Summary: Cultural Competence In Nursing
Kendra K. Collins
Cultural Competence in Nursing Care
Jo Anne Long Walker, Instructor
SOC 5820: Mgmt. & Admin. in Older Adult Settings
February 16, 2015
Cultural Competence in Nursing Care
The numbers of minorities in the United States has significantly increased within the last decade. More specifically, older adults ages 65 and older also are becoming more culturally diverse. Expectedly, these changes in the population changes are also affecting the composition of facilities that care for older adults with functional limitations. Due to the fast growing number of minorities, nursing staff should begin to implement cultural competence to specifically meet the needs of their older patients. According to McBride, cultural competence …show more content…
is the when health care professionals have the ability to deliver health care in ways that are acceptable and useful to older adults because it is consistent with their cultural background and expectations (2012). The crucial need to provide patients with culturally competent care was recognized by The American Nurses Association (ANA). ANA has shown the need of cultural competent care by stating in the association’s code that “nurses, in all professional relationships, should practice with compassion and respect for the inherent dignity, worth, and uniqueness of every individual.” Communication across cultural differences is the key to nurses providing adequate care in our increasingly diverse society.
In this article, I first will discuss why cultural competence in nursing care is important. I will then conduct a brief review of the cultural competence nursing literature, followed by an example of practicing cultural competence in nursing, a discussion of the model designed to assist nurses in providing cultural competent care, ways healthcare professionals can implement cultural competency, and pitfalls of providing cultural competent care.
Cultural Competence in Nursing: Why it’s Important
As mentioned in the introduction, being culturally competent in the nursing field is important, and there are several reasons why this type of care is important. When a nurse is knowledgeable about the patient’s and family’s expectations, traditions, values, norms, and lifestyle they are often able to provide care plans that are more effective at the beginning of service. Murphy (2011) asserts that practicing with cultural competency is important- because culture influences not only affect how nursing staff provide care, but also how illness is perceived by older patients. An additional importance of providing cultural competent care in the article is knowing the patient’s ethnicity, which can offer genetic information that is commonly shared by people of the same ancestry. For example, knowing how a disease will manifestation and how certain prescription medications will effect different cultural groups. Additionally, Murphy (2011) discusses how it is important to address attitudes to develop into a culturally competent caregiver. Being mindful of how individual’s behaviors and thinking are influenced by their culture allows nursing staff best meet the need of patients. Being knowledgeable of specific ethnic group’s rules communication patterns, family roles, rules of interaction, and spirituality will allow nursing staff to understand patient attitudes. Furthermore, Murphy (2011) notes that when nursing staff become “aware of their own attitudes and tendencies to stereotype with regard to different cultural groups allows you to provide genuine care and concern (2011).” Lastly, another importance is mentioned in the article Caring for Minority Ethnic Older People in Nursing Care Homes. Authors Mold, Fitzpatrick, and Roberts (2005) suggest facilities are unable to meet the range of language, cultural, and religious needs of the population which creates problems in delivering the best quality care to ethnic elders.
Experiences in Cultural Competence
Natalie Nieves, a case manager for VNA Health Care expresses her belief in the need for nurses of all backgrounds, sharing, "minorities can be majorities in the inner cities," she says. "Being bilingual is a plus in my field. Patients trust you a lot more, and they confide in you a lot more." An example of the need for cultural competent nursing is when emergency room nurse Deborah Flowers revealed her experience regarding cultural competent practice. Flowers (2004) shares that an elderly Native American man was brought into the emergency room by family and during his stay, he informed the healthcare professionals that, besides than coming to the hospital, he wanted to follow the traditional way of dying, adding he “made peace with God and was ready to die.” Toward his final days, his family was unable to be present and to continue to communicate his wants and needs. When he was approaching death, his wishes were ignored and the healthcare professionals provided multiple invasive life prolonging care. After reading Fowlers’ story, I gathered that when professionals lack cultural awareness and fail to provide culturally competent care it can add to the stress experienced by the patients and their loved ones.
