Transmigration of People Across the Globe - Essay Example

Cultural Diversity and Nursing Practice Transmigration of people across the globe is a reality today. Europe, North America, Australia and New Zealand now have a sizable population from other countries and the present migration policies and the demographical trends indicate that more migrations will be required in certain regions in the years to come. It is the colonial era that facilitated such large-scale migrations. Modern colonial history is more than 400 years now and the story of large-scale migration is also pretty old. However, the immigrants have not lost their distinctive identity during this lengthy period and it is foolish to expect that homogeneity with the host culture will ever be achieved. Nursing profession as a profession of caring need to cater to a rich variety of ethnicities. It is the goal of the medical profession to provide optimal health care for all patients. Unless cultural differences are taken into account, this goal cannot be accomplished. (Galanti, 1997, p. 135) Caring to the multitude of global ethnicities is a daunting task and many scholars have thought about this problem. There is consensus now among the health care profession that cultural diversity is a reality that has to be coped with. Increasing number of scholars opine that sensitivity to cultural diversity has to be integrated as an important agenda in the training of nurses today. There is an ever-increasing body of well-researched knowledge concerning the paramount importance of culture in health care. Illness and health care practices are culturally related. In order to provide effective care for clients from different ethnic groups these beliefs and practices have to be studied, taken into account and duly respected. (Leininger 1991; Meleie et al 1992 and Andrews 1999) The literature on Cultural Diversity and Nursing, now occupies a sizable space in all modern libraries. There have been many models that propose to integrate cultural diversity and nursing training. While the model of Leininger (1995) deals with cultural diversity and universality, the model of Littlewood (1989) has more basis on anthropology. The model put forward by Papadoupolos et al (1989) is engaging the attention of many nursing schools as a suitable model in training the global nurse of today. The purpose of Trans-cultural models is to help the nurses to see their individual practice in a scientific framework. They help the practitioner to see what he or she does in a cultural context. In addition they help us to examine our cultural assumptions and that of others. According to Papadopoulous Cultural Competence is the capacity to give healthcare giving due consideration to clients cultural belief's, behaviors and wants. Cultural Competence is both a process and an outcome and is gained from the synthesis of knowledge and skill, which the nurses acquire during their professional and personal lives. Since it is a process it is evident that it cannot be acquired overnight and has to be integrated into nursing education and through out the career .The following table will give a brief idea of the model. The Papadopoulos, Tilki and Taylor Model for Developing Cultural Competence CULTURAL AWARENESS Self awareness Cultural identity Heritage adherence Ethnocentricity Stereotyping CULTURAL COMPETENCE Assessment skills Diagnostic skills Clinical Skills Challenging and addressing prejudice, discrimination and inequalities CULTURAL KNOWLEDGE Health beliefs and behaviors Ethnohistory /Anthropological understanding Sociological /Political understanding Psychological and Biological understanding Similarities and variations CULTURAL SENSITIVITY Empathy Interpersonal/communication skills Trust Acceptance Appropriateness Respect Since Cultural Competence is a process, the stages in the process are a great help for the person aspiring a meaningful career in the context of cultural diversity. The first stage in the model is called Cultural Awareness that starts with an inward journey into our personal value and belief systems. This insight into our own cultural identity serves as a plank of our learning platform. The second stage is called Cultural knowledge. In this stage the person acquires knowledge drawn from a variety of disciplines such as anthropology, sociology, psychology, biology, nursing, medicine, arts and religion. Through meaningful contacts with people from different ethnic groups can enhance this knowledge base and make it more authentic through first hand contact with peoples from different cultural backgrounds. The third stage is the training ground for Cultural Sensitivity. It is in this stage the skill needed for appropriate interpersonal relationships with the clients are learned. . At this stage the nurses should understand how professionals look at nursing care. Clients are to be considered as true partners otherwise nurses and other health care people run the risk of using our powers in a high handed manner. The idea of equal partnership goes hand in hand with trust, acceptance, respect and willingness for negotiation. This stage can be achieved by the synthesis and practical use of the gained awareness, knowledge and sensitivity. At this stage it is necessary to have further focus to practical skills such as assessment of needs, clinical diagnosis and other caring skills. The Papadoupolous model also trains the nurses to recognize and challenge all forms of oppression and discrimination. Development of Cultural Competence being a process, throughout the professional lives of a nurse a set of cultural competencies are developed by her or him that are generic in nature. These competencies could be applied across different cultural groups (Gerish & Papadopoulous, 1999). It is a pipe dream that all health workers will be able to familiarize themselves with all the cultural entities that live in the world. However by using one's culture generic competencies one can acquire significant information needed to care for the client from any any cultural group. Case Study One evening two men came to the acute medical admission ward. They were young Iranians, named Moosa and Yacub, probably in their twenties. Moosa complained of severe abdominal pain. As the nurses tried to make the preliminary routine procedure for admission into the ward, Yacub was becoming increasingly impatient and shouted: We have come to see a doctor. Maria, a nurse from Philippines assured the young man that a doctor will examine his friend and she was only doing the routine preliminaries. But the young man refused to be satisfied by this explanation and tried to go in searching where