Healthcare and diversity of cultures are inseparable entities. They all have a direct influence over each other. As such, nurses and other healthcare providers are required to practice a significant level of competency to achieve quality outcomes of the care process (Diller, 2014). In a bid to understand the role of cultural competence in healthcare provision, I interviewed one JT an LPN working in New York at a renowned Nursing home. JT is born to a Mexican father and a Polish mother, and she has significant experiences living in the two parent countries before the family relocated permanently to the USA. JT says that she is the first born in her family and was born in her father’s nation where she spent most of childhood until the age of eight years. She and her family then relocated to Poland where they lived for the next four years. Their relocation to USA was necessitated by her father’s job opportunity at Microsoft. Her mother was a professional nurse and had acquired her education in the USA where they had met with the husband by chance while living in Illinois at the time as students. JT explains that she feels more attached to Mexico as opposed to her mother’s country of origin, but still retains a high regard for Poland.
JT explains that she exhibits heterogeneous cultural values which combine the Mexican culture and the Polish values. However, she says that there are no unique differences between the Mexican and Polish cultures especially on matters of social values, religion and the overall social structure. The languages are however distinct in nature with the Polish language adopting a high preference of German and Russian dialect. The Mexican language setting is however more diverse adopting a high preference for Spanish and Indian dialects. With JT’s preference for the Mexican culture and her insistence that the Polish and Mexican cultures do not have any major differences, we concentrated on the Mexican culture.
The Mexicans according to JT have high consideration for hierarchy and structure in matters relating to family and social welfare. The family forms the most important basic structure for a stable society, and this culture has been maintained from one generation to another. The father is regarded as the highest figure of authority within the family, but dialogue and respect for decisions is well protected as long as they suit the society norms. Women are regarded as a gift to the society since they provide the much-needed care for young children and the family in general by ensuring that the family is stable at all times. They mediate and seek peace when, for instance, the father and the children have issues. Children are regarded as a form of security of the family, and families with many children especially in rural settings are considered as having a secure and more predictable future. Children are also considered as a show of reproduction strength of the family.
Each member of the family, at the extended level, has a critical role to play for both close and extended family members. Family links are highly regarded, and the connection between family members is protected by the senior members of the family and particularly the elders. Usually, these family connections are enhanced by celebrating national holidays and religious celebrations in rural areas where all members of the extended family are invited. The major staple foods for the Mexicans according to JT include corn, wheat tortillas, beans, rice, chili peppers, chorizo, potatoes and pork. The preference for starchy foods is a major issue of concern for government and healthcare sector in Mexico and has been associated with the high malnutrition rates especially in the rural areas where population depend on agriculture and casual labor. In religion, JT notes that Mexicans have great regard for the Catholic faith but the protestant faith has in recent years been adopted among a large portion of the population. The lifestyle of the Mexicans takes great regard for artistic works and the young generation usually utilize weekends in revering joints and social events where beer and substance use is usually high.
An understanding of the culture of the population plays a critical tool in the care delivery process for the nurse. The insistence on patient-centered care means that the nurse has to develop a rapport with their patient so as to identify their need and develop comprehensive care plan that accommodates their culture and respond to their overall needs (Purnell, 2012). This holistic approach to care requires an understanding of several aspects of the population including religious beliefs, nutrition and dietary planning, family health and reproduction, leisure and lifestyle as well as gender issues such as equality and representation.
The society’s reliance on staple food could negatively impact on the health status of tat society. For instance, lack of proper nutritional and dietary settings for the families could increase the cases of malnutrition and related disorders (Chang & Kelly, 2007). The reliance on staple foods such as rice and potatoes by the Mexican population, for instance, implies a very uncertain and insecure society health into the future.
The Catholic and protestant faiths are the most preferred religious groups in Mexico. These groups and their traditional involvement and medicine means that most Mexicans apart from the minority few have no resistance to modern medicine. Religion plays a critical role on how the nurse provide scare to the patient (Diller, 2014). In cases where the religious beliefs of the patient bar the use of certain approaches to provision of care, the nurse has to carefully engage the patient and seek a more preferable method for the patient so that the quality of care is not compromised by their belief (Chang & Kelly, 2007).
Family health and reproduction:
Family health and views o reproduction and family planning have a significant influence on the care process. It is important that the nurse understand the family’s history on health matters as well as reproduction strategies within the family. These could provide a background for determining a genetic association of illness or complication to family health (Spector & Spector, 2004). On the other hand, reproduction views and beliefs could provide the nurse with the platform upon which to inform the patient of the need to have a manageable family through modern family planning methods.
Leisure and lifestyle:
Modern healthcare settings have experienced an overwhelming number of lifestyle related diseases. This is associated with the lavish lifestyles which are common in social events such as beige drinking and use of drugs and substance especially among the young population. These cultures are common among the urban youths in Mexico and could explain the high prevalence of lifestyle-related illnesses within this population. The need for the healthcare providers to insist on healthy lifestyles in such a population is thus a key aspect of holistic nursing (Spector & Spector, 2004).
Gender issues such as (relations, equality and representation)
Each society has its view of relations between genders and their role in the family and the society in general. When one gender is sidelined form the formulation of policies or deliberations of affairs then, their needs are more likely to be ignored. At the same time, these relations will determine the care process especially where family caregivers are to be incorporated in the care plan. The boundaries between gender relations may subsequently mean that the most preferred persons as caregiver by the nurse will not be able to take part in the care process due to such limitations (Purnell, 2012). The nurse must thus adopt a strategy that takes this issue into consideration developing the care plan so that such gender relations may not compromise the quality of care.
The issue of cultural competency on the era of holistic nursing has taken centre-stage. Patients’ preferences and healthcare organization policies insist on adherence to procedures that relate to cultural competence and which are deemed to impact on care outcomes. The Interview with JT provided a more diverse view of the society as one that exhibits different values and whose health status is solely dependent on these values. According to Purnell (2012), the nurse should not just focus on the illness presented but also the primary influencing factors that usually are linked to cultural values and norms. This then implies that the care process and specifically the care plan must respond substantially to these needs from a symptoms presentations view as well as the personal values and society influences that have a connection with the illness. Family history, cultural setting, social status and religious beliefs all have a significant impact on disease presentation and causes. Thus, treating just the symptomatic presentation may leave out the primary aspect which centers on the patient’s cultural and social life. The nurse, however challenging it is must exhibit patience and understand for the patient and their cultures as well as beliefs so that care is not just delivered in a fragmented manner but one that responds to the problems of the patient (Chang & Kelly, 2007).
Chang, M., & Kelly, A. E. (2007). Patient education: Addressing cultural diversity and health literacy issues. Urologic nursing, 27(5), 411-7.
Diller, J. (2014). Cultural diversity: A primer for the human services. Cengage Learning.
Purnell, L. D. (2012). Transcultural health care: A culturally competent approach. FA Davis.
Spector, R. E., & Spector, R. E. (2004). Cultural diversity in health and illness(pp. 256-268). Upper Saddle River, NJ: Pearson Prentice Hall.