Nurses enter the profession to help others and they make a difference every day. They want the best possible outcome for all their patients, regardless of their race, religion, culture, sex, sexuality or age, and will see all as equal. However, treating patients equally does not mean treating them the same. In fact, the opposite can be true.
Patients are individuals and their own lifestyles, values and beliefs can impact their health and the most effective treatment plans. Using a ‘one size fits all’ approach could have a negative impact on the health of some groups, rendering the treatment very far from equal.
Instead, nurses should be committed to delivering the same high standards of care to all patients and part of that standard involves treating the entire patient, not merely as a set of symptoms. Once you consider the entire patient, including their cultural background, it is possible to see how the condition may manifest and how the treatment plans should be implemented. Through providing culturally sensitive care, nurses can ensure that all patients are truly treated equally.
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Why Is Cultural Competency Important?
We are all human. We all have a skeletal system with a body relying on the same internal organs for respiration and circulation. We all grow in a womb and start life as babies. As a result, many might ask why it is necessary to consider different cultures in the medical process. There are several reasons why it is necessary, which illustrate why cultural competency is important.
While it is true that the human body is generally the same, with the major variation being between male and female, ethnicity can mean there are physiological differences that are more than skin deep. There are some conditions that are more common in some groups. Thalassemia, for example, is more prevalent in those of Mediterranean origin, while sickle cell anemia is more likely to be seen in patients whose ethnic origin is sub-Saharan African. Knowing the ethnic background of the patient can aid in the swift diagnosis of the patient as these conditions might be considered more quickly in the relevant ethnic groups rather than if the patient’s ethnic background was, for example, East Asian.
Beyond the physical differences, there are other reasons why culture is important. It can have significant implications on how patients describe their symptoms, how the patient should be approached and the most effective care plan.
Establishing Cultural Sensitivity In The Workplace
With the vast array of different cultures in the world, fully understanding all of them would be impossible. However, by establishing a culturally sensitive workplace, it is possible to successfully treat patients from all cultures. As the medical professionals who are often the ones who provide the greatest continuity of care to patients, nurses at all levels are ideally placed to learn about the culture of their patients and use that information when creating treatment plans or in informing other medical staff of the implications.
Nurses in management positions can implement policies for their nursing staff and wards as to how to effectively treat those from a different cultural background. These can include how patient information is taken and what questions need to be asked upon admission. If you work in an area where a large number of patients come from a particular cultural group, it is worthwhile recruiting from there whenever possible, as having a member of staff who has a full understanding of the culture can be invaluable. Unfortunately, at present, the medical profession is not as diverse as the population and any steps to change that will be beneficial for everyone.
If a nurse leader career is something that interests you, then it is a good idea to explore your training options. After qualifying, new nurses generally work for at least a few years as registered nurses (RNs). After obtaining this experience, they may consider their options for further qualifications to help them advance their career.
There are many post-graduate nursing degree options, including master’s and doctoral degrees. A doctoral degree such as a DNP is particularly valuable for those wanting to reach the pinnacle of their career as an advanced practice nurse and innovative leader. Courses can be studied in person at universities across the country, but many will find an online course is more practical and reaches the same high standards. Many reputable institutions offer an accredited online Post-Master’s DNP program, such as the University of Indianapolis. This course equips students with advanced skills, including skills in policy, leadership and advocacy, to prepare them to deliver the best possible health outcomes for their patients. Once qualified, these nurse leaders can help ensure that their workplace has all the necessary knowledge to support the delivery of culturally sensitive care.
Language Barrier
A significant hindrance to accessing healthcare in a diverse society can be caused by a language barrier. Even when treated in your first language, medical terminology can often seem like a different language. If English is not your first language, understanding it can be even harder. Bilingual patients may be proficient in both languages in their daily lives, but when stressed by the need for medical treatment, they may revert to their first language.
Being unable to fully understand adds more stress to an already stressful situation for the patient and their family. It can also mean that medical advice or a treatment plan for managing a chronic health condition is not fully understood and therefore not properly implemented, rendering it less effective. The language barrier may also mean that patients feel less confident in accessing healthcare in the first place, particularly if they feel they will not be able to properly describe their symptoms.
