The Concept of Cultural Competence and How it Can Be Used in Nursing - Literature review Example

THE CONCEPT OF CULTURAL COMPETENCE AND HOW IT CAN BE USED IN NURSING Name: Grade Course: Tutor’s Name: 4th September, 2010 Introduction In any country there are people with different cultures, languages, races, religions and ethnic backgrounds. The countries have organizations and government systems that ensure it serves the people effectively and satisfactorily. The organizations form the workplaces, the places of treatment, recreation places and so on. For the work places, the treatment institutions, recreational centers and so on to work effectively, it is important for the employees, managers, policy makers, administrators and other people involved in the management of the organizations to be culturally competent. Cultural competency is a process by which systems and people act respectfully and effectively to culturally different people, to people of different ethnic groups, different languages and so on in a way that values, recognizes and confirms that the people are of value to the society (NASW, 2001). Australia is one of the countries with people with different cultural backgrounds. The country has people who came from Europe, the aboriginal and the Torres Strait islanders. It has Lebanese, Chinese, Filipinos, Africans, French, Greeks and so many others who are immigrants from different parts of the world. These people have different values and cultures that should be respected and appreciated (Price, n. d.). Culture affects the beliefs, values and practices of patients as well as clinicians. Such cultures should be identified as well as how they affect healthcare and plans on how to provide healthcare with their understanding formulated (Miller, 2008). The discussion below is about cultural competency and how it can be used in Nursing. It includes the importance of cultural competence and how cultural competence can be achieved in nursing. Australia is a culturally diverse nation but the description given below does not give the specifics of how the different cultures affect health care provision. A general view of the importance of cultural competence in a culturally diverse environment is given which includes Australia. Cultural Competence in Nursing People in different communities have different cultures which constitute different beliefs, values and understanding of health care among other issues in the society. Because of such differences, it is important to understand the cultures of the patients in order to provide appropriate care. Being culturally competent is having the knowledge and understanding of a client’s culture (Srivastava, 2007). Cultural Competency is achieved through development of policies, attitudes and behavior that can enable professionals, agencies and systems to effectively work in cross cultural environments (Tseng & Streltzer, 2008). In a health care institution for example, policies, behaviors and attitudes that lead to the knowledge and understanding of the different cultures, languages, ethnic groups and religions in a society can help such an institution provide quality health care services. Some religions may not support some health care practices for example, but a culturally competent healthcare provider would just not offer the services because of that. He or she should have the necessary intervention skills to deal with such a situation (Tseng & Streltzer, 2008). In nursing, cultural competence is a process through which a nurse provides appropriate care to the patients considering their cultural context. Daniels defines it as having knowledge and understanding of the cultures, accepting and respecting the differences between cultures and adapting a suitable way to offer patients care (Daniels, 2004). The nurses have to have the knowledge of cultural values that are related to health and illnesses. In order to provide culturally competent services nurses have to implement self awareness, patient education and non judgmental approaches. Self awareness is used to help nurses identify their areas of weakness when it comes to biasness, stereotyping and prejudgments about patients that are culturally different. The nurses must be aware of their potential to misunderstand or bias against people of different cultural background. Self awareness encourages appreciation of one’s own culture and other people’s culture hence builds understanding between the patient and the nurse. With good patient-nurse relationship in a health care institution, patient services are improved as well as patient satisfaction (Daniels, 2004). Non judgmental approach: In a society where there are culturally diverse people, there is need for provision of culturally sensitive health care. In order to achieve such an aim, it is necessary for the nurses to adopt non judgmental approaches in offering health care services. Non judgmental approaches encourage openness among clients, freedom to disagree, honest feedbacks and the freedom to discuss real or perceived problems (Daniels, 2004). This results in a situation where the nurse gets all the important information and the patient gets satisfied. This approach improves patient nurse relationship which in turn leads to patient satisfaction and creation of an environment that supports healing (Daniels, 2004). Client Education: Education is very important in nursing and should be provided based on the patient’s needs. It should also be provided in a culturally sensitive manner. The aim of education is to make the patient understand issues about his or her health. When caring for people from diverse cultures, the nurse should assess the family history and incorporate it in health care, this includes assessment