Introduction
The ability of healthcare practitioners to comprehend the specific cultural needs of their patients and to offer appropriate care in accordance with those requirements is referred to as “cultural competence.” Cultural competence is an essential part of providing medical care. Providers of medical care need to adopt a strategy that is culturally sensitive and takes into account, as well as respects, the beliefs, values, and practices of their patients (Jongen et al.,2018). Providing care that considers a patient’s culture is essential since it improves their trust, contentment, and overall outcomes. In addition, it is essential to note that cultural humility, another essential component of cultural competence, refers to the capacity to keep an open and flexible attitude toward differences in cultural norms and continuously self-reflect on one’s preconceived notions and biases. It is essential to note that cultural humility. The purpose of this paper is to critically reflect on a cultural situation or incident that occurred during my clinical placement, apply the fundamental concepts of cultural competence and humility to the situation, and explore the implications of cultural competence for the healthcare system, the nursing profession, patient outcomes, and future nursing practice. This paper will also apply the fundamental concepts of cultural competence and humility to the situation.
Clinical Situation
During my night shift at NURS 450 clinical placement, I provided care for a 53-year-old Indigenous woman, Lily (Pseudonym), who was brought into the emergency room by the EMS following a suicide attempt. Lily lost her husband a year ago, and it was his first anniversary of death. Lily had a long history of mental health-related issues, including 22 years of depression. Lily was agitated and fearful as she was refusing to speak to the health care staff at first. She had some disorganized ideas, such as accidentally falling out of a window or getting eaten by wild animals at the hospital. Lily attempted suicide by trying to hang herself. Lily was put in a room in the unit and was given a call bell in case she needed anything.
The physician consulted the psychiatrist on call to come to assess the patient for possible admission to the mental health unit. The psychiatrist asked for the patient’s name and history, however, after reading her name, the psychiatrist told the nurses that Lily is a “frequent flyer” and is well known to the mental health unit. Once psychiatrists evaluated the patient, the psychiatrist decided to discharge the patient with a prescription for two new medications. Once the psychiatrist was done evaluating Lily, I advocated for the patient by speaking to the psychiatrist about the patient’s current situation. The psychiatrist said the Government of Canada and the health care system try to help Indigenous people, but it’s on them that they don’t want to do better for themselves. System-wide change begins with every individual that works in health by implementing the protocol of cultural safety and humility. First Nations are a part of the system-wide change by taking ownership of their health and wellness journeys (FNHA’s policy statement on Cultural Safety and humility). The psychiatrist wasn’t too worried about the patient and discharged her with a prescription for 2 new antipsychotic medications.
During the same shift, the EMS brought the patient to the emergency room again with a polysubstance overdose from the new medications prescribed that morning. When the patient came back with EMS, the psychiatrist was called to come in again. At this time, the healthcare team (RN, student, physician, and psychiatrist) had a brief discussion regarding patient care, and they were able to review their judgments, biases, actions, and choices that ultimately led to increased accountability, safe patient care, and promoting patient health.
This patient was indigenous, and there are many stigmas regarding Indigenous people and mental health-related issues. Indigenous people are often nervous when talking to nurses, possibly due to fear of being judged. Discrimination against the Indigenous population in the healthcare system has been a significant issue for a long time.
In the 1950s, the government of Canada established a national healthcare system to ensure that all Canadians had access to the appropriate medical and hospital treatment they needed. (Lavoie, 2018). The federal government safeguards the health care plan, but the respective provincial governments manage the health and social services themselves. Yet, because the federal government is responsible for Indians who are recognized as such under the Indian Act, implementing this proposal is not in the best interest of the indigenous population. Because the responsibility for providing medical and social services lies with the provincial government, indigenous groups on reserves are forced to endure hardship.
Madeleine Leininger recognized the significance of compassionate cultural care as an essential component in nursing. Leininger made this observation on the nursing profession while working as a nurse. She found that nursing needed the cultural and care expertise essential in inpatient care to support patients’ well-being. The goal of Leininger’s Culture Care Theory is to provide culturally competent nursing care by means of supportive, facilitative, and empowering actions that are generally tailored to meet the cultural preferences, beliefs, and lifestyles of individuals, groups, or organizations (Seamon, 2019). In order for the nurse to discover the cultural care values and expressions concerning kinship (social), religion, and philosophy, as well as political and legal, technological, economic, and educational care and health factors, the nurse must maintain an extremely active listening, observing, and participating role with cultural informants. According to the Culture Care Theory, nursing is a humanistic profession that focuses on compassionate care and caring activities to encourage, promote, and educate patients to maintain their health in culturally meaningful ways. This understanding of nursing is grounded in the Culture Care Theory (Foronda, 2019).
Care and cultural values that are right for the patient can be evaluated to synchronize Madeleine Leininger’s culture care theory into practice in healthcare. It’s all in how the nurse deals with, treats, and helps the patient. Providing culturally compatible care with or appropriate to the patient’s culture is one way to accomplish integration. The nurses will benefit from this approach since it allows them to address patient concerns from the patient’s own cultural perspective. At the time of admission, the nurses should evaluate any culturally-specific home remedies the patient may have been using and decide whether or not to incorporate them into the patient’s regular treatment. Healthcare services that rely on western medicine and traditional public health techniques often ignore the social and economic factors that significantly impact individuals’ health, and they seldom modify their practices to account for cultural norms(Curtis et al., 2019). Integrating spiritual practices into care has been shown to affect health outcomes positively. Including the patient’s loved ones, with their permission, can provide them with emotional support while also demonstrating respect for the patient’s culture. And if the patient is resistant to a certain treatment, the nurse can still adjust without betraying their values by creating a cultural care plan. The nurse-patient interaction might benefit from a superficial familiarity with a patient’s culture.
