There is no documentation of global health competency among advanced practice nurses, specifically for Nurse Practitioners in current health related literature. Global health competency is an issue of increasing importance as we face an era of immense globalization, migration, immigration, and widening income gaps. It is widely accepted that lower income status, ethnic and racial disparities place persons at risk for increased morbidity and mortality globally and locally. Additionally, advanced practice nurses, Nurse Practitioners, are increasingly seen as primary care providers for the future aiding rapidly aging and influxes of ethno-diverse cultures. This culminates with already existing high levels of poverty, reliance on government …show more content…
Most physician-driven efforts have been bio-medically focused. One competency assessment by Wilson, et al. was adapted from Medicine for undergraduate nursing by removing treatment and medical diagnoses (2012). In a study of 700 undergraduate nursing programs, only 29% offered global health as a separate course outside of standard community health and there are no reports in the literature establishing or documenting global health competence among graduate prepared advanced practice nurses. In another sample of 36 Canadian Association of University Schools of Nursing, only 0.81% of undergraduate students had international experiences and only 2 of 36 institutions had transcultural nursing requirements which limits abilities or competence in assisting diverse populations. We do know utilization of health belief models and transcultural theory have been very effective in implementing health interventions and this has been noted in several studies including the use of social capital in management of disease (Malin, 2014). Cultural mistrust of providers remains amongst low-income persons of minority status who have experienced previous inequity or discrimination has been repeatedly documented and will continue to be a barrier (Benkert,
The increasing population of immigrants in the United States has contributed to health disparities in the health care system. Cultural competence can remove health disparities by eliminating personal biases, and treating every person with respect. Simply recognizing and accepting different cultures is not enough, one must be able to consistently recognize and understand the differences in order to be culturally competent. Knowledge and culturally competent practices are a must for nurses to deliver quality care in our rapidly changing multicultural world (Edelman, 2014 p. 25).
Cultural competence is the ability to interact well with people of different cultural backgrounds (Rundle, 2002). It provides the best ways of meeting the needs of diverse patient population which is always on the increase, as well as ways of effectively advocating for them. This means that cultural competence has the benefit of enabling nurses to deliver services that respect and effectively respond to health beliefs and practice needs of diverse patients. Through the process of globalization, nurses are moving to places of nursing shortage to offer their knowledge and skills beyond their home
Theories of transcultural nursing with established clinical approaches to clients were founded in the mid-1960s and are an essential aspect of healthcare today. The ever-increasing multicultural population in the United States poses a significant challenge to nurses providing individualized and holistic care to their patients. Accurate assessments identify factors that define transcultural nursing and analyze methods to promote culturally competent nursing care.” (Maier-Lorentz, 2008)
The nursing profession has a long history of assessing and placing patient needs first when giving care. The tenets of nursing practice include meeting those needs using individualized care by collaborating with the patient, family, and health care team members. (American Nurses Association, 2010). The concept of transcultural nursing aligns with these tenets because it calls on nurses to provide patient-centered care by taking into account the patient’s background, beliefs, culture and values. In this paper, I will identify the factors that made it necessary to develop the transcultural nursing theory, describe the meaning of diversity and its relationship to the field of nursing, and explain three ways that I provide culturally sensitive care to my patients.
Leininger (1988) defined nursing as a transcultural phenomenon requiring knowledge of different cultures to provide care that is congruent with the clients’ life ways, social structure, and environmental context. This definition from the founder of transcultural care would support applying a cultural sensitive nursing care in the clinical setting, and highly linked to her definition of transcultural nursing as a legitimate and formal area of study focused on culturally based care beliefs, values, and practices to help cultures or subcultures maintain or regain their health (wellbeing) and face disabilities or death in culturally congruent and beneficial caring ways (Leininger, 1970, 1978, 1995). Moreover Leininger summarized the process of applying transcultural care as providing care that fits with cultural beliefs and life ways. From a professional perspective, it refers to the use of emic (local cultural knowledge and life ways) in meaningful and tailored ways that fit with etic (largely professional outsiders’ knowledge), in other words care should be individualized according to patient’s culture to promote holistic and effective nursing care.
