Cultural Implications of Nursing

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Cultural Implications of Nursing

• George Ann Daniels, MS, RN

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What is culture?

• Culture is a belief system that the culture
  members hold, consciously or unconsciously, as
  absolute truth
• Controls individual behavior
• Blueprint
• Reacting, feeling, behaving, interacting
• Facilitates/retards communications

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Characteristics of Culture

• Learned
• Shared
• Dynamic
• Diversity
• Reasonable
• Habituated Assumptions
• Ethnocentric
• Rituals

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Ethnicity or Ethnic Identity

• Ethnic identity is self-conscious
• Identified by symbolic elements that is the
  emblem of their society
• Cynosure
• Native language
• Style of dress
• Religion
• Ethnicity
• Selection of shared cultural characteristics as
  symbols of common group origin, history, or
  descent
• Adopting children from different races

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Minority

• Disadvantaged or less powerful group rather than
  to the numeric minority
• Deals with
• Social power
• Group size
• ethnicity

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Race

• Biologic characteristics as the markers of
  separate social status
• Asian, Blacks, and Whites

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Racism

• Uses skin color as the primary indicator of
  social value
• People are seen as inferior on the basis of skin
  color

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Subculture

• Holistic belief system that is marginal and
  subordinate to belief system of the culture
• Recognizable portion of the larger population
• Occupational group
• Nurses
• Dress, Language, beliefs
• Ethnic group

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Stereotype

• Preconceived, untested beliefs about people
• Exaggerated descriptors of character or behavior

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Transcultural Nursing

• Recognizes cultural background
• Influences, and determines both health and
  illness for the client
• Culturally sensitive nurse
• Assessment
• Respect
• Expected cultural variation

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Biocultural Variations

• Growth and Development
• Size, shape
• Nutritional tolerance
• Lactose tolerance, alcohol reactions
• Body odor
• Population with less body odor
• Asian and Native Americans
• Skin Color
• Know what is normal for each race

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Clients Perspective

• Nurses need to minimizing ethnocentric
  tendencies/maximizing cultural sensitivities
• Listen to subjective data
• Ethnographic interview
• 3 parts
• Open-ended questions
• Clarification of information
• documentation

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• Key Informant Technique
• Person who is an expert or native with knowledge
  about the specific culture
• Who is a key informant in your culture

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Language Differences

• Accreditation and Medicare requires an
  interpreter
• Blocked communications may result in negative
  outcomes
• Communication through an interpreter
• Page 320 Box 19-2 Craven

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Components of culture that impact nursing

• Religion r/t dietary instructions
• Death r/t cremation and amputated limbs
• Dress
• Treatments
• Medications

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Culturally sensitive care

• First become aware of ones own cultural heritage
• Become aware of the clients culture as described
  by the client
• Become aware from the client of adaptations made
  to live in a North American culture
• Health practices
• Formulate a NCP with the client that incorporates
  his/her culture

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Being Culturally sensitive

• Always address clients by their last name until
  they give permission to use other name
• Be authentic
• Be culturally sensitive to their language
• Find out what the client knows about his/her
  culture
• Avoid assumptions
• Show respect for client and support people
• Make a concrete effort to obtain the clients
  trust

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Cultural Parameters

• Health beliefs and practices
• Supernatural forces
• Illnessbad
• Gods will
• Holistic health
• Forces of nature
• Must be maintained in harmony or balance
• Medicine wheel
• Physical, mental, spiritual, and emotional
• Folk Medicine
• Yin-cold and yang-hot

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• Family patterns
• Who is in authority
• Matriarch
• Female must consult with husband prior to making
  a decision
• Communication Style
• Verbal and non-verbal
• Silence, touch, eye movement, body movement
• Dominant language
• Speak slowly with frequent validation
• Space orientation
• Personal space

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• Time orientation
• Americans are future orientated
• Avoid fixed schedules
• Native Americans/ Hispanics poor concept of time
• Not time driven
• Nutritional patterns
• Hot foods/cold foods
• Kosher foods
• Death and Dying
• Rituals
• Pain
• Boys dont cry
• Bite the bullet

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• Childbirth
• No showers, baths, until lochia stops
• Placenta soup
• Placenta mask