Culture is a “set of values, beliefs, and assumptions that are shared by members of an organization” (Huber, 2018, p. 56). Another definition of culture is “the internal and external manifestations of an individual, group or community’s worldview derived from learned beliefs, values and norms” (Warren, 2000). Our society is filled with many different cultures and to be able to provide quality care, the healthcare professional must be culturally competent. Huber (2018) states that the best way to understand the teamwork, communication and collaboration relationships between providers, patients and families is to recognize and appreciate how the organization’s culture impacts the nursing staff and how the nursing staff in turn embraces such culture. Being culturally competent is to be aware and recognize the many different surrounding cultures and develop the ability to adapt, accept and effectively communicate and interact with individuals across cultures (Dauvrin and Lorant, 2015). It is imperative to know and understand one’s own beliefs to be able to develop a positive attitude towards others’ cultural beliefs.
I plan on working as a psychiatric mental health nurse practitioner while still teaching mental health; so, it is crucial for me to be culturally competent since I am sure I will have (just as I do now) patients and students from many different background. Also, being culturally competent will help me fully embrace and appreciate the culture of my workplace and schools/hospitals I end up working or teaching. It will also help me use my own specific expertise to care for my patients while positively impacting them with my knowledge and appreciation of their different background. Working for the county, the population we serve contains a lot of diversity in cultures and requires that we all be well trained to be culturally competent. These training provide examples of how to provide culturally competent care to the mental health population while showing knowledge and respect to different cultural beliefs, values and practices so that the health care practitioners are able to demonstrate empathy, openness, or kindness toward ethnic minorities (Seeleman et. Al., 2009). According to Aggarwal et.al. (2016), studies have shown that a non-culturally competent health care provider may easily be subject to poor compliance, inappropriate management and errors of diagnosis. We do have an advantage in the fact that cultural competence training and education are now mandatory requirements for all mental health providers especially those working with culturally diverse groups of patients for “cultural competency training may improve the quality of mental health care for ethnic groups” (Bhui et. Al., 2007).
Aggarwal, N. K., Cedeño, K., Guarnaccia, P., Kleinman, A., & Lewis-Fernández, R. (2016). The meanings of cultural competence in mental health: an exploratory focus group study with patients, clinicians, and administrators. SpringerPlus, 5, 384. Doi: 10.1186/s40064-016-2037-4
Bhui, K., Warfa, N., Edonya, P., McKenzie, K., & Bhugra, D. (2007). Cultural competence in mental health care: a review of model evaluations. BMC health services research, 7, 15. Doi: 10.1186/1472-6963-7-15
Dauvrin, M., & Lorant, V. (2015). Leadership and cultural competence of healthcare professionals: a social network analysis. Nursing research, 64(3), 200–210. doi:10.1097/NNR.0000000000000092
Huber, D. L. (2018). Leadership and nursing care management (6th Ed.). St. Louis, MO: Saunders/Elsevier Publishers, Inc.
Seeleman C., Suurmond J., Stronks K. (2009). Cultural competence: A conceptual framework for teaching and learning. Medical Education, 43, 229– 237 doi:10.1111/j.1365-2923.2008.03269.x
Warren, B. J. (2000). Cultural Competence: A Best Practice Process for Psychiatric-Mental Health Nursing. Journal of the American Psychiatric Nurses Association, 6(4), 135–138. https://doi.org/10.1067/mpn.2000.108729
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Kate Laporte - Tuesday, 11 June 2019, 4:44 PM
Cultural Competence and Practice Change
Kate LaPorte
Cultural competence is important for understanding people and building respect for cultural differences and perspectives. According to Huber (2014), there are two crucial elements for a workplace to effectively deal with the growth of cultural diversity. The elements include the following: (1) knowledge of other cultures and (2) not being ethnocentric in the workplace (Huber, 2014). There is diversity in the workplace every day. Huber states, "A culture can be defined by a characteristic such as the following: National origin, Customs and traditions, Length of residency in the United States, Language, Age, Generation, Gender, Religious beliefs, Political beliefs, Sexual orientation, Perceptions of family and community, Perceptions of health, well-being, and disability, socioeconomic status, Education level, Geographic location, and Family and household composition" (2014, p.186-187). As a health profession, it is important to be culturally competent to not judge someone and to not put individuals in "boxes" (Huber, 2014). Also, is important for nurses and professionals in the workplace to emphasize positive behavior, employ cultural competence, and practice good communication strategies to be successful to make a change.
Soon, cultural competence will enhance my professional practice as a Family Nurse Practitioner (FNP). It is a goal of mine to develop positive attitudes towards one's cultures. Also, I will want to gain a sense of awareness and knowledge about individual culture as well. Knowing one's culture will allow me to deliver more patient-centered care.
Reference
Huber, D. L. (2014). Leadership and nursing care management (5th ed.). St. Louis, MO: Saunders/Elsevier Publishers, Inc.
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Thomas Breslin - Tuesday, 11 June 2019, 7:24 PM
Healthcare organizations strive to create an experience meeting patient’s cultural, social, and economic needs. Healthcare organizations work continuously to provide the highest quality of care, regardless of patient race, ethnicity, or cultural background. An organization must first establish a culture that fosters a positive climate for the staff providing care. Huber (2018), describes culture as, “a set of values, beliefs, and assumptions that are shared by members of an organization. An organization’s culture provides a common belief system among members. Culture provides a common bond so that members know how to relate to one another and how to show others who are outside the organization what is valued” (p. 50). Cultural competence is established when the organization formulates comprehensive strategies that provide exceptional care to the community.
