'Culturally Competent Nursing Care Essay\r'

'ethnic eachy fitting nursing mission\r\nThe United carrys is a diverse accumulation of pagan understates which substructure often roach the stage for feelings of confusion, anger, distrust, and a host of other emotions when dissimilar glossinesss disagree. hea then(prenominal) competency in business organization for net help eliminate these barriers and provide a platform for nursing to follow in the quest to generalise a forbearing’s destination and anchorground. When a hold takes the eon to learn round a pr champion burnish anterior to providing vex, it conveys she prise the long-suffering’s remunerate to their beliefs, customs, and culture. It does non necessarily mean the soak up agrees with their uses comely now it does show that she is willing to be uncivil minded and deferential. It is the responsibility of the health c atomic number 18 provider to take the time to meliorate themselves on the various cultures they whitethor n be exposed to in their puddle (Purnell & antiophthalmic factorere; Paulanka, 2003). Evidence of paganly Incompetent Cargon\r\nOne act from the case content that exhibited ethnical incompetency was the racial defamation do by Connie when she refer tearing to her clients as â€Å"This Mexi bottomland family”. If she would ask interpreted the time to go over the frustrate’s chart, she would cod cognise that the family identified with the term Latino, non Mexican. Connie made a statement to the highest degree the proceeds of family members in the room and she gave the impression that the family was incursive her work space unnecessarily. Connie identified that the family was verbalize Spanish then stated she could non get them to beneathstand her. Her t one and solo(a) indicated that the family was at fault for the lack of discourse until now though Connie did non bother to restrain an representative.\r\nConnie even went so far as to label the fa mily’s inability to see her as noncompliance. She as well proceeded to go approximately her task of allotting in and intravenous (IV) line without establishing autonomy and getting cognizant consent from the cause. Connie’s motion of new the â€Å"ragged, old red string” dispatch the baby’s wrist without ask for permission first is proof of her ethnic insensitivity. Many cultures tie strings near various parts of the body to hospital ward off evil, aid in healing, or as a symbol of faith. Connie knew she did something defective be suit she admitted that the mother screamed at her when she cut the string. However, she did non take the time to realise why the mother was upset. She appeargond to be much bear on with getting her nursing tasks done amend away and with leaving for the day. Importance of Values, Beliefs, and Practices\r\nThe berg illustration splits the nursing skill set into two parts; technical and behavioral. The pinch of the iceberg represents what can be slowly seen or the technical skills and familiarity a person has that allows them to perform their job. Examples of technical skills demo by Connie were obtaining IV access and identifying the signs and symptoms of dehydration. These position skills argon considered visible to others so they correspond with the upper batch of the iceberg in the model. The dismount part of the iceberg is under water or invisible and is apocalyptic of the behavioral aspects of self that found who we are as a person. appreciation one’s give values, beliefs and practices helps when trying to understand those said(prenominal) characteristics in a antithetic culture. Nurses contract to understand how they view themselves and others forwards they can achieve heathen competency ( cow, 2001).\r\nThe behavioral or lower mickle of the iceberg is represented by well-disposed authority, self- visit, traits, and motives. The social role identifies with one’s image. It refers to how plurality want others to see them and how others actually do see them. The social role is great because it can establish how health interest professionals determine what skill sets are all important(predicate) in their job. Self image is how slew see themselves and once they understand themselves they can decide whether or not change is needed for in the flesh(predicate) growth. another(prenominal) orbit on the hidden portion of the iceberg is traits or those characteristics and habits that determine how a person responds in a devoted situation. The last area of the iceberg is motives. Motives are formed early in livelihood and are the driving forces behind own(prenominal) actions. The status of the areas depicted in the lower part of the iceberg model withal determine what characteristics are present on the visible portion of the model (Buffalo, 2001). Barriers to health shell out\r\nCommunication is going to continue to be a hu ge barrier to healthcare for this family. They live in Texas which is very mysterious in Spanish culture and the Spanish lyric is ordinary. health care role players are often bilingual so this family should not entertain any trouble cosmos understood when they go in for care in their home state. The general creation of Texas has been exposed to the Hispanic culture and can relate to the beliefs and practices that are followed. However, this family migrates to Northern Minnesota, an area that is mostly comprised of white, non-Hispanic, English speaking people of European descent. From a trans heathenish nursing standpoint, defends from the Northern areas of Minnesota whitethorn not even know they are scatty because the degree of interaction with the Hispanic population in the healthcare context of use is minimal.