How do I prepare for cultural encounters?

Culturally competent nursing care involves sensitivity to culture, race, gender, sexual orientation, social class, and economics (Robinson, 2000). It means really listening to the patient's beliefs about health and illness and  understanding how culture influences health choices and actions (Robinson, 2000; Transcultural Nursing, 2004).

Ask yourself these questions before caring for patients:

1. How do I react when confronted with a "new" patient situation that does not fit my expectations? Does the situation provoke feelings of anxiety and discomfort? Am I able to assess what is going on within myself as well as within the patient?
2. What strategies to I use to gain clarification of a puzzling situation, and to enhance both my own and my patient's understanding?
3. Can I support and help patients understand that they are impacted by the same cultural differences in beliefs, expectations, behaviors that impact me?

When caring for patients, use the LEARN model as your guide:

• Listen with empathy and understanding to the patient's perception of the problem
• Explain your perceptions of the problem
• Acknowledge and discuss the differences and similarities
• Recommend treatment
• Negotiate agreement

Follow these principles with every patient encounter:

• Consider all clients as individuals first, as members of minority status, and then as members of a specific ethnic group.
• Never assume that a person's ethnic identity tells you anything about his or her cultural values or patterns of behavior.
• Treat all "facts" you have ever heard or read about cultural values and traits as hypotheses, to be tested anew with each client. Turn facts into questions.
• Remember that all minority group people in this society are bicultural, at least. The percentage may be 90-10 in either direction, but they still have had the task of integrating two value systems that are often in conflict. The conflicts involved in being bicultural may override any specific cultural content.
• Some aspects of a client's cultural history, values, and lifestyle are relevant to your work with the client. Others may be simply interesting to you as a professional. Do not prejudge what areas are relevant.
• Identify strengths in the client's cultural orientation that can be built upon. Assist the client in identifying areas that create social or psychological conflict related to bi-culturalism and seek to reduce dissonance in those areas.
• Know your own attitudes about cultural pluralism, and whether you tend to promote assimilation into the dominant society values or stress the maintenance of traditional cultural beliefs and practices.
• Engage your client actively in the process of learning what cultural content should be considered.
• Keep in mind that there are no substitutes for good clinical skills, empathy, caring, and a sense of humor.

Adapted from
Cultural Competence Practice and Training
http://www.diversityrx.org/HTML/MOCPT1.htm

Print the handout and answer the question below before going on to the last essential cultural area - Cultural Desire.