Working in an emergency department provides a platform to assist patients from all walks of life. The hospital provides multiple resources to assist patients with their health. In my opinion, the foundation of cultural competence begins with effective communication. Nurses must establish an effective relationship with patients to gain insight to their situation. Nurses need to evaluate how a patient’s age, race, literacy, sex, financial status, and home environment will affect their care plan. Leadership at my hospital provides resources to assist patients from diverse backgrounds. Language barriers can be bridged with language lines, underprivileged patients are assisted through case management consults, and care plans are designed to specifically model the individual’s needs. Maintaining cultural competency is continuous requiring staff to perform educational exercises to meet the demands of a changing patient population.
Culture competence requires nurses to think outside the box, and treat patients using a variety of different methods. An understanding and respect must be established between the patient and their family placing assumptions aside. As a nurse practitioner there is a greater importance on exhibiting cultural competency. A provider must understand the resources needed to establish effective communication and build trusting relationships with patients. Each patient will provide certain obstacles that need to be addressed to provide the highest quality of care. As a practitioner my goal is to take the time needed to understand a diverse population and what motivates patients. Being part of a healthcare team presents the opportunity to learn with each other through diversity. Working in a diverse setting opens the door to understand alternate viewpoints. A new graduate has the responsibility to seek-out strategic ways to provide diversified care. My objective is to use diversity as a learning tool to build confidence, and continuously improve my ability to care for all patients.
References
Huber, D.L. (2018). Leadership & Nursing Care Management (Sixth ed.) St. Louis, MS: ELSEVIER.
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Ceara Conley - Wednesday, 12 June 2019, 11:16 AM
Cultural competence is a very important and often over-looked area of nursing. To provide comprehensive care to a vast range of patients it’s important to have cultural competence (Montenery et al., 2013). “Because of globalization and growing immigrant populations, nursing students need to possess a high level of cultural competence to provide nursing care to patients from various cultural backgrounds” (Choi & Kim, 2018). In my future practice as a nurse practitioner it will be very important to be culturally competent in order to provide the best possible care for my patients. It’s important to remember that standard health care norms might not relate to all patients. When caring for patients holistically it’s important to remember the cultural differences in diet, language, health care expectations, medical wishes and views on medicine may be different from on patient to the next. It will be vital to understanding each patients culture and their specific needs and wishes to be able to provide them the highest quality of care. Part of being culturally competent in the workplace is allowing for all groups to be inclusive and creating group norms that allow everyone to have a voice and opinion in the group. Being inclusive in the workplace starts with a safe environment for interpersonal communication from all group members. I hope to be able to bring a culturally competent and diverse practice to my patients and my coworkers. However, in order to embrace cultural diversity in the workplace one must be aware of their own social biases, prejudices, stereotypes, and privilege. The cultural diversity awareness questionnaire in Chapter 9 of Northouse (2018), is a platform on which leaders can look inward to become more aware of their own barriers to promoting diversity (Northouse, 2018). Everyone has biases and prejudices in their life whether positive or negative prejudices. This questionnaire helps to identify prejudices that are negative and counter-productive to becoming more culturally competent. Once prejudices, stereotypes and privilege are identified only then can they be changed. Identifying these barriers are the first step in allowing for inclusion and promoting a safe environment of cultural awareness and diversity (Northouse, 2018). References
Choi, J., & Kim, J. (2018). Effects of cultural education and cultural experiences on the cultural competence among undergraduate nursing students. Nurse Education in Practice, 29, 159-162. doi:10.1016/j.nepr.2018.01.007
Montenery, S. M., Jones, A. D., Perry, N., Ross, D., & Zoucha, R. (2013). Cultural Competence in Nursing Faculty: A Journey, Not a Destination. Journal of Professional Nursing, 29(6). doi:10.1016/j.profnurs.2013.09.003
Northouse, P. G. (2018). Introduction to leadership concepts and practice (4th ed.). Los Angeles, CA: SAGE.
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Marissa Marvel - Wednesday, 12 June 2019, 3:28 PM
Hi Ceara,
I have enjoyed learning about cultural competence this week and your post was very informational. I agree that being culturally competent is so very important in healthcare, and it is crucial for people to understand their biases. Biases occur even when we are unaware of them, and a survey like the one in Northouse's book is a good example of the first step a healthcare provider can take to be more culturally competent. It is so important to have everyone feel as though they are being treated fair and equal, and for patients to be able to trust their providers. Everyone comes from different backgrounds with different languages, cultures, religions, beliefs, etc. We can all learn from one another when our environments are culturally diverse. I think one of the main concerns relating to this subject right now is how segregated people have become, intentionally, with social media only making matters worse.
Two main issues are considered to be problematic in the Unites States regarding social integration. One is social isolation, where a person has little contact with people in general. The other is relative isolation, which is when people have strong connections only with people who have the same attitudes, beliefs, values and opinions as they do (Gelman, McCormick, Tietler, Zheng, DiPrete, 2011). Therefore, our country really needs to put more significance on integration and building more cultural competency by breaking down these barriers.
