Examining the Issues Involved in Working with a Client in Terms of Ethnicity - Report Example

Examine the issues involved in working with a client that is different from oneself in term of ethnicity. An ethnic group is a culture or subculture whose members are readily distinguishable by outsiders based on traits originating from a common racial, national, linguistic, or religious source. Members of an ethnic group are often presumed to be culturally or genetically similar, although this is not in fact necessarily the case. Ethnic groups share a common origin, and exhibit a continuity in time, that is, a history and a future as a people. This is achieved through the intergenerational transmission of common language, institutions, values and traditions. It is important to consider this characteristic of ethnic groups if we are to distinguish them from a group of individuals who share a common characteristic, such as ancestry, in a specific point in time. On the political front, an ethnic group is distinguished from a nation-state by the former's lack of sovereignty. While ethnicity and race are related concepts, the concept of ethnicity is rooted in the idea of social groups, marked especially by shared nationality, tribal affiliation, religious faith, shared language, or cultural and traditional origins and backgrounds, whereas race is rooted in the idea of biological classification of Homo sapiens to subspecies according to arbitrarily chosen genotypic and/or phenotypic traits. Power issues, involved in working across difference (a) Religion issues In general, religion plays a major role in people’s lives. There are some very useful resources, which provide extensive guidelines for the management of patients from different religions. Religious beliefs have a major impact on attitudes toward many procedures in the hospital, e.g. organ transplantation, birthing practices, death and dying, diet, gender issues, abortion and modesty, to name a few. Certain religions require prayer at certain times of the day, so being sick or hospitalized can be very disruptive to an important routine. Prayer rooms are a valuable resource and patients need to be informed about them. In addition, hospital chaplains can sometimes co-ordinate visits from the appropriate priest, (b) Community issues Subsequently, because of varying preferences, communities form their own respective preferences in their modus operandi. The fact of essence lies in the fact that due their respect priorities, they form specific notions, and resultantly form a community. The evolution and dynamics of a community is not an overnight process. Quite the contrary, it is a process that is long overseen by issues that are specific and exclusive to the group of people now referred to as a community. (c) Practice/ritual based issues Differing priorities in social values and norms obviously means a difference in rituals as well. These rituals in effect may not be threatening to fellow communities, yet the exclusive nature that they determine makes it ‘untouchable’ for others, and hence creates a credible barrier between them and the majority group. (d) Minority political rights Though a delicate issue, yet its impact is quite otherwise. Minorities shall often complain about the lack of rights that they are given in a community. Yet contrastingly, they are the ones who are given the maximum rights. This is because rights for them are defined according to their needs and desires, whereas for the majority community, it is a vague concept. Minority ethnic groups always know who is the epicenter of their group, who to approach when a legal matter arises, where are their religious institutions etc. however, the same may not necessarily be the case with the dominant ethnic community. Thus a political struggle is born, and the tug-war remains ever so volatile. Contrasting constructions of this difference (a) Non-familiarity of the practitioner with minority norms having minimal or no idea about the background, perception and ideas of the patient can have drastically negative effects upon the course of treatment. This can generate serious ambiguities in both parties, and can jeopardize the cause of patient care/ curing is not only about dispensing of medicines – health care involves personalized attention to a human being, a feat that can only be possible if his demands are clearly understood. (b) Preferences of treatment ethics Different cultures and religions accord for varying opinions upon treatment methodologies. Certain provision in vogue in medical practices may not be allowed for certain ethnic groups. This can generate feeling of irritability, and in extreme cases, hatred for the practitioner. Resultantly, it would hamper the cause of support and care. (c) Lack of credibility In the possibility of being an immigrant or a refugee, or even a less popular ethnic community, the lack of credibility factor is always there. The practitioner is of course, a human being as well who lives and works in the same community. If he has preconceived notions about an ethnic identity, then it is likely to show during the course of the treatment. Regardless of ethical orientations of practitioners, these biases shall always remain. (d) Brand/labels and predispositions Associating one with a partaker of some malevolent activity in his community