Cultural Competence in Nursing and Health Care

Question: Discuss about the Cultural Competence in Nursing and Health Care. Answer: Introduction Every individual belong to a distinct culture, and that culture has a profound influence on different aspects of their life. People are recognized by their cultural identity which refers to belonging to a particular social class or groups. It is the feeling of belonging to a particular group such as nationality, ethnicity, religion, social class or generation. People's accent, behavior, choice of housing, employment and relationship are all influenced by their culture. In this context of the impact of cultural identity in our life, this essay gives a reflection personal, cultural identity, values, belief and behaviours and explains how this personal attributes of an individual can have an impact on the performance of a health care practitioner. Reflection on personal family traditions, values and behaviour I belong to an orthodox Hindu family born and brought up in India. I have lived in a joint family from the beginning and due to this I have always valued the family relationship and respected my elders. My mentality has been influenced by living in a joint family and interacting with the similar mindset of people in my community. I have always accepted and respected my elder's decision in every critical point of my life. I always valued the relationship and, this is the reason that I am happily married since 12 years ago. An Indian family believes in enduring relationship and parents play a significant role in molding a child's personality. I have inherited not only the physical characteristics but also the mental features of my parent. As a joint family, I have lived with my uncle, aunt, nephew, nieces in the same household. Joint family system is a peculiar characteristic of Indian social life. In our family people participate in common worship, eating, cooking and sharing properti es. We have a socialistic community where each earns according to their capacity and contribute their family competence. Being a health professional, this mentality has also influenced my profession. I have respected and understood each patient problem and tried to provide them maximum relief from their ailment. However, this was challenging in the beginning because of interaction with the diverse culture of people. Impact of personal values on performance as health care practioner India has a diverse group of people coming from the different culture, religion and, ethnicity. The cultural beliefs also have an impact on persons overall health and wellbeing. It influences their choices in health care and the treatment that they prefer. When I first started practicing as a health care practitioner, I came with my family value of respecting elders, being humble, pure and modest. My Hindu cultural values were also intact. According to the codes of Hindu religion, I also strive to protect my innate purity by wise living, avoiding harsh language and actions and maintaining a healthy body. However, my practice as a health practitioner became problematic in the beginning because I could not understand the cultural view of people who came for treatment. Cultural competency skill is critical in health care to provide safe and standard care along with respecting patients cultural notions. It enables building a therapeutic relationship with patients and facilitates shared d ecision making in health care. I found that due to belonging to different religions, patient's compliance to treatment regimen also differed. As far as my religion is concerned, I found that due to their beliefs of karma and reincarnation, many other people and I always accepted difficult circumstances as part of their karma. I found them to comply with my instructions. In that case, it was easy to treat such patients. Due to my upbringing in a Hindu joint system family, my decisions were always influenced by elders in my family. Similarly, I found Hindu patients took decision making related to health matters after consulting elder members of the family. So I always wanted to make sure informed consent was given regarding any treatment procedure so that no chaos occurs in the later stage. However, I faced some health challenges too when I saw that they also used traditional medicines like ayurvedic medicines, home and spiritual remedies along with general medications. Though they are good, combining all types of b ringing may prove fatal in the chronic illness where immediate medical attention is required instead of spiritual remedies. Being a Hindu, I knew their beliefs regarding health care and other alternatives that they choose to provide relief from health issues. However, when I interacted and treated other patients, I felt I lacked in cultural competency skills to judge the behavior of this kind of patients. A health care practitioner who understands the views and cultural practices of different religion are better placed to provide patient-centered care without stereotyping. I needed to be aware of modesty, privacy, dietary requirement and use of medications in various cultural groups. In the case of Muslims, I found that some groups give prime importance to spiritual interventions for healing disease. They give spiritual interventions more precedence over biopsychosocial needs. From an Islamic perspective, they regard illness as part of life and perceive it as a trial from God by which their sins are removed. But there are widespread misunderstandings of Islamic belief and values. Therefore, this type of c ultural affinity towards other alternatives forms of care act as view barrier to effective health care delivery. In the case of dealing with tribal people or people from the different ethnic group, one major obstacle to health care delivery is the language. My cultural values were different from this group, and I could relate their views my views about their health care. Secondly, interaction became involved also because of different dialect and language used by this people. This experience