Cultural Competence in Nursing

<p class="wp-block-paragraph">Cultural competence in nursing promotes individual-centered care, and it enables a focused assessment of patients&#8217; culture, social, and linguistics needs. Most healthcare organizations have incorporated cultural competence in nursing staff orientation program. Cultural competent organizations invest in diversity training and promote culturally oriented initiatives.</p>



<p class="wp-block-paragraph"> It is essential for healthcare staff and specifically nurses to obtain information about patients&#8217; cultural heritage. Besides, nurses can modify patients&#8217; environment when appropriate to promote compliance with care. Madeleine Leininger is the pioneer of <a href="https://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1020&;context=tdr">Transcultural Nursing</a> and challenges nurses to adopt cultural competence in nursing care delivery. </p>



<h2 class="wp-block-heading" id="h-impact-of-cultural-assessment">Impact Of Cultural Assessment</h2>



<p class="wp-block-paragraph">The Heritage assessment is a guide to the culturally oriented nursing evaluation questionnaire ( Cultural Assessment Tool ). It also enables nursing staff to learn about patients&#8217; ethnic, socio-economic, and cultural backgrounds. <br><br>Learning about different cultures can be challenging, but it facilitates cultural competence. This nursing approach promotes <a href="https://www.collinsdictionary.com/us/dictionary/english/cultural-awareness">Cultural Awareness</a>&#8211; nurses conduct self-evaluation of own culture and traditions. I will discuss some health traditions among Haitians, Nigerians, and Ethiopians in the paragraphs below.</p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/Cultural-data-collection-1024x763.png" class="wp-image-1433" width="512" height="382"/></figure></div>



<h2 class="wp-block-heading" id="h-cultural-competence-in-nursing-patient-interview">Cultural Competence In Nursing: Patient Interview</h2>



<p class="wp-block-paragraph">A thorough cultural competent nursing assessment should incorporate patients&#8217; age, sex, religion, heritage, beliefs. During an interview with three different families from three different countries, I realized that health practices and traditions are different around the world. I interviewed a few couples among the families were the Caribbean (island), Ethiopians, and Nigerians. <br><br>We discussed the principles used during health maintenance, which are personal or public health services offered in the promotion and restoration of health (world health organization). Health maintenance in one of the Caribbean islands (Haiti) remains challenging because of the socio-economic status of the population and scarce resources. For instance, the main university hospital in the country&#8217;s capital often operates with limited medical supplies.</p>



<h2 class="wp-block-heading" id="h-caribbean-island-healthcare-systems">Caribbean Island Healthcare Systems</h2>



<p class="wp-block-paragraph">The health care system in Haiti is not regulated, and authorities often ignore patients’ rights. It is evident that most patients receive substandard care and experience adverse outcomes in Haiti. The system protects only a few privileged groups with access to care. The majority of the population has minimal to no access to health care and receives different treatment according to their financial status. <br><br>It is an expectation for family members or significant others to be available during hospitalization in case the medical staff needs to obtain additional medical supplies. It is a cultural tradition for the patients&#8217; families to bring food from home because patients prefer homemade meals. Family members also assist with most of the activities of daily living. </p>



<h2 class="wp-block-heading" id="h-assessing-cultural-traditions-in-nursing">Assessing Cultural Traditions In Nursing</h2>



<p class="wp-block-paragraph"><g class="gr_ gr_9 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Grammar only-del replaceWithoutSep" id="9" data-gr-id="9">Haitian</g> culture is a mixture of African, Spanish, and French traditions according to its history. The culture is rich in traditions and remains unique and fascinating. Despite the constant economic instability, Haitians remain resilient and very proud of their culture and health traditions. Besides, some of them believe in treating their body like a temple, which means eating healthy, avoiding smoking, illegal substances, and promiscuous lifestyles. <br></p>



<p class="wp-block-paragraph">They engage in some physical activities, and many families highly value God and spirituality. Children often enjoy outdoor sports regardless of their family background. They often play soccer, basketball, volleyball, and tennis in school, on the streets, or at a sports club. Thus, the importance of cultural competence in nursing.</p>