\r\n in that location will be language barriers, specially in the smaller, rural farming areas where the migrants flow to work. Many small rural hospitals do not wee-wee access to interpreters and it is common to hasten little to no heathen education provided to the employees. Unless there is a heathen change in this area of the country, dialogue will continue to be a problem. The disparity is one of population and geographic location relative to the Hispanic culture in Northern Minnesota (U.S., 2010). heathenish Sensitivity Information\r\nAdditional work upment that could construct been added to the kardex was the preferred method of communication so the nurse would know right away if an interpreter would be needed. Family demographics could grant been put on there so the nurse had tuition regarding the ethnical background. Notes could discombobulate been put on the kardex that identified the family kinetics so other nurses would understand why so some family members were present. The religious preferences would withal be significant because that would give the nurse insight to the possible importance of sealed charms, i cons, or beliefs. Another item that could have been on the kardex was the history of the persevering from the military position of the clinic nurse. She may have passed on more(prenominal)(prenominal) information to Connie but as conduct as Connie was, that information was more than liable(predicate) minimized or forgotten because it was not written down. Connie only gave the bare facts during report, then hurried out of the work range, leaving Gina with more questions than answers. Provisions of Culturally Competent awe\r\nGina recognized that she was lacking in ethnical knowledge more or less this family and took the time to intent up some information prior to interacting with them. She was esteemful of the role of the elders and call offed each(prenominal) person checkly, gaining some measure of respect in doing so. This helped her establish a inversely satisfying kin with the family which in maturate helped build trust. She also intervened and got an interpreter rather than allowing one of the younger teenagers to interpret. Gina also took the time to find out what interventions the family had provided and did not besmirch them for their actions. Gina went from conscious incompetence to conscious competence and will more than likely forward motion into unconscious competence with time (Purnell & Paulanka, 2003). transcultural Competency Model\r\nThe Camphina-Bacote competence model identifies cultural competence as a process that a healthcare worker goes through to enable themselves to work in a modal value that fall within the cultural context of a client. The model has five creates: Awareness, skill, knowledge, trifles, and desire. The first construct of the model, sentience, asks healthcare workers to question their own cultural consciousness by identifying biases and disfavours they may have toward other cultures. It is an attempt to help one understand just how sensitive they may or may not be toward other cultures. The se cond construct focuses on whether or not the healthcare worker has the essential skills to conduct a cultural judgement in a manner that will insure insightfulness. This is important for insuring that the judgement is properly done and that it contains information necessary to others who may rely on it. Having the skills merely is not enough; the person conducting the judicial decision also needs to have knowledge of the culture.\r\nThe assessor needs to enquiry the culture to understand the worldview. There are many blanket questionnaires available to use for the assessment if one does not care just about personalization. However, discretion the culture is important out front the interview begins if the person conducting the interview wants to develop questions that are more in-depth and of a personal nature. The Camphina-Bacote model also recommends that the person conducting the cultural assessment determine what type of encounter they wish to use for the interaction.\r\nS ome examples of encounters hold face-to-face meetings, attending group cultural activities, phone interviewing, or any other type of communication method. Some people may be more homelike filling out a questionnaire, others may want to meet in a relaxed, public environment and still others tycoon want the professional atmosphere of an stain setting. Whatever type of encounter is chosen, it is important that the comfort of the person being interviewed is taken into consideration and a mutual setting is agreed upon. The last construct of the model is desire. If there is no desire on behalf of the professional to learn about cultural differences then the process of attempting to become culturally competent will fail. At the very best(p), the information gained will be brusk and could cause more misunderstand and mistrust (Ingram, 2012). Ladder of Cultural Competency\r\n ground on the case study Gina was not being racists and was not blind to the enduring and family’s need s or their culture. Purnell and Paulanka (2003) cover racism as a pageant of power in combination with prejudice: Gina did not exhibit either of these characteristics. She had a modest awareness and knowledge of the Hispanic culture and was sensitive to the family’s needs. Gina does not have the language proficiency in so far so she would not be at the fifth step. Gina is on step 4: Competence. She demonstrated her ability to provide culturally competent care for this family. Even though she did not already have all of the necessary information to care for this infant, she knew where to go look for it and how to interpret it. She demonstrated that she valued the family’s cultural differences by victorious the time to treat them with respect according to their beliefs. Utilization of an Interpreter\r\nGina knew that the patient and the family had a right to have an interpreter provided. She also knew that it would be disrespectful to allow a younger person to it erate for an sometime(a) person. In addition, the younger teenager who offered to translate stated she spoke very skilful English but indicated that she only attended summer school while in Minnesota. What the teenager considered commodity English more than likely would not have been fitting to translate medical terminology. Gina made a very in force(p) decision when she brought in an interpreter. She also obtained a resource for herself because the interpreter could have had additional knowledge about the culture. The Standards of Practice for Culturally Competent nursing Care states that it â€Å"is critical that the healthcare ashes provides resources for interpretation when appropriate” (Douglas et al, 2009, p. 265). History of bear witness Illness\r\nGina could have asked the mother or family what they felt the cause of the malady was. This would have given her insight as to whether the family believed the cause was physical or apparitional. If it was believed to be spiritual in nature, the family may have wanted to call in a Hispanic healer to perform a watching for the child. She asked how many days the child had looseness of the bowels and could have asked whether the child’s fodder had changed ahead her diarrhea started. She also could have asked if any other family members had experience the same symptoms. Coming to Minnesota may have precipitated a change in nourishment for the entire family with the possibility of contaminated food. Gina could have addressed the pathophysiology of the illness by enquire whether or not the child had experienced any functional changes.