Chapter 5 Culturally Respectful Care

Cultural assimilation

-Minorities living within a dominant group lose the characteristics that made them different -Values replaced by those of dominant culture

Racism

-Negative thoughts or actions against another individual based on their skin color or ethnicity -Ex: A White PT has requested that they do not receive any care from Black nurses.

Caring for a PT that perceives time differently.

-Nurse should maintain flexibility when the PT requests interventions at specific times.

Ancestry

-One's family or ethnic descent

Cultural humility

-Recognition of diversity and power imbalances among individuals or communities, with the action of being open, self-aware, egoless, flexible, exuding respect and supportive interactions, focusing on both self and other to formulate a tailored response.

How may a PT reflect pride in their ethnicity?

-Requesting native cuisine -Listening to folk music and dance -Asking to wear unique clothing -Valuing certain physical characteristics -Giving children native names

Primary informants of patients

-Should be the PT -If PT is unable to respond, a family member or friend can be consulted

Cultural attributes Native Americans

-Sustain eye contact -Blood and organ donation is generally refused

Stereotyping

-The assumption that all members of a culture, ethic group, or race act alike -Could be positive -Could be negative (racism, ageism, and sexism)

Culture shock

-The feelings a person experiences when placed in a different culture -May result in psychological discomfort or disturbances

What factor threatens to increase the number of people who are living at the poverty level?

-The feminization of poverty -Caused by an increase in female-headed households through divorce, abandonment, unmarried motherhood, and changes in abortion laws.

Caring for a PT whose language differs from that of the nurse

-The nurse should always first use a certified interpreter! -If they are unavailable, the nurse should then use the telephonic interpreting system or request assistance from a bilingual nurse.

Why is it important for a nurse to understand and accept each person as an individual?

-To provide holistic care

Caring for a PT that does not speak the same language after you have contacted and are waiting on the interpreter

-Use reassuring body language and make eye contact to assess needs.

What should a nurse be motivated by when learning about different cultures?

-With sincerity, respect, and concern; most PTs will respond positively

How are nurses recognizable as a subculture/subgroup?

-their legally sanctioned, authoritative stance vis-à -vis clients and the general public; manner of dress; language ("nurse-ese" includes a large vocabulary of acronyms specific to healthcare professions as well as its own subcultural lingo); and the rituals and ritualized behaviors into which nurses are socialized as nurses.

Race

-A group of persons related by common descent or heredity- arbitrary classification of modern humans, sometimes, especially formerly, based on any or a combination of various physical characteristics, -skin color, facial form, or eye shape, and now frequently based on such genetic markers as blood groups

Genealogy

-A line of descent traces continuously from an ancestor

Developing culturally sensitive care

-Allow PT time to get their thoughts together -Actively listen to PT's concerns -Provide prompts when words can't be found -Be physically and mentally present to show respect and care -Use an interpreter if needed! -Always be aware of PT's nonverbal body language -Be aware that hand gestures mean different things in different cultures

Nationality

-An ethnic group forming a part of one or more political nations

Best way to provide culturally appropriate care?

-Ask the PT how they would like to be treated based on their values and beliefs.

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate?

-Assessment of eye contact, personal space, and social taboos.

Cultural competence

-Aware of cultural differences but does not have to have expert knowledge of every culture -Make yourself familiar with relevant aspects of PT's culture -Build trust with PT by conveying a caring attitude; show respect for his or her beliefs

Cultural imposition

-Belief that everyone should conform to the majority belief system -EX: A nurse tells a pt from a different country that has special dietary requests, "You are living her now, and you should start eating those foods common to our diet."

Ethnocentrism

-Belief that one's ideas, beliefs, and practice are the best or superior or are most preferred to those of others

Ritual

-Common and observable expressions of culture in hospitals, clinics, homes, schools, and work settings -PT's perform rituals that are intimately important to them, particularly during times of illness

What not should a nurse be motivated by when learning about different cultures?

-Curiosity or a condescending attitude; most PTs will respond negatively

How can a nurse provide culturally competent care?

-Develop cultural self-awareness (check yourself FIRST!!!) -Develop cultural knowledge -Accommodate cultural practices in health care -Respect culturally based family roles -Avoid mandating change -Seek cultural assistance

Elements of Cultural Competence

-Developing self-awareness -Demonstrating knowledge and understanding of a patient's culture -Accepting and respecting cultural differences -Not assuming that the health care provider's beliefs and values are the same as the client's -Resisting judgmental attitudes such as "different is not as good" -Being open to and comfortable with cultural encounters -Accepting responsibility for one's own cultural competency

Cultural diversity

-Differences between groups of people in a certain geographical area (Ethnic groups, races, languages spoken, and religions)

Which behavior is an initial step in culturally responsive nursing practice?

-Discuss the meaning of the medical regimen with the PT

Poverty cultures often have the following characteristics:

-Feelings of despair, resignation, and fatalism -"day to day" attitude towards life; no hope for the future -Unemployment and need for government aid -Unstable family structure -Decline in self respect and retreat from community involvement

How is culture learned by each new generation?

-Formal and informal experiences

Health disparities

-Health differences between groups of people -Can affect how frequently a disease affects a group -How many people get sick -How often a disease causes death

Cultural blindness

-Ignores differences and proceeds as if they did not exist

Cultural sensitivity

-Incorporate PT's specific cultural beliefs into nursing care -Recognize and respect accepted patterns of communication

Cultural awareness

-Knowledge of various cultural beliefs and values (Differences among PT's and among health-care providers, or of the individual nurse)

Which factors contribute to the concept of culture?

-Language -Traditions -Religion -Art and music -Items and clothing worn -Health beliefs and health practices -Styles used for communication

What is a nurse's best action to take when they have inadvertently offended a PT?

-Learn from the mistake and do not repeat it.

Culture

-Learned behavior of an individual within a group -Provides social structure for daily living -Defines roles and interactions with others and in families and communities -Beliefs, religions, values, symbols, art, morals, laws, customs, attitudes, communications, traditions, music, concept of space, time, & values