Cultural
Competency in
the Practice of the
Nursing
Profession
Group 1 - Introduction







Crispo Alvar
Eva Cox
Norman Ilagan
Marie Jimenez
Zoya Poltilov
Ifeyinwa Utoh
Tsering Yanchen
Culture:
Impact on health beliefs of
clients and nursing practice
Tsering Yanchen
CULTURE



Accumulated learning for generational
groups of individuals within structured or
non-structured societies.
Heritage learned through formal and
informal experiences through the life
cycle.
Combined heritage of language and
communication style, health beliefs and
health practices, customs and rituals, and
religious beliefs and practices.
Contributions to Healthcare



Experience in different culture groups
may lead the nurse to understand the
complexity of culture, such as their beliefs
and practices in times of illness.
Skills related to cultural diversity can
strengthen and broaden health care
delivery, e.g. Personal Space.
Personal cultural heritage of the nurse can
maximize the care of the client, e.g.
volunteer services to public.
Barriers to culturally
competent care
Prejudice
 Ethnocentrism
 Stereotyping

Nurses must:


Develop Cultural Sensitivity
Be exposed to different people of
different ethnic backgrounds
Ethnicity:
Impact on health beliefs of
clients and nursing practice
Ifeyinwa Utoh
What is Ethnicity?
Ethnicity and culture are sometimes used
interchangeably but in the main perspective,
they are different.
 Ethnicity is a social construction that
indicates identification with a particular
group which is often descended from
common ancestors. Its members share
common cultural traits.
 For example : They share the same
language, religion and dress and they are an
identifiable minority within the larger
nation.

Ethnicity:
Impact on Healthcare


Nursing practice has expanded even
more and thereby embracing all
varieties of people in order to give
care.
Nurses need to understand the
impact of ethnicity as it relates to an
individual.
Ethnicity:
Impact on Healthcare

The diversity of ethnicity has made it
possible that even when patients are
told to fill out the admission forms,
there is a portion where one’s ethnic
group is required. Most times it is
necessary to fill it out, in order to
know how to better treat the patient.
Religion:
Impact on health beliefs of
clients and nursing practice
Norman Ilagan
Importance of Religion


Influence attitudes,
lifestyle, and
feelings about life,
pain and death
Help people live
fuller lives and
console or
strengthen people
during suffering
and in preparation
for death
Types of Religions

According to
Rosdahl, “in
the United
States, 35,000
churches with
1,500 different
identified sects
exist”
Religion:
Impact on Nursing Practice




Learn about major
religious differences
Respect their
confidences
Maintain a
nonjudgmental
attitude
Consider your
personal values
when seeking a
nursing position
Socialization:
Impact on health beliefs
of clients and nursing
practice
Marie Jimenez
Socialization & Nursing



Nursing is a
profession where
socialization is a part
of everyday nursing
care
Professional
socialization and it’s
effect on nursing
Socialization and its
impact on the
delivery of nursing
care for the client
Nursing Shortage



Current trend in nursing
Causes of nursing shortage
How quality patient care is affected in
relation to time and safety
Public Image of Nursing




Unique profession
“Lost” identity of
nursing
Recent “movement
toward reestablishing
identifiable dress
norms for
professional nurses”
(Professional Nursing
Concepts, 2007, p. 49)
“How do you look?”
handout/article
Problem Areas related to
Cultural Competency in
Nursing Practice
Eva Cox
Problems in Communicating
and Working Across Cultures
Language Barrier
 Age
 Attention
 Gender
 Prejudice, stereotyping, and
ethnocentrism

The Use of a Professional
Interpreter



Should know and understand
medical terminology
Should know the formal slang, and
conversational levels of the language
that he/she is interpreting
Should be able to communicate
without inferring judgment, bias, or
personal opinions
Therapeutic Communication
Techniques
Nonverbal Technique
 Use of Silence
 Clarification
 Reflection

Solutions to Language Barriers



Learn a second language, especially one
that is spoken by a large ethnic population
serviced by the healthcare agency.
Ex: Elmhurst Hospital - the nurse could
learn Spanish
Construct a loose-leaf folder or file cards
with words in one or more languages
spoken by clients in the community
Look at the client, not at the translator
when asking questions, and listening to the
client’s response
When English is a Second
Language, the nurse can…