Gelman, A., McCormick, T., Tietler, J., Zheng, T., DiPrete, T. (January 2011). Segregation in Social Networks Based on Acquaintanceship and Trust. AJS (116)4. 1234–83
Northouse, P. G. (2018). Introduction to leadership concepts and practice (4th ed.). Los Angeles, CA: SAGE.
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Victoria Mendel - Wednesday, 12 June 2019, 3:00 PM
Cultural competency in the workplace is critical for both patient care and success of the business. The Corporate Equality Index (CEI) produced by the Human Rights Campaign annually demonstrates that companies who had the highest reports of staff satisfaction, due to inclusion and respect of culture and individuality, are “also some of the most profitable and top-performing” (Lim, 2019, p. 49). As a future women’s health nurse practitioner, it is both prudent and moral to be culturally sensitive and accommodating.
In addition to the organizational success of a company, patients alike report higher trust and satisfaction with culturally competent providers; specifically, nurses. The results of a study published in China demonstrate that attributes under the umbrella of cultural competence of positive communication, trust building and shared decision making were significantly related to increased trust and satisfaction (Tang et al., 2018). Caring for women in the central coast of California include many Hispanic-Americans whom often only speak Spanish. Understanding their cultural needs and key factors of family-involved decision making and the Catholic religion as a driving factor are critical for complete care. My care for women in childbearing years of this group will be greatly influenced by their cultural norms.
Another group of women whom needs are often under met are those of the LGBTQ culture. Child and family theories will be amended for this group and ways of becoming mothers differ from the traditional roles. “A 2016 Gallup report estimated that 4.1% of adults in the US (approximately 10 million people) identify as LGBTQ” (Lim, 2019, p.48). It was also noted that more women than men identify as so, these are my patients. As a nurse I am under an oath to serve the underrepresented and disenfranchised. Becoming culturally competent to all demographics of women in the area will allow me to be an effective provider.
The provider needs to respond to the needs of both staff and patient in a holistic way. Healthcare perhaps more than any industry needs to become competent due to the nature of caring for the individual (Huber, 2014). As a women’s health nurse practitioner I will need to stay current with my own cultural beliefs and self-reflect on how that affects the care I give.References
Huber, D. (2014). Leadership & nursing care management. St. Louis, MO: Elsevier.
Lim, F. (2019). A guide to fostering an LGBTQ-inclusive workplace. Nursing Management, 50(6), 46–53. https://doi.org/10.1097/01.NUMA.0000558484.92567.db
Tang, C., Tian, B., Zhang, X., Zhang, K., Xiao, X., Simoni, J. M., & Wang, H. (2019). The influence of cultural competence of nurses on patient satisfaction and the mediating effect of patient trust. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 75(4), 749–759. https://doi.org/10.1111/jan.13854
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Thomas Breslin - Thursday, 13 June 2019, 4:02 PM
Victoria your post was very insightful regarding cultural competence, and brought up many good points. It was interesting to read your view on how organizational success correlates to employing culturally competent providers. The research indicates that patients report higher rates of trust and satisfaction when being treated by providers who possess cultural competence. This is an attribute that can be overlooked in healthcare; however, it’s clear that possessing cultural competence can improve the care providers give, and create a healthier work environment. Never working in women’s health, your recognition of cultural needs when caring for women in childbearing years was impressive. Cultural competence plays such an important roll in building strong relationships with patients. Huber (2018) states, “another important part of the explanation for changing birth patterns is that on average minority populations are younger than whites and thus are more likely to be having and raising children. There are notable differences by race and ethnic group in median age, which is the age at which half a group is younger and half older” (p. 176). Exhibiting cultural competence in your future practice of women’s health will help build trust and satisfaction for the patients you serve.
Another aspect of your post which was interesting was the needs of treating the LGBTQ community. Our hospital has just created a LGBTQ comity to meet the needs of this growing population, and exhibit cultural sensitivity toward this group. I did not realize the amount of women representing this group, and the impact on women health until reading your post. This is a group that is clearly underrepresented. Culturally competent providers will be needed to effectively treat this population going forward. I’m interested to see if there will be any care changes made resulting from the formation of the LGBTQ comity in my hospital.
Huber, D.L. (2018). Leadership & Nursing Care Management (Sixth ed.) St. Louis, MS: ELSEVIER.
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Ketaki Desai - Wednesday, 12 June 2019, 4:20 PM
Cultural Competence
Cultural experience is an essential obligation meant for mental health specialists working with customarily different patient groups. Cultural experience exercise may develop the excellence of mental health upkeep for an ethnic group (Betancourt, et al., 2016). Cultural competency will enhance a professional practice through cultural awareness where it consists of self-analysis of in-depth study of an individual's aesthetic and professional background. Cultural awareness begins with insight into the individual's values, social health, and beliefs. A cultural attentiveness assessment device can assist in assessing an individual’s level of cultural mindfulness.
Another professional practice enhancement in cultural competency is cultural knowledge that involves seeking and attaining an information base on various ethnic and cultural groups. Aesthetic experience is stretched out by retrieving information presented through sources such as course books, workshop demonstrations, journal articles, internet resources, university courses, and seminars.