A Model for Cultural Competence in Nursing
There is a model that guides healthcare professionals in providing culture competent care. The model was developed in 1991 by Josepha Campinha-Bacote. The model requires nurses to not only about be cultural competent, but should be involved in the process of becoming culturally competent. The model of cultural competence consists of five components, which include cultural awareness, cultural knowledge, cultural skill, cultural encounters and cultural desire. Campinha-Bacote (1991) shares which each of the five components consist stating:
Cultural awareness, involves self-examination and in-depth exploration of one’s own cultural and professional background. The second component is cultural knowledge, which is the process of obtaining information regarding different cultural and ethnic groups. The third component is cultural skill, which is the ability of a nurse to collecting information relevant to the patient’s cultural that affects the patient’s presenting problem as well as accurately perform a culturally specific physical assessment. The fourth component, cultural encounter, involves the process that encourages nurses to participate in cross-cultural interactions with patients from diverse backgrounds. The fifth component, cultural desire, refers to the motivation a nurse has to become culturally competent.
When nurses implement the outlined in the model in their care, it will allow them to provide patient-centered care.
Implementation of Culturally Competent Nursing
Facilities can provide nurses with tools to assist in providing cultural care.
In 2003, The National Center for Cultural Competence (NCCC) has provided a checklist provides guidance for ways to implement cultural competent care by nurses. One of the ways implement cultural care included in the list are for facilities to create a cultural competence task force, organization, committee, or work group. The NCCC stated that the group should be responsible for “policy making, administration, practice/service delivery and consumer levels and reflect the diversity within the organization and the community at large.” Additionally, determine the racially, ethnically, culturally and linguistically diverse groups within your geographic location served by the facility. Furthermore, determine which health disparities affect the population that are served by the facility. Next, it suggested to complete self-assessments, network and dialogue with other organizations, and seek resources from federally and privately funded assistance …show more content…
centers.
Pitfalls of Culturally Competent Nursing
While providing nursing care with cultural competence is an important key to providing appropriate care, there are pitfalls of providing such care evident in the nursing field. Although nurses and other healthcare professionals consist of racial or ethnic diversity, the diversity may create breakdowns in feedback and communication, creating jobs that are less satisfying. Workers who are unsatisfied make it more difficult for facilities to retain adequate workers. Additionally, facilities with a diverse group of nurses have been found to be both effective and less effective than those without a diverse group of nurses. This suggests that well-managed team diversity can be an asset to performance, but unmanaged diversity tends to detract (Cox & Blake, 1991). Another common pitfall of nurses becoming culturally competent is unintentionally grouping and stereotyping patients into a specific ethnic or culture group. Flowers (2004) declares that this stereotyping occurs “…on the basis of characteristics such as outward appearance, race, country of origin, or stated religious preference.” Additionally, nurses also unintentionally and incorrectly label patients. For example, United States citizens refer to themselves as Americans, but this is also a term South and Central Americans use to also label each other. Flowers (2004) indicates a more accurate way nurses can refer to an individual from the United States would be US citizen. Lastly, nurses must determine the level of assimilation or acculturation to the American society a patient belonging to other cultural and ethnic group has achieved.
Conclusion
After discussing and reviewing why cultural care is important, cultural competent nursing care experiences, and a literature review, it shows that with the increasing cultural diversity in the United States, it is necessary that nurses have the ability to deliver nursing care to older adults that will allow effective interactions to individuals from diverse backgrounds.
Furthermore, this paper includes ways for implementation and common pitfalls to be avoided in order to provide culturally competent nursing in older adults in long-term care and other settings.
References
Cox, T., & Blake, S. (1991). Managing cultural diversity: Implications for organizational competitiveness. Executive, 5(3), 45-56.
Flowers, D. (2004). Culturally Competent Nursing Care A Challenge for the 21st Century. Critical Care Nurse, 24(4), 87-87. Retrieved February 10, 2015, from http://ccn.aacnjournals.org/content/24/4.toc
Mayer, G., & Villaire, M. (2007). Health literacy in primary care: A clinician 's guide. New York: Springer Pub.
Parker, V. (2011). The Importance of Cultural Competence in Caring for and Working in a Diverse America. Journal of the American Society on Aging, 34(4), 102-102. Retrieved February 14, 2015, from EBSCOhost.
