back home or the society in which they grew up. The nurse in attending to individual patients must be able to dig out earlier experiences of the student that are relevant in addressing current situation. This can only be realized if the practitioner has received sufficient training. Unlike the society which seem to be biased and against certain religious groups or ethnic communities, practitioners are expected to behave differently. It is inevitable that the society will direct hatred towards certain racial, ethnic or religious community. As much as these differences are visible in society, the same should not penetrate the sphere of healthcare. Conclusion As many developed countries continue to receive immigrants from different parts of the world, it is important for practitioners to recognize conflicts that exist in society. This is to mean that the background of those seeking healthcare is vital for their treatment. Patients must be valued as individuals; their fears, customs, cultural and ethnic background taken into account on receiving treatment. In some cases practitioners have to deal with family members who are as important as the patient. In dealing with people’s cultures or customs practitioners must endeavor to exercise caution. In societies such as schools where one expects people from different cultural, ethnic, religious and racial background; it is important for the nurse to be well versed with the various communities. This will help to make the work easier once the process of healing commences. The approach used by the nurse will make the student comfortable since it makes him feel quite at home. Also the knowledge of the cultures of the patients helps to boost confidence and morale which is vital for the healing process. References Andersson E. P (1995). Marginality: Concept or Reality in Nursing Education. Journal of Advanced Nursing, Vol. 21(1) pp. 131-6 Choi H. (2001). Cultural Marginality: A Concept Analysis with Implications for Immigrant Adolescents. Issues in Comprehensive Pediatric Nursing, Vol. 24(3) pp. 193-206 Jenko M & Moffitt M.R. (2006). Transcultural Nursing Principles. Journal of Hospice and Palliative Nursing, Vol. 8(3) pp. 172-80 McEwen M & Willis E. (2006). Theoretical Basis for Nursing. (2nd Ed). Lippincott Williams & Wilkins Smith M.J & Liehr P. R. (eds) (2008). Middle Range Theories for Nursing (2nd Ed). New York, Springer Publishing Company. Read More