Social skills is yet another professional practice enhancement in cultural competency which consists of the nurse's ability to pull together crucial cultural information concerning the patient's presenting problem and correctly implement a culturally accurate assessment (Garneau, 2016). The Davidhizar and Giger model deals with a framework for evaluating racial, tribal, and cultural variances in patients.
Cultural encounter is also another cultural competency aspect in enhancing professional practice. It is the process that boosts nurses to unswervingly contribute in cross-cultural connections with patients from different ethnic backgrounds. Nurses gain cultural competency by openly networking with patients from multiple cultural experiences (Garneau, 2016). Cultural encounter remains a constant process which tends to evolve.
Cultural desire is yet another cultural competency that enhances professional exercise. It refers to the inspiration to grow into social awareness and to seek cultural encounters (Garneau, 2016). Cultural desire implicates the readiness to be direct towards others, to receive and to respect cultural variances as well as to be ready and willing to pick up from others.
Nurses increase substantial new information from various sources such as critical reflection, examination, clients served and colleagues, and put the knowledge acquired into practice (Marion, et al., 2016). The progression requires a continuous judgment of current competency, ever-expanding self-awareness, actions for personal and professional development, and periodic training of data based assessment tools. It also involves methods for critical review.
An essential section of the professional nursing exercise, enduring learning, takes part via formal education, observation, and self-direct study, continual education, and clinical training. Nurse advocates seek educational opportunities intended to take part in culturally similar principles into their maintenance for diverse populations and consumers.
Handmade coaching for nursing colleagues makes the opening to educate and cultivate one another on culturally-specific interventions that increase consumer outcomes of nursing upkeep (Marion, et al., 2016). Nurses who in general have had advanced education, come up with educational plans to improve culturally congruent healthcare meant for nurses and social group across the healthcare profession.
Nurses benefit from professional talks where they learn more about culturally congruent upkeep intended to lower health disparities and develop proper care, especially with the developing awareness of the contributing social factor of health (Marion, et al., 2016). Handmade instructions for nursing equals forms an opportunity to train one another on culturally-specific interventions that increase consumer conclusion of nursing upkeep.
There is inadequate proof of the effectiveness of cultural competency training as well as service delivery. Extra work is needed to evaluate enhancement in service consumers’ experiences and outcomes.
References
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports. Doi: 10. 1093/phr/118.4.293
Garneau, A. B. (2016). Critical reflection in cultural competence development: A framework for undergraduate nursing education. Journal of Nursing Education, 55(3), 125-132. Doi: 10.3928/01484834-20160216-02
Marion, L., Douglas, M., Lavin, M. A., Barr, N., Gazaway, S., Thomas, E., & Bickford, C. (2016). Implementing the new ANA standard 8: Culturally congruent practice. Online Journal of Issues in Nursing, 22(1). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-22-2017/No1-Jan-2017/Articles-Previous-Topics/Implementing-the-New-ANA-Standard-8.html [Accessed June 10, 2019]
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Valeria Hinojosa - Wednesday, 12 June 2019, 9:17 PM
As nursing continues to evolve, an increase in socially diverse patient populations will be witnessed. Shen (2014), reports a rapidly growing racial, ethnic and culturally diverse population has developed in the past two decades. As a future family nurse practitioner and leader in my profession, I must demonstrate cultural competence in the workplace. Cultural competence is an essential component in providing relevant, effective and culturally responsive healthcare services to the increasingly diverse U.S. population (Shen, 2014). Cultural competence consists of four categories: cultural awareness, cultural knowledge, cultural skill and cultural sensitivity (McElroy & Smith-Miller, 2016). In being culturally competent I will be more aware of any inner personal biases that I may have towards other cultures, lifestyles and beliefs. By practicing this, I will be able to provide diverse care that will incorporate others’ beliefs and/or views.
As a leader in my practice, I will be caring for a wide range of patients from different cultural backgrounds. In being culturally competent I will develop cultural understanding related to specific conditions or diagnostics. In doing so, I can gain a better understanding on a patient’s acceptance or refusal to certain treatments. Cultural competence will allow me to recognize and manage cultural differences in the unit and institution (McElroy & Smith-Miller, 2016). My goal is to become a family nurse practitioner and serve in an underserved population. Huber (2014) depicts minorities are roughly one third of the population right now, and in 2042 the nation is projected to be 54 percent minority in 2050. It is evident that the white percentage of US population will decrease, making our nation more culturally diverse. As a direct result of this, it is critical to provide culturally competent care and not allow any biased opinion alter the way we treat patients. In in this leadership position, I will be the one responsible to communicate and encourage staff members to learn and practice cultural competence. Cultural competence will allow me to learn from different religious beliefs, political beliefs, sexual orientations, age, family dynamics, socioeconomic status, educational levels, physical abilities and nationalities. In doing so, I will be more cautious to not generalize or categorize an individual based on their differences, rather I will embrace their differences and provide care to best fit their needs. In educating my staff with cultural competence I will ensure to provide effective communication when barriers such as language, cultural differences or low health literacy may be evident. Overall, in practicing cultural competence I will be aware of others’ differences and provide care effectively.