Planning, Implementing and Evaluating Culturally Competent Service Delivery Systems in Primary Health Care Settings. (2007, January 1). Retrieved February 15, 2015, from
http://nccc.georgetown.edu/documents/Getting_Started.html
Cultural Competence in Nursing Care
Jo Anne Long Walker, Instructor
SOC 5820: Mgmt. & Admin. in Older Adult Settings
February 16, 2015
Cultural Competence in Nursing Care
The numbers of minorities in the United States has significantly increased within the last decade. More specifically, older adults ages 65 and older also are becoming more culturally diverse. Expectedly, these changes in the population changes are also affecting the composition of facilities that care for older adults with functional limitations. Due to the fast growing number of minorities, nursing staff should begin to implement cultural competence to specifically meet the needs of their older patients. According to McBride, cultural competence …show more content…
is the when health care professionals have the ability to deliver health care in ways that are acceptable and useful to older adults because it is consistent with their cultural background and expectations (2012). The crucial need to provide patients with culturally competent care was recognized by The American Nurses Association (ANA). ANA has shown the need of cultural competent care by stating in the association’s code that “nurses, in all professional relationships, should practice with compassion and respect for the inherent dignity, worth, and uniqueness of every individual.” Communication across cultural differences is the key to nurses providing adequate care in our increasingly diverse society.
In this article, I first will discuss why cultural competence in nursing care is important. I will then conduct a brief review of the cultural competence nursing literature, followed by an example of practicing cultural competence in nursing, a discussion of the model designed to assist nurses in providing cultural competent care, ways healthcare professionals can implement cultural competency, and pitfalls of providing cultural competent care.
Cultural Competence in Nursing: Why it’s Important
As mentioned in the introduction, being culturally competent in the nursing field is important, and there are several reasons why this type of care is important. When a nurse is knowledgeable about the patient’s and family’s expectations, traditions, values, norms, and lifestyle they are often able to provide care plans that are more effective at the beginning of service. Murphy (2011) asserts that practicing with cultural competency is important- because culture influences not only affect how nursing staff provide care, but also how illness is perceived by older patients. An additional importance of providing cultural competent care in the article is knowing the patient’s ethnicity, which can offer genetic information that is commonly shared by people of the same ancestry. For example, knowing how a disease will manifestation and how certain prescription medications will effect different cultural groups. Additionally, Murphy (2011) discusses how it is important to address attitudes to develop into a culturally competent caregiver. Being mindful of how individual’s behaviors and thinking are influenced by their culture allows nursing staff best meet the need of patients. Being knowledgeable of specific ethnic group’s rules communication patterns, family roles, rules of interaction, and spirituality will allow nursing staff to understand patient attitudes. Furthermore, Murphy (2011) notes that when nursing staff become “aware of their own attitudes and tendencies to stereotype with regard to different cultural groups allows you to provide genuine care and concern (2011).” Lastly, another importance is mentioned in the article Caring for Minority Ethnic Older People in Nursing Care Homes. Authors Mold, Fitzpatrick, and Roberts (2005) suggest facilities are unable to meet the range of language, cultural, and religious needs of the population which creates problems in delivering the best quality care to ethnic elders.
Experiences in Cultural Competence
Natalie Nieves, a case manager for VNA Health Care expresses her belief in the need for nurses of all backgrounds, sharing, "minorities can be majorities in the inner cities," she says. "Being bilingual is a plus in my field. Patients trust you a lot more, and they confide in you a lot more." An example of the need for cultural competent nursing is when emergency room nurse Deborah Flowers revealed her experience regarding cultural competent practice. Flowers (2004) shares that an elderly Native American man was brought into the emergency room by family and during his stay, he informed the healthcare professionals that, besides than coming to the hospital, he wanted to follow the traditional way of dying, adding he “made peace with God and was ready to die.” Toward his final days, his family was unable to be present and to continue to communicate his wants and needs. When he was approaching death, his wishes were ignored and the healthcare professionals provided multiple invasive life prolonging care. After reading Fowlers’ story, I gathered that when professionals lack cultural awareness and fail to provide culturally competent care it can add to the stress experienced by the patients and their loved ones.
