Transcultural Nursing Teaching and Practice - Essay Example

Grade 22 November Trans-cultural Nursing Teaching/Practice Since the paper is based on culture, let us first understand the meaning of culture. Basically, culture refers to a set of characteristics of people that have many things in common such as speech, communication style, creed, faith, beliefs, food habits, social traditions, music, arts, etc. These aspects keep on changing with the passage of time. An actual definition of culture can be, “Culture is shared between persons in the form of meaningful symbols communicated through human relationships, and transmitted and perpetuated between persons over time. Culture is derived from the collective experiences of its members and thus is influenced by larger historical events” (Mendyka 1). Now what is culturally congruent care? It is basically the care provided by a compassionate, proficient, and culturally perceptive nurse or any other health care provider. In other words, when the cultural aspects of patients are considered and there is no bias in the treatment, then it is a culturally congruent care. The main aim of this paper is to present the nurses with knowledge and information that can be used and make their service and decisions pertaining to their patients culturally congruent. Convolutions, Amendments, and Requirements in Health Care Due to the rapid expansions of multinational companies, there has been an incessant increase in the quantum of migrating populations. The changes in the characteristics of such populations, the unstable fertility rates, and advancement in science and technology have resulted in an overall cultural revolution. Owing to such developments, there has been a need for change in the nursing practices worldwide. The current requirement pertaining to health care is that the nurses should be taught how to tackle the culturally diverse patients. “Today more than ever, there is a call for the exploration and inclusion of the concept of culture in nursing practice, education, and research” (Mendyka 1). In order to be culturally proficient, nurses require understanding of their own cultural outlook and that of their patients. Being culturally proficient means acquiring cultural knowhow and then relating that to their work ethics. Nurses should perform their duties while considering the cultural differences. Cultural proficiency simplifies the scenario and simultaneously, the quality of caring is enhanced. Nurses, normally, don’t have to move to outlying areas to fulfill their job requirements. As such, they are not confronted with all such problems like difference in cultures, ethnicities, rituals, etc. But in the United States, due to a lot of population immigration, such instances can be found in abundance. In fact it has become a norm to treat patients of varied cultural backgrounds in the United States. But it is not as easy as it seems to understand the different cultures and offer treatment accordingly. On the contrary, “A cultural assessment of a patient is crucial to discovering cultural beliefs and practices and providing culturally congruent care that is tailored to the individual client” (Alamah 11). It’s a huge task to get details from each and every patient about his/her culture. Another problem being faced is that the acuity and the basis of diseases differ from culture to culture. There are certain diseases that people have their own treatment. Such diseases can be termed as ‘folk diseases’. These treatments are passed on from one generation to the other and today it has become a part of their thought process to believe that except such treatment there is no other treatment. Such treatments of various diseases are unheard of by the nurses practicing in the urban areas. Moreover, there are many cultures around the world where the health and sickness of an individual is associated to God and Saints (Baca). “Culture and ethnicity create a unique pattern of beliefs and perceptions as to what ‘health’ or ‘illness’ actually mean” (Anderson 69). Also, there are certain medicines that the nurses might not have heard of before. But it becomes improper to bluntly neglect all such things when such a patient comes for health care assistance. In such circumstances, it becomes very difficult to have the same health care approach for the patients. For example, African Americans are prone to hypertension and Native Americans to diabetes (Meyer 5). Culture has great influence on the mannerism of patients. Mannerism includes the way they seek health care and the way they respond to the treatment and the health care providers. It is the necessity of time that nurses should understand the influence of cultures on the behavior of patients. Such kind of awareness will automatically get rid of all the barriers in health care. There are basically five important aspects that have a direct impact on the capability of any health care institution’s cultural competency. These are “valuing diversity, having the capacity for cultural self-assessment, being conscious of the dynamics inherent when cultures interact, having institutionalized cultural knowledge, and having developed adaptations of service delivery reflecting an understanding of cultural diversity” (Cross et al). It is a basic human right to have health care that is indifferent of culture. Madeleine Leininger is considered to be the initiator of trans-cultural nursing. According to Leininger, “The goal of trans-cultural nursing is to provide culture-specific and universal nursing care practices for the health and well-being of people or to help them face unfavorable human conditions, illness, or death in culturally meaningful ways” (Appendix 1 depicts a typical method to discover culture care. Language is yet another problem that is very critical. “An inability to communicate with a healthcare provider not only creates a barrier to accessing health care but also undermines trust in the quality of medical care received and decreases the likelihood of appropriate follow-up” (Anderson 69). Anderson is true in the sense that unless the nurse or other health care provider is certain about the problem or disease, the proper solution or treatment is not possible. And God forbid, if due to some communication gap any wrong treatment is given to the patient, the result can be very dangerous. The Robert Wood Johnson Foundation did a survey that shows that almost 20 percent of the patients denied getting treatment because the doctors were English-speaking. The survey was carried out on the Spanish-speaking residents of the United States (Anderson 69). It’s not that only the non-English speaking patients have communication problems. According to Anderson, In a national survey conducted by the Commonwealth Fund, 39% of Latinos, 27% of Asian Americans, 23% of African Americans, and 16% of whites, reported communication problems (Anderson 69). They claimed that their doctors didn’t pay heed to what they said and even they couldn’t understand the doctors. Moral and Legal Considerations Each and every one of us is