Determine if the client can speak or read
English
Speak slowly not loudly, using simple
words and short sentences
Avoid using technical terms, slang or
phrases with a double or colloquial
meaning like “do you have to use the
john?”
Ask simple questions that can be answered
by a “yes” or “no”
Legislations & Resolutions
Related to Issues on
Cultural Competency
Crispo Alvar
Definition
•
Cultural competency - a set of
congruent behaviors, attitudes, and
policies that comes together in a
system, agency, or among
professionals that enables effective
work in cross-cultural situations.
What makes culturally competent
healthcare imperative in the US?
•
•
The presence and interests of different
cultural constituencies have made
provision of culturally competent health
care imperative.
many minority cultural groups have
already experienced a disproportionate
burden of health care disparities e.g.
access to health care, and the quality of
care.
What is the status of cultural competency
in the US?
•
•
Surgeon General Report of 2005, stated that the
U.S. healthcare profession is still considered so
unprepared to provide culturally competent care
to our highly diversified population.
Because LPN’s also provides direct health care to
culturally diverse client populations in various
settings, we as Student of Practical Nursing
(SPN) owe to be educated and be provided with
the initial knowledge about Cultural
Competency. Hence this research paper
presentation.
Legislations and Resolutions
Related to Issues on Cultural Competency



Policymakers – uses this to draft consistent
and comprehensive laws, regulations, and
contract language
Accreditation and credentialing agencies –
uses this as guidelines in assessing and
comparing providers who offer culturally
competent services and assurance to
maintain quality of service for diverse
populations
Organizations – These are used to serve
guidelines and make it a bases for
performance assessment and evaluation –
The fourteen (14) established standards



1. Standards 1-3 address culturally competent
care
Standard 1. Ensure that patients/consumers
receive from all staff member effective,
understandable, and respectful care provided in a
manner compatible with their cultural health
beliefs and practices and preferred language.
Standard 2. Implement strategies to recruit, retain,
and promote at all levels of the organization a
diverse staff and leadership that are representative
of the demographic characteristics of the service
area.
Standard 3. Ensure that staff at all levels and across
all disciplines receive ongoing education and
training in culturally and linguistically appropriate
service delivery.
The fourteen (14) established standards
2. Standards 4-7 address language competency –
• These standards provide that every health care
organization offers and provides appropriate
language assistance services; put in place
appropriate oral and written notices of patients
right to receive language assistance; involve only
qualified interpreters and encouragement of
bilingual staffs; and make available easily
understood patient-related materials or post
signage in languages of the commonly
encountered groups.
The fourteen (14) established standards
3. Standards 8-14 address organizational support
for cultural competence –
• These standards require that health care
organization effect a written strategic plan with
the end in mind of providing clients culturally
and linguistically appropriate services; conduct
ongoing organizational self-assessment about
CLAS-related activities; ensure that individual
culturally relevant information are in place on
health records; maintain cultural profile and
develop collaborative partnership with
communities; provision of culturally and
linguistically sensitive conflict and grievances
resolution proceedings; and lastly, the
encouragement to make readily available
culturally relevant information to the public.
Title VI of the 1964 Civil Rights Act –


Implies that services provided with funding from the
federal government must be delivered without
regard to race, color, or national origin (HHS 2003).
To satisfy Title VI, a program, service or
agency must therefore provide "meaningful access"
at no cost to the LEP individual. – to include
hospitals, managed care organizations, state and
local welfare agencies, physicians, and research
programs— e.g. including providers of services
funded through Medicaid, Temporary Assistance for
Needy Families (TANF), the State Children's Health
Insurance Program (SCHIP), Head Start, and other
programs for families and youth.
The Nurse’s Role in
Developing Cultural
Competency
Zoya Poltilov
Cultural Competency


“A set of academic and personal skills
that allow us to increase our
understanding and appreciation of
cultural differences between groups“
Becoming culturally competent is a
developmental process and we will
experience it throughout the whole
nursing experience
The Cultural Assessment


The cultural assessment is a tool to
help nurses understand where
patients derive their ideas about
disease and illness
Cultural Assessments help to
determine beliefs, values and
practices that might have an effect on
patient care and health behaviors
The Cultural Assessment






Level of ethnic identity
Language and
communication
process
Migration experience
Self concept and self
esteem
Influence of
religion/spirituality on
the belief system and
behavior patterns
Habits, customs,
beliefs





Views and concerns
about discrimination
and institutional
racism
Educational level and
employment
experiences
Importance and
impact associated
with physical
characteristics
Current
socioeconomic status.
Cultural health
beliefs and practices
The Nurse’s Role


It is impossible to know every cultural
variation of the people for whom nurses
provide care, but the best way is to
involve your patient and the family in
determining the plan of care and to find
an alternative that will be acceptable for
that culture
All of these will help us in developing
cultural competency in the clinical area
Summary & Conclusion
Crispo Alvar
Eva Cox
Norman Ilagan
Marie Jimenez
Zoya Poltilov
Ifeyinwa Utoh
Tsering Yanchen