Post a thoughtful response to at least two (2) other colleagues' initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: "This is interesting - in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature..." and add supportive reference. Avoid comments such as "I agree" or "good comment."

References:

• Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

• Response posts: Minimum 100 words excluding references.

Discussion 1

There are many cultural barriers within the nursing field and as nurses we are obligated to break through these barriers, to provide the best care for our patients. Cultural baggage is when ones’ own culture views are at the forefront of speech, decisions, behaviors, and actions without even knowing it (Andrews & Boyle, 2016). To enter into thought or decisions from ones own cultural background could be detrimental to patient care. I had a patient who wouldn’t make decisions about her own care, she always looked to her husband to answer. We might assume abuse in our field but, it was their cultures beliefs that the male is the authority and therefore makes all the decisions. He was very loving to her and really wanted the best, but it was difficult for some to put their values and beliefs aside and acknowledge their values. Ethnocentrism is thinking one’s group is superior to all. Racism would be an example of this. Each group thinking, they are superior or better than the other. Cultural imposition is imposing one’s own views, values, practices, and beliefs onto others. As with my example for cultural care, there was a nurse that repeatedly attempted to get the female patient to decide and was very vocal about how women have rights. This nurse could not understand how or why the women would not make any medical decisions. This resulted in the family refusing care and essentially affected the patients healing. Prejudice is inaccurate perceptions or judgments about people based on ethnicity, race, national origin, gender, sexual orientation, social class, and religion. I once had to take a patient over for a co worker about an hour into our shift. The patient was very rude and made derogatory comments to this nurse. The patient thought the nurse was homosexual and would try to “hit on him”. The patient assumed that ALL male nurse must be gay. The mean and vile comments the patient would make towards this nurse were notorious, he would discriminate against all male nurse. Discrimination is treating one person or group different from others. This patient refused treatment from all male nurses. Cultural congruence is evidenced-based nursing aligned with the preferred cultural values, beliefs, and practices of the patient and families. Assuring that we respect and can provide appropriate care aligned with the patient’s cultural values and beliefs (Marion, et al., volume 22 2017).

A culture self-assessment is critically reflecting own culturally based attitudes, values, beliefs, and practices and emphasizes strengths and areas for growth, thereby enabling nurses to set goals for overcoming barriers and deliver culturally congruent and competent care (Andrews & Boyle, 2016, p. 34). Knowing and understanding ones own cultural beliefs and actions will help the nurse to break through certain barriers they may not even know the had up. This will allow better acceptance and understanding of the very cultural diverse world we live in. The self-assessment doesn’t change one’s own views, experiences, beliefs or practices but allows the mind to understand that just because it’s what “I” believe doesn’t mean it’s what “you “believe. Ultimately, completing a cultural self-assessment will allow self to just get a better understanding of self and to know strengths and weakness with ourselves when it comes to understand others.

The five steps involved in the process of delivering culturally congruent nursing care are comprehensive cultural assessment, mutual goal setting, planning, implementation, and evaluation. Comprehensive cultural assessment is a self-assessment and holistic of patient that includes health history and physical exam (pg. 23). Mutual goal setting is perspectives from entire health care team, the patient, and patient’s family. Setting expectations and goals from all parties. After goals and expectations are set the planning begins. Implementation of the care plan set forth by the medical staff using the goals, wants and needs of the patient. Evaluation of the care plan form multiple diverse perspectives. This allows the care team to determine the plans effectiveness, ensures cultural congruent care, culturally competent care, quality care, and ensures best practices are used. These steps help to assure optimal care from the health team and ensure patients cultural values are respected.

References:

Andrews, M. M., & Boyle, J. S. (2016). Transcultural Concepts in Nursing Care 7th edition. Philadelphia, PA.

Marion, L., Douglas, M., Mary A, L., Barr, N., Gazaway, S., & Thomas, E. (volume 22 2017). Implementinting the New ANA Standard 8; Culturally Congruent Practice. American Nursing Association.

Marion, L., Douglas, M., Lavin, M., Barr, N., Gazaway, S., Thomas, L., Bickford, C., (November 18, 2016) "Implementing the New ANA Standard 8: Culturally Congruent Practice" OJIN: The Online Journal of Issues in Nursing Vol. 22 No. 1.

Discussion 2

It is without a doubt that our cultural roots and surroundings shape who we are as individuals. It shapes how we think, act, and feel as we interact with the people who surround us. We carry our cultural beliefs and practices with us wherever we go. As citizens of a country where many different cultures are practiced, it is imperative that nurses are well rounded and aware of how to deliver culturally congruent nursing care (Rew, 2014). Throughout this discussion board I will review the basic terms that are frequently used when discussing culture, define cultural self-assessment and its importance, and discuss the five-step process recommended for use when delivering culturally congruent nursing care.

Some basic terminology used when discussing culture are as follows; (A) cultural baggage is a term used to describe an individual that assumes that certain beliefs, behaviors, and speech without even being knowledgeable regarding another culture. (B) Ethnocentrism is the belief that one’s own culture is more superb than another's. (C) Prejudice is a biased opinion regarding something or someone that is not actually based on facts but assumptions. (D) Discrimination describes when individuals are being treated unfairly due to their differences in race, age, and sex. (E) Cultural congruence is the ability to acknowledge various cultural backgrounds of the individuals they interact with (Andrews & Boyle, 2016).

Nurses serve at the forefront of patient interactions. Often time’s nurses are the first person that a patient interacts with when they enter a hospital setting. Therefore, it is imperative for nurses to be culturally sensitive when delivering patient care as many patients present with specific needs and expectations. In order to be sensitive to these patient's needs, a nurse must perform a cultural self-assessment. A cultural self-assessment is a tool used by nurses to reflect on their own cultural beliefs and practices and how it has shaped the person and nurse they are today (Andrews & Boyle, 2016). During a self-assessment nurses are able to identify both their strengths and weaknesses they may encounter while delivering cultural congruent care (Andrews & Boyle, 2016). This process allows for nurses to identify any areas where they may be biased or stereotyping any specific cultures.

Performing a cultural self-assessment is the beginning of a five step process for delivering culturally congruent and competent nursing care. After a self-assessment the nurse should then perform a client cultural assessment taking into consideration the patient's subjective and objective data. The nurse and patient should then set mutual goals while developing the patient's care plan and implementation (Andrews & Boyle, 2016). Also during this step, the nurse should collaborate with any necessary folk, religious, or spiritual healers. The final step evaluates the patients care plan and objectives by the client and providers. Nurses should take into consideration the safety, accessibility, quality, best practices, and evidence-based practices (Andrew & Boyle, 2016). This problem solving method is a continuous process that is always evolving depending on a patient’s needs. Being culturally sensitive to patients needs not only helps them to feel more secure about their hospital stay, but assist in providing well-rounded holistic care.

References

Andrews, M. M., & Boyle, J. S. (2016). Transcultural concepts in nursing care (7th ed.). Philadelphia, PA: Wolters Kluwer.

Rew, L. (2014). The influence of culture on nursing practice and research. Journal for Specialist in Pediatric Nursing, 19, 1-2. http://dx.doi.org/10.1111/jspn.12058