gave me the lessons that cultural awareness and knowing cultural orientation is an important part in the delivery of safe and quality treatment to patients (Christopher et al., 2014). Implications for improvement in health care performance Cultural competency is acquired by the knowledge and interpersonal skills that allow people to interpret and work with people belonging to different cultures. My goal was also to engage in critically reflective practice and overcoming all the challenges faced while overcoming intercultural boundaries. The foremost thing in this regard was to let go of my preconceived notions and start thinking from individual patients perspective regarding illness or disease. Having the skills to work outside ones comfort zone and being able to negotiate with people having a different view about disease and healing will be necessary skills to develop to improve my performance. Cultural competence skills allow understanding of attitude and behavior of people and enable health practitioners to work effectively in cross-cultural situations (Renzaho et al., 2013). The increasing diversity of worlds population also accentuates the need for health professionals like me to deliver culturally competent nursing care. To become culturally competent, I need to first culturally aware of health beliefs and notions of individual patients. Secondly, knowing local language or dialect is also important to provide patient-centered care. Learning culturally competent care is a continuous and changing process, and this cannot be learned in one day (Truong et al., 2014). I also developed this skill after interactions with diverse groups of patients and gaining experience from those situations. Developing cultural awareness allowed me to see the complete picture regarding why people did not adhere to my medications or why they did not prefer certain treatment options (Jeffreys, 2015). It made me more conscious regarding what kind of interventions I will adopt to treat patients with preconceived notions about disease and healing process. It helped me significant ly in improving my standard of care, and it also leads to better health outcomes. I would like to give one example regarding how to meet patients cultural expectation as well as treat them for illness and health problems. This account is given relating to the perspective of Hindus and how they approach illness and diseases in life. According to the Hindu law of karma, people's life cycle goes through birth and rebirth. They see events in life as a result of their karma (Lipner, 2012).. So when I faced patient with this strong belief in karma, I encouraged family members to arrange rituals or prayers for the patients or provide them holy books to read. The purpose behind this was to make patients accept treatment regimen. They are more likely to adhere to the treatment when they are not interrupted in their cultural practices. Secondly, belief about diets is not universal for all Hindus. In such situations, my approach was always to discuss with family members regarding their belief and dietary habits. This meant in needed to ensure that their preferred food option was available in hospitals. In the Indian culture, elder persons or elder son is given the right to take important decisions in palliative care. But in western countries, the mostly patient is given the freedom to make decisions related to resuscitation, artificial hydration and nutrition and intravenous infusion. Therefore, in the Indian context, I always made sure that informed decision making in treatment was exercised by consulting important members of the family. Therefore the key competency skill gained through my experience in dealing with culturally diverse patients is gaining knowledge about different people's culture and protocols. Secondly, I also learned that critically reflecting on my culture and professional paradigms to understand the cultural limitations. I developed the proficiency to engage and work effectively in different cultural and religious context congruent to the expectation of patients and their family members (Purnell, 2012). I was serious regarding brining a positive change in my performance so that I can improve the quality of life of patients. So, the key elements that all health care professionals will require in the domain of competenct skills are valuing diversity, developing cultural self-assessment skills, being conscious of dynamic prevalent in cross-cultural interactions and making adaptations that reflect cultural understandings (Bonder Martin, 2013). Conclusion Thus, from the reflective essay on personal, cultural identity and their impact on the performance of health care practitioner, one can conclude that cultural awareness is an important part of health care delivery. The essay gave detail on personal values, beliefs and values present in an individual and this factor influences other important decisions in their life. My held my own cultural belief and understanding due to my upbringing and living in the joint Hindu family system. Through my experience and interaction with different patients in my professional practice, I identified my weakness in skills, and I came to the conclusion that I was judging people according to my own preconceived cultural notions. However, mistakes encountered during practice helped me to develop my skills and broaden my understanding of different cultural behaviour in response to treatment procedure. Developing cultural competency skills helped me to treat culturally diverse people and bring better health outcomes. Mind map Reference Purnell, L. D. (2012).Transcultural health care: A culturally competent approach. FA Davis. Bonder, B., Martin, L. (2013).Culture in clinical care: Strategies for competence. Slack. Lipner, J. (2012).Hindus: Their religious beliefs and practices. Routledge. Jeffreys, M. R. (2015).Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. Springer Publishing Company. Truong, M., Paradies, Y., Priest, N. (2014). 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