Cultural awareness is about realising that people belong to a diverse range of cultures and that they will, accordingly hold different values, behave in different ways, have different ways of viewing the world and different approaches to the way they live their lives.
Cultural awareness is about having the resources to relate positively to people from a diverse range of cultural backgrounds and appreciate the contribution that different groups make to a rich and dynamic society.
Male domination
Case summary: An Arab woman had just given birth and needed blood drawn from a male lab technician. Her husband is not happy with this and does not allow that. Finally, he makes his wife completely cover up and give blood.
Cuture needs: Arab women are mysterious, because of their strict religious beliefs, they rarely show their faces. Even in street encounters, and it will certainly be gown, veil, wrapped up, and never easy to speak with outsiders. In Arab, for pregnancy or gynecological needs, women prefer a female doctor, however. In Arab culture, women are reluctant to discuss these concerns with men. For Arab families, honor is one of the highest values. Since family honor is dependent on female purity, extreme modesty and sexual segregation must be maintained at all times. Male nurses should not be assigned to female Muslim patients. In many parts of the world, female purity and modesty are major values. In this instance his sense of responsibility and need to protect her modesty from very much an “intrusive” health care experience for the most part could be curbed by a simple sign placed on the door that says “Please Knock before entering, this patient observes modest dress and requires the announcement of your presence.” This would help communicate to the patient and her husband that
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we understand and wish to honor your modesty. This is empowering for the family. The rudeness or sense of oppression of the pt. the nurses might have felt would be understandable. However, when ever patients. or their families are rude or pushy we only need ask ourselves …. What is the underlying motive behind rudeness …. The answer is fear.
Impact: In this case, the lab technician draws blood successfully. However, it done with most of the patient covered. This is not the perfect way to draw blood in this situation. We have to protect the patient, ensure the safety of the phlebotomist or nurse drawing the blood and lead to a successful blood draw. If draws blood with most of the patient covered, it is not safety. It would be a risk of infection.
Measure: Lack of culture understanding would create cultural conflicts and hostility. Get to know the specific culture and understand it. If we know the culture before we get the patient, we can get things ready and do the things in the best way. In this case, if they know the Arab culture before they meet the patient, they can sent a female lab technician at first. Then can avoid the husband being unhappy and get more benefits for the treatment. The patient and her family would be more cooperative. Try to find Arab staff to assist if possible. It can be the same with Muslim patients.
Pain management
Case summary: A middle-aged Chinese patient refused pain medication. He believed that he could bear the pain. The nurse found him restless and uncomfortable. Again the nurse offered pain medication, again he refused, explaining that her responsibilities at the hospital were far more important than his comfort and he did not want to impose. Only after she firmly insisted that patient comfort was one of her most important responsibilities did the patient finally agree to take the medication.
Culture needs: Chinese are taught self-restraint. The needs of the group are more important than those of the individual. Another factor that may be involved in Asian’s refusal of pain medication is courtesy. They generally consider it impolite to accept something the first time it is offered. The safest approach for the nurse is to anticipate the needs of an Asian patient for pain medication without waiting for requests from the patient.
Impact: Lack of culture understanding make misunderstandings. In this case, it made the patient suffer from pain for a long time. Eventually the patient accepted the pain medication. That was not too bad. However, if the nurse knew the Chinese culture before, it could make it better.
Measure: Nurses should be aware of Asian rules of etiquette when offering pain medication, food or other services. Try to express more passion at the first time that offer your help to the patient. Try to make the patient feel that you really want to and could not say any “No”. But if patients continue to refuse medication, their wishes should be respected.
Symbols
Case summery: A Vietnamese woman was rushed to the hospital by her adult children. The emergency room personnel discovered dark red welts running up her arms, shoulders and chest, yet the only presenting complaint was dizziness. When questioned, her son explained that he had rubbed her body with a quarter.
A nurse became concerned when she found an elderly Chinese patient rubbing himself with a quarter( she thought he was trying to hurt himself). When she took the coin away from the patient, he became very upset, grabbed it back from her and continued to rub his arms and legs, leaving dark red scratches.
A Vietnamese girl in her first year at an American elementary school, was not feeling well one morning, so her mother rubbed the back of her neck with a coin. When the school staff discovered the welts on the girls neck, they immediately assumed they were seeing a case of child abuse and reported the family to the authorities.
Culture needs: In each case the patient was practicing a traditional form of healing known as coin rubbing. There are several variations, including heating the coin, but they all involve vigorously rubbing the body with a coin. This produces red welts, which can distract medical staff from the real problem or be mistaken for child abuse. Asians rubbing their children with coins is not any more abuse than Americans having thin pieces of metal wrapped around their children’s teeth and tightened until their teeth move out of place. Braces are usually applied for merely aesthetic reasons. Coin rubbing, at least, is an attempt to heal. Apparently, it often works, only the failures show up in the medical system.
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Impact: Lack of culture understanding make misunderstandings. In this case, it was easy to mistakenly believe that the coin rubbing is a kind of abuse. But actually it just a traditional way to heal some diseases in Asian. This mistake can create sued case. That would be a trouble. But if we knew the Asian culture before, that problem would be avoided. It is important to recognize and become familiar with this practice, and not to be distracted from the real problem or mistakenly make accusations of child abuse.
To be culturally competent the nurse needs to understand his/her own world views and those of the patient, while avoiding stereotyping and misapplication of scientific knowledge. Cultural competence is obtaining cultural information and then applying that knowledge. This cultural awareness allows you to see the entire picture and improves the quality of care and health outcomes.
Adapting to different cultural beliefs and practices requires flexibility and a respect for others view points. Cultural competence means to really listen to the patient, to find out and learn about the patient’s beliefs of health and illness. To provide culturally appropriate care we need to know and to understand culturally influenced health behaviors.
In our society, nurses don’t have to travel to faraway places to encounter all sorts of cultural differences, such as ethnic customs, traditions and taboos. The United States provides plenty of opportunities for challenges stemming from cultural diversity. To be culturally competent the nurse needs to learn how to mix a little cultural understanding with the nursing care they offer. In some parts of the United States culturally varied patient populations have long been the norm . But now, even in the homogeneous state of Maine where we reside, we are seeing a dramatic increase in immigrants from all over the world. These cultural differences are affecting even the most remote settings.
Since the perception of illness and disease and their causes varies by culture, these individual preferences affect the approaches to health care. Culture also influences how people seek health care and how they behave toward health care providers. How we care for patients and how patients respond to this care is greatly influenced by culture. Health care providers must possess the ability and knowledge to communicate and to understand health behaviors influenced by culture. Having this ability and knowledge can eliminate barriers to the delivery of health care. These issues show the need for health care organizations to develop policies, practices and procedures to deliver culturally competent care.
Reference: http://www.culturediversity.org/asia.htm
http://www.culturediversity.org/mide.htm
Work effectively with culturally diverse clients and co-workers CHCCS405A
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