ReferencesHuber, D. (2014). Leadership and management principles. In D. Huber (Ed.), Leadership and Nursing Care Management(pp. 159-186). Saint Louis, Missouri: Elsevier.
McElroy, J., & Smith-Miller, C. (2016). Cultural Awareness Among Nursing Staff at an Academic Medical Center. The Journal of Nursing Administrators,46, 3rd ser., 146-153.
Shen, Z. (2014). Cultural Competence Models and Cultural Competence Assessment Instruments in Nursing. Journal of Transcultural Nursing,26(3), 308-321. doi:10.1177/1043659614524790
Please refer to attached word doc. for APA format
Cultural Competence Week 6.docx
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Gehane Gajjaoui - Wednesday, 12 June 2019, 10:14 PM
Nursing is an evolving domain that requires a multifaceted approach to provide optimal patient care. Culture is defined as a set of values, beliefs, and assumptions that are shared by members of an organization (Huber, 2014). Being culturally competent in nursing allows a nurse to better understand his or her patient cohort, build rapport, accurately assess and develop a plan to meets the needs of his or her patients. Upon graduation, I plan to provide culturally competent care in the following manner.
Effective communication between nurses and patients is significant on the impact of compliance and successfulness in a patient’s treatment plan. Cultural competence includes a certain amount of appropriate communication skills (Huber, 2014). Dealing with diversity in the workplace stemming from either one’s co-workers or patients, it is important to not assume that a cultural group can be held to certain criteria for every person who belongs to that race and/or ethnicity (Huber, 2014). This can begin with the avoidance of racial designation. Racial designation is the origin of which people identify themselves from. Being mindful of ones race however, not letting that affect my decisions in one’s plan of care, will allow me to identify communication barriers as a clinician. This will enhance my professional practice because it will allow me to avert any stereotypes I may have of a patient being from a specific race and will allow me to learn how each patient understands a disease and treatment. It will also be important for me as a clinician to be able to identify the cultural context from whichever part of the world my patients may be from. More specifically, patients from high context versus low context cultures. This will enhance my career as a clinician because it will allow me to understand how information in communicated through human transaction. This will also allow me to be able to build rapport with my patients because they may view me as more relatable with this kind of mindfulness. Ultimately, it is important for nurses to recognize cultural diversity as it is necessary to know and respect diverse perspectives. Practicing good communication strategies through the methods previously mentioned will be pivotal in enhancing my professional practice and to be able to provide optimal care.
Reference
Huber, D. L. (2014) Leadership and nursing care management. St. Louis, Missouri: ELSEVIER.
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Tarajean Lewis - Wednesday, 12 June 2019, 10:22 PM
Cultural Competence
Tarajean Lewis
Regis College
Cultural competence is vital to the success of any business or workplace; however, it is extremely important in the nursing community. Nurses and nursing leaders need to be able to reflect on their own values and understand why they feel the way they do about these particular values, then use this understanding to competently and sensitively care for clients of other cultures (Canadian Nurses Association, 2018). Huber (2014) states that cultural competence in the healthcare workplace takes continuous education and learning about other cultures, but also requires the effort of healthcare administration to hire a diverse profile of employees. It is crucial for healthcare facilities to support cultural competence in all ways and having a culturally diverse staff supports this with evidence that clients can appreciate.
Cultural competence should be taught at all educational facilities from an early age and is extremely important for nursing students to embrace in order to give the best care to clients daily. “Teaching nursing students how to be culturally competent is essential so they can provide optimal care for patients, families, groups, and communities from diverse backgrounds. Foundational to cultural competence is the nurse-patient relationship” (Dunagan, Kimble, Gunby, & Andrews, 2014, p. 320). The relationship between the nurse and the patient affects patient satisfaction of care, communication and goal setting.
HealthyPeople 2020 cites the shortage of health care providers who are culturally competent and knowledgeable about LGBT issues as one of the top contributors to the oppression and discrimination affecting their health (Orgel, 2017). This example of culture incompetence is unacceptable to any patient or culture and solidifies the continued need for cultural education among the nursing community.
I have been working as a women’s health nurse practitioner for 14 years and have met a diverse panel of patients through different offices and locations that I have been employed. I have learned that not all patients of a certain culture have the same beliefs or values as their culture as a whole. I have become very accustomed to simply asking the patient what their preference is or comfort level regarding certain parts of the physical exam or medication route of administration, for example. According to a blog post called “10 best practices to promote cultural awareness in the nursing profession” there some items to promote cultural awareness that I am currently executing and additional items that I feel that I need to work on. I feel that on a daily basis, I perform (1) Treating Patient’s as Individuals and (2) Clear Communication. I feel that there should be a more diverse employee population at my current position, however, there are less than 20 employees in our office, we have a small number of employees, to begin with. I also am not participating in any regularly scheduled ongoing education for cultural competence awareness. I would like to institute an education presentation one to two times yearly about cultural competence as there is nothing in place like this at my current employer’s office (Regis, 2018). The Canadian Nurses Association has an excellent reference point on their position paper regarding cultural competence, “cultural competence does not have an end point; rather, it is a lifelong process of striving to learn about and understand a particular culture” (Canadian Nurses Association, 2018, p.1). This concept of lifelong learning applies to any aspect of nursing care; new information, better technology, and improved practices are established daily as the world of healthcare matures at an amazing rate.References
Canadian Nurses Association (2018). Promoting cultural competence in nursing. Retrieved
from https://cna-aiic.ca/-/media/cna/page-content/pdf-en/cultural-competence-and-safety-
competencies.pdf
Dunagan, P. B., Kimble, L. P., Gunby, S. S., & Andrews, M. M. (2014). Attitudes of prejudice
as a predictor of cultural competence among baccalaureate nursing students. Journal of Nursing
Education, 53(6), 320-328. doi:10.3928/01484834-20140521-13
Huber, D. L. (2014). Leadership & nursing care management (5th ed.). St. Louis, MO: Elsevier
Saunders.
