1. Chapter 12 Considering Culture

2. Considering Culture What is Culture?
Way of life a group of people chooses to follow.
Unique characteristics that are shared, like symbols, rituals, rules and other learned behaviors.
A family is one type of cultural group.
Culture is not the same as ethnicity.
Includes group values, customs, communication styles, worldviews, expectations, norms and the group’s behavior and social practices.
Healthcare has its own culture and nursing is one subgroup.
Nursing culture: caring, clean, efficient, intelligent, willing to serve others, flexible and problem solvers.

3. Considering Culture Cultural Trends of the United States
Continuing growth of population and patient population.
More people need healthcare.
The emerging majority of people of color.
Growing Latino population increases cultural and language challenges for nurses.
Ability to meet needs for more diverse population.
Requires more awareness of cultural nuances, as well as of different social and religious needs.

4. Considering Culture Cultural Trends of the United States (cont.)
The aging population
Population continually getting older
Need sensitivity to the culture of aging.
Caring for the elderly is a specialty, gerontological nursing.
Poverty
Income is directly related to health.
Increases access to health insurance.
Safer housing and neighborhoods.
Avoid living in environmentally hazardous areas.
More opportunity to engage in health promotion/education.
Transportation and access to healthcare.
Poverty has its own culture – helplessness and hopelessness.

5. Considering Culture Cultural Trends of the United States (cont.)
Gender roles and human sexuality
Increasing opportunities for women.
Increased opportunities for the lesbian/gay/bisexual/transgender (LGBT) population.
Role model and promote acceptance of these cultural changes.

6. Considering Culture Personal Cultural Awareness
Cultural competence is basic expectation of nursing.
Awareness and acceptance of cultural differences.
Need to develop awareness of own culture before understanding others.
Consider cultural groups where you are member.
Examine all aspects of yourself and see how they intertwine.
Culture is the accumulation of someone’s life and makes people who they are.
One member of an ethnic group is not the same as the next.

7. Considering Culture
Culturally Competent Care: care that meets the cultural beliefs of an individual.
Eight descriptors to define cultural competence:
Integration of nursing knowledge with cultural needs of patient.
Understanding that meeting cultural needs improves health.
Appreciation of cultural needs deepens respect between two people and fosters cooperation.
Communication based on cultural understanding.
Sensitivity to cultural needs helps health needs to be met more successfully.

8. Considering Culture
Culturally Competent Care – Eight Descriptors (cont.)
Dignity is aspect of holistic care and does not exist without respect for culture.
Knowledge about culture helps to meet overall needs.
Acceptance of culture is critical aspect of cultural competency.
How to develop personal culture competency
Cultural desire: desire to understand what makes people different.
Cultural awareness.
Cultural knowledge.
Cultural skill.
Cultural encounter: the time you actually deliver the care.

9. Cultural Diversity as a Professional Attribute
Barriers to Cultural Competency
Ethnocentricism: thinking that one person’s culture is the “best”.
Cultural imposition: imposing the rules of one’s culture on another.
Cultural blindness: refusing to recognize cultural needs of another.
Stereotyping, prejudice, and racism
Cultural conflict: getting into power struggle over culture.
Cultural shock: literally shocked by immersion into another culture.

10. Considering Culture Common Ethnic Groups in United States:
European Americans – 72% of population
Native Americans – 9% of population
African Americans – 13% of population
Asian Americans – 5% of population
Hispanic Americans – increasing population
Each cultural group holds its own health beliefs and has some common health issues.

11. Considering Culture Cultural Assessment
Used to obtain the information needed to provide culturally competent care.
Basic cultural assessment, overall questions:
What makes you sick?
What do you do when you are sick?
What makes you better?

12. Considering Culture Cultural Assessment (cont.)
Basic cultural assessment, more detailed questions:
Primary language.
Special foods necessary for healing.
Role of family in person’s health beliefs.
Spiritual beliefs related to illness, wellness and death.

13. Considering Culture Nurse Managers and Culture
Need to understand significance of culture on two levels: patient care and personnel management.
Share the unit’s cultural philosophy when interviewing new employees.
Educate employees about culturally competent care.
Embrace diversity of staff.