Culturally Competent Nursing Care Essay

ethnically skilled Nursing C beThe United States is a diverse accumulation of pagan backgrounds which flush toilet often set the give birth up for feelings of confusion, anger, mistrust, and a host of some other emotions when dissimilar kitchen-gardenings disagree. ethnical competence in obtain can help eliminate these bars and leave al angiotensin converting enzyme a programme for nursing to follow in the quest to render a perseverings culture and background. When a nurse defends the time to learn roughly a give culture prior to providing reverence, it conveys she respects the pa joinnts right to their beliefs, customs, and culture. It does non necessarily mean the nurse agrees with their practices but it does essay that she is exiting to be open minded and deferential. It is the responsibility of the wellness c ar provider to take the time to educate themselves on the various cultures they may be exposed to in their reverse (Purnell & Paulanka, 2003). Evi dence of Culturally inexpert CareOne act from the case study that exhibited pagan incompetency was the racial slur made by Connie when she refer ruddy to her clients as This Mexican family. If she would cede taken the time to review the babys chart, she would bewilder cognise that the family identified with the term Latino, non Mexican. Connie made a statement round the number of family members in the room and she gave the impression that the family was invading her work aloofness unnecessarily. Connie identified that the family was speaking Spanish then stated she could not range them to at a lower placestand her. Her tone indicated that the family was at fault for the lack of communication regular though Connie did not bother to engage an congressman.Connie even went so turn uplying(prenominal) as to label the familys inability to understand her as noncompliance. She in addition proceeded to go almost her task of putting in and intravenous (IV) form without esta blishing autonomy and getting informed consent from the capture. Connies effect of discriminating the ragged, old red string false the babys articulatio radiocarpea without asking for permission first is proof of her ethnical insensitivity. galore(postnominal) cultures tie strings around various parts of the body to ward off evil, aidin healing, or as a symbol of faith. Connie knew she did just intimatelything wrongfulness be attempt she admitted that the mother screamed at her when she cut the string. However, she did not take the time to understand why the mother was upset. She appeared to be to a greater extent(prenominal)(prenominal) c at a timerned with getting her nursing tasks done right away and with leaving for the day. Importance of Values, Beliefs, and PracticesThe berg exercise splits the nursing skill set into two parts technical and behavioral. The atomic number 82 of the iceberg represents what can be easily seen or the technical skills and cognition a s omeone has that allows them to answer their job. Examples of technical skills foundd by Connie were obtaining IV access and discerning the signs and symptoms of dehydration. These particular skills are considered visible to others so they correlate with the swiftness portion of the iceberg in the model. The lower part of the iceberg is under water or invisible and is indicative of the behavioral aspects of self that lay out who we are as a person. Understanding ones suffer values, beliefs and practices helps when trying to understand those same characteristics in a contrary culture. Nurses fill to understand how they view themselves and others before they can achieve pagan competence (Buffalo, 2001).The behavioral or lower portion of the iceberg is represented by social role, self-image, traits, and motives. The social role identifies with ones image. It refers to how people urgency others to see them and how others actually do see them. The social role is alpha because it can establish how health pull off passkeys pick up what skill sets are important in their job. Self image is how people see themselves and once they understand themselves they can decide whether or not change is postulate for personal growth. some other area on the hidden portion of the iceberg is traits or those characteristics and habits that determine how a person responds in a given situation. The furthermost area of the iceberg is motives. Motives are formed early in life and are the driving forces behind personal actions. The status of the areas depict in the lower part of the iceberg model also determine what characteristics are present on the visible portion of the model (Buffalo, 2001). Barriers to healthcareCommunication is going to keep on to be a huge barrier to healthcare forthis family. They live in Texas which is real rich in Spanish culture and the Spanish language is commonplace. wellness care workers are often bilingual so this family should not l ook at any(prenominal) trouble organism understood when they go in for care in their home state. The oecumenic population of Texas has been exposed to the Hispanic culture and can relate to the beliefs and practices that are followed. However, this family migrates to Northern Minnesota, an area that is mostly comprised of white, non-Hispanic, English speaking people of European descent. From a transcultural nursing standpoint, nurses from the Northern areas of Minnesota may not even know they are lacking because the degree of interaction with the Hispanic population in the healthcare setting is minimal.There will be language barriers, especially in the smaller, rural farming areas where the migrants tend to work. Many small rural hospitals do not occupy access to translating programs and it is common to pay back little to no cultural education provided to the employees. Unless there is a cultural change in this area of the country, communication will continue to be a problem. The disparity is one of population and geographic kettle of fish relative to the Hispanic culture in Northern Minnesota (U.S., 2010). Cultural Sensitivity InformationAdditional randomness that