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POST 1- Anthony posted:

The American Association of Colleges of Nursing (AACN) (2008) defines culture as “a learned, patterned behavioral response acquired over time that includes implicit versus explicit beliefs, attitudes, values, customs, norms, taboos, arts, and life ways accepted by a community of individuals”. As nursing is a profession of caring for others, we must recognize that a patient’s health status is going to be affected in many parts by the patient’s culture. For a nurse to be considered culturally competent, they must adopt attitudes, understanding, and skill sets to allow them to care for members of a given culture (AACN, 2008).

To begin working on gaining cultural competence, nurses need to examine their own culture, and how it influences their lives and health. What are attitudes of those in their community. Most nurses have a basic trust in the health care system, and this trust is a part of our nursing culture. We have customs of pinning ceremonies at nursing school graduations. Our values and attitudes reflect our caring and compassionate approach to providing care for others. Much of what we have learned and adopted as our own is a result of the culture of nurses we have worked with.

Nurses can compare their own culture to that of individuals. Does the patient’s culture have a basic mistrust in the healthcare system? What factors have contributed to this? How will this be a barrier to the patient meeting their desired goals and outcomes… and most importantly, how can we overcome or reduce the barriers?

Recently, I have returned into unit-based hospice care after spending a few years providing hospice care in homes. I have noticed a few of my peers lack the cultural competence for many patients and their families that have been trying to maintain care at home. Many of my peers have the attitude that if a patient cannot take care of themselves, and the caregivers are unable to provide the type of care they expect as an ‘acceptable’ level, then some of my peers feel the patient would be better cared for in a long-term care facility. This view is especially present in situations where the individual patient would have benefited from skilled nursing care but has been refusing it; and families are unable to convince them to accept the help. My peers in this example lacked the ability to understand care might be tailored to best fit the needs and wishes of the individual and their caregivers.

 Reference

American Association of Colleges of Nursing. (2008). Toolkit of resources for cultural competent education for baccalaureate nurses. AACN. https://www.aacnnursing.org/Portals/42/AcademicNursing/CurriculumGuidelines/Cultural-Competency-Bacc-Tool-Kit.pdf

POST-2 Sandra Posted:

Cultural competence in nursing is so important in caring for our patients. There are skills involved with nursing, not just theory, knowledge, assessment, and care, but to be culturally competent is an addition I believe has been talked about more often lately. Many hospitals require cultural diversity or cultural competency classes that are mandatory for all staff, not just nurses to attend.

What makes a culturally competent nurse…respectful understanding for a patient’s beliefs, values, and expectations, your own awareness, values, assumptions, and values of the medical system, and finally the ability to adapt patient care to fit their expectations and preferences. Several steps to cultural awareness include, being aware of your own cultural biases and becoming more sensitive to the differences within your cultures. The next step is to gain knowledge of other cultures . The last step would be to apply the knowledge that you have learned to your everyday practice (Galanti, 2005).

There is one instance that stands out for me that had occurred about 12 years ago while I was working in Charlotte, NC. I was caring for a patient that had end stage lung cancer. They had been receiving radiation and chemotherapy for some time, but the treatment had not been effective, and the patient had significant disease progression. The patient was admitted with intractable pain and while caring for this patient, we were to instructed to call them by their chosen female name. This patient was born a male and was in the middle of her transition to becoming a female when she was admitted. Some nurses on our unit found it difficult to care for her. They had done their job and didn’t hold back care because of her personal preference, but I know it was difficult for some. Michele had passed away alone in her hospital bed and I can remember feeling hopeless for her, hopeless for her family that chose not to be there with her and how lonely she must have felt. I assisted with post-mortem care with the nursing assistant and can remember how strange it was because she was in transition and had not fully become a female. The nursing assistant and I did discuss our feelings afterwards and both of us felt the same. It was more sadness than anything else. It wasn’t judgement, it wasn’t shock, it was a genuine feeling of despondency.

Achieving cultural competence starts from changing your own attitude. Seeing a patients’ culture as an obstacle can be turned around to see it as making your job more interesting and will make you and your patients; happier in the long run.

Reference

Galanti, G.-A. (2005). Culturally competent rehabilitation nursing. Rehabilitation Nursing, 30(4), 123–126. https://doi.org/10.1002/j.2048-7940.2005.tb00093.x