02.01 Cultural Care

Hi guys. Welcome to the lesson on cultural care. So we have people of all different races and cultures living in the US and it can be hard to keep up sometimes, particularly in terms of healthcare norms. As community nurses, understanding how to tap into our resources for everyone is even harder. So in this lesson, we are going to talk about why understanding the differences between cultures affects community health and what we can do to stay on top of it all. So let’s jump in.

Let’s break down what cultural awareness actually means. A culture is a group with a specific set of values and beliefs, customs and traditions. This can be religion, ethnicity, nationality, occupation and so on. This has a huge influence on our behaviors. Awareness is knowledge of a fact and a willingness to understand it. So cultural awareness is knowing there’s a difference between ourselves and others and being willing to understand those differences. Remember that each culture has its own strengths and sometimes we can actually benefit from that. Now, how do we get to the point of awareness?  We have to first understand our own culture. Here we are talking in regards to health. We need a basic understanding of our core belief system and traditions and how they affect our ability to maintain our health. When we understand ourselves then it becomes easier to take a step back and explore the same for others around us and understand what kind of effect those differences have as well.

So why is that all important? For one, understanding different cultural norms help reduce inconsistencies in care. Care is patient-centered. So we need to meet the needs of our clients as well as advocate for them to improve outcomes. This can’t be done if we don’t understand their basic beliefs and behaviors. Being culturally aware also gives people a sense of respect. We never want to push our own beliefs on our patients. We talked about knowing our audience back in earlier lessons. Understanding cultural differences is a big part of that and we want to maintain respect without bias or judgment. Culture changes our communication style, the way we provide education in the community to promote health and wellness and it changes the way we provide care.  Now, there’s nothing that says we have to like what that culture believes, but we do have to accept and honor it.   

So let’s talk cultural competence. This is the ability to communicate across cultures. For what? Again, so we can meet the social and cultural needs of our patients. So this is broken down into four components to help us understand why it’s so important and how to achieve it. Awareness is understanding our own biases toward any cultures other than our own. Attitude is where we examine those biases so we can hopefully get rid of them in order to understand the differences and be able to communicate more effectively. The object here is to eliminate stereotyping. If I’ve met each component, I should be able to confidently talk to my patients without offending them. Something real important here too guys, never be afraid to ask questions and make sure you’re watching and listening! That’s how we learn.

As I’m talking about not offending my patients, here comes cultural sensitivity. This just helps us learn about people of other cultures so we can meet their needs better. If this sounds redundant, it’s because it’s important. But there is a difference between competence and sensitivity. That difference is that sensitivity is actually knowing differences exist, realizing the effects it has on a person’s health and adapting to them. We don’t get to decide if those differences are right or wrong. We just adjust with respect to them. And once again, if I can be flexible with my patient’s values I should be able to communicate without being offensive.

So how do we go about understanding a patient’s specific cultural needs? We assess! Aren’t we always assessing for something? So the purpose of a cultural assessment is going to be the same as others just on a cultural scale to eliminate bias. Unless you’re using a specific tool, you probably won’t even realize you’re doing it. We want to figure out what group they identify with, their primary language, their preferences, their interpretation of health and wellness or a specific disease, etc. Then, what about their answers makes them approach health maintenance differently? This helps us identify barriers to care and education too. So I’m sure everyone knows someone who doesn’t believe in using medication. They would rather try other natural avenues to promote wellness. This can be considered a culture. It’s still a group of people that share the same beliefs. My point is if this is what’s discovered during my assessment, won’t it change my approach to health promotion with that person? Am I going to discuss the different medications available for blood pressure? I don’t think I will. I have to adapt my teaching to what my client believes in. So maybe instead I talk about behavioral treatments like diet and exercise to bring it down more naturally, right? What I’m doing here is understanding that there is a belief that I can’t change, I won’t attempt to change, I will acknowledge and accept, and I’m going to act accordingly all while maintaining and respecting that person’s core values.  

Now that I’ve talked you to death about all this, let’s move on to how do we get here? How do we make sure we are culturally aware, sensitive and competent? We go to diversity trainings. This is where we can address our own biases and barriers with certain cultures. These trainings facilitate an open conversation about what we need to change about ourselves. Remember I said earlier you can’t begin to understand someone else without first understanding yourself. That’s why we have self-assessments. These are more personal reflection tools. When you take these assessments, you are gauging your level of understanding on others’ beliefs while also evaluating your own. When you are fully aware and competent, everything should come together.

So what does all of this have anything to do with community health? Well, I keep saying nursing is about person-centered care and know your audience. None of that is possible if you’re not looking at the whole person. Complete cultural competence boosts our abilities as nurses. It improves our ability to communicate, to educate and to advocate. That translates into better compliance in the community. More compliance equals better health outcomes. Doesn’t that meet our goal to promote well-being?

Some key points to review. Cultural sensitivity is our ability to know differences exist and accept them for what they are. To be culturally aware, you have to understand yourself first. Most importantly, total cultural competence equals better outcomes in the community. If you don’t adjust your approach to the person’s cultural needs, you only address half the person.

So that’s it for the cultural care lesson. Make sure you check out all of the resources attached to this lesson. Now, go out and be your best self today! And, as always, happy nursing!