1. Chapter 12: Considering Culture

2. 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

3. 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

4. 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?

5. 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

6. 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)

7. 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

8. 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

9. 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

10. 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

11. 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?

12. 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?

13. 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

14. 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

15. Review: Leadership NCLEX Questions 8-37