A number of us can recall times when patients paid visits to their doctors with only one hope and expectation; that the health issue they were having would be cured by the doctor. Things are however different today as patients shift their focus on the need for medical personell to be more responsive to their cultural heritage. According to some reliable reports, the percentage of ethnic minorities in America today is approximately 28%.
This is expected to have risen to 35% by the year 2020 and this hence means that there is a growing need to adjust healthcare provision methods so as to bring into the picture various cultural attitudes.In this text, I define culturally competent care appropriate for my own workplace and identify the served populations as well as issues of vulnerability on the same.
I also discuss those cultural competence standards met and those that are yet to be met while identifying the nursing care delivery impacts in instances where standards are met and where they are not. In the end, I come up with an opinion of the proposed solutions in instances where standards are not being met.
Culturally competent care appropriate for my workplace
As already noted in the introductory section, the world is increasingly becoming a global village and hence with that in mind, there is a growing need to embrace diversity and come up with measures aimed at accommodating a wide range of cultural attitudes. This need has already been classified as urgent for my workplace. The need to come up with programs that address this need has also been recognized.
As far as my workplace is concerned, culturally competent care calls for the commitment as well as involvement of each and every individual including but not limited to the administration, doctors, nurses as well as other care givers. This group is largely responsible for being much more responsive to the various verbal clues, values as well as attitudes individuals are more comfortable with as a result of their heritage.
According to Cherry & Jacob (2005), the healthcare tailoring concept has been around for quite a while. That is, previously we have had gender and age being used as a basis of medical specialties. Hence as far as my workplace is concerned, cultural sensitivity is a mere addition to the already existing refinement. It is also important to note that as far as cultural competence is concerned, patients need not be exposed to the same methods that are utilized in their homelands.
Andrews (2008) is of the opinion that cultural competency goes a long way to initiate a well founded understanding of the various ways in which patients respond to the clinical setting.It is important to note that based on the increasing diversity, a need exists to base our reflections on the whether as an organization, the workforce we have mirrors the existing diversity of the various patients we serve. This calls for a review of the various opportunities in place. By ensuring that the workforce reflects the societal diversity, the ability of the organization to avail to patients’ culturally competent care shall be strengthened.
According to Cherry & Jacob (2005), a healthcare organization whose workforce does not reflect the societal diversity loses a wonderful chance to enhance the care experience for a sizeable chunk of patients.It is important to note that over time, patients seeking healthcare services in the various health facilities have continued to receive quality healthcare; thanks to the unfailing efforts by the American Medical Practitioners. This has gone a long way to enhance the country’s equalization of care delivery.
However, according to Andrews (2008), many are coming to the realization that ‘quality’ perceptions largely differ as far as culture is concerned and hence there is a growing need to rethink a number of approaches.Probably by intuition, we have come to the realization that there exists traditions as well as value systems that largely differ as far as the various cultural group are concerned. This is probably the reason why we have come to the conclusion that there is a growing need to familiarize ourselves with these differing traditions as well as value systems so as to guarantee better satisfaction in regard to patients as well as better outcomes in regard to treatment.
For instance, according to Joint Commission Resources Inc. (2005), Latino patients are essentially very outspoken and forthright in regard to the symptoms they have. In addition to that, when it comes to conventional treatments, they are in most cases highly receptive. However, when it comes to Chinese patients, they may not be as forthcoming in regard to their symptoms and they may at times they may gibe the doctor inconclusive or misleading information especially in cases where they feel uncomfortable or nervous.
Hence in such a situation, homeopahetic remedies may be more relevant.It is important to note that the awareness of the above information should not be used as a basis for altering the treatment advanced to patients. However, such information go a long way to help health workers to explain the various inconsistencies that may be noted in regard to what the patient has availed and what examination findings show.
Equally important to note is that we have been able to devote scarce healthcare resources to those uses which we believe are more urgent. This is a valuable opportunity that has been noted as well as identified courtesy of cultural competency. To ensure that patients receive premium services, cultural competency has been invoked as a way of availing the same to patients without the need to increase capital investment or expense. Hence in this regard, cultural competency has resulted in the accrual of two primary benefits, that is, the improvement of outcomes and secondly, the tendency of patients to decrease their reliance on emergency care which is relatively costly and instead concentrate more on seeking preventive care.
Though clinical research on this area is still ongoing, Cherry & Jacob (2005) are of the opinion that cultural competence directly or indirectly affects high quality outcomes. We note that in some instances where there exists a healthcare worker-patient language barrier; there is a high possibility of basic diagnostic errors. However, we also note that if the health practitioner’s behaviors, age, voice tone as well as gender make the patient uncomfortable, the interaction between the heath practitioner and the patient cannot be maximized.
This is because while some actions may not have much meaning in the American culture, they certainly do for other cultures. It hence follows that medical services have had to be tailored around cultural experiences that are largely shared and that have an effect on the caregiver-patient interaction. It is important to note that though not impossible, interaction between the caregiver and the patient can be frustrated by differing cultured.