the doctor was to be found. Meanwhile, another Indian nurse also came in the scene and asked the man to wait till the doctor came. She also added that the man did not appear to be in worse condition and he can afford to wait a little till the doctor arrived. When the man refused to obey and was about to go in forcefully, the nurses had no choice other than to call the security personnel to stop his further advancement. Meanwhile the security staff came and intervened. There was some verbal heated exchange with the security staff. The situation was worsened by the poor English language skills of the young man. The man did not heed to the reconciliatory attempt of the well-trained security personnel. The Incident in the Cultural Context What caused the behavior of Yacub His behavior can be better understood only in the context of Iranian and Islamic culture. The cultural issues, which are directly linked to this incident, will be a great help to understand the behavior of Yacub. Most Iranians and rich Muslims do not look at nurses as health care professionals and their suggestions and advice are not given much importance. So it is up to the doctors and hospitals to highlight the extend of professional training and expertise that the nurses have and their role in health care. Among the Muslims and Iranians both male and female patients prefer to be seen by male doctors. However, for gynecological problems they prefer women doctors. What the Westerners and the Americans call Male Dominances in Islamic culture is only Paternalism. Men give orders in Islamic culture but they are the protectors of their families. It is difficult for an Iranian man to tolerate when a woman refuses to take orders from him. Apart from this many Iranians and Muslims have language barrier and no knowledge of the cultural aspects of English communication. In the above-mentioned cultural context Yacub did not like the intervention of the nurse as he considers her only as a helper of a doctor. Yacub preferred his friend Moosa to be examined by a man. Yacub was behaving in the typical style of a Muslim man whose command the nurse was supposed to obey and not to argue about. It wounded his ego in a big way. The language barrier produces an enormous feeling of inferiority in many Iranians and his outbreak can be explained only with the help of subliminal forces that were at work in him due to his language inadequacy also. The young Iranians are not familiar with the courtesy expressions in English, which is typical to the language, and many foreigners find it extremely difficult to master them. This situation will be often understood by the Anglicized nurse as an expression of rudeness while their lack of courtesy words is only their ignorance of the right expressions in English. Did Yacub expect from the nurse a body language of greater respect to him as a man He is used to a fair degree of show of respect from the women in his culture and the lack of that now in the new hospital environment might also trigger some amount of rudeness on the part of Yacub. The situation that happened in the hospital can only be called unfortunate. What way was Yacub guilty What way was (were) the nurse(s) guilty There is no point in establishing the guilt or innocence of the one or the other .It is the problem of cultural sensitivity that is at stake in this issue. Conclusion Though there is greater awareness about the role of ethnicity and culture and their effect on health care the actual healthcare service is organized is in a mono-cultural way based on Western and American ideologies. (Khan & Pillay 20903). Moreover there is the risk of health care profession being labeled as insensitive to the attitudes, beliefs and values of ethnic minority groups. (Racine 2003; Omeri & Atkins 2002; Papadopoulos & Lees 2002). Ii is imperative to bear in mind that all nurse client interactions are basically multicultural as every person some how belongs to an ethnic group. All cultural interaction is the result of the interplay of perception of ones culture and that of others. So the basis of understanding other cultures should begin by a perception of ones own culture. The formation of stereotype thinking about other people's cultures is a pitfall. The concept of stereotype may be correct or wrong. Nursing student by creating a proper awareness about ones own culture becomes competent to understand other cultures. Much of the communication difficulties with other cultures can be minimized first of all realizing that it is difficult communicate even with people who share same ethnicities. The feeling of alienation that a person experiences in normal conditions because of the differences with ones own community can be painful. Now think of the pain that is felt by the minority ethnicities in their helpless conditions, the painful feeling of neglect in an alien land. Nurse's profession is a profession of caring and caring can be done only with a high sense of other centeredness. ========== Works cited Andrews, G.J. (2002): Towards a more place-sensitive nursing research: an invitation to medical and health Geography. Nursing Inquiry, 9 (4): 221-238. Galanti Geri-Ann. (1997) Caring for Patients from Different Cultures: Case Studies from American Hospitals. University of Pennsylvania Press: Philadelphia. Page Number: 135. Gerrish K and Papadopoulos I (1999): Transcultural competence: the challenge for nurse education. British Journal of Nursing, Vol 8 No 21, pp1453-1457. Khan, I & Pillay, K. (2003): Users' attitudes towards home and hospital treatment: a comparative study between South Asian and White residents of the British Isles. Jounal of Psychaiatric and Menatal Helath Nursing, 10(2): 137-146 Leininger (1991): Culture care and diversity: A theory of nursing. New York: National Leage for Nursing Press Littlewood R. (1989) Towards an intercultural therapy. Journal of Social Work Practice 3.8-19 Meleis, A.I. & Lipson, J.G. & Paul, S.M. (1992): Ethnicity and health among five Middle Eastern Immggrant groups. Nursing Research, 41(2):98-103. Omeri, A & Atkins, K.(2002): Lived experiences of immigrant nurses in New Soouth Wales, Australia: searaching for meaning.International Journal of Nursing studies, 39 (5): 495-505. Papadopoulos I, Tilki M and Taylor G (1998) Transcultural Care: A Guide for Health Care Professionals, Quay Books: Wiltshire Papadopoulos,I & Lees, S (2002): Developing culturally competent researachrs Journal of Advanced Nursing, 37(3):258-264 Racine, L. (2003): Implementing a postcolonial feminist perspective innursing research related to non-Western populations. Nursing Inquiry, 10(2): 91-102. ===================== Read More