Discuss about the Cultural Competence in Nursing for Responsibilities.
Nursing is a profession that is nobler than any other profession in the world, as it allows one to provide compassionate care to the sick so that they can attain recovery as easily and smoothly as possible. It is a professional that demands extreme physical investment equal to the emotional investment to the work that a professional nurse is doing. The profession of nursing had never received the recognition it deserved for the extremity of responsibilities it carries within the nursing workforce until very recently and the health care industry is beginning to understand the importance of the nursing workforce at large (Suurmond et al., 2010). It has to be understood that the health care in a domain where the wellbeing of the patients is the ultimate outcome and their health and well being is intricately linked with the emotional contentment of the patients and it is only possible if there the patients are allowed to voice their grievances and communicate their woes to any of the health care team (Shen, 2015). This is another extremely important albeit additional job responsibility of the nurses, the patients are more connected with eth nursing staff as they spend the majority of their time being cared for and assisted by the nurses. Hence the importance for a effective communication and compassion in the nursing workforce is paramount and that is what magnifies the importance of the nursing workforce in the health care domain (Kardong-Edgren et al., 2010).
However, it must not escape notice that, the along with indispensability, the nursing workforce is associated with many challenges as well. As mentioned above, the responsibilities of a nurse does not end in planning and implementing the care plan for the patient, educating the patient about the severity of his health related situation and communicating with the patient is also one of the most pivotal steps for being a holistic nurse (Loftin et al., 2013). One of the biggest challenges of the nursing workforce in the way of generating a mutually respectful relationship with the patients and their families is the cultural differences in between. The differences in beliefs, thoughts and most importantly the language creates a massive communication gap in between the nursing workforce and the patients (Williamson & Harrison, 2010). Hence the need for cultural competency in the nursing profession has become existential for the nurses. This essay will critically evaluate the emerging need for cultural competence in the nursing profession, and all the barriers culturally safe health care delivery and how to overcome them taking the example of the aboriginal population of the Torres Strait Island population.
One of major health care concerns that have emerged in the last decade is the health disparity that is engulfing the health care sector in steady pace. The only way to ensure that health care services are circulated among all sectors of the society equally and unequivocally is enforcing a culturally competent health care (Waite & Calamaro, 2010). Culture is nothing but the amalgamation of the thoughts, views, beliefs, customs, actions and communications that links one person to a particular race, ethnicity, religion or social groups. Every individual is linked to a particular cultural background and adheres to the norms and traditions of that particular culture, and cultural competence is nothing but safeguarding the cultural beliefs and principles of that particular individual. Cultural competence in the context of health care refers to assuring that the components of the treatment plan, regardless of how insignificant it may seem, will not force the patient to participate in any action that has the potential to violate the cultural beliefs and tradition of the patient. For the nursing workforce, cultural competence is acquiring skills, behaviours and attitudes that facilitates cross cultural health care practices (Waite & Calamaro, 2010).
The health care industry has transformed completely in the last few decades and in the tenure for the entire transformation, the nursing care has been a dynamically yet consistently evolving entity. The change that has been brought forward in the society in terms of diversity and inclusion requires taking the nursing workforce to incorporate equality, diversity and inclusion completely in their professional attributes. The need for cultural competence integrated into the very core of health care has been emerging steadily for a long time and now it has finally attracted the eye of the health care authorities by minuscule lengths. There have been a number of different definitions put forth about the cultural competence and uts reaction to the health care (Jirwe, Gerrish & Emami, 2010). According to the Transcultural health care, a book by renowned health and wellbeing expert Larry Purnell, cultural competency has been defined as the care practice that accepts and respects the cultural difference between different patients of a particular diversity group, along with adapting to different care techniques that are congruent to the cultural needs and norms of the particular patient (Purnell, 2012). Therefore, regardless of different definitions, the cultural competence in the context of health care refers to the capability in the nurses to be able to design a care plan that does not include any elements that has the potential to threaten the religious beliefs of that individual (Amerson, 2010).
There are different components of culturally competent care, and each component holds paramount importance in contrasting a culturally safe health care practice for the huge diversity of patients that the health care sector now caters to. The very first element or the very first step towards attaining the culturally competent health care practices is generating cultural awareness. It is a process of self assessment and self exploration of the elements of a particular nurse’s own culture and the culture the nursing professional works in. This is process where a nursing professional evaluates and explores the cultural beliefs and norms of the cultural background one works in and compare them to his or her own cultural understanding in order to generate a care practice that acknowledges the needs of the patients belonging to different cultural backgrounds (Douglas et al., 2011). For instance, if a particular nursing individual is practicing in a demographic where the majority of the residents are Asian, the first step for the nurse would be to generate awareness about the Asian culture and how the caring techniques can be modified to include Asian cultural beliefs for the contentment of the patients. The next step or component is extremely dependent on the previous step, this step in cultural knowledge, this is where a nursing professional working within a culturally diverse target population gathers as much as he or she can about the different ethnic and racial backgrounds he or she caters to. The third component to culturally competent health care services is concerned with acquiring cultural skills, that will allow the nurse to discover the health care related concerns of the patients in a culturally acceptable manner (Campinha-Bacote, 2011). It has to be mentioned in this context that physical assessment is a mandate in case of most of the prognosis or nursing investigation procedures, however there are different ethnic communities or religious backgrounds where physical assessment is strictly prohibited. In such cases the nursing professional will have to resort to techniques where the nurses will have to utilize culturally safe assessment tools and frameworks to ensure that the patients’ cultural norms are neither being violated nor are the health care outcomes are being compromised. The fourth component of cultural competency in health care is cultural encounter, which is more of a strategy to enforce culturally safe care within the nursing context. In this element the nursing individual is encouraged to engage in direct communication with the patients about his or her cultural background and components that need to be incorporated within the treatment plan. The last step or component in the cultural competence in the context of nursing is the cultural desire, the only component that allows the nursing individuals to explore about different cultural backgrounds further going out of the way in order to enrich the cultural knowledge so that he or she can serve the patients better (Giger, 2016).