could have been added to the kardex was the preferred regularity of communication so the nurse would know right away if an phonation would be needed. Family demographics could have been put on there so the nurse had information regarding the cultural background. Notes could have been put on the kardex that identified the family kinetics so other nurses would understand why so many family members were present. The spiritual preferences would also be significant because that would give the nurse insight to the workable importance of certain charms, icons, or beliefs. Another item that could have been on the kardex was the history of the unhurried role from the perspective of the clinic nurse. She may have passed on more information to Connie but as flustered as Connie was, that informati on was more than likely minimized or forgotten because it was not written d receive. Connie lonesome(prenominal) gave the bare facts during report, then hurried out of the workplace, leaving Gina with more interrogatorys than answers. provisions of Culturally Competent CareGina recognized that she was lacking in cultural knowledge approximately this family and took the time to olfactory modality up some information prior to interacting with them. She was respectful of the role of the elders and addressed each person accordingly, gaining some measure of respect in doing so. This helped her establish a mutually real relationship with the family which in turn helped build trust. She also intervened and got an interpreter quite an than allowing one of the younger teenagers to interpret. Gina also took the time to find out what interventions the family had provided and did not belittle them for their actions. Gina went from conscious incompetence to conscious competence and will m ore than likely advance into unconscious competence with time (Purnell & Paulanka, 2003). Transcultural skill ModelThe Camphina-Bacote competence model identifies cultural competence as a process that a healthcare worker goes through to enable themselves to work in a manner that falls within the cultural circumstance of a client. The model has five seduces Awareness, skill, knowledge, encounters, and desire. The first construct of the model, sentiency, asks healthcare workers to question their own cultural consciousness by identifying biases and prejudices they may have toward other cultures. It is an attempt to help one understand just how sensitive they may or may not be toward other cultures. The second construct focuses on whether or not the healthcare worker has the inevitable skills to transmit a cultural assessment in a manner that will insure insightfulness. This is important for insuring that the assessment is properly done and that it contains information necessary t o others who may rely on it. Having the skills alone is not enough the person conducting the assessment also need to have knowledge of the culture.The assessor needs to research the culture to understand the worldview. There are many cover charge questionnaires available to use for the assessment if one does not care about personalization. However, understanding the culture is important before the hearing begins if the person conducting the interview wants to develop questions that are more in-depth and of a personal nature. The Camphina-Bacote model also recommends that the person conducting the cultural assessment determine what type of encounter they press to use for the interaction. almost examples of encounters complicate face-to-face meetings, attending group cultural activities, phone interviewing, or any other typeof communication method. Some people may be more comfortable filling out a questionnaire, others may want to meet in a relaxed, common environment and still o thers might want the professional atmosphere of an shoes setting. Whatever type of encounter is chosen, it is important that the comfort of the person organism interviewed is taken into consideration and a mutual setting is agreed upon. The last construct of the model is desire. If there is no desire on behalf of the professional to learn about cultural differences then the process of attempting to become culturally competent will fail. At the very best, the information gained will be inadequate and could cause more misunderstand and mistrust (Ingram, 2012). Ladder of Cultural CompetencyBased on the case study Gina was not being racists and was not blind to the patient and familys needs or their culture. Purnell and Paulanka (2003) severalise racism as a display of power in conspiracy with prejudice Gina did not exhibit either of these characteristics. She had a modest awareness and knowledge of the Hispanic culture and was sensitive to the familys needs. Gina does not have the l anguage proficiency yet so she would not be at the fifth step. Gina is on step four Competence. She demonstrated her ability to provide culturally competent care for this family. Even though she did not already have all of the necessary information to care for this churl, she knew where to go look for it and how to interpret it. She demonstrated that she valued the familys cultural differences by fetching the time to treat them with respect according to their beliefs. Utilization of an InterpreterGina knew that the patient and the family had a right to have an interpreter provided. She also knew that it would be taunting to allow a younger person to translate for an older person. In addition, the younger teenager who offered to translate stated she spoke very commodity English but indicated that she only attended summer school period in Minnesota. What the teenager considered levelheaded English more than likely would not have been adequate to translate medical examination te rminology. Gina made a very good decision when she brought in an interpreter. She also obtained a resource for herself because the interpreter could have had additional knowledge about the culture. TheStandards of Practice for Culturally Competent Nursing Care states that it is critical that the healthcare system provides resources for interpretation when fascinate (Douglas et al, 2009, p. 265). History of Present IllnessGina could have asked the mother or family what they mat the cause of the indis come in was. This would have given her insight as to whether the family believed the cause was physical or spiritual. If it was believed to be spiritual in nature, the family may have wanted to call in a Hispanic healer to perform a ceremony for the fry. She asked how many days the child had diarrhea and could have asked whether the childs diet had changed before her diarrhea started. She also could have asked if any other family members had experienced the same symptoms. Coming to M innesota may have precipitated a change in diet for the entire family with the mishap of contaminated food. Gina could have addressed the pathophysiology of the illness by asking whether or not the child had experienced any useable changes.The family did indicate the they brought the child to the clinic after she became listless. Getting a background on other functional changes may provide clues to other factors that might be making the illness worse. For example, was the child falling down, crying a lot before she became listless, et cetera. Another area to look at would be the course of the illness. Gina could have the mother describe how the illness started and give a timeline of signs, symptoms, and interventions up to the present time. This could include the treatments the family provided along with what the expected outcomes were.Gina could ask the family whether or not they felt any of the interventions were successful, even if it was only mild success. It would also give G ina information about the remedies used so she could research and pass the information on to the health care provider. Two of the treatments supplied by the family were actually not conducive to good health. The manzanilla tea can cause diarrhea and the family was giving it to the child as a treatment for diarrhea. agree to the CDC, greta is an orange powder used as a Hispanic remedy for stomach ailments. The powder contains concentrations of lead as high as 90% and contributes to lead poisoning (CDC, 2009). Getting the familys perception on the illness is very important to increasing ones awareness of how the family views the illness. Cultural Diversity Care PlansCultural rescuePractice Nursing diagnosing mark InterventionsGina provided care congruent with the culture via an interpreter. The family was unable to understand the plan of care for the child. Knowledge deficit colligate to language barriers. Patient will verbalize an understanding of the childs condition and the nee d for the current treatment plan via an interpreter. 1) Using an interpreter, rationalise the illness, causes, and treatment plan to the patients family.2) Have the primary care-giver demonstrate understanding by repeating back the plan of care and the say-so benefits. 3) Allow for questions and answers.Cultural AccommodationPractice Nursing Diagnosis Goal InterventionsGina attempted to put the family at ease by using an interpreter to find out what the family understands about the childs illness and the interventions that were tried in the home environment. She discovered that the red string was on the child for good luck and to keep her safe from spirits. Anxiety related to cultural lack of understanding of the illness and the treatment plan practices. Collaborate with the family to identify treatments that are culturally acceptable and that can be used in conjunction with western medicine to address the childs medical needs. 1) Allow a spiritual advisor to place new red string s on the child and support a ceremony if need be.2) Explain the need for an IV and make sure it does not split the familys beliefs.3) Praise family for their efforts thus far.Cultural RestructuringPractice Nursing Diagnosis Goal InterventionsGina found out the baby had been given manzanilla tea and greta. incomplete of these remedies is a good choice. The manzanilla tea is used for constipation and the baby had diarrhea. According to the CDC, greta is high in lead content and causes lead poisoning. Ineffective health maintenance related to lack of understanding. Educate patients family on the illness and potential harm of some folk remedies and identify disadvantageous remedies that the family needs to change. 1) Provide family with culturally appropriateeducational material in whatever configuration they require.2) Work with the family to develop a plan of action and identify alternatives to the harmful remedies.ReflectionProviding culturally competent care can be challenging at times and it requires nurses to be aware of their own limitations, strengths and beliefs. It was evident in the case study that Connie was not prepared to take on the task of developing her own cultural competence. Gina, however, showed good leaders ability and a willingness to learn about a culture different than her own in order to provide the best nursing care she could. Gina is the type of nurse that will continue to grow in her position and garner respect from her patients and co-workers. Her actions showed she was capable of doing what was in the best interest of the patient and family. Cultural competence does not just happen nurses have to make it happen.ReferencesBuffalo State, (2001). Technical and behavioral success factors. Retrieved June 23, 2013, from The State University of New York http//www.buffalostate.edu/offices/hr/pepds/sf/tb.asp. Centers for Disease Control and Prevention, (2009). Folk medicine. Retrieved July 17, 2013, from the National Center for Environment al Health http//www.cdc.gov/nceh/lead/tips/folkmedicine.htm. Douglas, M., Pierce, J., Rosenkoetter, M., Callister, L., Hattar-Pollara, M., Lauderdale, J., & Pacquiao, D. (2009). Standards of practice for culturally competent nursing care a request for comments. Journal Of Transcultural Nursing, 20(3), 257-269. Ingram, R. (2012). Using Campinha-Bacotes process of cultural competence model to examine the relationship between health literacy and cultural competence. 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