entitled to have health care that corresponds with culture. Observations from some studies indicate that the culturally motivated health care and the performance of health care are interrelated (Jeffreys). This means if a health care institution adheres to the culturally congruent health care for all its patients, then the overall performance of that institution will be appreciable, and vice versa. The astounding number of legal cases claiming of improper health care suggests that the legal implications can be serious. The nurses are not only bound morally but legally as well to provide better health care indifferent to culture. If the moral values are considered by nurses and other health care providers, most of the problems relating to culturally congruent health care will automatically be resolved. If this may be the case, then they will “come simply to perceive the morally relevant aspects of situations and so to adopt a moral perspective on them without deliberation (unless the situation is unusually confusing or unclear)” (Huddle 886). This is a very practical way of overcoming the problem of culture in nursing. If in any situation the nurses consider the moral values, there is no way that they will disregard the problems being faced by patients of different cultures. Counter Arguments Some of the scholars believe that it is impossible to inculcate new norms of social/professional behavior into old and long-standing medical/nursing practices. According to such scholars, it is the long-standing medical practices and attitudes of yesteryear that continue to make reaching, educating and treating diverse racial, ethnic and socio-economic communities difficult and expensive. Health education and preventive medicine are certainly better received if there is an understanding and affirmation of the individuals and their communities. When patients are treated holistically, as whole souls who come from different belief systems, socioeconomic strata, ethnic/racial groups, such validation goes a long way to enhancing the medicines and treatments of ‘traditional’ nursing and medicine and making patients better, faster. One aspect that probably has not been thought of by people who advocate the culturally congruent nursing practices is that if the nursing practices are to be changed then how about the expenses to be incurred? Who is supposed to bear the high expenses? Morality is understandable and one should definitely consider the moral aspects but everything has a limit. You cannot enlighten other people’s house by setting your own house on fire. This is totally absurd. Hospitals are meant for treatment and not for comfort and luxury. But since the morality issue is considerable in such cases, the best that can be done is the participation of the government. The respective state governments should start such training programs that may impart training to nurses on being culturally congruent. After all it is the government who allows the migrations and it should be responsible for the after effects. Another possible solution, in case the government does not interfere or participate, can be that hospitals arrange for the required training of some of its nurses and/or health care providers and whenever any patient demands such nurses or health care providers, some extra fee may be levied. The patients should understand this and stop complaining. If they want any specific service, they should pay for the same. If they want a health care provider who is culturally congruent then they should bear the extra charges. There are certain things that come to us by virtue of birth; here, ‘by virtue of birth’ means those qualities that are infused in us automatically by virtue of the genes (heredity) such as our temper, nature, features, etc. Similarly, there are certain things that we learn from the environment and society that we live in. Our mindset becomes of the same frequency as that of our society. We think the way our society thinks. There are certain qualities that education can teach us; like professionalism, but there are certain things that even education cannot teach us and being culturally congruent is one such quality. You cannot become a German simply by learning German language but by being a citizen of Germany. Similarly if it is expected that people should be culturally congruent, the whole society has to be taught else people will get double-minded. Instead of organizing training sessions for nurses and other health care providers, the stress should be laid on inculcating the feelings of cultural harmony among the society. There is another group of scholars who believe that it is difficult to formulate and gauge the efficacy of diversity education in nursing programs. Several models have been formulated that assess the reported growth and develop cultural competencies of nursing students in BSN programs in the United States, Canada and Great Britain. The mainstream nursing and medical practice has much to gain from the diverse racial/ethnic cultures that it serves. Greater understanding of other cultures and their benefits and practices in health and patient care can only add to nursing across the board. Today we face a challenge to educate the nurses in a manner that can meet the expectations of the migrating population. Instead of being only culturally congruent, the nurses should also be able to adapt to the diversity of the nature of the problem. The future of nursing can expect more diversity because it is estimated that by the year 2050, the minority population will be 40 percent in the United States. In order to cope with the ensuing problem, it is advisable that the nurses go for some diversity education. Works Cited Alamah, Wehbe. “The Use of Culture Care Theory with Syrian Muslims in the Mid-western United States.” Online Journal of Cultural Competence in Nursing and Healthcare 1.3 (2011): 1-12. Web. 22 Nov. 2012. Anderson, Laurie M. “Culturally Competent Healthcare Systems: A Systematic Review.” American Journal of Preventive Medicine 24.3S (2003): 68-79. Web. 22 Nov. 2012. Baca, Josephine E. “Some Health Beliefs of the Spanish Speaking.” The American Journal of Nursing 69.10 (1969): 2172-2176. Web. 22 Nov. 2012. Cross, Terry, Barbara Bazron, Karl Dennis, and Mareasa Isaacs. Towards a Culturally Competent System of Care: A Monograph on Effective Services for Minority Chldren Who are Severely Emotionally Disturbed: Volume 1. Washington, D.C.: Georgetown University, 1989. Print. Huddle, Thomas S. “Teaching Professionalism: Is Medical Morality a Competency?” Academic Medicine 80.10 (2005): 885-891. Web. 22 Nov. 2012. Jeffreys, Marianne R. Teaching Cultural Competence in Nursing and Health Care: 2nd Edition. New York: Springer Publishing Company, 2010. Print. Leininger, Madeleine. “Transcultural Nursing: A New Scientific Subfield of Study in Nursing.” Transcultural Nursing: Concept, Theories and Practices (1978): 8-12. Print. 22 Nov. 2012. Meyer, C.R. “Medicine’s melting pot.” Minn Med 79.5 (1996): 5. Web. 21 Nov. 2012. Appendix 1 Source: http://www.ojccnh.org Read More