What Is The Impact Of Culture

Published Date: 02 Nov 2017

Many countries in the 21st Century with the increase in global movement have become multicultural. In today’s multicultural society, minority ethnic groups form 7.9% of the UK population (office for National Statistics, 2001 cited by Black 2008). Nurses because of cultural diversity have to face the challenge of working with patients from different cultural background. According to Hancock (2003) one of the challenges is bringing to this multicultural society a high quality care that meets the appropriate needs of the patient, thus it is important that care is provided in a manner that respects and accommodates everyone’s cultural and religious needs. Awareness about cultures and their impact on interactions with health care is fundamental for nurses in any care setting.

Culture is one of the organising concepts upon which nursing is based and defined. Leininger (2002) defines culture as a set of values, beliefs and traditions that are led by a specific group of people and handed down from generation to generation. Culture is learned shared and transmitted values, life way practices of a particular group that guides thinking, decisions and actions in particular way. The most primary means to transmit culture and preserve it is communication (Berenson LD, 2011). Culture is not static; it is a dynamic ever-changing process. Cultural values and norms differ from one society to another.

Nurses working in a multicultural society need to be aware that other cultures other than their own exist and avoid assuming that other people will conform to a particular cultural pattern. What could be accepted to some cultures may be odd to others (Berenson LD 2010). Part of treating individuals with respect involves respecting and understanding their culture and values. Judging people of other cultures on the basis of what is acceptable to us can lead to serious misjudgements, misunderstanding and failures of care. Berenson LD (2010) goes on to say knowing about our patients cultures and individual beliefs is as important as knowing their physical problems, functional limitations and response to illness to provide safe competent and comprehensive nursing care. It is essential that nurses consider specific cultural factors impacting on individual patients and be aware that intra cultural variation means that each patient must be assessed for individual cultural differences.

Black (2008) says nursing care these days has progressed beyond treating illnesses through diagnosis and prescribing a cure, a comprehensively holistic approach to patient care-transcultural nursing is being advocated for by the practice. Transcultural nursing as defined by Leininger (1997 cited by Narayanasamy 2003) as ‘a formal area of study and practice focused on comparative holistic culture care, health, and illness patterns of people with respect to differences and similarities in their cultural values, beliefs, and life ways with the goal to provide culturally congruent, competent and compassionate care’. Nurses acquire the necessary skills needed to provide culturally competent services through education and training, mentorship and continued professional development. Tanscultural nursing’s strategy is about addressing the patient’s cultural needs, equal access to treatment, respect for cultural beliefs and practices including religion, diet, personal care needs, daily routines, communication needs and cultural safety needs (Narayanasamy,2003). When patients and nurses meet, three cultures also meet that of the nurse, patient and setting.

Nurses need to implement their knowledge of cultural diversity to develop a culturally sensitive nursing care. This enables nurses to be more effective in initiating nursing assessments and serving as patient’s advocates. When nurses have knowledge of other cultures, they are in a position to influence professional policies. Transcultural care is transferred into practice through a nursing practice that is culturally sensitive. It utilises APIE (assess, plan, implement, evaluate) when assessing, the nurse needs to find out what the patient knows about their health and treatments. Cultural awareness, sensitivity and competence plays a very important role in nursing practice. Respect for the patient and support group is very vital whether it includes religious leaders or family. Regardless of culturally differences a nurse needs to gain the trust of the patient, if language is a barrier the nurse should pay attention to the means of interpretation. Brady (2001 cited by Culley 2001) says successful interpersonal communication necessitates the interpretation of speech, tone, language register, facial expressions, body language, gestures, use of space and assumptions shared between the communicants. A professional interpreter should be called to make sure the patient needs are met.

Cultural competence is the ability to provide effective care to patients who come from different cultures and plays an important part in nursing. It requires sensitivity and effective communication, both verbally and non- verbally. It is an evolving process that depends on self awareness, knowledge and development and application of skills. All nurses should never make assumptions about their patient’s beliefs for example that all Jehovah’s Witnesses do not like blood transfusions. A competent nurse finds out about the patient’s cultural practice in a professional manner. Being cultural insensitive can lead to stereotyping, discrimination, racism and prejudice. Some cultures do not call elders by their first names which can be hard for some nurses with this background treating elderly people. Nurses should always find out how the patient wants to be addressed. Some people may have different beliefs about medical care and treatment in UK, which some nurses may not understand, but need to respect regardless. As culture, behaviour and beliefs is learnt from birth, we become integrated into that culture and this can have effect on how we interact and relate to the health system.

Culturally competent nurses advocates for patients to benefit from a better outlook of the health care system and practice, mutual respect, dignity, consideration and overall good health. Nurses should challenge some unsafe cultural practices like female circumcision. Stitching of female private parts as this can cause serious health problems and body tissue sacrifices, but safeguard against cultural imposition. The current NMC standards for pre-registration nursing education (2004) focus on anti-discriminatory practice in relation to beliefs and culture in its broadest sense. If nurses are to be sensitive to the needs of patients from different cultures, they need to be able to assess and identify the specific cultural needs of their patients and how these would affect them; understand their cultural background; plan interventions taking into account their cultural care needs; have skills and knowledge to enable them to intervene on their behalf or access others in the wider community who can do so and manage care for a number of different cultural groups. This could be priests, Imman, Rabbi, other religious leaders or elders.

In conclusion cultural competent nurses thrive to prevent and combat prejudice and stereotypes through holistic and culturally inclusive practice by articulating for clear guideline policies regarding prevention of inequalities, prejudice and stereotypes.