Cultural Competency as a Skill - Admission/Application Essay Example

? Cultural Competence The essay aims to address a two-fold objective to wit to discuss potential cultural/linguistic needs of a chosen culture or ethnic group; and (2) to discuss the role of the nurse in meeting the identified needs and how professional practice should support the CLAS standards. Cultural Competence Introduction The United States is a culturally-diverse country consisting of different races, ethnicities, societies, and groups. Due to high immigration rate, health care professionals need to equip themselves with sets of approaches that are sensitive to the cultural needs of the patient, one of which is the cultural competency. Berry-Caban and Crespo (2008) define cultural competency as “a set of skills that allow health care providers to increase their understanding and appreciation of cultural differences between groups” (p. 115). In addition, Leever (2011) stated that cultural competence is always present in cultural awareness, knowledge, skill, encounters, and desires (p. 562). Thus, cultural competence provides a big picture of every patient’s culture which may impact the delivery of care and how nurses deal with patients. In addition, cultural competence leads to a conflict-free health care system because clashes of cultural beliefs between the health care providers and patients will be addressed and avoided. Hispanics are considered as the fastest growing population in the United States with approximately 32 million residents (Castro & Ruiz, 2009, 278). Hispanics have rich culture and majority of the population are considered “limited English proficient”. Aside from language issues, other cultural factors that may affect nurse-patient relationship and delivery of quality care include gender role concepts, cultural beliefs about the effectiveness of cures and treatments, and cultural values and attitudes (Castro & Ruiz, 2009, 279). In line with this, the author will discuss the potential cultural/linguistic needs, foods, rituals, health beliefs, and any religious orientation of Hispanics patients influencing achievement of health and participation in screening/prevention, identifying risk factor, diagnostics/interventions, and outcomes. In addition, this paper will also discuss the National Standards for Culturally and Linguistically Services (CLAS) in Health Care, one’s reflection of cultural identity, and the role of the nurse in meeting the needs of the patients and supporting the CLAS Standards. CLAS Standards To address the needs of those considered as limited English proficient individuals, the U.S. Department of Health and Human Services (USDHHS) developed the CLAS in compliance with the Title VI, Civil Rights Act of 1964 entitled “Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons” (p. 48). CLAS have 14 standards and is grouped into themes, namely: culturally competent care, language access services, and organizational support for cultural competence. Culturally competent care includes ensuring effective, understandable, and respectful care in congruent with patients’ cultural health beliefs, practices, and language, implementation of strategies to recruit, retain, and promote a diverse staff, and ensuring continuous CLAS education and training; language access services include offering and provision of language assistance services, provision of verbal and written notices in preferred language, assuring the competence of language assistance to limited English proficient patients, and availability of easy to understand patient-related materials and post signage in the preferred language; whereas, organizational supports include development, implementation, and promotion of a written strategic plan outlining provision of culturally and linguistically appropriate services, conducting initial and ongoing organizational CLAS evaluation, ensuring collection, integration, and updating of patients records, maintaining demographic, cultural, and epidemiological profile of the community, development of participatory and collaborative partnerships with communities, ensuring culturally and linguistically sensitive conflict and grievance resolution and processes, and regular release of progress and successful innovations in implementing the CLAS Standards to the public (Hoffman, 2011, 51). Knowing the CLAS Standards will guide the health care practitioner in delivering a culturally-competent, holistic, and patient-centered care. Furthermore, awareness of the CLAS Standards will aid in identifying the needs of the Hispanics population. The Culture of the Hispanics Population Hispanics are considered as the largest minority in the United States. As stated earlier, Hispanics are one of the minority groups in U.S. who are considered with limited English proficiency thus, Hispanics linguistic needs serve as a barrier in the provision and acceptance of care. In addition, Hispanics may have different needs in terms of food, rituals, health beliefs, and religious orientation compared to the general population because of cultural preferences. For instance, Berry-Caban and Crespo (2008) stressed the importance of three Hispanics cultural values which may have affect health care, namely: importance of la familia, respeto, and confianza (p. 119). Hispanics highly valued the family in making major decisions and are not likely to request or accept help from social workers or services. Health care practitioners should address this value by involving the family in any major decision concerning the health status of the patient. Respeto is another