<h2 class="wp-block-heading" id="h-nutritional-traditions">Nutritional Traditions </h2>



<p class="wp-block-paragraph">Most Haitians walk at least two to three miles daily involuntarily due to expensive transportation system and lack of infrastructure. It is considered normal to walk to a store, and they believe in fresh (organic food) or homegrown products. Most Haitians do not use the microwave because they prepare meals daily. Therefore, most of them do not like to eat leftover foods. <br></p>



<p class="wp-block-paragraph">They utilize honey, palm oil, castor oil, and herbs as natural remedies to treat certain symptoms and illnesses. They use a lot of natural resources, and they do not always believe in prescription drugs. Haitians love to prepare food daily, and deep freezing is not a common practice among Haitians. </p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/cultural-tradition-1024x570.png" class="wp-image-1435" width="512" height="285"/></figure></div>



<h2 class="wp-block-heading" id="h-disease-management">Disease Management</h2>



<p class="wp-block-paragraph">Some Haitians protect themselves against diseases by drinking herbal tea specific to the geographic region of the country. Others believe strongly in castor oil and use it for cold relief, skin cuts, burns, bruises, fever, and joint diseases such as arthritis, swelling, and minor sports injury. About 90% of the population will have a bottle of that oil in their medicine cabinet. An assessment of cultural traditions in nursing interview will guide a specific care plan. <br></p>



<p class="wp-block-paragraph">They use the oil wisely since supply is sometimes limited. Honey is also typical, and many Haitians believe that it is the best because it is raw and unrefined. Honey, <a href="https://flaviar.com/barbancourt/distillery">Rhum Barbancourt</a>, tea, and local lime juice are the remedies to treat a cold, fever, and other body aches. They also use other rituals such as carrying their rosemary around their neck for protection or sometimes specially made items or a protective symbol of some sort. </p>



<h2 class="wp-block-heading" id="h-health-traditions">Health Traditions</h2>



<p class="wp-block-paragraph">Helmet, braces, and other protective gears are expensive there, so it is not common practice for young children to protect their heads and other joints. Family is the support system there and is very important to them. Family members will travel across the country to support each other and will bring natural remedies from the <g class="gr_ gr_6 gr-alert gr_spell gr_inline_cards gr_disable_anim_appear ContextualSpelling ins-del" id="6" data-gr-id="6">countryside</g> to assist with the recovery process. </p>



<p class="wp-block-paragraph">Most of the families can not afford restoration in a health care setting, so they prefer to take the patients home to avoid medical costs. They also pray a lot during the process, and some of them are involved in ritual dances and ceremonies by “Voodoo” priest, a pastor or chaplain. Therefore, cultural competence in nursing will enable nurses to identify these traditions.</p>



<p class="wp-block-paragraph">Some catholic will hope for a quick response from the Virgin Mary and often pray the Saints to ask for forgiveness and mercy. Those who are protestant will pray to God and hope that his power will heal them. Finally, family members will make soup and tea daily to promote wellness and assist in the recovery process.</p>



<h2 class="wp-block-heading" id="h-cultural-competence-in-nursing">Cultural Competence In Nursing</h2>



<p class="wp-block-paragraph">If you are a nurse caring for Haitians, you should expect a lot of visitors from church, temple, or from the family. They will also bring homemade meals because the hospital food is bland, according to many Haitians. Nurses should also expect prayers and scripture reading, so modify the environment to meet the patients&#8217; needs. </p>



<p class="wp-block-paragraph">Nurses should educate patients, families, and visitors about hospital protocol to avoid misunderstandings. They might need a cross, rosemary, or items specific to their beliefs. Lastly, most Haitians speak Creole, not French, so a translator might be required. Nurses will obtain these data when they implement cultural traditions in nursing. </p>



<p class="wp-block-paragraph">Nurses need to attend cultural competency training to promote awareness about other countries&#8217; traditions and myths. Cultural desire enables nurses to perform a thorough cultural assessment. Evidence shows that most patients will comply with care when the Multidisciplinary team involves them in the care planning process. Nursing education should incorporate information about heart disease because Haitians tend to consume high fat and salt consumption. </p>



