Cultural Competence In Nursing Practice Essay

Cultural competence is defined as possessing the skills and knowledge necessary to appreciate, respect, and work with individuals from different cultures. It is a concept that requires self-awareness, awareness and understanding of cultural differences, and the ability to adapt to clinical skills and practices as needed
(London et al. 2003). In the Orthodox Jewish community, there are many strict cultural guidelines that the women must adhere to. Within the following paper I will provide examples that demonstrate why cultural competency is important in nursing. When seeking treatment in the Orthodox Jewish law,it permits men and women from being alone together unless they are close family member, or married to each other. …show more content…Cultural Competence In Nursing Practice Essay
In the Orthodox Jewish community they believe in “Be fruitful and multiply”. It is Gods will how many children she will have, in this case the woman will avoid ever having a cesarean section as it can limit the amount of children she can have and she will not be able to fulfill Gods will.

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After childbirth, the nurse must be aware of the religious practices of naming a child. The woman will not fill her paperwork at the hospital, but rather fill it after the ceremony and return its afterwards. The giving of the name is thought to be a religious event and will lose significance if it is announced before either of these times (Abdelhak 2005). Orthodox Jews observe the Sabbath or Shobbas, which begins at sundown Friday evening and ends on Saturday evening. At this time no electrical appliance may be used or or any traveling by car. If the orthodox Jewish woman is discharged the day of Shobbas; the nurse should know that she will not be able to leave the hospital until Shobbas has ended  Cultural Competence In Nursing Practice Essay

An individuals’ culture is one attribute that differentiates them from the person standing next to them. Ones’ culture often shapes their lifestyle, sexuality, spirituality, and their perception of common social norms. Many often overlook the importance of cultural competence, and agree that it should be approached in case-by-case scenarios. Essentially, it is our moral obligation as human beings to attempt to understand the variety of different cultures. Being aware of cultural competence is essential in the nursing field. Nurses must learn to embrace and respect the cultural differences between each patient; not doing so can impede the progress of the nurse to patient communication process; it can cause the patient to withhold information, and even result in conflict. When a nurse falls subject to being racist, stereotyping or discriminating, it can often cause misinterpretation of the needs of a patient and what the patient is saying. For example, the perception of death, and how one may grieve within that situation is often overlooked and ignored by nurses. While some cultures view death as reincarnation, rebirth, or a form of deep sleep; according to Barrett, the African culture understands it “as a transition—a bridge that brings the deceased to a better place…you are born, you die, but you continue to live in the spirit realm.” (As cited In Collins and Doolittle, 2006, p.962) Within this essay, the customs and traditions of death within the African culture will be explained to aid in cultural awareness. There will be an in-depth understanding of how one (not being culturally conscious) can greatly affect the nurse to client relationship, and how, in result, the client will progress in relation to death and grievance.Cultural Competence In Nursing Practice Essay

In this multicultural society, going a culturally competent wellness attention professional is an indispensable and ambitious requirement. The United States is rapidly developing into a multicultural, pluralistic civilisation of assorted peoples. Harmonizing the U.S. Census ( 2000 ) , more than 30 per centum of the entire population is composed of diverse cultural minorities other than non-Hispanic White persons. As America is going progressively diverse, cultural competency is taking on an increasing importance. With this focal point on cultural competence in nursing and the significance environing the construct, it is of import to understand its significance and deduction on our continuously germinating and diversifying health care system. Harmonizing to Walker and Avant ( 2005 ) , “ construct analysis examines the makeup and function of a construct. ” Furthermore, concept analysis seeks to analyse and explicate a peculiar construct ( Walker & A ; Avant, 2005, p.64 ) . This concept analysis of cultural competency provides conceptual lucidity and scrutiny of the properties and history of cultural competency every bit good as the philosophical and theoretical application and relation of cultural competency to the nurse-patient relationship.Cultural Competence In Nursing Practice Essay

Specifying Properties of Cultural Competency
Harmonizing to the McGraw-Hill Concise Dictionary of Modern Medicine ( 2002 ) , cultural competency is “ the ability to understand, appreciate, and interact with individuals from civilizations and/or belief systems other than one ‘s ain, based on assorted factors. ” Walker and Avant ( 2005 ) identified specifying properties as “ the bunch of properties that are the most frequent associated with the construct and that allow the analyst the broadest penetration into the construct ” ( p. 68 ) . Cultural competency is best described as a procedure that can be categorized into three dimensions: consciousness, attitudes, and behaviours. After reappraisal of the literature, cultural competency is best described as a procedure categorized into three dimensions: consciousness, attitudes, and behaviours ( Dudas, 2012 ) . The specifying properties of cultural competence were identified as ability, openness, and flexibleness ( Suh, 2004 ) .