Implications of Cultural Humility/Competency/Safety In;
The Health System
Improved health outcomes for culturally varied people are one of the implications of cultural humility, cultural competence, and cultural safety in the health care system. Reducing healthcare inequities, improving patient satisfaction, and enhancing provider-patient communication and relationships are the means through which this goal can be accomplished. Language obstacles, cultural beliefs, and access to care are only some of the social determinants of health that can be addressed with the help of cultural humility and safety practices (Hughes et al., 2019). These factors all have an effect on health outcomes. Another benefit of cultivating cultural humility, competence, and safety within the Health Care System is that it encourages a more varied and inclusive culture in the workplace. Understanding and appreciating cultural diversity among healthcare professionals and staff contributes to a more positive work environment, which in turn leads to a reduced staff turnover rate. Also, it has been demonstrated that healthcare personnel who are culturally competent suffer fewer incidences of burnout, which ultimately results in a higher quality of care being offered to patients.
In the context of interprofessional care and cooperation, having cultural humility, competence, and safety has extra implications, one of which is that it improves communication, coordination, and collaboration among team members (Slim & Reuter-Yuill, 2021). Providers who demonstrate cultural humility and safety are more able to comprehend the perspectives and experiences of their colleagues, which in turn fosters a more collaborative and successful approach to patient care. This ultimately results in better patient outcomes and more effective utilization of available resources.
The Nursing Profession
Nursing is a discipline that professes to address the human person holistically, focusing on all person dimensions: body, mind, and spirit (Lemmer, 2005). Care of the spirit is a professional nursing responsibility and an intrinsic part of holistic nursing. The holistic nursing perspective requires nurses to view each person as a biopsychosocial being with a spiritual core. These nurses must be sure to address the spirit and other dimensions to provide holistic care.
The implication of cultural humility/competency/safety for the nursing profession is that it fosters tremendous respect for the diversity of patients and their cultures. Culturally competent nurses can establish a rapport with their patients, which leads to better communication, trust, and respect. This, in turn, leads to increased patient satisfaction and adherence to treatment plans, which ultimately improves health outcomes. Another implication of cultural humility/competency/safety for the nursing profession is that it promotes self-reflection and continued learning. Culturally competent nurses recognize the need for ongoing education and training to address the needs of diverse patient populations. They engage in reflective practice and seek feedback from patients, colleagues, and other healthcare providers to continually improve their cultural competence.
Patient Outcomes
Promoting patient-centred care is one of the implications of cultural humility, cultural competence, and cultural safety for patient outcomes. When providing care, culturally competent practitioners place the patient’s values, beliefs, and preferences at the forefront of their work. This results in a more individualized treatment plan that is more likely to be successful (C et al., 2016). This strategy raises patient satisfaction and improves treatment adherence, eventually resulting in better health outcomes. One of the implications of cultural humility, cultural competence, and cultural safety for patient outcomes is the reduction of inequities in healthcare. Healthcare personnel can understand and meet the specific healthcare requirements of various populations when they have cultural competence (Stubbe, 2020).This results in more equitable access to and utilization of healthcare services. As a direct consequence of this, these populations will experience improvements in their health.
My Future Nursing Practice
Cultural humility, competency, and safety are all important concepts for healthcare providers, including nurses, to understand and practice. These concepts have several implications for my future nursing practice: This includes Recognizing and respecting cultural differences: Cultural humility requires healthcare providers to recognize and respect each patient’s unique cultural beliefs, values, and practices. As a nurse, I will need to take the time to learn about my patients’ cultural backgrounds and understand how these may affect their health and healthcare needs.
Secondly is Developing cultural competence: According to Greene-Moton & Minkler, 2019, Cultural competency refers to effectively working with patients from diverse cultural backgrounds. This includes understanding how culture can affect health beliefs and practices and communicating effectively with patients who may have different cultural norms around communication and decision-making. Moreover, providing culturally safe care: Cultural safety means that patients feel safe and respected in the healthcare setting, regardless of their cultural background. As a nurse, I will need to create an environment where patients feel comfortable expressing their cultural beliefs and values and where their cultural needs are met. Furthermore is avoiding cultural biases and stereotypes: Cultural humility requires healthcare providers to reflect on their own cultural biases and stereotypes and to recognize how these may impact their interactions with patients. As a nurse, I must be aware of my cultural background and beliefs and strive to provide unbiased care to all patients. Finally, I will strive to understand my patient’s cultural backgrounds and language and to provide care in a manner that is tailored to their individual needs. I will strive to create a safe and supportive environment for my patients to communicate and participate in their healthcare and to be open to feedback and criticism from my patients. By incorporating these elements into my practice, I can ensure that I am providing quality care that respects my patient’s cultural and linguistic differences and that I am providing a safe and supportive environment for my patients to communicate and participate in their healthcare.
Conclusion
The paper discusses the case of a patient I encountered in my clinical placement and emphasizes the importance of cultural safety and humility in healthcare. The paper highlights the need for healthcare providers to understand and appreciate cultural differences to provide quality care that respects patients’ cultural and linguistic differences. Madeleine Leininger’s culture care theory is presented to integrate cultural values into patient care. The paper emphasizes the need for system-wide change and for First Nations to take ownership of their health and wellness journeys. The paper also discusses the implications of cultural humility/competency/safety in the healthcare system, including improved health outcomes for culturally diverse populations, a more inclusive and diverse workplace culture, and a higher quality of care provided to patients. In conclusion, the paper emphasizes the importance of providing culturally safe care, avoiding cultural biases and stereotypes, and striving to understand patients’ cultural backgrounds and language to provide tailored care.
References
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