of if the patient needs an interpreter or not, the extent of family support, the level of education and the change in social life I the client came from a different country (Daniels, 2004). The nurse should also evaluate the client’s knowledge on a specific topic which will help the nurse known the kind of beliefs or values the client bears in relation to the specific topic. The topic may be about the disease the patient is suffering from of the method of treatment (Daniels, 2004). Clarification of non verbal and verbal signs is also important to avoid misconception between the two and the nurse should also make use of a language that can easily be understood by the client (Daniels, 2004). The Importance of Cultural Competence in Nursing “Juan is a Hispanic client of age 32 and speaks broken English. He has home health care three times a week for his new ostomy. The patient complains that, sometimes the Nurses act like he is stupid because of his bad English and in some instances the Nurses act like he is lazy. Juan Further states that he thinks the Nurses think of him as lazy because he is Hispanic and the Nurses think that all Hispanics are lazy. The last comment from Juan was “I just can’t speak good English” (Daniels, 2004, p. 107). One thing is clear from the above case, Juan is not happy about how he is being treated. He does not want to be considered stupid nor does he want to be looked at as a lazy person. The patient wishes that if he could speak good English, all his problems of misunderstanding would be over. There is also high probability that the patient and the nurses do not understand each other very well. Juan thinks the Nurses regard him as stupid and lazy. With such an attitude about the nurses, patient-nurse relationship becomes poor and this is what forms the basis of nursing. It should be an intimate and trusting relationship that should extend to the family of the patient (Pera & Van Tonder, 2005). In the above case, there is no trust between the patient and the nurses. Such cases can be avoided by being culturally competent. Cultural competency just as noted earlier, encourages openness among patients, freedom to disagree and freedom to discuss the real problems. In the above case for example, if the nurses would recognize what Juan thinks of them, they would change their approach to a non judgmental and encourage Juan to tell all his problems. With poor nurse-patient relationship, the quality of health care is reduced (Pera & Van Tonder, 2005). A culturally competent nurse is aware of his or her weakness in being bias and so would rarely act like described by Juan. The nurses described by Juan may have been bias because he was Hispanic. Cultural competence therefore encourages good patient-nurse relationship (Pera & Van Tonder, 2005 & Daniels, 2004). Cultural competence is also important for achievement of optimal and efficacious care. Depending on one’s culture, there are fine distinctions that are important in health seeking behaviors, diet, and attitude that determine if the patient will come back for treatment or not or who the patient would want to receive care from. Culture is a pattern of leaned beliefs and behaviors of a group of people. It includes communication styles, values, thoughts, and ways of interacting, customs, views on roles and relationships and practices. If people of a specific culture’s values cannot be recognized, then there will be no understanding between the two parties and no efficacy achieved (Rose, 2010). Additionally, healthcare institutions must focus on provision of the needs of individuals that they serve of which as stated above if not done, optimal efficacious care may not be achieved and, the patients may decide not to use the facilities that do not serve them properly. Without cultural competence therefore, the financial bottom line of the health care institutions will be affected (Rose, 2010). Conclusion In order to ensure good nurse-patient relationship, efficacy and optimal provision of health care services and achievement of optimal financial and strategic performance of health care institutions, public health officials and healthcare administrators should ensure that cultural competency and cultural diversity is incorporated in the policies, value statements, missions, visions, strategic plans of the organizations and in other directive strategies of the health care institutions. Policies, organization plans, missions, visions and organizational directive strategies guide the nursing practices. If with a mission to incorporate cultural competence and diversity into the organization, the nurses will be taught to be culturally competent or even the newly employed will be required to be competent culturally. References References Daniels, R., 2004, Nursing Fundamentals: Caring & Clinical Decision Making, Connecticut: Cengage Learning. Miller, C. A., 2008, Nursing For Wellness In Older Adults, 5th Ed., Mary Land: Lippincott Williams & Wilkins. National Association of Social Workers (NASW), 2001, NASW Standards for Cultural Competence in Social Work Practice, Viewed on 2nd September, 2010: Pera, S. A. and Van Tonder, S., 2005, Ethics in Health Care, 2nd Ed., Johannesburg, South Africa: Juta and Company Ltd. Price, C., n. d., Australian Population: Ethnic Origin, Journal of People and Place, 7(4), 12-16. Viewed on 2nd September, 2010: Rose, P. R., 2010, Cultural Competency for Health Administration and Public Health, Boston, MA: Jones & Bartlett Learning. Srivastava, R., 2007, The Healthcare Professional's Guide To Clinical Cultural Competence, Amsterdam, Netherlands: Elsevier Health Sciences. Tseng, W. and Streltzer, J., 2008, Cultural Competence in Health Care, Japan: シュプリンガー・ジャパン株式会社. Read More