Cultural Diversity Research Paper
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Cultural Diversity in the Nursing Profession
Nurses perform an essential job in a health care environment that serves as a reflection of diversity and cultural complexities of the society we are living. Nurses take care of different clients by their age, sex, education, socioeconomic status, regional locations, sexual life-style, physical and mental disabilities, as well as ethnic and racial backgrounds. In this paper I will investigate the variety of those issues and their involvement in nursing care. This paper describes the important role of the nurse in cultural transactions within the scope of health care, and offers an approach to cultural acceptance that is coming out of the nursing process. May people are migrating all over the world, as well as there are many different existing groups which make emphasis that much more should be done in nurse care regarding patients’ cultural diversities.
Additionally to the main care approach, nurses should introduce the commitment and desire to change. As time goes by, people are learning to practice in a global society. We are living in the world with its mobile and diverse populations; the cultural mix is becoming more intensive. This is specifically challenging to nurses as they are expected to deliver care that involve these differences.
2. Cultural Diversity
During last several decades, literature about nursing care had examined culture as a notion and shaping factor of health behaviors. There are few nursing theories that emerged to explain and address culturally retrieved perspectives and meanings of illness and health behavior. In those theories culture is represented as an essential nursing care aspect. But nevertheless, there are developed guidelines as to their practical implementation and further education. Culture is dynamic issue. It can change gradually, but that change is permanent.
Culture is one of the several things that are essential enough and no one can be left out of it. All people belong at least to one culture; and there are many people that can boast of belonging to more then one. In 2000 Dennis defined culture as the life ways of the particular group of people. It contains attitudes, beliefs, values, rituals, customs, and behaviors. It can vary within the definite group by sex, age, religion, and class. The life ways of a definite group are their transferred changes and memories in those life ways that occur over time. Changes within a culture are ceaseless and are influenced by social environment to the extent to which the group members are change adaptable. For instance, when members of some culture immigrate to other country with the other culture, they often encourage their cultural individuality, but they also take on some new culture attributes. Japanese can enjoy American football and hot dogs and still be diligent in practicing the Shinto religion. On constant basis, change increases in the immigrants’ offspring who arrived to the country in the very early age or were born here.
3. Cultural Change
Nurses should acknowledge the process of gradual cultural change through acculturation or socialization. When culture dynamism is accepted, the description of behaviors or the naming of definite cultural attributes has restricted utility.
A client of any culture can be born, receive education and live their whole life in the other country. And still acculturation degree will most probably differ among them. It will also be different among members of the same group as they can have different backgrounds, including education level, economic status, or even time period they spent in the other country. That list of data regarding different cultural characteristics will acquaint the nurse with wide outlines of a cultural group, but be barely helpful in the process of individual health care. For the simple reason that group members are in the process of constant adaptation and change, the nurse cannot apply just one behavioral pattern to all group members. Factually, in this situation the dependency on the static characteristic can increase the risk of client behavior stereotyping arousal. Stereotypical behaviors are generally being referred to as unchanging, fixed, characteristics that are attributed to all members of a definite culture. Many psychologists now offer a generic view of culture that starts with the individual and spreads to comprehend components of the context in which that individual appears, including family, friends, occupation. For example, some Native Americans avoid eye contact to show their respect to the companion; though, this behavior may not be applicable of all of them. It should be also mentioned that some Native Americans may not practice it. It is impossible and moreover impractical to investigate in cultures through mixture of behaviors, rituals, and beliefs. But the individual, as well as cultural group s/he belongs to should be focused during the health care process.