The term culture is defined as “the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups” (Potter & Perry, 2013). With the increase of culturally diverse populations in the United States, it is important for nurses to practice cultural competence. Cultural competence is the ability to acquire specific behaviors, skills, attitudes, and policies in a system that permits “effective work in a cross-cultural setting” (OMH, 2013). Being culturally competent is essential because nurses who acknowledges and respects a patient’s health beliefs and practices are more likely to have positive health outcomes (OMH, 2012). Every culture has certain views and attitudes concerning
Cultural competence can be defined as using the ability of one’s awareness, attitude, knowledge and skill to effectively interact with a patient’s many cultural differences. Madeline Leininger, a pioneer on transcultural nursing describes it this way; “a formal area of study and practice focused on comparative human-care differences and similarities of the beliefs, values and patterned lifeways of cultures to provide culturally congruent, meaningful, and beneficial health care to people” (Barker, 2009, p. 498). The importance of cultural diversity in healthcare allows for the delivery of appropriate cultural autonomy. Showing respect for others will lead to trust between nurse and
In order to deliver nursing care to different cultures, nurses are expected to understand and provide culturally competent health care to diverse individuals. Culturally competent care is tailored to the specific needs of each client, while incorporating the individual’s beliefs and values (Stanhope & Lancaster, 2006, p. 90). By being culturally competent, nurses are able to help improve health outcomes by using cultural knowledge and specific skills in selecting interventions that are specific to each client (Stanhope & Lancaster). Therefore, nurses “should perform a cultural assessment on every client with whom they interact with” (Stanhope &
The Giger and Davidhizar Transcultural Assessment Model was developed for undergraduate nursing students in 1988 by Joyce Newman Giger and Ruth Davidhizar. The assessment model provides a framework for nursing students to easily assess and provide care for patients from many different cultural backgrounds. Six cultural aspects are highlighted: communication, time, space, social organization, environmental control, and biological variations (Giger & Davidhizar, 2002).
Cultural competency is becoming essential in American healthcare with the increasing and diversification of immigration. The Department of Homeland Security, 2014 statistics indicates over 750,000 immigrants received naturalization in the US. These naturalized citizens represent over 20 countries varying from Hispanic, Indian, Asian, African, and Middle Eastern cultures. A change in the way American healthcare treats these cultures is necessitated to provide efficient care and achieve positive outcomes. Douglas et al. (2014) guidelines are to empower patients to help diminish the inequities of their own healthcare. The guidelines for culturally competent care are meant to guide the nurse, nurse educators, and nurse managers in their competent treatment of persons of other cultures. These guidelines mandate a nurse use education, self-assessment and reflection, and diversification of the workforce to meet the demands. The ten guidelines are knowledge of culture, education and training in culturally competent care, critical reflection, cross-cultural communication, culturally competent practice, cultural competence in health care systems and organizations, patient advocacy and empowerment, multicultural workforce, cross-cultural leadership, and evidence-based practice and research.
Núñez, A. E. (2000). Transforming cultural competence into cross-cultural efficacy in womenʼs health education. Academic Medicine, 75(11),
Being culturally competent and delivering culturally sensitive care is imperative for anyone in the medical profession. It is important because of the many diversities faced every day in the health care field. However, simply understanding the fact that there are so many health disparities is not enough. In order to reach out and effectively care for patients of different backgrounds and cultures one must understand the importance of cultural competency. In order to be culturally competent, a nurse must have knowledge of the different cultures, and
The development of the Giger and Davidhizar Transcultural Assessment Model (GDTAM) came about because of nursing students’ need to provide culturally diverse care for patients. The model acknowledges that each culture is individually unique and assesses them according to six phenomena: communication, space, social organization, time, environmental control, and biological variations. In this model “nurses must use transcultural nursing knowledge as a skill and an art to provide care to diverse populations in a culturally appropriate and competent manner” (Sagar, 2012, p. 57). It goes on to discuss how the model sees cultural competence as “a dynamic process implemented by an individual or health care agency by using significant interventions based on the client’s ‘cultural
Throughout this paper I will be pulling information from the Giger and Davidhizar Transcultural Assessment Model. It is pertinent for health care workers to be familiar with this model because of the growing affects that culture has on a patient’s view of disease prevention and health restoration. This model focuses on six cultural phenomena: communication, time, space, social organization, environmental control, and biological variations. It is important for nurses to utilize this tool while performing assessments on patients because of the substantial effects that each one has on a patient’s perspective. Every person is unique and knowing that no one perspective is universal will aid the nurse in treating each patient with culturally competent care.
The Transcultural Assessment Model, developed by Giger and Davidhizar (2006), focuses on assessment and intervention from a transcultural nursing perspective. In this model, the person is seen as a unique cultural being influenced by culture, ethnicity, and