<h2 class="wp-block-heading" id="h-cultural-traditions-assessment-of-an-ethiopian-family">Cultural Traditions Assessment Of An Ethiopian Family</h2>



<p class="wp-block-paragraph">Ethiopian culture does not differ much from Haitian culture. After interviewing a family who lives next door, I noticed some similarities in Health traditions. For instance, they love herbal tea and fresh food. In that culture, the family mentioned that they value their bodies, and they strive to remain healthy. The family said that health maintenance includes living a good life without drinking, clubbing, eating none organic food, microwaving food, and smoking. <br></p>



<p class="wp-block-paragraph">They also verbalized the importance of physical activities and stated that most Ethiopians walk three to four miles daily. They eat mostly fresh fruits and legumes, and a lot of them do not eat pork for religious reasons. The family talked about the importance of fasting to cleanse the body and to promote a healthy lifestyle.</p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/Ethiopian-culture-1024x684.png" class="wp-image-1449" width="512" height="342"/></figure></div>



<h2 class="wp-block-heading" id="h-ethiopians-health-traditions">Ethiopians Health Traditions</h2>



<p class="wp-block-paragraph"> They follow a fasting schedule for almost every two to three months According to the same family. Ethiopians commute mostly by foot and drink herbal tea as cleanser and remedy. In addition, they are very involved in outdoor activities and encourage children to play sports. The family also voiced that Ethiopians use religion as their primary protection and use bees and unique bracelets to protect themselves against certain diseases. <br></p>



<p class="wp-block-paragraph">They avoid late-night partying and drinking to promote a healthier body, and one should avoid contact with the ill to prevent disease transmission. They believe in early bedtime to improve optimal health. When they are sick, family members or friends will make home remedies before seeking medical advice. If long term recovery is necessary, the family will care for the patients at home to avoid medical bills.</p>



<h2 class="wp-block-heading" id="h-nursing-implications">Nursing Implications</h2>



<p class="wp-block-paragraph">Family members also provide direct care to their relatives at home. The care approach should be individualized to meet patients&#8217; cultural traditions. Nurses should demonstrate cultural competence when collecting initial cultural data from patients. The patients might skip hospital meals, so a nutrition plan will be beneficial to Ethiopians. Besides, nurses should exhibit a desire to modify patients&#8217; care plans to accommodate nutritional preference. </p>



<h2 class="wp-block-heading" id="h-nigerian-cultural-traditions">Nigerian Cultural Traditions</h2>



<p class="wp-block-paragraph">The culture in Nigeria is not very different from the other two countries. The Nigerian family wanted to talk about reproductive health and postpartum care. When a woman is pregnant, she remains actively involved in household activities. She also goes to work outside the house. A heritage assessment will promote cultural traditions in nursing. </p>



<p class="wp-block-paragraph">Some of the expectant mothers do not believe in prenatal vitamins. Therefore, family members make healthy meals for the mother and encourage the expectant mother to eat extra. They believe the mother must eat for two. The pregnant mother does not seek prenatal care, but she plans a home birth delivery with a midwife. </p>



<p class="wp-block-paragraph">The mother avoids direct contact with most people to protect the fetus. The family encourages the mother to increase calories and fluid intake. Nutrition includes mostly legumes and meat stew to promote the <g class="gr_ gr_747 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Grammar only-ins replaceWithoutSep" id="747" data-gr-id="747">healthy d</g>evelopment of the fetus. Nurses should adopt cultural competency in nursing to collect significant data about health traditions. </p>



<h2 class="wp-block-heading" id="h-nigerian-child-birth-process">Nigerian Child Birth Process</h2>



<p class="wp-block-paragraph">During delivery, the woman&#8217;s family must arrange to be present. The family also brings grocery items to prepare meals for the next month during the postpartum period. The woman often chooses natural birth and plans a natural birth delivery or at a birth center. Midwives will make the necessary arrangements and prepare the family for the delivery process. <br></p>