Awareness, the first dimension established in cultural competency, can be described as cognition cultural resemblances and fluctuations. One must see one ‘s ain inclinations, prejudices, ideas, and thoughts. When ethnocentrism is engaged, bias can step in with carry throughing cultural competency. Bias may besides include racial favoritism, generalisations, and stereotyping, all of which have the possible to step in with accomplishing cultural competency. Further, consciousness includes an apprehension of oneself and a individual ‘s ain civilization ; to grok the demands of another, one must grok oneself ( Dudas, 2012 ) .Cultural Competence In Nursing Practice Essay

Attitude is the 2nd dimension and incorporates the culturally adept health care supplier demoing sensitiveness toward those of differing civilizations than their ain. Openness is an indispensable value when sing attitudes. Preventing the leaning to be judgmental of others and non saying that all beliefs are the same is besides seen as of import. Acknowledging, accepting, and esteeming societal fluctuations and being comfy with difference civilizations are necessary attitudes to hold in the accomplishment of civilization competency ; along with the desire and willingness to germinate to other ‘s demands. Some claim that these attitudes are a ethical and moral duty of all medical staff ( Dudas, 2012 ) .

The 3rd dimension, behaviour, represents the actions the health care professional shows when accommodating and seting attention to be culturally congruous. This requires information of the civilization, attitudes, wonts, heritage, and behaviours of those in the health care suppliers attention and calls for creativity in the usage of that information. Behaviors will be alone as healthcare suppliers interact within, among, and between groups, understanding and appreciating the differences encountered ( Dudas, 2012 ) .Cultural Competence In Nursing Practice Essay

Ability is the first property of cultural competency. It is described as the health care supplier ‘s ability to proficiently and efficaciously supply attention to communities and people of diverse ethnicities. Cultural competence is about the health care supplier ‘s extended ability to acknowledge and take cultural difference and disparity between patients and medical professionals. Most of the current accounts of cultural competency include the word “ ability ” ( Suh, 2004 ) .

The 2nd and 3rd properties are openness and flexibleness. Openness largely includes health care suppliers ‘ being respectful, accepting, and holding an unfastened head. It mostly includes holding an nonsubjective mentality and a nonjudgmental attitude to cultural properties. Flexibility by and large means an ability to germinate and accommodate oneself to different fortunes and state of affairss. Flexibility related specifically to cultural competency means encompassing ethnically relativistic position, grasp of and dedication to other civilizations, and intersubjectivity ( Suh, 2004 ) .Cultural Competence In Nursing Practice Essay

History of the Concept
Recent research in the wellness scientific disciplines arena has merely begun to detect connexions between civilization and research design, analysis, and rating and their necessity. In contrast to its usage in the context of health care suppliers in wellness attention scenes, the impression of cultural competency in the model of research has been restricted. “ Cultural competency in research is the ability of research workers and research staff to supply high quality research that takes into history the civilization and diverseness of a population when developing research thoughts, carry oning research, and researching pertinence of research findings. ” In order to better understand the possible function of cultural differences among population groups, research workers must admit the go oning demographic displacements taking topographic point in our society. An apprehension of how such alterations may impact their research survey design, analysis and reading, and as a consequence how best to prosecute diverse populations in research is profound. The bulk of research workers do non appreciate or hold non received preparation that allows them to integrate the angle of minority populations into their work. This leads to the cultural position of the bulk being the lone position in the behavior of their work. Cultural competency is critical for research workers to guarantee: ( 1 ) valuable communicating and interface between survey participants and research workers ; ( 2 ) sufficient analysis and account of consequences as they pertain to the patient/population impact ; and ( 3 ) suited battle in survey design and executing for community/population based research. Cultural competency could assist to progress engagement of minority populations in research surveies, guaranting that assorted subgroups in the population are every bit represented ( Atim & A ; Cantu, 2010 ) .Cultural Competence In Nursing Practice Essay

Since research became a aspect of the nursing profession, there has been a demand for educational research workers, medical staff, and assorted cultural communities to come together to heighten and increase apprehension of unwellnesss, diseases, and conditions that affect people of changing racial, cultural, and cultural backgrounds. It is common to happen that executing analysis on health jobs in cultural communities is frequently restricted by deficiency of available information. Therefore, it is critical to partner off cultural communities to plan culturally appropriate research surveies and gather information that can be integrated in clinical determination devising and policy. There is besides a demand to measure culturally alone intervention methods and common people medical specialties to direct and inform clinical determination devising. Analyzing how unwellnesss and diseases manifest in changing civilizations, measuring culturally specific intervention methods, and detecting how belief systems influence the “ illness experience ” are important wellness issues require farther enquiry ( Victor, 2009 Cultural Competence In Nursing Practice Essay ) .

