The ever-increasing multicultural population in the United States requires culturally competent health care. The paper will seek to evaluate the application of the nursing process in the delivery of culturally competent health care to diverse population groups. There has been an increase in the diversity of the United States population caused by the influx of people coming from diverse ethnic and cultural groups. Therefore, nurses should always strive to utilize their knowledge and experiences to devise a method of care that is suitable for each culture. The nursing process consists of several processes which include evaluation, implementation, planning, diagnosis, and assessment. Different cultures have diverse beliefs concerning certain aspects of each process; therefore, nurses should always modify the type of provided care to suit different cultures. Finally, the paper concludes that the diverse culture of the United States may need intense modification of different nursing processes to develop universal care nursing practice.
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Application of the Nursing Process to Deliver Culturally Competent Care
Over the past centuries, nursing practice has been a continually evolving field to adapt to some contemporary issues in society. However, in the recent past, there has been a growing trend of consumer desire for culturally competent healthcare in an increasing diverse multicultural society. The ability to provide this type of healthcare is a very critical expectation of a nurse working in a highly stressful health care environment. Culturally competent healthcare is beneficial in producing a desirable outcome leading to satisfaction of the patients. Therefore, nurses are encouraged to acquire necessary skills and knowledge in cultural competency for a better practice.
Cultural Competence
Cultural competence has been explored by different scholars who have described the concept in varying ways. According to Douglas et al. (2014), cultural competence entails a continual process of striving to become self-aware and knowledgeable about cultural diversity and to value diverse cultural practices exhibited by patients (495). Nurses have accepted this concept in delivery of ethnically competent care to different cultural groups. Douglas et al. (2014) aim to incorporate the nursing process in the definition of culture competence by describing cultural competence as the ability of nurses to recognize and value cultural differences among patients in order to provide quality healthcare to a culturally diverse population (p.51). Therefore, culturally competent nurses should be sensitive to matters relating to culture, race, ethnicity, gender, and sexual orientation when working with different patients. Furthermore, culturally competent nurses should achieve efficiency in cultural evaluation, communication methods, and the process of acquiring knowledge of various aspects of healthcare practices in different cultures. Providing culture-sensitive healthcare enables the nurses to be more efficient and specific in meeting the patients’ needs. For instance, understanding an individual’s religion may affect the kind of medical service offered to the patient.
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Cultural Desire
Cultural desire is very critical in provision of healthcare among nurses. According to Douglas et al. (2014), cultural desire is the motivation of nurses to want to engage in the activities that promote cultural competence in the healthcare system. Therefore, cultural desire is the driving force for any nurse in attaining competent culture-sensitive nursing practices. Humility is one of the promoting factors of cultural desire, because when nurses are humble, they will be willing to understand and study patients’ diverse cultural practices without prejudice. However, nurses are not expected to blindly accept the patients’ cultural practice, but they should always recognize the fact that all the patients are unique and must be treated with love and care. According to Campinha-Bacote (2009), the research has shown a negative outcome linked to inequality in provision of healthcare services. Therefore, nurses should continually connect the relationship of cultural competence with social justice.
Social Justice
In the nursing process, social justice is very critical when delivering medical service to patients of various social status. Social justice should be founded on respect for self and others, cultural tolerance, fairness, and equity when treating patients. The International Council of Nurses believes that nurses should seek and advocate for those who are served and underserved in society to ensure that everyone’s needs are addressed. Ethnic principles differ depending on one’s idea of the correct action. However, the nursing principles of social justice are based on a broad view of different factors that affect different populations and healthcare systems. Furthermore, nurses are encouraged to advocate for social justice in all the provided services through promotion of empowerment, relief of suffering, and liberation among the patients. Nurses are also expected to educate the population around them on the way to advocate for social justice for themselves.
Cultural Awareness
All nurses should be aware of their culture to facilitate an effective understanding of other cultural practices. According to Douglas et al. (2014), cultural awareness is conscious self-evaluation of the matters concerning health-related beliefs about different aspects of healthcare provision, such as the causes of diseases, spread of diseases, and efficiency of different treatment methods available (p.112). Nurses should evaluate some of the prejudices, stereotypes, and biases that originate from their cultural foundations. After the evaluation of these factors, the nurses can, therefore, ensure that the services they offer are not influenced by these beliefs. For instance, there are several prejudices targeted at different cultural minority groups in American society. Thus, African Americans and Asian Americans are always viewed as less deserving in society. Nurse’s personal beliefs and biases may lead to unequal treatment of patients with diverse cultural backgrounds. Campinha-Bacote (2009) indicates that African Americans have been determined to have a high chance of being overdiagnosed with heavy psychotic disorder and more likely to be treated with antipsychotic drugs, irrespective of the diagnosis. Therefore, to avoid this kind of prejudices that directly affect the outcome of healthcare services, nurses must first recognize different biases that exist in their cultural beliefs.
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Cultural Knowledge
Cultural competence is a broad lifelong process that nurses must evaluate continually to understand numerous aspects of different cultural practices. According to Douglas et al. (2014), an understanding of various factors that influence differences in cultural practice is critical in preventing overgeneralization of cultural practices and stereotyping (p.111). A connection between different cultural practices and healthcare provision is very important in delivery of evidence-based, culturally proficient nursing care. The nurses should strive to understand the impact of culture on personal values, traditions, and behavior of the patients. These medical workers should also further strive to ascertain the health seeking behavior of individuals, populations, families, and communities. For instance, according to Campinha-Bacote (2009), most of African Americans may avoid visiting healthcare centers due to their beliefs about the efficiency of healthcare professionals. Therefore, the African Americans may postpone visiting a medical institution and do that only when it is absolutely necessary. That is why some of American residents may believe in sympathetic magic. The nurses should also evaluate the impact of health policies on culturally diverse groups by focusing on the economically disadvantaged and underserved members of these societies (Douglas et al., 2014, p.111). In healthcare provision, the nurses should identify the resources that may be required by different cultural groups seeking medical attention. The medical staff should recognize and determine the impact of communication styles suitable for every individual, family, and society. Identification of the impact of communication styles will facilitate the process of obtaining culturally sensitive information from the patients. Therefore, cultural competence is vital to enable communication that will exhibit respect for cultural diversity and to ask culturally delicate questions about cultural beliefs and practices that should be carefully considered in the delivery of effective healthcare. Knowledge of different cultural practices will enhance the accuracy of cultural assessment and healthcare provision among nurses.