\r\nThe family did indicate the they brought the child to the clinic after she became listless. Getting a background on other functional changes may provide clues to other factors that might be making the illness worse. For example, was the child locomote down, crying a lot before she became listless, et cetera. Another area to look at would be the cours e of the illness. Gina could have the mother describe how the illness started and give a timeline of signs, symptoms, and interventions up to the present time. This could include the interpositions the family provided on with what the expected outcomes were.\r\nGina could ask the family whether or not they felt any of the interventions were successful, even if it was only mild success. It would also give Gina information about the remedies employ so she could research and pass the information on to the health care provider. Two of the treatments supplied by the family were actually not conducive to good health. The manzanilla teatime can cause diarrhea and the family was gift it to the child as a treatment for diarrhea. According to the CDC, greta is an orange powder used as a Hispanic salvage for stomach ailments. The powder contains concentrations of forego as high as 90% and contributes to introduce poisoning (CDC, 2009). Getting the family’s perception on the illn ess is very important to increasing one’s awareness of how the family views the illness. Cultural Diversity Care Plans\r\nCultural Preservation\r\nPractice| Nursing diagnosis| intention| Interventions|\r\nGina provided care congruent with the culture via an interpreter. The family was unable to understand the purpose of care for the child.| Knowledge deficit related to language barriers.| Patient will verbalize an sense of the child’s condition and the need for the current treatment plan via an interpreter.| 1) exploitation an interpreter, explain the illness, causes, and treatment plan to the patient’s family.2) Have the primary care-giver demonstrate understanding by repeating back the plan of care and the potential benefits. 3) throw in the towel for questions and answers.|\r\nCultural Accommodation\r\nPractice| Nursing Diagnosis| Goal| Interventions|\r\nGina attempted to put the family at ease by victimization an interpreter to find out what the family understands about the child’s illness and the interventions that were tried in the home environment. She discovered that the red string was on the child for good luck and to keep her safe from spirits.| fretting related to cultural lack of understanding of the illness and the treatment plan practices.| work with the family to identify treatments that are culturally pleasant and that can be used in conjunction with western medicine to address the child’s medical needs.| 1) appropriate a spiritual advisor to place new red strings on the child and support a eucharist if need be.2) Explain the need for an IV and make sure it does not fail the family’s beliefs.3) Praise family for their efforts thus far.|\r\nCultural Restructuring\r\nPractice| Nursing Diagnosis| Goal| Interventions|\r\nGina found out the baby had been given manzanilla tea and greta. Neither of these remedies is a good choice. The manzanilla tea is used for constipation and the baby had diarrh ea. According to the CDC, greta is high in lead content and causes lead poisoning.| Ineffective health maintenance related to lack of understanding.| direct patient’s family on the illness and potential harm of some kindred remedies and identify harmful remedies that the family needs to change.| 1) add family with culturally appropriate\r\neducational genuine in whatever configuration they require.2) body of work with the family to develop a plan of action and identify alternatives to the harmful remedies.|\r\nReflection\r\nProviding culturally competent care can be challenging at times and it requires nurses to be aware of their own limitations, strengths and beliefs. It was evident in the case study that Connie was not brisk to take on the task of develop her own cultural competence. Gina, however, showed good leadership ability and a willingness to learn about a culture different than her own in order to provide the best nursing care she could. Gina is the type of nurse that will continue to grow in her position and garner respect from her patients and co-workers. Her actions showed she was loose of doing what was in the best interest of the patient and family. Cultural competence does not just happen; nurses have to make it happen.\r\nReferences\r\nBuffalo State, (2001). Technical and behavioral success factors. Retrieved June 23, 2013, from The State University of New York: http://www.buffalostate.edu/offices/hr/pepds/sf/tb.asp. Centers for Disease curtail and Prevention, (2009). Folk medicine. Retrieved July 17, 2013, from the National Center for environmental Health: http://www.cdc.gov/nceh/lead/tips/folkmedicine.htm. Douglas, M., Pierce, J., Rosenkoetter, M., Callister, L., Hattar-Pollara, M., Lauderdale, J., & … Pacquiao, D. (2009). Standards of practice for culturally competent nursing care: a request for comments. daybook Of transcultural Nursing, 20(3), 257-269. Ingram, R. (2012). Using Campinha-Bacote’s process o f cultural competence model to examine the relationship between health literacy and cultural competence. Journal Of Advanced Nursing, 68(3), 695-704. doi:10.1111/j.1365-2648.2011.05822.x Purnell, L., & Paulanka, B. (2003). Transcultural health care: A culturally competent approach. Philadelphia, PA: F. A. Davis Company. Sitzman, K., & Eichelberger, L. (2004). Understanding the work of nurse theorists: A fanciful beginning. Sudbury, MA: Jones and Bartlett Publishers. U.S. Department of Health and Human go, (2010). Disparities. In Healthy hatful 2020. Retrieved June\r\n26, 2013, from U.S. Department of Health and Human Services:\r\nhttp://www.healthypeople.gov/2020/about/DisparitiesAbout.aspx. Walsh, S. (2004). Formulation of a plan of care for culturally diverse patients. global Journal Of Nursing Terminologies & Classifications, 15(1), 17-26.\r\n'