Including cultural competency in nursing course of study is an of import get downing measure to fix healthcare suppliers for culturally diverse pattern environments. It is besides indispensable to supply go oning educational chances to healthcare suppliers to augment their apprehension of different cultural beliefs sing wellness and illness, culturally specific intervention methods, and common people medical specialty. Welcoming leaders from a assortment of cultural communities to educate healthcare suppliers on their beliefs and patterns is a valuable manner to heighten consciousness and apprehension. There is turning grounds in nursing literature to back up the instruction of healthcare suppliers sing cultural competency ( Victor, 2009 ) .Cultural Competence In Nursing Practice Essay

Opposing positions of the term most appropriate to utilize for the construct of cultural competency are widely discussed in the nursing literature. These footings include cultural proficiency, cultural accomplishment, cultural sensitiveness, cultural apprehension, cultural consciousness, and cultural cognition ( Burchum, 2002 ) . Cultural proficiency is grounds of a committedness to alter and to derive new cognition through carry oning research, developing new culturally sensitive attacks, and by presenting the information to others ( Burchum, 2002 ) . Cultural accomplishment is the ability to obtain pertinent cultural informations and information about patient ‘s immediate conditions and execute a culturally sensitive and specific appraisal ( Flowers, 2004 ) . Cultural sensitiveness is appreciating and valuing diverseness. It means esteeming a patient ‘s beliefs and values thought it differs from one ‘s ain ( Burchum, 2002 ) . Cultural apprehension is recognizing that civilization shapes one ‘s beliefs, values, and behaviours as it relates to wellness issues and is understanding that marginalisation influences forms of seeking attention ( Burchum, 2002 ) . Cultural consciousness refers to self scrutiny and in-depth find of one ‘s ain cultural and professional background and possible prejudices and biass ( Flowers, 2004 ) . Cultural cognition is the seeking and geting of an information base on difference cultural and cultural groups. It is familiarity with conceptual and theoretical models that will explicate how members of a peculiar civilization interpret unwellness ( Flowers, 2004 ) . Although, there has been a leaning by some to utilize footings such as cultural sensitive to bespeak a conceptual equality to cultural competency, this and alike footings are in fact constituents of cultural competency ( Burchum, 2002 ) .Cultural Competence In Nursing Practice Essay

Philosophical and Theoretical Application
Florence Nightingale ‘s with soldiers during the Crimean War and her work with the Australian Aboriginal people leads her to being coined as the first transcultural nurse in modern history ( Zander, 2007 ) . However, the proposal to make and establish a new field of transcultural nursing that incorporated the construct of cultural competency began with Madeleine Leininger in the late fiftiess and her Culture Care Diversity and Universality theory ( besides called Culture Care Theory ) . In 1965, Leininger introduced the first transcultural nursing plan at the University of Colorado ( Zander, 2007 ) . The Transcultural Nursing Society was established in1974 and the first Transcultural nursing book in 1978. The Journal of Transcultural Nursing began in 1989 ( culturally competent attention: unseeable and seeable ) . In the late 19901s, several theoretical accounts were developed to include patient ‘s cultural factors in nursing pattern such as the Sunrise Model ( Suh, 2004 ) .Cultural Competence In Nursing Practice Essay


Theories and doctrine are used by a subject to separate it from other subjects. Leininger ‘s theory was built around the construct of cultural competency and was foremost published in 1988. The Culture Care Theory guides the nurse to execute a culturalogical appraisal and to develop a attention program sensitive to the patient ‘s cultural background. This theory encompasses cultural competency by concentrating on understanding both similarities and differences in patient groups and civilization attention catholicity versus cultural attention diverseness. Using the theory allows the health care supplier to better buttocks and supply resources and support that are respectful and most good for that specific patient in his or her civilization. Cultural competency and the Culture Care Diversity and Universality theory require instruction of other civilizations, including faiths, moralss, and societal constructions to do healthcare suppliers more sensitive to patients with all types of backgrounds ( Leininger, ) .Cultural Competence In Nursing Practice Essay

Nurses today are confronted by a universe in which they are required to utilize transculturally-based nursing theories and patterns in order to care for people of miscellaneous civilizations ( Leininger, 1996 ) . The chief aim of the theory of the Culture Care Diversity and Universality is to detect and explicate different, worldwide culturally based attention factors act uponing illness, decease of persons or groups, and wellness. Using research consequences to supply culturally competent, safe, and meaningful attention to patient ‘s of different or similar civilizations is the intent and end of Leininger ‘s theory ( Leininger, 2002 ) . Leininger ( 2002 ) believed that “ substantial theory-based research cognition was greatly needed with a planetary and comparative focal point to care for people of diverse civilizations ” ( pg. 189 ) . Leininger laid claim to the concept of culturally congruous attention, which is the cardinal end of the theory. Today, the Culture Care theory has been good established today and is used by many nurses worldwide. The theory is known for its wide, holistic yet culture-specific focal point to detect meaningful attention to diverse civilizations ( Leininger, 2002 ) . Culturally congruent, responsible, and sensitive attention and the construct of cultural competency can no longer be omitted in human wellness services and new wellness attention reforms as health care services are more popularly being rendered to immigrants, refugees, and other culturally diverse people ( Leininger, 1994 ) .Cultural Competence In Nursing Practice Essay

There are five major, alone, and lending characteristics related to the Culture Care Theory. The first is that holding been launched in the mid-1950s, the theory is one of the oldest theories in nursing. Second, it is the lone theory entirely concentrated on interrelatednesss of civilization and attention on wellbeing, disease, and decease. The 3rd characteristic of the Culture Care Theory is that it is the most complete and multidimensional theory to determine specific and comprehensive culturally based attention pattern and significances. Fourth, it is the first nursing focused on researching international cultural attention fluctuations and attention commonalties. Bing the first nursing theory with a distinctively designed research method ( ethnonursing ) to fit the theory is the 5th alone characteristic. Fifth, it is the first theory focused on societal organisation factors, informations related to planetary position, assorted environmental contexts in ethnohistory, and generic ( emic ) and professional ( etic ) civilization attention ( Leininger, 2002 ) .Cultural Competence In Nursing Practice Essay

