Kimberly, the student nurse, is generally professional in her assessment of the patient named Dhia Her. However, there is a degree of awkwardness to the conversation that is difficult to ignore. However, the evaluation must take into consideration the language barriers and cultural beliefs of the patient because it appears that these are somewhat prohibitive in the assessment process. At the same time, a nurse performing this type of assessment must also consider the development of new ideas and approaches that will encourage greater cultural competence towards patients that have distinguishable language and cultural barriers that make it difficult for nurse assessments to be clear and concise at all times.
In this example, Kimberly represents inexperience as a student nurse and demonstrates a lack of understanding of the cultural differences of many patients and how this impacts patient care and wellbeing. It is believed that with additional education and training, Kimberly and others in similar situations will reap the benefits of this knowledge in order to achieve greater cultural sensitivity in patient care. These efforts will demonstrate that student nurses are capable of improving their interactions with patients by recognizing the importance of cultural competence in treating patients. Furthermore, this education and training will expose nurses to patients from a variety of cultures.
Many nursing students do not recognize the importance of cultural competence in the earlier stages of their growth and training (Chen and McAdams-Jones, 2011). It is only with experience and additional training that many students become fully aware of the challenges associated with this understanding and its necessity to nursing practice in a variety of settings (Chen and McAdams-Jones, 2011). Cultural competence in nursing practice must be addressed in all areas of education in order to accomplish the desired objectives by using models that have been deemed effective in this practice (Alexander, 2008). To be specific, “The current health care workforce has not been adequately prepared or educated to care or work with persons of the non-majority culture in anything other than in a dominating, overseer type role” (Alexander, 2008, p. 415). In this context, it is important to identify the reasons behind the slow shift in understanding the importance of cultural competence (Alexander, 2008). It is necessary to transcend existing stereotypes and other factors that prohibit effective treatment outcomes for patients from diverse cultures as a result of poor cultural competence (Alexander, 2008).
It is known that “The goal of culturally congruent care can only be achieved through the process of learning cultural competence; therefore, you must become empowered, active learners in this process, integrating it into all aspects of practice. Confidence (self-efficacy) is one factor that may influence motivation, persistence, and commitment to cultural competency” (Jeffreys, 2006, p. 37). Under these conditions, it is important to identify the factors that are significant in enabling nursing students such as Kimberly to develop and maintain the confidence that is necessary to work effectively with patients from different cultures, including expanded comprehension of cultural identifiers and customs, as well as different languages (Jeffreys, 2006). These efforts will enable nursing students to gain valuable experiences in working with culturally diverse patients in many different settings (Jeffreys, 2006).
Transcultural nursing represents an opportunity to examine a variety of customs and beliefs so that patient care is not compromised during the assessment, care and treatment phases (Leuning et.al, 2002). In addition, cultural competence must be built upon through additional experiences with patients from other cultures because there is a continuous increase in diversity in many healthcare organizations as the general population becomes more diverse (Leuning et.al, 2002). This is critical in developing strategies in nursing instruction to educate students regarding the importance of cultural awareness and understanding when treating patients (Leuning et.al, 2002). These opportunities will encourage inexperienced nursing students such as Kimberly to develop their skills and to break down barriers to communication that currently exist throughout nursing practice (Leuning et.al, 2002). These efforts are likely to improve nursing care and treatment for all patients when these barriers are minimized or are eliminated altogether (Leuning et.al, 2002).
In this case example, Kimberly is a student who does not necessarily recognize the critical nature of cultural competence and how it impacts patient care. This is an important issue because if it is not managed properly, it reflects poorly on a nurse’s ability to provide effective patient care. Although it is not required to fully recognize all cultures and languages in great detail, a level of skill and knowledge must evolve that will capture the spirit of cultural diversity and facilitate its benefits for all patients. Nurses who gain these experiences are likely to be effective in supporting their own relationships with patients from diverse cultures rather than ignoring or refuting them whenever possible. It is this practice that will support the ongoing development of new ideas and opportunities to enhance communication with patients and to improve relationships through demonstrated compassion, support, encouragement, and understanding.
Nursing students such as Kimberly must learn from challenging and awkward experiences with patients and must look to other avenues in order to accomplish the desired objectives in care and treatment. It is expected that these efforts will support expanded attention to cultural competence to avoid similar errors in future patient interactions and to provide additional support for patients who otherwise might have difficulties in communicating with nurses due to language and other cultural barriers. This practice will support successful quality of care and treatment for patients that crosses boundaries in different ways.
Alexander, G.R. (2008). Cultural competence models in nursing. Critical Care Nursing Clinics of North America, 20, 415-421.
Chen, H.C., and McAdams-Jones, D. (2011). Nursing students’ perceptions of cultural competence. International Journal of Behavioural and Healthcare Research, 2(3), 265-276.
Jeffreys, M. (2006). Cultural competence in clinical practice. Retrieved from http://www.nsna.org/portals/0/skins/nsna/pdf/imprint_febmar06_features_jeffreys.pdf
Leuning, C.J., Swiggum, P.D., Barmore Wiegert, H.M., and McCullough-Zander, K. (2002). Proposed standards for transcultural nursing. Journal of Transcultural Nursing, 13(1), 40-46.