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Cultural Competence for the Global Nurse 7 CEUs

Cultural Competence for the Global Nurse 7 CEUs

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Published by RN333
Course for understanding cultural diversity for nurses
Course for understanding cultural diversity for nurses

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Published by: RN333 on Sep 05, 2010
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07/01/2012

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Course Objectives
This course has been approved for 7 clock hours by the Commission on Case Manager Certification fromJanuary 1, 2006 through December 31, 2006.
The goal of this program is to help nurses become culturally competent by raising their awareness andunderstanding about cultural issues in their work environment and professional practice, includingspecial areas such as pain management, women's health, and mental health.After you study this information, you will be able to -
Define cultural competence.
Identify barriers that inhibit the provision of culturally competent nursing care.
Describe the components of a personal action plan for becoming culturally competent.
Understand the need for enhanced communication skills across language barriers.
Describe strategies for improving direct nurse-patient communication and effective use of interpreters.
Describe how culture can influence a patient's expression of pain and pain tolerance.
Discuss how cultural background affects a nurse's response to and management of pain.
Relate strategies for identifying and responding to a patient's pain in a culturally appropriatemanner.
Describe cultural influences on women's health beliefs and practices.
Discuss how to work within the framework of cultural and folk beliefs that may interact withcommon preventive care for women.
Recognize a variety of ethnic and cultural beliefs and practices related to childbearing andfamily.
Identify needs unique to nontraditional families.
Describe four cultural values underlying mental health nursing and how these may not fit thecultural norms of less dominant cultural groups in a diverse population.
Discuss the conceptual basis and examples of culture-bound syndromes.
Identify supportive nursing actions to give mental health care that is culturally appropriate to the patient.
Explain characteristics of the increasingly diverse workplace.
Describe how cultural differences in work patterns and communication styles influence thenursing environment.
Identify person- and organization-centered strategies for working effectively within a diverseenvironment.The world is changing. Free flow of information and escalating mobility of people break down bordersand bring the world to each of us, regardless of where we live. As globalization shrinks the world, italso enlarges our own space by bringing cultural diversity to our doorstep. The ever-increasingdiversity challenges us to adopt a global perspective. In the healthcare arena, the International Council
 
of Nurses (ICN) represents nurses worldwide and reminds us that globalization has health implicationsas we treat people from many nations or move about the world for work. The Transcultural NursingSociety, Inc., promotes culturally competent care, a tool to provide nursing care for our broader-baseclientele.Culturally competent care isn't new. It's the 40+-year-old creation of Madeleine Leininger, RN, PhD,LHD, DS, CTN, FAAN, founder of Transcultural Nursing, the nursing discipline that blends culturewith nursing practice. Leininger defines culturally competent care as the use of sensitive, creative, andmeaningful care practices to fit with the general values, beliefs, and lifeways of clients for beneficialand satisfying healthcare, or to help them with difficult life situations, disabilities, or even death.As nurses, we become culturally competent by knowing our own culture and learning about thecultures of patients we serve. Next, by comparing and contrasting cultures, looking for similarities anddifferences, we dispel biases, the beginning of truly respecting those who are different from us. Witheach cultural encounter and through life-long learning, we continue on the dynamic journey towardcultural competency.The recent advent of standards and requirements for cultural competency in healthcare institutionsfurthers Leininger's imperative for nurses to educate themselves for what she describes as intense anddemanding transcultural nursing practices. The following CE modules provide a learning opportunityaimed to help nurses think globally and integrate culture into nursing practice.For more information about Transcultural Nursing and certification in this specialty, contact JeanneHoffer, RN, EdD, CTN, PO Box 784, Bath, OH 44210, (330) 665-1897, e-mailajhoffer@earthlink.net.
CHAPTER 1 - AN ACTION PLAN FOR CULTURAL COMPETENCE
Gloria Kersey-Matusiak, RN, PhD, CRRN 
 Not everyone who talks is communicating. Consider Mrs. Garcia,* a 46-year-old Spanish-speakingwoman, who was admitted to the hospital after a myocardial infarction. Barely able to speak English,she tried to communicate through her daughters. After several days, the nurses noticed that she was lesstalkative. One nurse complained, "Mrs. Garcia is a difficult patient to work with. She's got a badattitude." Some nurses started to limit their contact with this patient. Even her family membersremarked, "She's acting funny toward us as well."Maria,* a Spanish-speaking nurse who had been visiting Mrs. Garcia regularly, suspected that thesechanges signaled a sudden alteration in the patient's personality. Maria became further alarmed whenupon greeting her that morning, Mrs. Garcia responded, "I can't find the words."She decided to confer with Jenny,* a nurse practitioner, who requested a neurological workup.Diagnostic testing eventually confirmed that Mrs. Garcia was experiencing transient ischemic attacks.She was lucky that a nurse like Maria came along. Maria could not only speak Spanish, but couldeffectively communicate with Mrs. Garcia to assess the real problem.Communicating with patients from diverse cultural backgrounds is only one challenge facing nursestoday. Nurses will need to think and act in ways that are culturally sensitive as they provide care.Similar expectations permeate corporations, educational institutions, and other organizations within
 