Out of the Culture Care theory grew the Sunrise Model. The dawn theoretical account is a conceptual usher picturing the major interconnected dimensions of the theory that need to be discovered in order to bring forth civilization attention cognition. The theoretical account presents different factors that need to be considered to get at a holistic image of persons, households, groups, civilizations, communities, or establishments related to civilization attention forms and demands. Presently, the theory and the dawn theoretical account are being used to make culturological wellness attention appraisals for primary attention and to develop culture-specific nursing attention patterns. Datas obtained from the dimensions of the dawn theoretical account lead to a comprehensive holistic manner of cognizing and understanding people. Using the theory with the dawn theoretical account helps the nurse to believe holistically to detect a patient ‘s meaningful lifeways that relate to the their wellness, unwellness, or deceasing procedure. The theory and theoretical account are major forces in traveling nurses from the traditional medical theoretical account of nursing to a new nursing paradigm for the twenty-first century ( Leininger, 1996 ) .Cultural Competence In Nursing Practice Essay

Cultural Competence in the Nurse-Patient Relationship
Cultural competency begins with the recognition that every person is born, reared, and brooding in educational, societal, and organisational civilizations. These civilizations shape premises, beliefs, values and behaviours ( New South Wales Health Department, 2010 ) . The American Nurses Association ( 2001 ) recognized the demand to supply culturally competent attention and stated in the association ‘s codification that “ The nurses, in all professional relationships, patterns with compassion and regard for the built-in self-respect, worth and singularity of every person, unrestricted by considerations of societal or economic position, personal properties, or the nature of wellness jobs. ” When health care suppliers interact with patients, the similarities and differences between cultural outlooks frequently make the interaction both more interesting, and more challenging. In a wellness scene, these challenges must be met if just, appropriate and accessible services to all patients are to be provided ( New South Wales Health Department, 2010 ) . Interpersonal communicating is cardinal in the ability of a supplier to bridge cultural differences to construct an effectual relationship with a patient. The healthcare supplier must construct resonance and trust, convey unconditioned positive respect, be cognizant of wellness disparities and favoritism impacting a peculiar patient ‘s minority group, and efficaciously use translator services when needed ( Beach, Cooper, & A ; Saha, 2006 ) .

Diversity of the world’s population has reached a point where it is vital to address and more importantly to understand, the ever growing challenge that transcultural nursing poses to the nursing profession. Addressing this issue avoids discrimination and promotes equality within holistic nursing practice in order to meet patients’ needs. Health care professionals should be qualified to deliver, on a daily basis, proficient care and sensitive skilled communication to culturally different individuals (Maier-Lorentz, 2008).

To exercise professional nursing in a conceptual way holistic nursing care focuses on physical, emotional, social, environmental and spiritual aspects as well as on the idea that any individual involved in treatment care should be treated as a whole and with dignity (Dossey & Guzzetta, 2005).

One of the areas to be discussed is Transcultural Nursing and Leininger’s Transcultural Theory of Culture Care Diversity and Universality and its research enablers: the Sunrise Enabler and the Ethnonursing Method.

Another area will be Holistic Nursing Practice and Nightingale’s Nursing Theory of Environmental Adaptation as well as the liaison between Transcultural Nursing and Holistic Nursing Practice.

Nightingale’s theory has been chosen over others because she was the first to acknowledge nurses’ work in a theoretical framework and also because she was considered to be the mother of nursing practices (Ellis, 2008).

The development of culture care theory introduced health care professionals into a new nursing dimension formed by issues such as culture background, spirituality, environment and others that demonstrated how culture and health care are linked (Leininger, 2002a).

Holistic Nursing Practice encourages active communication and reciprocal understanding, underlines the exercise of physiological and psychosocial awareness, it is based on logical thinking and supports values such as autonomy and patient wishes and tendencies (MacKinnon, 2010).Cultural Competence In Nursing Practice Essay

Transcultural Nursing
Transcultural nursing may be defined as a method to contrast and observe how individuals view health care, biased by their culture background. The principles of practising transcultural nursing are to provide complete nursing care to individuals or groups by treating them with respect and taking into account their cultural factors. It is all about nursing practice applied to cultural values and limitations (Leininger, 1991).

Definitions of transcultural nursing incorporate many factors that shape the individual’s cultural orientation. These include are age, sexual orientation and financial aspects. It has been suggested that by ignoring these culture background factors, health care professionals do not achieve enough cultural experience to be incorporated in holistic nursing practice (Barnes et al. 2000). This absence might lead to unsafe nursing care and both dissatisfied patients and professionals (Curren, 2006 cited in Leininger & McFarland, 2006, pp.159-160).