Orgel, H. (2017). Improving LGBT cultural competence in nursing students: An integrative
review. ABNF Journal, 28(1), 14–18. Retrieved from https://search.ebscohost.com/login.
aspx?direct=true&db=ccm&AN=121353795&site=ehost-live
Regis College Online. (2018, May 08). 10 best practices to promote cultural awareness in
nursing [Blog post]. Retrieved from https://online.regiscollege.edu/blog/10-best-practices-to-promote-
cultural-awareness-in-the-nursing-profession/
** See Word attachment for correct APA format
Cultural Competence.docx
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Victoria Mendel - Thursday, 13 June 2019, 11:39 AM
Tarajean,
I too found some alarming research on LGBTQ persons. The article "A guide to fostering an LGBTQ-inclusive workplace" (Lim, 2019) discusses the current nature of the workforce for these individuals. Although this article is not about patient care directly, it still serves to enhances interpersonal relationships with our co-workers from differing cultural backgrounds and lifestyles. All of which will trickle down to better patient care as we have all learned by now.
I was excited to read that you are currently a women's health NP, as that is the specialty that I am studying for. I would love to know more about the role and what you think of it. According to the Lim, data from the Gallup report shows that millennials, which are the main cohort in the child-bearing ages, are increasingly identifying as LGBTQ, up at 7.3% in 2016 from 5.8% in 2012 (2019, p. 48). This represents a large group of women that will come through our offices seeking care. It is crucial that we continue to learn and expand our definitions on what individual care looks like.
Research shows that patients trust increases as nurses cultural competence increases (Tang et al., 2018). If we can provide an honest and open communication with our LGBTQ patients we will harbor this trust and effective care environment. Huber stresses the importance of inclusion and demonstrates how far reaching nonacceptance can go in the realm of healthcare (2014). In the early twenty-first century issues of gay marriage trickled into the ideas of insurance, who can visit, who is legally allowed to visit and make decisions for the patient (Huber, 2014). As we can see acceptance is not only morally right but also has legal repercussions as well. Let's hope we all remain committed to creating an environment of inclusion and celebrating differences in our care.
References
Huber, D. (2014). Leadership & nursing care management. St. Louis, MO: Elsevier.
Lim, F. (2019). A guide to fostering an LGBTQ-inclusive workplace. Nursing Management, 50(6), 46–53. https://doi.org/10.1097/01.NUMA.0000558484.92567.db
Tang, C., Tian, B., Zhang, X., Zhang, K., Xiao, X., Simoni, J. M., & Wang, H. (2019). The influence of cultural competence of nurses on patient satisfaction and the mediating effect of patient trust. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 75(4), 749–759. https://doi.org/10.1111/jan.13854
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Brieann Maslov - Wednesday, 12 June 2019, 10:32 PM
Week 6 Discussion Initial Post
Culturally competent care is imperative for all populations of patients within the US, as well as internationally. With the extent to which people currently travel and migrate; healthcare is a globally interconnected phenomenon. “We are living in a changing and changed world. At the international level, the interdependence among nations has increased significantly, fueled by the trend of globalization” (Xu, 2007, p. 219). In most communities in the U.S., many cultures live and work together. As healthcare providers, we need to be aware, sensitive and respectful of each other’s beliefs and ways of life. Regardless of what culture or cultures we consider ourselves to belong, we will serve those of other cultures. “Through your lifetime, you will undoubtedly be exposed to and work with individuals from cultures very different from your own. As a leader, it is important to recognize that not every culture shares the same ethical ideals as yours. Different cultures have different rules of conduct, and as a result, leadership behaviors that one culture deem ethical may not be viewed the same way by another culture (Northouse, 2018, p. 286).
Students and nurses can gain perspective and cultural awareness by doing immersive work in other countries. One study which evaluated student nurses’ experiences as they worked outside the U.S. found that “by exposing students to diverse cultures and health system disparities, they begin to understand why migration to the United States is so prevalent. Realizing what immigrants leave behind and how significant the adjustment to U.S. culture is, assists students in developing empathy for others. Exposure to other cultures and service opportunities can create transforming experiences that may lead to greater involvement with disadvantaged persons closer to home” (Wilcox, 2012, p.9). Important to note, learning another culture is an enriching experience and one to be valued. I disagree with the notion that another culture is disadvantaged, we are all equal, although our circumstances may be different. We can all gain insight from each other. It is my opinion that the notion of charity or mission work might lend itself towards perpetuating an elitist mentality if not carefully considered. Cultural learning must be done with an open mind and not one intent on imposing one’s own ideals unto another. While it is certainly lifechanging and incredibly useful to understand and experience the native lands of as many cultures as possible, we can also immerse ourselves in multicultural experiences near our own homes. Both international and local involvement with cultural experiences can open our eyes and improve our capacity to give better care to our patients.