This is one of the main reasons why we have had proposals to the effect that Permanente medicine incorporate a self test for the care giver so as to enable him or her to come up with a self assessment which may go a long way towards determining if there exists a need for additional training.
Populations served and issues of population vulnerability
In relation to cultural competence, the various populations served are many and varied. As noted in the introductory segment, the percentage of ethnic minorities in the American population is estimated to hit 35% by the year 2020. Currently, we have the same standing at 28%. As far as ethnic cultural competence is concerned, the population covered can be classified in terms of religion, ethnicity as well as gender.
In regard to ethnicity, we have the categorization grouped into three including Native American, Hispanic, African American and lastly White. However, the composition of these ethnic groupings is changing continuously as per the figures presented by recent demographics. When it comes to religion; we have the Muslim community as well as Christian community. Gender is classified as male or female.Over time, most of the issues revolving around population vulnerability have been resolved by tailoring the services to be fully responsive to the various needs of the population.
For instance, we have several language used in signage postage and in most instances, care providers have had to be bilingual. It is also important to note that sensitivity trainings have been established with the sole purpose of stimulation an understanding of caregiver-patient cultural considerations. However, it is important to note that there are issues that are yet to be dealt with and as such, the cooperation of every stakeholder is needed so as to realize a fully culturally responsive system of healthcare.
Standards of cultural competence: a discussion
It may be noted that though gains have been made over time as far as the adoption and implementation of standards of cultural competence is concerned, some projections are yet to be met. According to, there are five elements that are essential when it comes to enhancing an institution’s prowess as far as cultural competence is concerned. These elements are presented as the respect for diversity, cultural self assessment prowess, awareness of the cultural interaction dynamics, cultural knowledge that is significantly institutionalized and lastly, service delivery adaptations that mirror an enhanced cultural diversity understanding.
Some of standards of cultural competence that have relatively been well met include respect for diversity, cultural self assessment prowess and lastly, awareness of the cultural interaction dynamics. When it comes to the respect for diversity as well as awareness of the cultural interaction dynamics, it is important to note that there have been efforts to seek feedback from those served. This feedback acts as a way of coming up with improved programs that serve to enhance the respect for diversity and a better understanding of the various cultural interaction dynamics. There are also well laid down rules as well as procedures on handling individuals from diverse backgrounds.
However, when it comes to awareness of the cultural interaction dynamics, cultural knowledge that is significantly institutionalized and service delivery adaptations that mirror an enhanced cultural diversity understanding; much more needs to be done. This is more so when it comes to cultural knowledge that is significantly institutionalized where there is a need to manifest the same at every organizational level. The organizational levels in this case comprise of or could be taken as the practice level, administration level as well as policy making level.
What is more, there is a growing need to ensure that the various policies, structures as well as services and attitudes of the institution prominently reflect these standards of cultural competence.When it comes to the delivery of nursing care where standards are being met as well as where they are not, potential impacts abound. Meeting the standards guarantees that accrual of a number of benefits including but not in any way limited to the reduction of treatment instructions as well as diagnoses that are largely incorrect.
With this in mind, serious mistakes are avoided. Further, delivering nursing care where standards are met goes a long way towards avert instances where patients may encounter experiences which are rather unpleasant as a result of insensitivity in cultural terms. Hence in that regard, the overall patient satisfaction rankings are bound to increase.
Further, it is important to note that going forward, the ability of an institution to deliver culturally competent healthcare shall be ranked along its ability to govern issues revolving around accessibility, convenience as well as price. Hence the responsibility of every healthcare institution should be aimed at ensuring that all the standards in regard to cultural competency are being met.
Solutions that could be implemented where standards are not being met
It is important to note that there are a number of solutions that should be considered in scenarios where standards are not being met for one reason or the other. This includes an enhanced understanding of the culturally competent initiatives as a continuous process and hence there is no single recipe or best fit as far as cultural competence is concerned.
Hence taking the whole initiative as an ongoing process could go ahead to help matters where standards are not being met. Further, there is a need to tailor medical and healthcare services around cultural experiences that are largely shared and that have an effect of the caregiver-patient relationship. Communication also needs to be enhanced and if need be, interpreters should be introduced into the picture. Words as well as instructions should also be presented in a number of languages where appropriate.
In conclusion, it is important to note that cultural barriers have informed a number of treatment instructions as well as diagnosis that are largely incorrect and this has often led to mote complications. Further, even in instances where the treatment is taken to be largely successful, patients might find it hard to seek the services of a particular caregiver because of cultural insensitivity which informs their unpleasant experiences.
Hence with that in mind, cultural competence can be said to have an effect of the satisfaction rankings of a patient. It therefore follows that going forward, minority groups will seek to assess cultural competency alongside accessibility, convenience as well as price in an attempt to find out if their needs which are largely unique are being addressed as they should.
Joint Commission Resources Inc. (2005). Providing Culturally and Linguistically Competent Health Care. Joint Commission Resources
Cherry, B. & Jacob S.R. (2005). Contemporary nursing: issues, trends, & management. Elsevier Health Sciences
Andrews, MM. (2008). Tran cultural concepts in nursing care. Lippincott Williams & Wilkins