Nurses extolled to be culturally sensitive for better healthcare

With the globalization of health care, nurses must be culturally sensitive to understand the beliefs, values and practices of patients to be able to provide cross-cultural health care, according to Mary Curry Narayan, a board member of the Home Healthcare Nurses Association.

Speaking before the 21st American Pacific Nursing Leaders Council Conference, Narayan said patients immediately recover when health care is given in a culturally competent way.

A certified transcultural nurse and a clinical specialist, she reminded her colleagues that cultural competence is taking their insights and knowledge about culture and incorporating them into practice for the benefit of patients.

Researches show that when patients receive culturally insensitive and inappropriate care, their condition worsens. “They stay away from our clinics and they are alienated from our care. But when patients receive culturally competent care, outcomes improve. Patients follow our directions better, they improve better, quicker, faster when care is given in a culturally competent way,” said Narayan.

At the same time, she emphasized that in order to build health care teams who can achieve high quality patient care, there is a need to be culturally sensitive and respectful toward different cultures of their colleagues.

“Each individual is a unique and creative blend of their ethnic culture and all the other cultures to which they belong: the culture of their religion, occupation, age group, gender and socioeconomic group,” she added.

Narayan said she learned to become culturally sensitive and culturally competent when she had a Chinese patient who was terminally-ill. She thought she was practicing a caring and respectful behavior when she openly discussed the prognosis to him. “I believed that I was respecting his right to know the truth. However, both him and the family were deeply upset with my lack of subtlety and human kindness because in their culture to openly talk about death is to hasten death. I caused deep psychological and cultural pain to that family,” she said.

In Western Biomedicine, there has been a growing interest and acceptance of the wholistic healing traditions, an Asian and Pacific Islander health-illness belief that disease was caused by an imbalance or disharmony of the person’s holistic-body-mind-spirit-nature relationship.

Although Western Biomedicine calls it psychoneural immunology, this field of study recognizes the relationship of body-mind-spirit and any imbalance in one part affects the entire person.

Nursing is a unique profession because it has a unique gift to offer — caring. “However, caring behaviors are culturally determined. What is a caring behavior in one culture may be a disrespectful and offensive behavior in another culture,” Narayan said.

For example, a nurse from a Southern European culture uses a lot of touch because it is a soothing, caring behavior in her culture. But if her patient is a Hindu Indian who comes from a culture in which any touch, except the minimal touch needed to performing nursing task is taboo, the patient will feel she has been treated with offensive behavior, not caring.

An official who comes from the US federal health care system believes that documentation is a sign of a nurse who cares about her patients. On other hand, a nurse who comes from a culture with a largely oral way of passing on history, documentation has nothing to do with caring.