As a women’s health nurse practitioner, cultural awareness is vital. How a woman envisions her life, her health, her relationships, her roles within the family and/or community, are all influenced by culture. In order to be a responsible care provider, I will need to understand a woman’s values and goals in order to assist her in attaining them. These are, for some women, very private issues and for them to be honest and forthcoming, they will need to feel safe, heard and respected by their care provider. References
Northouse, P. G. (2018). Introduction to leadership concepts and practice (4th ed.). Thousand Oaks, CA: SAGE.
Wilcox, J. (2012). Lived Experiences of Nursing Students Engaged in an International Service Learning Project. Online Journal of Cultural Competence in Nursing and Healthcare, 2(3), 1-10. doi:10.9730/ojccnh.org/v2n3a1
Xu, Y. (2007). Making a Case for Cultural Competence in Nursing. Home Health Care Management & Practice, 19(3), 219-221. doi:10.1177/108482230296813
Week 6 Discussion Initial Post.docx
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Clarisse Rua - Wednesday, 12 June 2019, 11:26 PM
The first step to cultural competence is acknowledging that we are surrounded by diversity not only at work but also in our everyday lives. In healthcare, we come across many different types of patients and beliefs. It is important that we understand and recognize this. There are many components to cultural competence including customs and traditions, language, age, generation, gender, sexual preference/orientation, religious and cultural beliefs among other characteristics. “There is never an endpoint in cultural competency. The rich and growing diversity of our society makes it impossible to be an expert in all aspects of all of the groups and subgroups in our nation. Things always change (Jackson, 2002).” We learn and expand our knowledge throughout our career and learn as we go. Full cultural competence will never be achieved because times are always changing, but having a base knowledge and making an effort to understand others values can go a long way in taking care of others.
Something that I also noted is that to understand cultural competence every person has to understand his or her own personal views and opinions. When looking at all the components of cultural competency, we form our own opinions and how we will use this information to take care of others. “The achievement of cultural competence is, as they say, a journey, not a destination, a lofty goal that no one can ever reach. It is a worthy goal, however, and its pursuit is gratifying (Adams, 2013).” As this author stated, it is a journey to learn cultural competence. One grows up with beliefs we were taught by our parents and mold it into our own beliefs as we grow up. Understanding the views of others and being more open-minded can help us learn more about ourselves.
When I start practicing as an FNP I will be more considerate of my patient’s and coworkers practices and beliefs. As of right now, I do work and take care of a diverse population of people in the emergency department. I try to understand their cultural practices and learn each and every day from them. “As health care professionals, we should be committed to practicing cultural competence to ensure the interactions we have with individuals from diverse ethnic and racial backgrounds are culturally appropriate (Barrow, 2012).” If we do not take the time to be culturally competent, we will not be able to take care of our patients in a holistic matter and have positive patient satisfaction. It can also be seen as culturally insensitive not taking the initiative to learn about others beliefs and practices. This is why it is important to consider developing our cultural competence as we meet new people throughout our careers. Patients will appreciate us taking the time to listen and learn more about them.
References:
Adams, T. S. (2013). Cultural Competence-A Personal View. 27(4), 14. Retrieved on June 10, 2019 from http://link.galegroup.com.regiscollege.idm.oclc.org/apps/doc/A329182900/PPNU?u=mlin_m_regis&sid=PPNU&xid=5de0f058
Barrow, S.-K. L. (2012). Diversity and Cultural Competence. 26 (4), 5. Retrieved on June 10, 2019 from http://link.galegroup.com.regiscollege.idm.oclc.org/apps/doc/A286972359/PPNU?u=mlin_m_regis&sid=PPNU&xid=8a5f060e
Jackson, V. H. (2002). Cultural Competency: The Challenges Posed By a Culturally Diverse Society and Steps Toward Meeting Them. 22(2), 20. Retrieved on June 12, 2019 from http://link.galegroup.com.regiscollege.idm.oclc.org/apps/doc/A86127311/PPNU?u=mlin_m_regis&sid=PPNU&xid=fb0895e6
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Valeria Hinojosa - Thursday, 13 June 2019, 5:52 AM
Hi Clarisse,
I enjoyed reading about your reflection on cultural competence and how you will use it to successfully care for your patients as a nurse practitioner. You brought up very good points in discussing that we were all raised with certain visions that were engraved into us in our childhood. As we grew in age and experienced life, these visions and beliefs progressed even more or may have changes based on our personal experiences. In practicing as nurse practitioners we must provide culturally congruent care that is meaningful and fits cultural beliefs and lifeways of our patients and colleagues (Shen, 2014). As leaders in our health organization, we can apply many methods to measure the level of understanding of cultural competence in our staff. One method that could be used is the Cultural Awareness Scale, the responses to this scale would provide areas in which efforts can be made to enhance cultural competency in staff members (McElroy & Smith-Miller, 2016). I agree with your report that cultural competence is an everlasting journey, and because of this we should continue to grow and learn about different types of religions, languages, cultures, sexual preferences and much more. In my current place of work, we are seeing a higher LGTB community and it is situations like these were demonstrating cultural competence is critical. A recent study that aimed at reporting nurses understanding of the LGBT community, depicted that a group of emergency care nurses had no previous LGBT education specific to the needs of the population (Bristol, Kostelec & Macdonald, 2008). The results of this study provided self-awareness and increased knowledge by creating a more open, supportive patient experience for the LGBT community members seeking care at our facility. Overall, I believe you have a pronounced understanding of how to use cultural competence to help you be an effective leader in your team.