may brand or label the people of an ethnic group as being outcast. This can create severe disparities within the society, and would also show their impact during the treatment process. The construction of one's identity in relation to this difference Identity politics is the political activity of various social movements which represent and seek to advance the interests of particular groups in society, the members of which often share and unite around common experiences of actual or perceived social injustice. Such groups argue that they are in some way socially or politically disenfranchised, marginalized or disadvantaged relative to the wider society of which they form part. These movements seek to achieve better social and political outcomes for the members of such groups. In this way, the identity of the oppressed group gives rise to a political basis around which they then unite. (a) Nationalism This specially includes indigenous peoples' movements which ultimately result into a secluded and isolated stance within the society itself. Though there is nothing ideologically wrong with it, yet the more the ethnic groups in a society, the more will the dynamics of that place be volatile. (b) Race The concept of racism is extremely important in certain societies. This is one reality that one cannot change about oneself. This is the single most volatile issue in the developed world. Again, this creates intrinsic differences which in turn diversifies people from each other. (c) Religious fundamentalism This is probably one of the hottest topics in this world these days. Majority of clashes that take place these days are due to this factor. The practitioner has to keep note of such issues, and must endeavor not to let these affect adversely, the cause of his work. (d) Gender, sexuality or disability-based identities: In the name of Autism rights, deaf culture, disability rights, feminism, gay rights, masculism and transgendered rights, there are a lot of new ethnic groups being formed. Regardless of theological differences that one might have, they are to be treated as they present themselves, and must be given due regard. Emotions potentially experienced when working across this difference (a) Bias Many groups may have biases that may be there at the onset of social interactions. From the time of childhood grooming, the development of children is do in the context of social norms. They begin to identify with people they are akin top and stay vary of those who are different from them. The difference can be of various types: monetary, class, gender, religious or ethnic. Out of these, probably the last one is the most defining of them all. For the simple reason that you cannot change the factors unto which this variation is created. If one belongs to a certain ethnic group (b) Prejudice Being humans, every person has preconceived ideas and notions about issues and people. This prejudice becomes a permanent part of the personality and cannot be taken out of it as such. These can adversely affect the cause of the care being provided by a health practitioner. (c) Lack of association and trust if one is not too familiar with the people of a particular ethnic group, a general feeling of discomfort and lack of trust is likely to sink in., this shall make the initial process of rapport building more difficult for the therapist and can hamper the cause of the treatment. (d) Moral value differences differing ethnic groups may also present difference in moral values. This can be really testing for a practitioner, as his ethical standards would be under pressure, and he might have to indulge into something that he might not like and vice versa. Potential ways practitioners can increase the chances of working across difference Patients/clients and their relatives all have a set of beliefs which guide their daily life. Some will have strong religious beliefs, whilst others may have limited contact with religion in terms of formal worship, but will have strong beliefs in a god or gods, or in moral principles which are based on religious beliefs. While for some, these beliefs may mean little obvious difference in their lives, illness and death can highlight these beliefs. (a) Language Every language is part of a culture and has its own cultural features. Interpreters are an important resource in providing a voice for patients whose proficiency in English is poor or insufficient for the situation. To decide whether the patient needs an interpreter, assess whether their English language ability is adequate for the situation. In certain circumstances it is crucial that the patient has full understanding and there are no misinterpretations by patient or staff. (b) Communicating Effectively Health and social care involves basic principles that apply to all patients/clients irrespective of cultural or linguistic background. However, any health care system is necessarily based on the predominant culture and medical system. All of us, including health professionals, often make assumptions based on our own culture. In many cultures, the patient/client and his/her family make up a single client group with which you need to interact. Asking a patient/client "Could you tell me what would happen to you if you were in your former country?" or "I don’t have a great understanding of this" or "I am interested