Cross-cultural communication enhances the efficiency of the nursing processes. It entails different factors that should be considered by nurses when interacting with patients and their family members from a diverse cultural background. Therefore, nurses should strive to determine the way in which different cultural groups communicate. Nonverbal cues provide a major factor that should be considered when providing nursing services, because most of the patients would only be willing to communicate some culturally controversial information through nonverbal cues. Therefore, a careful understanding of these cues and their meaning in different cultures is essential to attain cultural competency among the nurses. According to Bosher and Stocker (2015), communication is one of the major problems affecting the provision of culturally competent nursing care (p.110). Consequently, due to a language barrier, most of the nurses may not be comfortable with patient from other cultures. Furthermore, some of the nurses did not comprehend most of the signs used by patients from different cultural backgrounds. That is why nurses should be educated on some essential communication methods used by different cultural groups. They should at least have a comprehensive knowledge of the most common nonverbal cues used by different cultural groups to enhance the efficiency of communication with patients (Bosher & Stocker, 2015, p.110). Furthermore, there are several nonverbal cues that may have a conflicting meaning in different cultural groups. To avoid miscommunication, nurses should ensure that they are well conversant with such cues and their meanings in different cultural groups. Eye contact may have a different meaning in various cultural groups. For instance, American nurses are encouraged to maintain eye contact when communicating with patients. However, Arabic persons and North Americans consider eye contact to be inappropriate. North Americans believe that staring at the floor during conversation indicates that one is listening to the speaker intently. American nurses are also taught to use touch as a therapeutic means of communication. However, touch may have different meanings to non-American patients. Therefore, nurses should strive to understand these differences in meanings to avoid misunderstandings that may derail the nursing process.
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Cultural Competence Practice
After identification of different cultural aspects affecting nursing processes, nurses should strive to ensure that they actively employ the knowledge and skills gained to enhance the nursing processes. Cross-cultural practice entails a complex combination of information about different cultural groups and worldviews, while reflecting on self-awareness as well as cultural views and attitudes (Douglas et al., 2014, p.113). Cross-cultural care includes thorough assessment of physiological, cultural, and physical aspects of the patients, when planning the type of care to be given to a patient. The cultural focus should be on the ethical, sociocultural, and political features that are unique to each patient (Douglas et al., 2014, p.113). For nurses to be culturally competent, they should acquire knowledge of different cultural groups and have a continued interest in learning cultural aspects of different groups in the society. However, it may not be possible for a nurse to be fully competent in all the cultural practices around the world. Nurses are more likely to attain cultural competency when they effectively utilize the acquired knowledge of different cultural practices to assess the beliefs and cultural background of the patients coming from various cultural backgrounds. This way, the nurses can easily identify some major aspects that may affect the kind of healthcare needed by their patients.
Nurses understand that patients are entitled to social and cultural rights that are important for their free development. Furthermore, culturally competent nurses recognize the harmful effects of cultural biases on the patients’ health and recovery process. Nurses also ensure that the patients enjoy the right to voice their concern on different aspects affecting their health. Nurses ensure that patients’ freedom is not affected by facilitating the patients’ possibility of accessing quality healthcare in a way that accommodates their cultural needs and priorities. Therefore, nurses need to acquire skills that help these indispensable professionals advocate for and protect the patients against the devaluation of their cultural expression and beliefs in healthcare facilities.
The Contribution of Healthcare Institutions
Nurses may not achieve a culturally competent treatment process without assistance received from healthcare facilities. Healthcare organizations and agencies should strive to provide facilities that enhance safe delivery of healthcare services, including culturally competent and compassionate care to all the patients seeking medical attention from these healthcare institutions (Douglas et al., 2014, p.113). In such a manner, nurses will be inspired to offer culturally competent nursing services. Furthermore, the managing bodies of these institutions are responsible for developing and managing culturally competent nursing systems by reflecting these principles in the vision and values of the organizations they head. The managing body of the organizations should further endeavor to develop strategies and procedures aimed at refining delivery of culturally competent healthcare to culturally dissimilar patients who may visit the facility. Improved community engagement is very critical in any healthcare system because, through the engagements, the organization can obtain some critical data about the diverse cultural practices in the organization (Douglas et al., 2014, p.113). An in-depth understanding of different cultural practices in the society will enhance the quality of healthcare services in America. The inclusion of community members in different actions affecting the institution, such as decision making and policy improvement, leads to culturally appropriate interventions that result in improved outcome among patients served in the facility.
In conclusion, there are numerous challenges that arise from the diversity of cultural practices in American population and they necessitate making several adjustments in the nursing processes to ensure that all the nurses are capable of providing culturally competent healthcare services. Nurses should recognize the correlation between patients’ culture and their health. Recognition of cultural contribution of patients’ health will directly influence the nurses’ behavior towards the patients. Factors such as communication and the type of health procedures performed on the patients are highly influenced by patients’ cultural practices. Therefore, it is important for every nurse to understand and incorporate cultural practices into their nursing practices for the most effective healthcare delivery.