influencing factor in health care. Hispanics respect authorities such as doctor during a patient-doctor relationship and may not ask important questions or express verbal disagreement as a sign of respect (Berry-Caban and Crespo, 2008, 119). The value of respect held by Hispanics may impact compliance related to taking medication and follow-up services as Hispanics will not dare to questions or disagree on how and when medication should be taken as well as when to follow-up with the physician because it would reflect lack of respect to authority figure. Lastly, confianza or trust happens through long-time relationships must always be remembered by health care practitioners before trying to discuss and private health issues. Hispanic culture views health through the continuum of mind body and spirit. They are also a present-oriented society – Hispanics do not seek preventive health care and delay treatments or appointments unless deemed necessary. Majority of the Hispanics are Catholics and health care practitioners must be aware that natural birth methods, such as rhythm and abstinence, are the only acceptable method of birth control. Being thin is also viewed negatively by most of the Hispanics; instead, Hispanics view plumpness as ideal. In addition, Hispanics believe that illness occur due to the imbalances of hot and cold; therefore, exposure to extremes of environmental temperature may lead to illness and the cure to an acquired illness is the opposite temperature or eating of hot or cold foods (Dayer-Berenson, 2011, 172). A nurse should consider these health beliefs of Hispanics when counseling for health promotion and disease prevention, treatments, family planning, and weight control managements. Author’s Cultural Identity Just like Hispanics, I highly valued the importance of family in making major decisions and emotional expression. I am a 30-year old female who grew up in a middle class family with several brothers and sisters. Both my parents worked all my life as they value the importance of hard work. My parents got divorced but there’s a stepfather who has been around since I was seven years old. My father died when I was 15 years old. I am Christian-Baptist and almost have the same beliefs as Catholics. My religion has taught me that life is a gift and that couples should put God at the center of the relationship; thus, I strongly disagree with artificial birth control methods and pro-abortion policies and highly regarded the sanctity of marriage. I also believe that relationships have to be built on time that I married my high school sweetheart. Currently, I live in the same small hometown in the South with my husband two young boys’ ages 1 and 2. I have been a registered nurse for 10 years working almost all of that time in Psychiatric nursing - specifically children and pediatrics. Role of the Nurse in Applying the CLAS Standards to Healthcare In line with the Joint Commission on Accreditation of Health Care Organizations (JCAHO) Standards of improving effective communication, cultural competence, and patient- and family-centered care, the nurse’s role in applying CLAS starts from admission to discharge or transfer and includes: informing patients of their rights, identifying preferred language for health care discussion, collecting data about patient race, ethnicity, and any cultural, religious, or spiritual beliefs of practices that may affect care, identifying familial and dietary references prior to treatment and counseling, and provision of discharge instruction in congruent with the patients culture (JCAHO, 2010, 9-29). Note that in the provision of culturally-competent care, both the CLAS Standards and the JCAHO Standards emphasized the importance of spiritual assessment as this may play a vital role on how nurses deliver health care and the degree of acceptance by the client. Other components specified include by CLAS and JCAHO Standards include language, group, social, and nutritional assessment. Conclusion The United States is a culturally-diverse country and having cultural competency is a must among health care providers. Cultural competency refers to a set of skills that enriches the cultural awareness, knowledge, skill, experience, understanding, and appreciation of a health care provider. Cultural competency is well-applied in Hispanics because of being limited English proficient, gender role concepts, cultural beliefs about the effectiveness of cures and treatments, and cultural values and attitudes. CLAS standards, together with the JCAHO standards, addressed cultural diversity and nurses play an important role in implementing the standards and demonstrating cultural competence. References Berry-Caban, C.S. & Crespo, H. (2008). Cultural Competency as a Skill for Health Care Providers. Hispanic Health Care International, 6(3): pp. 115-121. doi: 10.1891/1540–4153.6.3.115. Castro, N. & Ruiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners, 21: pp. 278-286. doi:10.1111/j.1745-7599.2009.00406.x. Hoffman, N.A. (2011). The Requirements for Culturally and Linguistically Appropriate Services in Health Care. Journal of Nursing Law, 14(2): pp. 49-57. doi: 10.1891/1073-7472.14.2.49. JCAHO. (2010). Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals (p. 1-93). Illinois: The Joint Commission on Accreditation of Health Care Organizations. Retrieved on April 15, 2012 from http://www.jointcommission.org/assets/1/6/aroadmapforhospitalsfinalversion727.pdf Leever, M.G. (2011). Cultural competence: Reflections on patient autonomy and patient good. Nursing Ethics, 18(4): pp. 560-570. Read More