To promote transcultural nursing care, Narayan (2001) felt that there are four crucial attitudes to assume – caring, empathy, openness and flexibility. This shows the patients a cultural understanding, appreciation, consideration and willingness from health care professionals that are based on individual care.

Cultural education and the creation of culturally competent care professionals are one of the biggest challenges yet to tackle worldwide. For instance, in America, as the migrant population increases notably so it does the need for reducing inequalities and barriers such as language. Maier-Lorentz (2008) firmly understood that such a need could be met by the targeting of bilingual health care professionals coming from different backgrounds. Moreover, she suggested that in order to provide culturally competent nursing care, some knowledge of non-vocal communication signs could be of great value, as it is in eye contact, touch, silence, space and distance, and health care habits.

Green-Hernandez (2004) recommended that as a step towards multicultural competency, professionals that need to deal with farmers should familiarize themselves with their specific customs such as using animal medication for their own conditions as a consequence of living far away from the care institutions.

With the purpose of understanding culture, Andrews & Boyle (1997) gave out diverse illustrations. For example, they suggested that by understanding a people’s proverbs, professionals may grasp knowledge of the cultural values shared by that population. The authors also stressed the importance of culture knowledge when coming across two different ways to view stealing. For one culture it may not be acceptable whereas for another one, e.g. gipsy people, it may be ok, as long as it is coming from a better-off person. Furthermore, they also found, through researchers, that different cultures may think that by being a demanding patient, the treatment they receive may improve.Cultural Competence In Nursing Practice Essay

Riley (2004) reported that a foremost test for nurses in an ethnically different society is communication. Not just words but also tone and volume form spoken communication which in diverse cultures differs greatly. For example, Thai people are regarded as not talking too much as they believe it is a sign of idiocy whereas Cuban people are happy with talking vociferously. He also pointed out that Europeans are not afraid of talking about emotions whereas Asians are hesitant to do so.

With regards to communication without words Riley (2004) explained that eye contact is not always expected. For instances, in Native America and Asian cultures it is offensive and among Muslim Arab women it is allowed only to their husbands. Therefore, he identified the importance for healthcare professionals to be culturally aware.

Phillimore (2011) explored the challenge of provision of diversity needs in the UK based on studies done on health care service provision to new migrants, during 2007/08 in Birmingham. She stated that with political forces wanting to reduce welfare support for new migrants, such provision becomes quite a challenge. She also believed that, in the long run, this disregarding of health care needs will lead to further issues for the health care system that otherwise could be avoided by just providing what is needed now: cultural and language services and health support.

It was also suggested that in today’s political climate offering of ethnically specific provision by the community and for the community, results in the local needs not being met, as the existing GP systems are already overstretched. She concluded that a number of migrants are condemned to an unwelcoming future since UK seems to embrace a tendency of anti-migrant sentiment and a move to community institution instead of multicultural provision (Phillimore, 2011).Cultural Competence In Nursing Practice Essay

The Culture Care Diversity and Universality Theory by Madeleine Leininger
In the 1950’s Madeleine Leininger, a nurse-anthropologist, realised that nursing practice was requiring a theory to allow people to transform nursing into a more advanced and beneficial discipline that challenges nurses to open up to cultural variety and universality (Leininger, 2006).

This was developed as a response to the demand for multicultural care which was immense and yet incomplete as many healthcare systems did not consider the need for bringing together culture and nursing care (Giger & Davidhizar, 2008).

The culture care diversity and universality theory developed by Leininger in 1991 (Leininger, 2002a) is unique in that it focuses on competent care, can be used upon any culture and is based not only on individuals but groups and families too.

The theory addresses the importance of a consistent cultural competence instrument to acquire cultural awareness through a constant learning attitude and approval towards human differences and rights by health care professionals (Burford, 2001, cited in Baxter, 2001, pp. 202-203).

Leininger (2002a) insisted on the importance of transcultural knowledge as a tool to avoid human acts such as the event of September 11, 2001. She then proposed the culture care theory as the most holistic approach to gradually transform the health system. This much needed transformation requires understanding of individuals in ways that identify and respect their cultural background and will lead us to understand such transcultural dismay.

The theory was used in a study among Hispanic home care patients in the US, 2007, in order to identify cultural needs. As a result, care delivery improved in some areas and there was a suggestion describing the use of the model as a tool to reduce costs in the health care system (Woerner et al. 2009).

Leininger’s theory applies not only to races from different backgrounds but also to today’s controversial groups such as transgendered people, disabled people , the youth, poverty and the homeless that may pose a certain degree of difficulty of understanding to healthcare professionals. There is also an agreement that, thanks to Leininger’s culture care theory, the nursing profession today knows how to allow for culture when looking after individuals and has a widely spread caring philosophy in hospitals (Clarke et al. 2009).

