Chapter 12: Considering Culture

What Is Culture? A way of life that involves: unique characteristics that are shared by human beings Values, customs/traditions, rituals, communications styles, language, behavior, & social practices A family is one type of cultural group Culture is not the same as ethnicity Ethnic: group of people within a cultural system, share traits such as: religion, culture, language, appearance Race: shared characteristics that are genetically/biologically transmitted, such as skin color Health care has its own culture and subgroups Nursing culture Nurses are expected to be a culture of caring people who are clean & efficient Also expected to be: intelligent, quick thinking, willing to serve others, & have a general ability to solve problems

Population Mosaic of the United States Cultural Trends of the United States The population is growing The emerging majority of people of color Growing Latino population increases cultural and language challenges for nurses Requires ability to meet needs for more diverse population Requires more awareness of cultural, social, and religious needs

Population Mosaic of the United States (cont’d) Cultural trends of the United States The Population is Aging, pg.178 Population continually getting older, mainly due to improved healthcare, what examples does the author provide? Need sensitivity to the culture of aging (busy med-surg unit=the culture of aging is not addressed Gerontological nursing as a specialty; what advice does the author give to nurse managers? Poverty Income is directly related to health Patient Protection and Affordable Care Act Poverty has its own culture: sense of helplessness and hopelessness (ripple effect) What can nurses do?

Population Mosaic of the United States (cont’d) Cultural Trends of the United States Gender roles and human sexuality Increasing opportunities for women Increased opportunities for the lesbian/gay/bisexual/transgender (LGBT) population It is essential that nurses role model, promote, & accept these cultural changes

Personal Cultural Competency, pg.180 A basic expectation of nursing Awareness and acceptance of cultural differences Need to develop awareness of own culture before understanding others' Culture is the accumulation of someone's life and makes people who they are One member of a group not the same as the next For example: American Indians in the U.S. (500 recognized tribes)

How to Develop Culturally Competent Care Care that meets the cultural beliefs of an individual Eight descriptors to define cultural competence: Integration Understanding Respect Communication Sensitivity Dignity Knowledge Acceptance

How to Develop Culturally Competent Care (cont’d) How to develop personal cultural competency Cultural desire: there needs to be desire to learn Cultural awareness: appreciation for cultural differences Cultural knowledge: seek knowledge regarding specific cultures Cultural skill: apply the knowledge that you know Cultural encounter: this is the time to actually deliver culturally competent care

Barriers to Cultural Competency Ethnocentrism, pg. 184 : is one of the greatest barriers to cultural competency, what does it refer to? Cultural Imposition, pg. 184: occurs when one person imposes the rules of his/her culture on another person. Cultural Blindness Stereotyping Prejudice Racism Cultural Conflict Cultural shock: occurs when you are immersed into a culture & literally emotionally shocked Cultural shock happens to some new nursing graduates *all these have similar unpleasant characteristics, all of them interfere w/excellent nursing care & quality relationships w/people

Common Ethnic Groups in the United States European Americans: 77% of population Native Americans and Alaska Natives: 0.2% African Americans: 14% Asian Americans: 6% Hispanic Americans: 17.6% People can identify themselves as part of multiple ethnic groups Each cultural group holds its own health beliefs Some common health issues within groups

Cultural Assessment, pg.187 Used to obtain the information needed to provide culturally competent care What is the best way to find out this information, who is the best person to ask these questions to? Basic cultural assessment, overall questions What makes you sick? What do you do when you are sick? What makes you better?

Cultural Assessment (cont’d) Basic cultural assessment, more detailed questions What is your primary language? What special foods are necessary for healing? What is your family situation? What is the role of family in your health beliefs? What are your spiritual beliefs related to illness, wellness, and death?

Hiring and Managing a Diverse Workforce Organizational values and management policies should include diversity Diversity in hiring process Concept of inclusion: refers to being inclusive of diverse backgrounds

Nurse Managers and Culture Need to understand significance of culture on two levels: Patient Care Personnel Management Share the unit's cultural philosophy when recruiting Educate employees about culturally competent care Embrace diversity of staff

Review: Leadership NCLEX Questions 8-37