The globalization phenomenon has led to increased diversity in regards to the type of patients that a nurse can come across while discharging his or her professional duties. Globalization has led to the breaking down of racial and cultural barriers which hitherto segmented various aspects of human interaction including the provision of health care services. With the increased patient diversity due to globalization, a need has thus emerged for cultural awareness training within nursing education and development realms (Campinha-Bacote, 2011). However, this is not the case as a majority of nurses who are churned out of the nursing education system are largely exposed to the dominant culture of their locale. Bynum et. al (2012) opines that In an era of cultural integration as a result of globalization, the people who are tasked with delivering nursing care should endeavor to treat a patient as a unique person. Unfortunately, this is yet to constitute the core of cultural competence and patient centeredness that should be modern day nursing. This is a problem which has manifested itself in a number of ways at my place of employment.
Once at my place of employment, a son to a man who was dying broke into the hospital and took away his dying father to die at the parking lot. The father had been terminal ill and he was on life supporting machines. Upon being informed that the sick man would be taking his last breath sometime during the eventful night, the young man decided to break into the hospital. It was a while later during interrogation that the son revealed that it was a cultural tradition to allow the dying to take their last breathe in an open space so as to freely release their spirit. It was a cultural belief that dying in a closed space like a medical word or a high dependency unit would enslave the man’s soul. Subsequently, the son was arrested and arraigned in a court of law. This is just one of the multiple incidences that I have since experienced at my workplace as the number of ethnic populations, immigrants and minorities that are seeking modern healthcare services continue to rise. It has thus become paramount for nurses to gain the required cultural competencies that required in dealing with a diverse group of patients. Due to instances of cultural insensitivity, we have seen a steady decline of clients who come from other cultural backgrounds that is outside the dominant culture representation of the majority of the clientele. Efforts to employ cultural diverse nurses have also hit a snag as the facility has largely been portrayed as not only being unfriendly to clients that come from different culture but also the healthcare staff who are deemed to be outsiders. Lack of diversity awareness and training has also exposed the institution to a number of costly litigations. Some clients often misconstrue the lack of cultural understanding and awareness among the nursing care givers to be acts of discrimination based on either cultural or racial undertones.
The increasing attention that healthcare industry is giving to the emerging patient’s or nursing advocacy theories is enough incentive to ensure that nurses are keen at developing the requisite cultural skill that is required in the process of formulating approaches to treatment that are culturally relevant and mutually acceptable. Mutually acceptability is a key component of this cultural approach to nursing as it is important to acknowledge that healthcare facilities and the larger healthcare industry has its own guiding laws and principles. For instance, in the case where a son broke-out his dying father out of the high dependency unit it is important to similarly acknowledge that in as much as the patient had his cultural beliefs, so did the healthcare institution have its own internal policies of discharging patients. An agreeable middle ground has to be reached while acknowledging the rights of both parties.
Providing healthcare needs within a largely globalized society will always remain a challenge especially when multiple interests have to be factored. The most important element of cultural awareness that nurses have to understand is the fact that elements of culture are both external and internal and cannot be summarily covered under the nursing curriculum. Also, Hammond (2010) rightly argues that it should be understood that cultural diversity by itself constitutes diverse forms right from religion based, social and racial diversity. Each situation that will be encountered will be different and will require a varied approach in its resolution. According to Renee (2010) the acronym ASK – which stands for awareness with skill and knowledge has been developed to address different emerging scenarios that could have cultural implications to the care receiver. The trick here is to be always open minded and willing to integrate the various elements of a particular cultural dispensation in the delivery of nursing care services. Of utmost importance is to desist from making any form of assumptions regarding a particular scenario. For example, if a patient is not eating, a nurse should not be quick to assume that this is a case of lack of appetite due to prevailing symptoms or an intense drug routine. The patient could as well be fasting.
Barry, M. and Edgman-Levitan, S. (2012) Shared Decision Making—The Pinnacle of Patient-Centered Care. New England Journal of Medicine, 366, 780-781
Bynum, S., Davis, J., Green, B. and Katz, R. (2012) Unwillingness to Participate in Colorectal Cancer Screening: Examining Fears, Attitudes, and Medical Mistrust in an Ethnically Diverse Sample of Adults 50 Years and Older. American Journal of Health Promotion, 26, 295-300.
Campinha-Bacote, J., (May 31, 2011) "Delivering Patient-Centered Care in the Midst of a Cultural Conflict: The Role of Cultural Competence" OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 2, Manuscript 5.
Hammond, W. (2010) Psychosocial Correlates of Medical Mistrust among African-American Men. American Journal of Community Psychology, 45, 87-106.
Reneé S. Holleran. (2010). “How Can Nurses Increase Their Cultural Awareness?” Medscape.