For this model to assist the health care professional to understand factors as important as management and policies, as well as being able to reflect on their decisions and actions, Leininger designed two tool assessments, The Sunrise Enabler and the Ethno Nursing research method, which are based on monitoring treatment care on a daily basis (Hubbert, 2006, cited in Leininger & McFarland, 2006, pp. 354-356).Cultural Competence In Nursing Practice Essay

The sunrise enabler focuses mainly on total life ways and caring factors influencing health and well-being, disabilities and death. It also identifies features influenced by the patient’s cultural background whereas ethnonursing finds ways in which multicultural care could be better. In doing so, the reflected culture becomes part of the holistic nursing practice (Leininger, 2006).

The Sunrise Enabler
The Sunrise Enabler is used as an assessment tool to enable multidisciplinary teams to deliver suitable and competent cultural assessments that impede intolerance and stereotype behaviour. This is to supply the healthcare system with a guide to cultural vicinities ranging from religious beliefs to economic factors (Giger & Davidhizar, 2008).Cultural Competence In Nursing Practice Essay

Wherever a healthcare professional starts the model either from the top or from the bottom, the most important feature is to listen to the individuals, trying to grasp ideas and concepts rather than enforcing them (Leininger, 2002a).

Healthcare professionals struggled to understand the meaning of factors influencing the care practice so crucial when applying the culture care theory. Such factors as culture beliefs, environment and religion were to be included in the nursing care, therefore Leininger (1997) built the Sunrise Enabler to illustrate such aspects.

The Ethno-nursing Method
This method was developed to fit the purposes of qualitative research methods. It is a systematic method for studying multiple cultures and care factors within a familiar environment of people and to focus on the interrelationships of care and culture to arrive at the goal of culturally congruent care. Ethnonursing is a particular research method developed by Leininger to inspect the theory. It was developed to allow health care professionals to discover new ways of helping different cultural groups distinguish features of nursing care (Leininger, 2006).

Leininger (2006, p.6) stated that the ethnonursing method “…was new and unknown in nursing and was different from other qualitative methods including ethnography”.

Holistic Nursing Practice
The exercise of modern nursing is based on the view of holism that underlines the individual’s wholeness. Healing viewed as an indication of nursing practice that treats people as whole, developed in the late 20th and early 21st century into a popular subject in nursing in order to clarify the meaning of wholeness and holism. As a result, alternative therapies surfaced as approaches of practice in holistic nursing (Locsin, 2002).Cultural Competence In Nursing Practice Essay

The definition of holistic came into effect in the 20th century. Then the word holism included the physical, emotional, mental, social, cultural, and spiritual view. This view of holism was envisioned by Florence Nightingale who is seen today as an example to follow, although many of her studies are not used in today’s nursing practice (Beck, 2010).

“Holistic nursing care embraces the mind, body and spirit of the patient, in a culture that supports a therapeutic nurse/patient relationship, resulting in wholeness, harmony and healing. Holistic care is patient led and patient focused in order to provide individualised care, thereby, caring for the patient as a whole person rather than in fragmented parts” (McEvoy & Duffy, 2008, Vol.8, p. 418).

Furthermore, it addressed the expansion of multidisciplinary and collaborative teams as a way to applying holistic care into practice and asserted that the practice of holistic care by health professionals should avoid intrusion and, when really needed, as it is the case of unconscious patients, should use skills that include aspects such as consideration, disciplined criticism and liability in order to exercise nursing in a holistic approach (McEvoy & Duffy, 2008).

Since individuals from different culture backgrounds may appreciate holistic nursing practice and care choices in different ways so is the healthcare provided in different ways (Locsin, 2001). It may also be the case that some individuals may feel embarrassed to mention alternative remedies used in the past, therefore the assessment should be supportive rather than disapproving (Maddalena, 2009).

Pearcey (2007) ran a study on clinical practices amongst student nurses to draw on a few key points related to holistic nursing practice. It was found that the notion of holistic care was not clear within nursing practice. Some students claimed not to know the right meaning of holistic nursing practice and also claimed that tasks and routines are what nursing is all about. The study showed an evident lack of professionalism and knowledge amongst care professionals as well as a huge gap between what is taught and what is really applied at work. The author concluded that there is a real risk of inconsistency within the profession.Cultural Competence In Nursing Practice Essay

Within the practice of holistic care there has been lately a huge influence of alternative or complementary medicine which care experts have tried to professionalise by setting certain values to be met. A study amongst nurses and midwives accomplished in England, 2008, revealed this but also the lack of initiative from the NHS to incorporate such practices, even though it was demonstrated that a huge variety of them were successfully applied on patients where biomedicine seemed not to work. Such practices included reflexology, aromatherapy, acupuncture and massage that actually underlined biomedicine rather than substituted (Cant et al. 2011).


Whilst carrying out an interview on medical students in the UK, a student suggested that it is actually a catch-22-situation when looking after patients from diverse races as they have diverse predominance of whatever conditions that eventually will require different treatment, a world apart from what is being taught in medical schools with regards to treating everyone in the same way (Roberts et al. 2008).

A quick look to Harrison (2008) for a concluding comment on multicultural nursing in relation to holistic care, offers us this brief view: a Western health care organism that has not managed to treat minority communities in a holistic manner is a system that claims to care for one and all identically.Cultural Competence In Nursing Practice Essay

The Theory of Environmental Adaptation by Florence Nightingale
According to Nightingale’s Theory of Environmental Adaptation, an individual’s health is improved by looking after the surrounding environment. It goes further than this and asks for the environment to be operated by the health care professionals as an approach to healing (Howett et al. 2010).

