Therapeutic Nursing Practice: A Case Study

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).

In rural Iowa, there are few individuals who are knowledgeable of the Hispanic culture due to the small number of Hispanic individuals that have sought out care in the past. Recently, there has been an influx the number of Hispanic Americans seeking care in this area, making the delivery of culturally sensitive communication and care an important topic. According to DeNisco & Barker (2016), the nature of nursing care encompasses the need to be aware of cultural diversity (p. 581). Meaning that nurses need to strive for cultural competence to reach the societies expectations in the delivery of nursing care (DeNisco & Barker, 2016). We are going to take a look at how nurses can make a few changes that will make providing culturally competent care to the Hispanic population easier in these settings.

My name is Vik Seedheeyan. I have been working for the Raphael Medical Centre for the past 22 years. I started off as a care assistant. I then went to do my nurse training and became a Registered Mental Health Nurse. I took on more responsibilities and worked my way up becoming the Team Leader, then Nurse Manager and recently I was appointed as the Director of Nursing.

With the increasing immigrant population a third barrier affecting access to health care is a cultural barrier. Culture barriers can include values and beliefs, language and race and ethnicity. Health beliefs and behavior can become a barrier when patients decide not to seek medical treatment and instead turn to home remedies and healers when treating illnesses. Approximately 10% of Americans speak a language other than English and can be classified ad being limited in their proficiency. For these patients language becomes a barrier and they are less likely to receive optimal medical treatment (Flores, 2006). Horton and Johnson (2010) stress the importance of communication in reducing disparities and increasing the trust of patients in the health care system. As reported by the American College of Physicians, evidence reveals that racial and ethnic minorities are more likely to receive inferior care when compared with non-minorities. This occurs even when minorities have access to insurance and adequate income (Racial and ethnic disparities in health care, 2010).

During clinical time in the nursing program there are many opportunities for students to explore their new found nursing skills. While engaging in patient care responsibilities there are many languages, customs, values, lifestyles, beliefs, and behaviors that will differ from their own. Each patient may need healthcare providers to consider certain aspects in order to provide culturally competent care. There are many cultures that have migrated to the United States over the years including the people of Haiti. There are many aspects of their healthcare ideals that may need to be considered while providing healthcare in the hospital setting. This cultural assessment will consider the healthcare matters of an 81-year-old woman on the

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

Can you imagine the how the healthcare industry would be without language, what seems to be impossible to imagine is the everyday reality of some patients because of their native language. Language is a major contribution to the health disparities that some populations face, because it makes it difficult for some patients to communicate their problems as well as understand the care they provided. Language contributes to the health disparities that some populations face because it creates a barrier between the patient and the care provider, making it difficult for a patient to receive proper care. Language barriers create a communication gap between a patient and a provider, forcing the patient to feel misunderstood and unable to trust his/her provider to properly care for them. I come from a family that speaks more than one language, so I have seen the impact language barriers can have on someone who doesn’t speak fluent English.

With the large increase multicultural population in the United States, nurses encounter patients with differences in healthcare beliefs, values and customs. To provide adequate nursing care, nurses must be aware of these differences. They must respect and acknowledge the patient’s culture. To do this, nurses need education on cultural competence to ensure patient satisfaction and better patient outcomes.

In nursing school, we are normally taught that we should respect the dignity and rights of all clients. As the "world becomes reduced" and societies and individuals become more mobile, we are progressively able to network with people that are from other cultures. Cultural respect and competence for others becomes particularly significant for us as nurses and patient supporters. Applying the principles and theories of communication is important for sufficient patient care. A lot of various communication methods are executed and have diverse focuses. Small groups use mechanisms such as objectives, standards, cohesiveness, behaviors, and therapeutic issues. Duty, process and midrange groups are separate categories. Orientation, tension, cohesion, working and dissolution are stages groups go through. Successful personal and professional communication profits the patients and other health professionals; however, the lack of applicable communication can lead to poor patient results and a hostile and fruitless work setting (Doane, 2004). However, the cultural group targeted in this paper is the Native Americans because this group has become a challenge for public health nurses.

In a culture as diverse as the United States it is of utmost importance that individuals in settings such as the health care field learn to communicate with people from different cultures. This type of setting offers many chances for misunderstanding, miscommunication, and mistrust. It is imperative for the health care field to have an effective strategy to minimize these negative consequences of poor intercultural communication. One must also remember when implementing a communication strategy that there are many elements that effect the experience; cultural variations, personal dignity, and interpersonal relationships. An effective intercultural

Singleton, K., & Krause, E. (2009). Understanding Cultural and Linguistic Barriers to Health Literacy. The Online Journal of Issues in Nursing, 4(3), Retrieved from http://www.nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/ojin/tableofcontents/vol142009/no3sept09/cultural-and-linguist

The CLAS standards are designed to help improve health and mental health care disparities that exist in the U.S. It attempts to respond to racial and cultural changes in our demographics, and it has also been used for legal and accreditation requirements (National Class Standard Fact Sheet, 2013). According to the U.S. Department of Health and Human Services (2001), The CLAS standards are intended to meet the needs of underrepresented racial, ethnic and linguistic groups who have historically had unequal access to health services (Executive Summary,

The National Standards for Culturally and Linguistically Appropriate Services (CLAS) are designed to improve health quality and fairness by helping health organizations implement cultural and linguistic services in their facilities (United States Department of Health & Human Services (HHS), Office of Minority Health, n.d.). In this discussion, I will describe one CLAS standard that is significant to the Haitan-American culture, how I can implement culturally competent care to these individuals utilizing this standard, and what the biggest nursing challenge would be when implementing competent care to this culture.

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

One of the greatest things about nursing is that we have the opportunity to share with different cultures and learn about them. Our patients are complex; they each have their religion, culture, and life choices. Delivering health advice and not knowing much about a patient’s cultural background will influence how the patient may perceive the nurses’ advice. The article that I did my research on was published in 2011, by Perez-Avila, Sobralske and Katz; the name of the article is “No Comprendo: Practice Considerations When Caring for Latinos With Limited English Proficiency in the United States Health Care System”. In the United States, Hispanics form the largest minority. Most of this community has limited English