References
Bristol, S., Kostelec, T., & Macdonald, R. (2018). Improving Emergency Health Care Worker’s Knowledge, Competency, and Attitudes Toward Lesbian, Gay, Bisexual, and Transgender Patients Through Interdisciplinary Cultural Competency Training. Journal of Emergency Nursing, 44(6), 632-639. Doi:10.1016/j.jen.2018.03.013
McElroy, J., & Smith-Miller, C. (2016). Cultural Awareness Among Nursing Staff at an Academic Medical Center. The Journal of Nursing Administrators, 46, 3rd ser., 146-153.
Shen, Z. (2014). Cultural Competence Models and Cultural Competence Assessment Instruments in Nursing. Journal of Transcultural Nursing,26(3), 308-321. doi:10.1177/1043659614524790
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Kerlange Charles-Alsaindor - Thursday, 13 June 2019, 10:21 AM
Greeting class,
The United States is steadily becoming more racially and ethnically diverse. As the demographics continue to change, cultural awareness in the healthcare setting is an essential tool for nurses, doctors and all involved in providing care. Due to this change in demographics, it is essential that myself, as a healthcare provider, appreciate the influence culture has on health. The necessity for culturally competent health care is an international concern due to the rise in global immigration (Smith, 2018).
Cultural competence will enhance my professional practice since knowledge of an individual’s culture and ethnicity conveys values and beliefs that forms the foundation for much of their behavior, emotion, and lifestyle. Patients hold these views and customs based on cultural standards that incorporate the many facets of health and illness, it is important that all health care providers are able to provide care that recognizes this impact. It is a known fact that people from racially different background experience a higher rate of sickness and disabilities and less access to health care in comparison to the rest of the populace. For example they experience higher rates of infant mortality (black women), coronary heart disease, stroke, diabetes, asthma, cancer, and HIV, to name a few. Nonetheless the reason for these discrepancies are complex, enhancements in cultural proficiency teaching for nurses and other healthcare workers are considered to be amid the most dire and possibly effective interventions necessary to reverse these situations (Loftin, 2013).
Reference
Loftin, C., Hartin, V., Branson, M., & Reyes, H. (2013). Measures of cultural competence in nurses: an integrative review. TheScientificWorldJournal, 2013, 289101. doi:10.1155/2013/289101
Smith, L. S. (2018). A nurse educator’s guide to cultural competence. Nursing made incredibly easy 2018, 16(2), 19-23. doi: 10.1097/01.NME.0000529955.66161.1e
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Re: Week 6 Discussion 1: Cultural Competence and Practice Change
by Roseann Green - Thursday, 13 June 2019, 8:09 PM
Understanding that each patient is a unique person can help nurses effectively interact with patients and has a significant effect on patient outcomes. Nurses need to have the ability to explore patients’ beliefs, values, and needs in order to build effective relationships with them and their families (Carr-Ruffino, 2006). Throughout my twenty-eight years of nursing I have had to care for patients of every race, religion, and nationality. When I initially meet someone of another culture, I always ask questions and try to observe their behaviors so I can care for them accordingly. In the past I felt as if I just needed to ask the question or provide the treatment that needed to be rendered quickly yet safe. I had it in my mind that the person that I was caring for or their family would not be happy with my care because I was not the same culture. The United States is one of the most culturally diverse countries in the world and after researching the topic itself, I realized that this isn’t a quality that myself alone was dealing with, but it was an issue that must be addressed across the nursing profession. In the future I will keep in mind that similarities are shared across the “human culture,” regardless of the differences that exist among individual cultures and groups (Tiedlt, 2015). These include, but are not limited to desire for safety, good health, education and well-being of our children, love and belonging, self-esteem (feeling of worthiness), and the ability to pursue and achieve our potential. I will be more confident in my skills as a practitioner and not feel ashamed or misunderstood if I start an assessment with a cultural questionnaire or assessment of my patient. I am sure that this will not only act as an “icebreaker” for my mentally ill patient, but it will enable me to recognize differences as diversity rather than abnormal behavior or inappropriate responses to the environment, help me respect the benefits of diverse values and behaviors to people and to the organization and allow
acceptance that each culture finds some values more important and some behaviors more desirable than others.
References
Carr-Ruffino N 2006 Managing Diversity: People skills for a multicultural workplaceCarr-Ruffino, N. (2006). Managing Diversity: People skills for a multicultural workplace (7 ed.). Boston: Pearson. 201906132005381168257952
Tiedlt 2015 Multicultural TeachingTiedlt. (2015). Multicultural Teaching. Retrieved June 13, 2019, from http://extension.psu.edu 201906132008041478983522
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