Florence Nightingale defined nursing as “…the act of utilising the environment of the patient to assist him in his recovery” (Funnell et al. 2009). She determined that the deficiency of factors such as uncontaminated air, clean water, sanitation, hygiene and sunlight is unhealthy to the human being. Furthermore, she reasoned that temperature, environment and nutrition affect the patient (Kozier, et al. 2008).

This theory of nursing includes inspection, recognition of environment changes and their execution and supporting the patient health care by allowing the environment to benefit the patient (Neils, 2010).

Selanders (2010) reviewed and compared this theory’s aspects with modern day practice and reported that Nightingale’s concept, such as air, light, noise and cleanliness is equal to today’s concept of physical environment; health recommendations to psychological environment; food to nutritional status and observation to nursing management. The author also estimated that the theory has been used in several qualitative works and some studies on the childbirth process.Cultural Competence In Nursing Practice Essay

Transcultural Nursing vs. Holistic Nursing Practice
According to Leininger (2002b) patients are not provided full holistic care by health professionals. Factors such as kinship, religion, environment and culture are largely missing. For that reason, care professionals should avoid being judgmental when delivering holistic care and rather provide an all-inclusive care that respects the individual’s cultural background (Maddalena, 2009).

As a student nurse, it is vital to value the development of cultural awareness and competency within the profession in order to encourage and address all stages of holistic nursing practice as it is meaningful to today’s multicultural society. Leininger (1997) also claimed that essential practice is needed to create a regulation of multicultural nursing that could be of use to much ignored cultures.

For example, acute medical treatment, medication, and patient fulfilment can be improved by understanding care beliefs when bringing in nursing care which, in turn, could save the health care system financially and also have a desired positive outcome on patients (Woerner et al. 2009).

Individuals or groups may clash with health professionals if they are not showing respect for each other’s cultural beliefs resulting in poor treatment and patients losing hope in the health care system. Hogg (2010a) also underpinned this understanding as crucial to delivering accurate holistic nursing practice. However, not only patients may lose faith in the system. Hogg (2010b) also affirmed that nurses from black and minority ethnic have suffered, at some point, racial harassment as well as lack of opportunities according to their numbers in the nursing profession.

As holistic nursing practice centres on recognition of patients’ rights and choices (Potter, 2005 cited in Dossey et al. 2005, p.347), it is subsequently supporting the meaning behind multicultural care. The association of both precepts confirms an ongoing engagement to pursue equality and diversity as promoted by the Nursing & Midwifery Council (2008).

“Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status” (The International Council for Nurses, 2005).Cultural Competence In Nursing Practice Essay

When assessing, planning, implementing and evaluating a patient’s needs as to medication, health professionals should take into account culture’s physiologic traits, as it can seriously impact the treatment. For instances, due to genetics, for one patient a normal given dose may develop a reaction whereas for another it may not work at all (Anon, 2005).

An person who is culturally competent can pass on considerately and expeditiously with patients who have multiple and changing ages, genders, civilizations, faiths, genders, disablements, linguistic communications and ethnicities. Culturally competent wellness attention suppliers make every attempt to afford services that are consistent with the patients ‘ demands and moralss foremost of all by admiting them, and secondly by, reacting to them suitably wherever possible ( New South Wales Health Department, 2010 ) . It is necessary for health care practicians to develop a broad scope of positions, cognition, accomplishments, attitudes, and patterns which can be used to better their cultural competency and steer their relationships with patients and coworkers ( New South Wales Health Department, 2010 ) . However, it is of import that suppliers do non accidentally stereotype or label a patient ( Flowers, 2004 ) .

Lack of cultural competent attention impacts both patients and healthcare suppliers. Peoples with rural backgrounds are used to covering through household and affinity webs, in contrast to those with urban backgrounds. Health attention establishments frequently represent loss of personal pick in the sense that the patient does non “ cognize ” the suppliers. Extinguishing this feeling of loss is a critical portion of provider-patient interactions and supplying culturally competent nursing attention ( Marlie & A ; Putsch, 1990 ) . It has besides been found that failure to supply culturally congruous attention can greatly increase the emphasiss experienced by critically sick patients ( Flowers, 2004 ) . It is difficult for patients to construct a sense of trust in a health care supplier or a service if they feel they have been dismissed or disregarded, their concerns have non been understood, or they have non received the best services because of their cultural background or ethnicity or linguistic communication ( New South Wales Health Department, 2010 ) . Culturally competent wellness attention suppliers set up regard and trust with patients which in return addition patient satisfaction. Health results besides improve such as a more efficient usage of the staff and patients ‘ clip, more accurate information, and more helpful and satisfactory results for staff and patients ( New South Wales Health Department, 2010 ) .Cultural Competence In Nursing Practice Essay