Determining a patient’s first language should be part of the information nurses take when a patient is registered with a practice or admitted to a hospital. It may be possible to assign them a nurse who speaks the same language or a translator. At the very least, all medical staff should be aware of the possible language barrier and be willing to explain treatment plans and diagnosis several times if necessary. Taking the time to explain slowly can also be beneficial, giving the patient time to first translate the information and then fully understand it, and even look up terms if necessary. It may also mean timing discussions with the patient for a time when a friend or family member can be present to translate.
Written information on the management of chronic conditions or other health advice to be given to the patient on discharge can be translated into their first language to ensure they are fully able to understand the implications. Information provided through community health initiatives such as leaflets or websites should also consider the language that the person reading it will best understand. Translating materials into the languages commonly spoken in the community will help spread the message and give patients of all cultures the best possible chance to implement healthy changes.
Diet
Food plays a part in many cultures, whether it is particular dishes eaten for a specific occasion or foods that are forbidden in that culture. Food is also important for health, with a healthy diet making a patient less likely to develop health conditions. Additionally, diets can play a part in the management of some chronic conditions such as diabetes, Crohn’s disease and ulcerative colitis, as well as aiding in recovery from injury and surgery.
When providing meals in hospital or creating diet plans for patients, nurses need to not only know the health implications of different foods for different conditions, but they also need to consider any cultural restrictions. Someone of the Islamic faith will require halal meals, while for Jewish people the food needs to be kosher. Neither group will eat pork and Hindus will not eat beef, so these different dietary requirements need to be considered by hospital catering. While Muslims do not drink alcohol, this does not mean that alcohol-based medicine cannot be used. However, if there is a non-alcoholic alternative, that should be offered first.
Religion is not the only reason that food may be forbidden. Many people today opt for a vegetarian or vegan diet for environmental and animal welfare reasons. Ethical restrictions should also be considered when creating diet plans. A diet high in protein can help support post-operative recovery and may also be used in the treatment of muscular problems, but suggesting dishes high in fish, meat, eggs or dairy will not be helpful for a vegan.
If patients receive the correct dietary information for their condition that will suit their cultural diet, the health outcomes will be better.
Sensitivity to Beliefs
As a nurse, you will have your own belief system and the beliefs of others may seem peculiar or even wrong. However, it is not the place of nurses to try to change the beliefs of others. Instead, you should try to make reasonable adjustments to accommodate their beliefs. For instance, in some cultures, there is a tradition of deferring decisions to the eldest male of the family. If this is the case, then do not press a female patient to make decisions but instead provide the opportunity for her to discuss her condition and options with her father or husband.
Patients who feel their beliefs will not be respected will be less likely to seek medical help, which can make a condition harder to treat. It will also increase distrust between the patient and medical professionals. By showing respect for other’s beliefs, you can increase the accessibility of healthcare.
Avoid Assumptions
Assumptions about culture are often drawn from stereotypes, which may be offensive to the patient. You cannot assume you know where a patient comes from simply based on their looks. Even if you are sure of a patient’s ethnic origin, it does not mean you can make assumptions regarding their culture. Someone whose ethnic origin is the Indian sub-continent might be a Muslim, Hindu or Sikh. There is an equal chance they might be a Christian or have no religion at all. Even within one religion there are differences, as some follow it more strictly than others. The key to this is in talking to the patient instead of assuming a particular diet or belief based on their appearance.
You should also be careful about applying cultural responsibility. For example, you may notice that a large number of black patients in your hospital have a dietary deficiency. However, this does not mean that there is definitely an issue in the diets common to their culture. Poverty is a major cause of ill health and a black patient is statistically more likely to live in poverty than a white patient. The poor diet is more likely to be due to poverty than a cultural tradition.
Improving Cultural Competency
The key to improving cultural competency on both an individual level and across the workplace is to listen. Through gathering information from patients and in conversation, you can learn what is important in their culture and understand the implications for healthcare. You can also learn about different cultures from your colleagues. Nursing is always a life-long learning journey and learning about other cultures is part of that.
We all need healthcare at different points in our lives, and it can help bring us together. By providing culturally sensitive and respectful treatment, nurses can help establish trust in a diverse community, which will encourage everyone in that community to be more willing to seek medical advice.
Language and cultural differences can act as barriers to healthcare, but through respect and patience, these can be overcome. Practical measures such as translators also play a part in removing barriers. If in doubt about any of the cultural implications of a treatment, just ask. Patients and their families will usually be glad to provide the information and happy to know that they will be respected. By offering culturally sensitive medical treatment, nurses at all levels can help improve patient care for everyone.