Health care is a professional domain that demands the science behind everything and cultural competence has a strong relevance to back its extreme importance. The patient population is diversifying every day and taking the example of the United States of America, the ethnic population represents 37%, which is roughly the one third of the entire population of the united states of America and with the influx escalating every day authors have stated the percentage to increase to more than 50% in the coming two decades. Now taking Australia as an example demographic, almost 30% of the entire population is represented by the ethnic communities. Hence, when the nursing workforce has to cater to a population so diverse, the need for cultural competence is paramount (Hockenberry & Wilson, 2014). There are many instances where a great challenge is presented for the nursing staff to deliver optimal health care delivery when the patient is neither able to communicate their preferences and grievances, nor are able to understand anything the nursing professional might be conveying to them.
Considering the Australian population for example, a vast majority of the Australian aboriginals belonging to the Torres Strait island community are devoid of the access to proper health care facilities due to the health care disparities and barriers put forth because of the cultural differences (Long, 2012). One of the major barriers or challenges put forth by the cultural difference in the Australian context is the language barrier, the aboriginals are not able to communicate their health problems to the health care staff as no one is familiar with the native dialect, with a culturally competent care practice in place, nursing workforce with interpreters or cultural competence officers who are familiar with the dialect can easily overcome this barrier so that optimal health care can be made available to them. On a similar note, health illiteracy is one of the major reasons behind the low life expectancy of the indigenous populations (Jeffreys, 1015). These minority groups are often not even aware of the health benefits and schemes they are eligible to sue free of cost under the government sponsored schemes, like vaccination, maternity care, child care, aged care acute care and what not, the lack of communication can be easily overcome by enforcing culturally competent nursing care.
According to different empirical studies done on the patients satisfaction in the aboriginal or ethnic population of Australia, more than 50% of the individuals denied taking the assistance of health care facility because they felt the health care facilities did not respect their cultural beliefs and taking the assistance of the health care facilities will put their cultural believes and traditions into risk (Purnell, 2012). Different authors have investigated the cultural awareness of the nursing workforce of the Australian health care sector has revealed an alarming lack of knowledge regarding the cultural diversity in the nursing workforce, hence it can be stated that the aboriginals are not completely flawed in fearing their cultural and religious beliefs before availing the health care facilities. However the need for health equality cannot be over looked hence, just taking into consideration the cultural competence can ensure equal distribution of health care benefits to the minority or ethnic groups of the society as well (Purnell, 2012).
In nursing profession, attaining the cultural competency requires strong verbal and non-verbal skills. However, some pitfalls are to be avoided to achieve cultural competency. It is not beneficial to make judgment about other nurses and seniors in the workplace. Questions related to cultural practice can be asked in professional manner. Nurses should be more thoughtful. cultural competency. Firstly, stereotyping should be completely avoided. Patients from various ethnic or cultural group visit in the hospital. Nurses should not have a generalised concepts about the outward experience, religious preference, race, country of origin and others (Spencer et al., 2015). According to Varcoe et al. (2015) stereotyping only restricts an individual to oversimplified conception or opinion about an individual or to focus on one aspect ignoring other important aspects of that person. It is necessary to respect the various subcultures, and beliefs of ethnic groups. One may be highly mistaken to think that people belonging to Asian-American culture would all be same. Instead it comprise of Taiwanese, chinese, Japanese, Korean, Vietnamese and Filipino. Further, in these cultures, geographic, religion, language variation exists. Similarly, the Aboriginal and the Torres Strait Islanders in Australia may have different spiritual, religious and health beliefs. They should not be communicated based on the presumption that they are all like (Hart & Mareno, 2014). Secondly, the nurses should not engage in labelling patients. The patients are already in dilemma and anxiety about the diagnostic and the therapeutic encounters. The fear of labelling may prevent the patients to share about the past home remedies used for illness, herbal therapies, and other religious efforts. Nurses should be able to assist the care users in performing these activities instead of disdaining. However, any negative outcomes must be communicated in very subtle manner (Baker & Beagan, 2014). In conclusion, the nurses can be in ideal position to interconnect between patient culture, language, and health literacy. It will improve the health outcomes.
The health care workforce is at cross roads and with the population of the major nations diversifying more and more every day, the day is not far where the ethnic communities will dominate the population at large. And if the health care workforce is not able to change their ways adapting techniques to cater to the differential needs of the dynamic patient population the health care industry will be facing a challenge that can potentially threaten the very foundation that the health care industry is based on. Health care equality is a fundamental right, and health care facilities should be available to each and every sector of the society without any disparity. However in case of the ethnic communities the accessibility of the health care facilities are restricted because of the gaping lack of culturally safe health care practices.
It has to be understood that the recovery of a patient depends heavily upon the emotional contentment of the patient. There is a distinct relationship between a patient’s culture and his or her health and if the health care facility does not integrate the cultural beliefs and traditions with the treatment procedure then the caring procedure will inevitably be disrupted. Hence the health care facilities must incorporate the frameworks and models for integrating cultural competence within the practice standards, so that ethnic individuals do not shy away from availing health care benefits just with the fear of their cultural beliefs being violated. However, this cannot be achieved with just frameworks and policies, there is need for conscious effort and respect in the nursing professionals for different cultures and a little cooperation from the ethnic communities to help the health care workforce can cater to their unique needs with better understanding about their culture and traditions.
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