society that must now serve an increasingly diverse clientele. Fortunately, nurses - the healthcare providers closest to patients - are in an excellent position to meet this healthcare imperative.
Barriers to Cultural Competence
Becoming culturally competent can be difficult for even the most conscientious nurse. Even though thenotion of transcultural nursing has been around since the 1960s, nurses' momentum in this area has been slowed by trends and patterns, such as a lack of minority nurses, the dominance of the westernmedical model, limited cultural knowledge and racism, stressors in the managed-care work environment, and only limited culturally specific curricula and teacher preparation.Lack of Minorities: Healthcare beliefs, values, and practices of many nurses may differ dramaticallyfrom those of their patients. The lack of minority representation among nurses may further limit nurses'access to those who might provide information about the cultural or ethnic groups they represent.However, it is important to keep in mind that there can be as many differences among members of thesame cultural group as there are differences between cultural groups. For example, second-generationimmigrants who become acculturated to their new county's values and norms may share the attitudesand beliefs of the majority, host population, while more recent immigrants from the same country mayhold fast to their own traditions.The Western Model: Many nurses' professional values remain entrenched in the western medicalmodel. Nurses learn to depend upon that model to guide their healthcare decision-making, unaware thatother cultural groups use their own traditional orientations. For example, Hmong immigrants from Laos believe in both natural and supernatural etiologies of diseases and highly value the spiritual healing of shaman rituals, while many South Asians practice Ayurvedic or homeopathic medicine.
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People fromimmigrant groups can have difficulty trading traditional beliefs about healthcare for those that areforeign to them. When they face nurses who are not sensitive to their traditional orientations, severalthings - misdiagnoses, unnecessary emergency room visits, longer hospital stays, cancelled diagnosticor surgical procedures, suffering, and potentially harmful complications - can undermine healthservices.
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Ignorance and Racism: Unfamiliarity with culturally diverse groups and persistent racism, whichrestricts access to services based on race, haunt healthcare. For example, a recent study explored professional and community perceptions surrounding the healthcare of Arab-Americans. Investigatorsfound that health professionals' lack of awareness of Arab cultural and religious values and Arab-Americans' lack of knowledge about the American healthcare system impeded communication betweenthe two groups. Arab clients perceived healthcare providers as being disrespectful or rude toward themwhen they were unable to communicate in English. Some even felt that they were being laughed at or that they were not being treated as adults. These clients were more comfortable with Arab-speaking providers who were better able to communicate with them and explain procedures. As a result, Arabclients viewed Arab-speaking providers as much more culturally sensitive to their needs.
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A study in Canada found that racist attitudes in healthcare institutions and in individual nurses caringfor diverse patients hampered culturally competent care.
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Researchers found that racist attitudes, whichalso permeate many US organizations, resulted in rigid hospital schedules, policies, and procedures;inadequate translation services; and a general resistance to the accommodation of dietary preferences.The same attitudes caused individuals to dismiss or ignore the needs of patients and to attribute

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