Advantages of integrating the construct of cultural competency are the specific pertinence to daily nursing attention and nurse-patient relationships and the quality of nursing attention through proviso of culturally congruous attention is greatly improved. Disadvantages to the nurse-patient relationship in ague attention scenes may be that an interview and observation in a patient ‘s ain environment is non possible, a patient with altered mental position may non be able to efficaciously collaborate during the appraisal, and application of cultural competency may be clip devouring ( Mannion & A ; Scott, 2002 ) . It is believed that the intersubjective relationship between the nurse and patient is prerequisite to quality nursing attention is. This relationship is characterized by receptive and caring attitudes toward patients and their wellness attention demands and is without speculation or judgements. Knowledge of patients ‘ cultural properties and acknowledgment of and responsiveness to cultural differences allows for this type of nurse-patient relationship to take topographic point ( Frederickson, Kleiman, & A ; Lundy, 2004 ) .

Example of Cultural Competence as Related to Nursing Practice
Harmonizing to Walker and Avant ( 2005 ) , a theoretical account instance “ is an illustration of the usage of the construct that demonstrates all specifying properties of the construct ” ( p.69 ) . The undermentioned instance demonstrates the specifying properties of the construct of cultural competency.Cultural Competence In Nursing Practice Essay

As nurses, we can be culturally competent in other cultures apart from our own. Such a case is possible since cultural competency is all about improving one’s ability to alter one’s assumptions, stereotypes and false beliefs and being fully aware of the other side of the story thus ruling one’s way of thinking as the only way out.

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According to the Division of Social Services and the Family and Children’s Resource Program (1999, Para. 5), cultural competence entails inculcation of the ability to work in an effective way with individuals originating from varying economic, cultural, religious, ethnic and political backgrounds.

However since it difficult to appreciate other people’s traditions, beliefs, customs and values without appreciating and recognition our cultural identities, our own cultural competence should come first.

Cultural intelligence focuses on identification of in political, economic, cultural, religious and ethnic existing differences amongst people (Strader, 2004, p.9). On the other hand, cultural sensitivity entails taken positions inasmuch as the identified cultural attributes are concerned, which could either be geared towards fostering positive or negative stereotypical perceptions.Cultural Competence In Nursing Practice Essay

Cultural competence then comes in as an attempt to bridge and aid in fostering inculcation of the ability to work in an effective way with individuals originating from varying economic, cultural, religious, ethnic and political backgrounds.

It is important for the terms to be differentiated since they give different implications especially in the nursing practice when it comes to the control and regulation of the patient’s operational environment.

In relation to environmental control and patient teaching, nurses require open-minded skills. According to the Division of Social Services and the Family and Children’s Resource Program (1999, Para. 7), this encompasses the willingness to set aside one’s cultural affiliations by accepting other people’s perspectives and points of view in an attempt to understand them amicably.

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Open-mindedness bars one from practicing uncomfortable behaviors, taking risks and even curtailing his/her defenses of unfamiliar cultural indulgencies and inclinations.

Module four
America has had well documented historical health disparities. For instance, the comparison for health indicators for whites and blacks in Chicago and Illinois were made by Silva amongst others (Orsi, Margellos-Anast, & Whitman, 2010, p.349) for the period 1980-98. In 2002, Keppel made significant contributions on the subject of health disparities.Cultural Competence In Nursing Practice Essay

The Silvas’ results confirmed that, although health disparities have significantly reduced, they persisted among five ethnic or racial groups of the US (Orsi, Margellos-Anast, & Whitman, 2010, p349). Despite the narrowing of white-black Hispanic health discrepancies in the national arena, Chicago situation was completely opposite in 1980-98.

The health disparities in the US can be attributed the problem that has ailed the nation throughout its history: racism and poverty discrepancies. Whites have better health compared to blacks (Orsi, Margellos-Anast, & Whitman, 2010, p353).

Despite the lack of adequate evidence, stresses attributed to racism perceptions have the capacity to inculcate poor health amongst the blacks since racism foster education discrepancies and vary social economic levels. It is thus not shocking for Chicago, being one of the segregated regions to have increasing health disparities.

To deal with the problem, various government and private sponsored programs are established. For instance, the institute of medicine has a particular focus of racial discrepancies in breast cancer.Cultural Competence In Nursing Practice Essay

In addition, federal initiatives are established to help create awareness of the discrepancies in health the first one being the 1985 secretary’s task force report on minority and black health discrepancies (Orsi, Margellos-Anast, & Whitman, 2010, p 349).

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Others include the healthy 2010 population, which has 467 objectives, 2 chief goals and 28 areas of focus. Among the main goals is the elimination of health disparities as well as fostering a healthy population of the US.

The impediments to deal with the health disparities include poor urban areas’ response to deal with the instigators of the disparities and the approach used in the campaigns. The campaigns are conducted with the identified causes in mind: racism and poverty being the main ones, which serve to foster stereotypic perceptions.Cultural Competence In Nursing Practice Essay

It is however, surprising to learn that even in the modern world of equality and appreciation of human race similarity with racial criteria of human differentiation serving as only superficial identity, health disparities are still differentiated along the same lines. Cultural Competence In Nursing Practice Essay

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