A Model for Cultural Competence in Nursing
There is a model that guides healthcare professionals in providing culture competent care. The model was developed in 1991 by Josepha Campinha-Bacote. The model requires nurses to not only about be cultural competent, but should be involved in the process of becoming culturally competent. The model of cultural competence consists of five components, which include cultural awareness, cultural knowledge, cultural skill, cultural encounters and cultural desire. Campinha-Bacote (1991) shares which each of the five components consist stating:
Cultural awareness, involves self-examination and in-depth exploration of one’s own cultural and professional background. The second component is cultural knowledge, which is the process of obtaining information regarding different cultural and ethnic groups. The third component is cultural skill, which is the ability of a nurse to collecting information relevant to the patient’s cultural that affects the patient’s presenting problem as well as accurately perform a culturally specific physical assessment. The fourth component, cultural encounter, involves the process that encourages nurses to participate in cross-cultural interactions with patients from diverse backgrounds. The fifth component, cultural desire, refers to the motivation a nurse has to become culturally competent.
When nurses implement the outlined in the model in their care, it will allow them to provide patient-centered care.
Implementation of Culturally Competent Nursing
Facilities can provide nurses with tools to assist in providing cultural care.
In 2003, The National Center for Cultural Competence (NCCC) has provided a checklist provides guidance for ways to implement cultural competent care by nurses. One of the ways implement cultural care included in the list are for facilities to create a cultural competence task force, organization, committee, or work group. The NCCC stated that the group should be responsible for “policy making, administration, practice/service delivery and consumer levels and reflect the diversity within the organization and the community at large.” Additionally, determine the racially, ethnically, culturally and linguistically diverse groups within your geographic location served by the facility. Furthermore, determine which health disparities affect the population that are served by the facility. Next, it suggested to complete self-assessments, network and dialogue with other organizations, and seek resources from federally and privately funded assistance …show more content…
centers.
Pitfalls of Culturally Competent Nursing
While providing nursing care with cultural competence is an important key to providing appropriate care, there are pitfalls of providing such care evident in the nursing field. Although nurses and other healthcare professionals consist of racial or ethnic diversity, the diversity may create breakdowns in feedback and communication, creating jobs that are less satisfying. Workers who are unsatisfied make it more difficult for facilities to retain adequate workers. Additionally, facilities with a diverse group of nurses have been found to be both effective and less effective than those without a diverse group of nurses. This suggests that well-managed team diversity can be an asset to performance, but unmanaged diversity tends to detract (Cox & Blake, 1991). Another common pitfall of nurses becoming culturally competent is unintentionally grouping and stereotyping patients into a specific ethnic or culture group. Flowers (2004) declares that this stereotyping occurs “…on the basis of characteristics such as outward appearance, race, country of origin, or stated religious preference.” Additionally, nurses also unintentionally and incorrectly label patients. For example, United States citizens refer to themselves as Americans, but this is also a term South and Central Americans use to also label each other. Flowers (2004) indicates a more accurate way nurses can refer to an individual from the United States would be US citizen. Lastly, nurses must determine the level of assimilation or acculturation to the American society a patient belonging to other cultural and ethnic group has achieved.
Conclusion
After discussing and reviewing why cultural care is important, cultural competent nursing care experiences, and a literature review, it shows that with the increasing cultural diversity in the United States, it is necessary that nurses have the ability to deliver nursing care to older adults that will allow effective interactions to individuals from diverse backgrounds.
Furthermore, this paper includes ways for implementation and common pitfalls to be avoided in order to provide culturally competent nursing in older adults in long-term care and other settings.
References
Cox, T., & Blake, S. (1991). Managing cultural diversity: Implications for organizational competitiveness. Executive, 5(3), 45-56.
Flowers, D. (2004). Culturally Competent Nursing Care A Challenge for the 21st Century. Critical Care Nurse, 24(4), 87-87. Retrieved February 10, 2015, from http://ccn.aacnjournals.org/content/24/4.toc
Mayer, G., & Villaire, M. (2007). Health literacy in primary care: A clinician 's guide. New York: Springer Pub.
Parker, V. (2011). The Importance of Cultural Competence in Caring for and Working in a Diverse America. Journal of the American Society on Aging, 34(4), 102-102. Retrieved February 14, 2015, from EBSCOhost.
Planning, Implementing and Evaluating Culturally Competent Service Delivery Systems in Primary Health Care Settings. (2007, January 1). Retrieved February 15, 2015, from
http://nccc.georgetown.edu/documents/Getting_Started.html