Cultural Competency : Cultural Analysis

In taking care of a patient, it is important for nurses to respect the patient, their beliefs, and their right to autonomy. Provision One in the Code of Ethics states “the nurse practices with compassion and respect for inherent dignity, worth, and unique attributes of every person” (ANA, 2015, p. 7). With a Jehovah’s Witness patient, the nurse must first acquire information regarding their religion and how it may impact their care and their wishes related to their healthcare. Once their patient’s beliefs are noted and understood, the nurse must establish a professional and therapeutic relationship with their patient without bias to their religion and the associated beliefs. The duty to act without bias can be found outlined in Provision 1.2 (ANA, 2015).

This book is certainly an eye opener. I always knew that culture played an important part in one’s everyday experience, but I never imagine it to be so extensive and tragic. When Dan Murphy stated “when you fail one Hmong patient, you fail the whole community”(p.253), I believe that he meant that as other Hmong families hear about Lia’s family tragic experience, they too feel the fear and disappointment caused by the health system of modern society. When another Hmong family has a sick child, they will hesitate to bring their child to the hospital because of the thinking that they may be forced to go against their cultural regimes. I think that whole Hmong family will neglect analyzing the Lia’s situation, and again run from the thinking that

The EYLF proposes that cultural competency cannot be mastered but is something educators continually strive for; by respecting, understanding, engaging with and positively acknowledging and teaching cultural diversity within the childcare industry.

Cultural competency is a set of appropriate behaviours, attitudes and policies among professionals and enables them to work efficiently in cross-cultural situations (NCCC, 2006). A culturally competent health care system can eliminate cultural inequities, provide greater quality of care, and have less patient dissatisfaction and more positive health consequences. A conclusion reached in a study (Palafox et al., 2002) states, culture influences the outcome of medical examination and; therefore, it is vital to provide culturally competent health care services. Cultural competency is especially important in the context of radiographic examination due to the variety of culturally different patients a radiographer comes in contact. The following case study effectively highlights the impact of cultural competency.

To begin with, a cultural difference between Hmong and Americans are their opinions about Lia’s medical condition. “When Lia was about three months old, her older sister Yer slammed the front door of the Lee’s Apartment” (Fadiman 1997:20). After slamming the door Lia’s eyes rolled in the back of her head and she

“The new mestiza copes by developing a tolerance for contradictions, a tolerance for ambiguity. She learns to be an Indian in Mexican culture, to be Mexican from an Anglo point of view. She learns to juggle cultures. She has a plural personality, she operates in a pluralistic mode—nothing is thrust out, the good, the bad, and the ugly, nothing rejected, nothing abandoned. Not only does she sustain contradictions, she returns the ambivalence into something else”

As we have seen, the government impacted the Lee family by not having the proper programs implemented in time to save her life but the life of Lia Lee has had an enormous impact on the government’s implementation of cross-cultural programs, interpreter training, and even a shaman program. Although the government changed the life of the Lees their story had a more permanent effect on the government. This is a story of miscommunication causing a tragedy, but in the long run institutionalizing a brand new program to prevent this from happening again. It changed the way that American hospitals deal with people of other cultures now. This story is rich with the fascinating Hmong culture and the American medical system. What one could learn from this book is enormous and could help change the way American’s view other

It is not always easy to decide about the care of a patient, because the patient’s cultural beliefs do not always coincide with the beliefs of the nurse. Ephesians 4:2 in “Be completely humble and gentle; be patient, bearing with one another in love” (English Standard Version). God has loved us unconditionally from the beginning of time, and has always been patient with us. It is time that humans show the love that God has for us onto others and respect one another no matter the differences. This paper will discuss the importance of respecting another person’s culture, what stigma is and whether if Lia’s family viewed her that way, brief history of the Hmong, the preventions that could have taken place, and how to incorporate

The book The Spirit Catches You and You Fall Down by Anne Fadiman talks about a young Hmong child who is treated by American doctors for her epilepsy. It goes on to explain how the differences in the two cultures, Hmong and American, affected the medical treatment of this child. Her doctors and her parents had different views on how to effectively treat her. This book demonstrates how the lack of communication across different cultures can impact the medical treatment and the outcomes of patients.

Cultural Perspective in the Hmong Community The abuses that were mentioned the Hmong community is still happening in America today, yet we do not hear much about it. The reason being may be the cultural perspective in the Hmong community that prohibit or limits an individual to report these abuses. In the article Hmong Immigrants’ Perception of Family Secrets and Recipients of Disclosure, it examines the issues that Hmong families’ have of keeping secrets and it discusses the things that Hmong families consider to be secrets and why these families keep it within themselves. The Hmong are a very conservative group of people and telling others about their family problems can lead to stigma, shame, and humiliation (Xiong, 2006).

I have learned that it is important that educators  and health providers be trained on cultural competency to understand the population they are serving. Marks, Sims, and Osher (King, Sims, & Osher, n.d.) define cultural competency  as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross–cultural situations" ( as cited in Cross et al., 1989; Isaacs & Benjamin, 1991). Health providers and educators should investigate demographic patterns or trends in the place where they live and work. This brings awareness of the types of cultures that they might come across when they are working with people. Organizations should integrate and implement policies that promote the value of  diversity, self-assessment, manage the dynamics of difference, acquire and institutionalize cultural knowledge, and adapt to diversity and the cultural contexts of communities they serve (Georgetown  University, 2004). Georgetown University (2004) also stresses that culture competency grows gradually and is always open for improvement.

Exposure to a variety of cultures and having an understanding of those cultures as a PA is highly beneficial for several reasons. Having this knowledge would enhance a PA’s cultural competency by broadening their perspective, making the PA more acutely aware of symptoms pertaining to cultural attributes, and improving their critical thinking skills, communication skills, and sensitivity. Exposure to various cultures provides greater insight into the perspectives of the individuals of those cultures. This insight contributes to understanding of individuals, and therefore, opposes judgment and promotes productivity. Furthermore, this understanding of individuals’ cultures can help PA’s to be sensitive and sympathetic when considering a patient

Understand cultural competence and why is it important especially for that have a diverse workforce.

Cultural competency can be viewed as an ongoing journey of commitment and active engagement through the process of cultural awareness, knowledge, skills and cultural encounter (Coolen, 2012).Trust is the underlying purpose behind cultural competency in the development of health care provider and patient relationship. Health care professionals need to become more sensitive, respectful and attentive to the patients cultural beliefs and practices. Self-awareness is particularly important when communicating where barriers exists, unconscious prejudices may hinder the successful building of therapeutic relationships. In order to provide culturally sensitive pain management, a patients pain must be considered within the context of the individual’s

Lia Lee was a Hmong infant born with epilepsy. Lia’s parents were immigrants to a Western nation. However, the parents held tightly onto traditional beliefs from their native country. The incongruent belief structure of the East and West created difficulty when the two systems collided in an effort to care for Lia Lee. Specifically, when the drug therapy prescribed for Lia Lee was not followed by her parents. Subsequently the child’s medical team contacted child services, which lead to Lia’s removal from her family. The result of the cultural misunderstanding was fragmented family. In addition to fueling the distrust of the western healthcare system by an already marginalized community.