<p class="wp-block-paragraph">Shortly after birth, the new mother will remain inside the house for a minimum of 30 days. Her immediate family will make fresh, healthy meals and will encourage her to eat a lot to replace the energy that she lost during labor. The new mother consumes mostly hot solids and liquids. The dietary plan also includes cold meals about a month later. </p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/Nigerian-Fufu-Picture1-1024x617.png" class="wp-image-1451" width="512" height="309"/></figure></div>



<h2 class="wp-block-heading" id="h-cultural-traditions-and-postpartum-care">Cultural Traditions and Postpartum Care</h2>



<p class="wp-block-paragraph">The new mother performs warmth sitz bath for several days to promote healing after birth. It is a cultural tradition for the newborn to remain inside for a minimum of thirty days and does not always have access to a pediatrician. The newborn receives breast milk because the baby <g class="gr_ gr_33 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Grammar only-ins replaceWithoutSep" id="33" data-gr-id="33">formula</g> is expensive. Besides, there is no <g class="gr_ gr_8 gr-alert gr_spell gr_inline_cards gr_disable_anim_appear ContextualSpelling ins-del multiReplace replaceWithoutSep replaceWithoutSep" id="8" data-gr-id="8">government-subsidized</g> program like there is in the United States. </p>



<p class="wp-block-paragraph">When the mother fully recovers, ;the family will go back to the village. The husband will reward his in-laws with monetary compensation, cattle, <g class="gr_ gr_9 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Punctuation only-ins replaceWithoutSep" id="9" data-gr-id="9">and</g> clothing to exhibit his appreciation. These data should be part of the cultural traditions in nursing to promote patient care.</p>



<h2 class="wp-block-heading" id="h-implications-for-nurses">Implications For Nurses</h2>



<p class="wp-block-paragraph">Nurses should expect a large group of visitors, and some of them can perform rituals during labor. The new mother might need more blankets and additional gowns compare to other patients. Nurses should understand Nigerian culture to facilitate patient-centered care. It is vital to incorporate cultural traditions in nursing to patient care.<br></p>



<p class="wp-block-paragraph">The <g class="gr_ gr_103 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Grammar only-ins doubleReplace replaceWithoutSep" id="103" data-gr-id="103">e</g><g class="gr_ gr_143 gr-alert gr_spell gr_inline_cards gr_disable_anim_appear ContextualSpelling ins-del multiReplace" id="143" data-gr-id="143">xpectant</g> mother might benefit from a bigger room with additional recliners to accommodate visitors. Nurses should monitor nutrition intake to prevent excessive salt and fat intake. Nursing staff should check the room for safety in case visitors decide to use unapproved items. For example, <g class="gr_ gr_10 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Grammar multiReplace" id="10" data-gr-id="10">candle</g>s, water heater, <g class="gr_ gr_12 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Punctuation only-ins replaceWithoutSep" id="12" data-gr-id="12">and</g> other devices.</p>



<h2 class="wp-block-heading" id="h-conclusion">Conclusion</h2>



<p class="wp-block-paragraph">Cultural competence in nursing is essential in the patient care planning process. Nurses should participate in cultural competency training to provide patient-centered care. It is also vital for nurses to demonstrate cultural desire to obtain relevant data about patients&#8217; cultural traditions. </p>



<p class="wp-block-paragraph">It was very interesting to learn about patients’ cultural traditions and to establish a comparison among different cultures. One can conclude that there is no good or bad culture. Awareness is very important in cultural competence in nursing along with acknowledgment of the patients’ culture. </p>



<p class="wp-block-paragraph">If healthcare professionals fail to assess cultural needs and background, they will not be able to fully understand patients’ behaviors and beliefs during nursing care. It is beneficial for nursing staff to assess their patients&#8217; ethnic, socio-economic and cultural background when caring for them. </p>



<p class="wp-block-paragraph">During a nursing evaluation, <a href="https://www.pdffiller.com/jsfiller-desk18/?projectId=386180691#0fa2d9333e4609fde866dd06032b4040">the heritage assessment tool</a> is a helpful guide that nurses can utilize to collect cultural data. Finally, the Joint Commission requires that healthcare organizations improve <a href="https://nursesophieconsulting.com/the-impact-of-nursing-evolution-on-clinical-practice/">nursing practice</a> by incorporating an initial cultural assessment on admission.</p>



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