Cultural Competency Summative 1

Cultural Competency Summative

Deanne Buchholtz
University of South Florida











Cultural Competency Summative 2
Introduction
I took an honors class my first time in college called Cultural Awareness. We would sit
around a table discussing our individual roles and responsibilities within modern society. All
semester the professor stressed the idea that we live in a mixed salad as opposed to a melting
pot. He meant that, although various societies and cultures have converged, they have not
assimilated into one major society, but have rather maintained their unique qualities and values.
When tossed together, the result is a mix of flavors and textures that complement one another.
Leininger takes this notion and applies it to the healthcare system. When we respect an
individuals cultural background, we perpetuate a culture of integrity and optimize that patients
experience within the community health setting.
Theory
Leininger designed her Theory of Transcultural Nursing Care around the concept of
tailoring the health care a patient receives around that individuals cultural values, beliefs, and
practices. The goal of implementing this theory in health practice, beyond providing patients
with universal standards of care, is to emphasize individualized needs in regards to culture. This
in turn promotes a level of awareness and empathy by health care staff, and moreover, places the
patients holistic sense of well-being, his or her mind, body, and spirit, over the mere physical
treatment of illness (Leininger).
Interview
To gain more insight into the way this theory works, I had a simple conversation with a
patient in my clinic. My informal interview was conducted on a patient at the cancer center who
Cultural Competency Summative 3
relocated here from Poland and now resides with his daughter and her family. She was present in
the exam room and I used her to translate since S.W. spoke no English. When asked about what
it means to be Polish, he stated, It means my family is large and were all together over food all
the time, and we talk and laugh and yell loudly without ever expressing our feelings.
Leiningers theory can be of value when regarding S.W.s health promotion as he undergoes
treatment for his throat cancer. It has been made apparent that he places family and food in high
importance, which will help the nurse guide his care in a culturally meaningful way. Beyond just
treating the physical symptoms of illness, the nurse has a responsibility to promote the patients
mental and emotional health as well. S.W. had stated that although his family spends a lot of
time together, there sometimes exists a lack of true communication. A battle with cancer, at any
stage of life, undoubtedly potentiates a struggle for that individual to process thoughts and
emotions, as well as to maintain a positive outlook. A goal for the nurse, in regards S.W.s
cultural background, could be to provide resources for counseling to promote mental and
emotional health. This practice may provide and outlet for the patient that seems less daunting
than making efforts to open up to family members.
Utilizing Resources
With the example of S.W. in mind, I recognize that as healthcare staff, we should strive
to utilize every possible resource to better aid our patients unique needs. Maintaining resources
and making culturally-competent decisions that promote health based on the patients personal
values, beliefs, and practices will impact that individuals view of his or her care. Valuing the
patients culture and tailoring the health care plan around those needs not only will validate the
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patient, but will also encourage compliance to the treatment plan. Implementing and maintaining
the changes delineated in a treatment plan are crucial to optimizing the patients overall health.
Culturally-competent decisions by health care staff are the tools to bring this concept to fruition.
Identifying S.W.s particular cultural resources, choices, and decisions will aid health
care staff in encouraging his self-efficacy. We can help outline those positive practices, such as
spending time together cooking and talking as a family,that will promote mental and emotional
well-being during treatment. We can also encourage healthy eating practices, such as limiting the
high-fat foods that comprise the traditional Polish diet, while increasing intake of fresh fruits and
vegetables high in antioxidants. Equipping S.W. with knowledge and tailoring options around his
normal practices will encourage him to make positive changes within his purview.
Role of the Community Health Nurse
The case with S.W., where we as healthcare staff glean knowledge from the patient regarding his
background and interpersonal behaviors to better suit his treatment needs, provides a prime
example of the role of Community Health Nurse. One must flex his or her actions to meet the
needs of the particular patient or environment. This nurse should strive to recognize and esteem
the cultural values of the patient or group he or she cares for, maintaining an air of non-judgment
and empathy. Leininger said health care providers need to be flexible in the design of programs,
policies, and services, to meet the needs and concerns of the culturally diverse population
(2002). To gain a holistic view of a patients culture and health care needs, a community health
nurse must consider ethnicity, religion, rituals, diet, and health care perceptions. For example,
Cultural Competency Summative 5
S.W. stated that he is a practicing Jew. With this in mind, his nurse may design a diet/treatment
plan sensitive to his personal values, beliefs, and practices.
Repatterning Best Practices
The designing of a plan tailored toward S.W.s unique cultural and religious needs
represents an example of how healthcare staff may improve best practices through cultural
awareness. This concept of repatterning, or restructuring, revolves around modifying an action or
normal practice to achieve a more optimal outcome. More specifically, this is the action of
creating a treatment plan to suit individual needs. In the case of S.W., health care staff may
design a plan that includes a counselor or therapist in his religious community, while creating a
diet plan sensitive to Jewish values. S.W. will more likely maintain a plan containing these
considerations, and thus receive a level of care that promotes his overall well-being.
Conclusion
I have always truly valued cultural awareness and empathy. Leiningers Theory of
Transcultural Nursing aligns itself with my personal beliefs regarding the role of nurses and
health care staff at-large in a vastly diverse community. This theory emphasizes the individuals
needs over mere generalized health practices in order to reach a patient physically, mentally,
emotionally, and spiritually. In our country especially, where countless cultures and sub-cultures
collide, we must strive to know our patients beyond the name on a chart. We must provide
culturally-congruent care, being mindful of those specific values and practices that will not only
promote comfort and validation to the patient, but also provide an optimum level of care.
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References
Leininger. Madeleine Leiningers Culture Care: Diversity and Universality Theory.
Leininger, M. Madeleine leiningers culture care: Diversity and universality
theory. Retrieved from http://nursing.jbpub.com/sitzman/ch15pdf.pdf
Leininger, M. (2002). Culture Care Theory: A Major Contribution to Advance
Transcultural Nursing Knowledge and Practice. Journal of Transcultural Nursing,
Vol.13,No.3 http://currentnursing.com/nursing_theory/transcultural_nursing.html.