to know more". These are ways to encourage intercultural dialogue and by doing this, you are acknowledging to the patient your understanding of his or her different perspectives and experience. (c) Diet Issues The availability of food products, culture, life experience and religion determines one’s diet. Food has cultural significance in terms of gaining and maintaining health and strength. Patients/clients should be asked about their preferred diet. It is good practice to remember that dietary preferences also extend to eating implements and where food is actually eaten. Some people may prefer to eat with spoons or their fingers rather than a fork. Others may require privacy when they are eating and on an open ward, this may mean drawing the screen around the patient/client. (d) Family, Community and Medicine Many people from ethnic minorities come from societies where the community is more important than the individual. There are a number of different family structures ranging from the grandmother taking the role of head of household to young boys being responsible for older female siblings. This may be a function of the culture, but it may also be due to circumstances created by restrictions in family members able to migrate. (e) A Specific Note on Refugees Identification of refugees and survivors of torture and trauma is difficult, but this can be important. The detrimental impact of the asylum process on the health of asylum seekers is a recognized concern. Knowing the country of origin will give some indication of whether a particular patient is likely to have experienced war and physical or psychological abuse. The most important barriers to healthcare are language and cultural differences and the fact that some asylum seekers may be illiterate. Asylum seekers have difficulty in finding information on health services, in particular primary care. The Staff – Patient Relationship In many countries, health workers are figures of authority and patients/clients play a passive role. Complaints are seldom made because of concerns that staff will think them unappreciative and that future care may be affected. In addition, many people are afraid of doctors and hospitals and their fear is magnified if they do not understand what is wrong with them. Hospital is often the last resort and the decision to have what may be considered by medical staff as an urgent operation may be taken only after trying other non-medical treatments first. Attitudes towards hospitals and hospital staff depend largely on the patient’s previous experiences and expectations. If, for instance, a patient expects that a particular treatment should result in an instant cure, a step by step treatment process will need to be explained very clearly. Staff attitudes to patients also affect interactions within the hospital system. The interview to collect data on the patient’s history may be perceived as very threatening and daunting depending on previous experience. Some patients/clients do not expect or understand the depth of questioning that is normal in a health care or hospital culture. Disclosure of personal information including current symptoms or health history may not always be appropriate at the first meeting. Some people from specific cultural backgrounds or who have been tortured/traumatised may have difficulties in disclosing personal information. You need to be patient and make an effort to establish a trusting relationship with the patient/client. Identify yourself clearly with a readable identification badge, which helps to make you more approachable. Be aware of your own attitudes. These are clearly transmitted both verbally and non-verbally. Awareness of your own expectations and recognition that they are simply expectations based on your own culture and experience is helpful. A preliminary step in the process of developing a culturally appropriate service is the willingness to engage in some self-analysis to establish your own beliefs, attitudes, expectations and practices, which can then be affirmed or modified as appropriate. Explore ways of accommodating different requests and cultural practices. For instance, in some situations it may be possible to allow a woman concerned about modesty to wear pyjamas to surgery rather than a hospital gown. The approaches and roles of different therapies in the management and care of the patient’s/client’s condition should be explained. Further, these types of services are offered both in the hospital and a community setting and care should therefore be taken to ensure patients'/clients' needs are taken account in arrangements for making appointments and home visits. Consider the patient’s medical and non-medical (social) needs. Employ a multidisciplinary approach involving a range of health professionals. Allow patients and their families considerable self-determination in the process of planning for their care and needs. Check that the patient, family and care providers fully understand the proposed care plan. Ensure that post-hospital care involves co-operation and collaboration between the hospital and relevant home and community care services. References “Southern Area Health Authorities - Cultural Handbook for Staff.” Ethnicity Online. 01 Dec 2005 < http://www.ethnicityonline.net/articles.htm>. “Wikipedia”. Ethnicity. 01 Dec 2005. . Read More