In an increasingly diverse, multicultural society, nurses are challenged to provide effective care to patients of all religions, races, and cultures. This three-part series will explore various aspects of culturally competent care in nursing practice.
The foundation of cultural sensitivity is the awareness that differences between people exist, without assigning a value to them. This simply means you don’t assume all differences are negative or demand complete assimilation into the dominant culture here. This is consistent with the nursing mission of patient advocacy and patient-centric care, as well as the ethical responsibility to respect the rights and dignity of every patient.
In the broadest sense, cultural sensitivity can include not just culture, but race, religion, gender, ethnicity, and sexual orientation. All of these factors can influence a patient’s world view and interactions with the healthcare system. Nurses should be able to shift their perspectives to understand that what is “normal” or expected in their own world view may not be ordinary behavior in another culture. To deliver culturally competent care, nurses should be able to identify how a patient’s experiences are influenced by culture—either through general awareness of, say, general Hispanic culture, or by asking questions about a patient’s preferences or expectations—and then adapt their own behavior to fit within the norms of another culture.
Within nursing practice, there are several cultural factors that might affect how you interact with patients:
Support structures. Within the family, do men have more influence than women? Are the elderly revered for their wisdom, or seen as feeble and in need of guidance? Some cultures place the goals of the family as a whole above the needs of a specific individual. Nurses should understand the crucial role of family structures and hierarchies when dealing with diverse patients.
Special health concerns. Many ethnic groups have higher rates of certain conditions, due to a combination of genetic, dietary, and lifestyle factors. These can include obesity, hypertension, diabetes, even breast cancer. Nurses should be aware of these and ready to offer patient education and support regarding special concerns.
Religious concerns. These can include concepts of modesty, diet, end-of-life issues, or procedures that are restricted or prohibited within a certain faith. Some cultures also believe that a state of illness or wellness is determined by a higher power, which may influence compliance with medical treatments. The role of the nurse is to advocate for patients without making judgments about the treatments they choose or reject.
Belief systems. Different cultures can vary widely in their beliefs about diet, personal hygiene, and other health-related matters, making it more challenging for nurses to teach self-care. Some cultures rely heavily on their own traditional medicine—herbal remedies, acupuncture, faith healing, etc. A nurse who understands cultural belief systems can help a patient understand and integrate his or her own beliefs with our current healthcare system, for the best possible outcome.
Culturally competent care does not require you to change your own world view; it simply means you accept others, act with empathy, and adapt your behavior as necessary to respect the values of other cultures.
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