Nurses should apply pragmatic approach to the culture matter of patients that must be flexible enough to take many scenarios into account. The first step is understanding diversity concept. In this context, diversity is an undividable concept that involves not just ethnic groups and color people, but also other marginal people in society. These groups are involved for the reason that they experience discrimination on the ground of their lifestyle choices, for example, sexual preference, or socioeconomic status. There are few theoretical models for cultural assessment. Leininger (1990), Campinha-Bacote (1996) and Giger and Davidhizer (1995) developed three of the most frequently utilized models. The Leininger model is the demonstrative systems approach to assesing cultural understanding. The author defines cultural content categories as legal, educational, kinship, political, economic, philosophical, religious, and technological. Giger and Davidhizer suggest that nursing review the following factors in their cultural assessment: time; space; communication; environmental control; biologic variations; and social organization. The Campinha-Bacote model evaluates cultural knowledge, cultural skill, cultural awareness, and cultural contacts as cultural competence components in delivery of nursing care. Literature regarding the issue also proposes many information collection tools that were developed to construct clients profile from other cultures and to identify how associated behavior affects the psychological, biological, and sociological health dimensions. Nevertheless, theoretical models and assessment tools integration into the factual nursing practice is still an evolving process. The most common speculation is that there is a convergence point where people enjoy being the same before differences cause deviation. This similarity is predominantly the result of the common need of all people to be treated with respect.
Nurse ability to accept the need of all people to be treated with respect is based on awareness of the intercommunion of three cultures. First, it starts with the personality of the nurse as cultural entity. Each nurse introduces two cultures into the relationship with clients. First, characteristics and qualities of personal culture are main shaping factors of professional and personal behavior. Second, and equally essential is acknowledging that the health care delivery system, which the nurse represents and assists the client and family to reach, is also the unique and separate culture.
Both cultures, the culture of health care system and that of the nurse, must find balance with a third culture- client’s. When even one culture is not carefully taken into consideration there can be obstacles to achievement of productive, positive, and caring relationship of the client and nurse.
Individual philosophy of the person’s life, whether it is consciously introduced or not, is the foundation of his or her behavioral standards. The performance of the nurse is affected by philosophy. Each philosophy introduces values that can be clearly seen through behavior and patterns of thinking. For example, when the nurse is not confident in her life values, it will be apparent in the nursing care delivery. Ineffective care will substitute goal-driven, consistent care. So, the capability to provide sensitive, optimal care demands knowing and owning personal beliefs, feelings, and attitudes and acknowledging their impact.
Nurses take care for the person in total. If nursing care is truly integral, then culture should be an undividable part of the nursing process. Culturally competent care can be achieved when individualized health care involves harmonious and complementary blend of the patient’s attitudes, beliefs and values, with health care practices of the country where s/he is being cared. The process of nursing is the main tool for critical thinking. It promotes decision making and is a systematic, contemplative method of care planning for individuals, families, and communities. Utilization of the nursing process as a fundamental mechanism by which culture is introduced into care can be as follows. There are three main nursing process models, which differ from one another by the number of steps involved. Four step model include assessment, planning, intervention and evaluation. Five step model includes assessment, nursing, diagnosis, planning and intervention. And finally six step model contains assessment, nursing, diagnosis, outcome and identification. All mentioned steps can be circular and occur at the same time for different situation, as nurse can carry out therapeutic intervention for one case, as simultaneously collect additional data and evaluate outcomes for another two cases.
While dealing with patients of other cultures, collection of necessary data appears to be most important, as it will be used in further health care process. And the success of treatment depends on how accurately the information was collected and processed. Of course it is possible to collect huge amount of data that will appear to be irrelevant for the case. Then, examination process is also important. Interview process is a two-way process. Even though it is essential to raise concerns and lead the patient in the information collection discussion, listening is one of the substantial parts of the interview process. The nurse must give encouragement and space to have patients tell their life story. It can take some time at first, but in the long-term perspective it will save a lot. The nurse should just listen carefully and making notes what the patient and his family are saying without trying to evaluate. Evaluation will come next. Nurse should ask about patient’s personal identification, follow who is answering the question (whether it is client or his family member), also it is important what language does the clients speak with the nurse, as well as recognize the need in interpreter. Questions about titles (how should the patient be addressed) and food will be also helpful.
Biological variations between groups should be taken into consideration. Skin color is one of the most apparent. Pathological and common skin conditions reveal themselves differently in dark and light skin, for example, erythema, anemia, and jaundice. It may happen that normal variations be confused with some disease or bruises. Therapeutic ranges and parameters of medication can vary. For instance, therapeutic ranges of lithium are lower for African Americans then for whites. The observations made during the examination demand astute and keen perceptions and evaluation of clues. Nurses should be able to both perform nursing tasks and continue to observe behavior of the client.
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