Cultural Competency in the Practice of the Nursing Profession

1. Cultural Competency in the Practice of the Nursing Profession

2. Crispo Alvar Eva Cox Norman Ilagan Marie Jimenez Zoya Poltilov Ifeyinwa Utoh Tsering Yanchen Group 1 - Introduction

3. Culture:Impact on health beliefs of clients and nursing practice Tsering Yanchen

4. 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. Tsering Yanchen

5. 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. Tsering Yanchen

6. Barriers to culturally competent care • Prejudice • Ethnocentrism • Stereotyping Tsering Yanchen

7. Nurses must: • Develop Cultural Sensitivity • Be exposed to different people of different ethnic backgrounds Tsering Yanchen

8. Ethnicity:Impact on health beliefs of clients and nursing practice Ifeyinwa Utoh

9. 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. Ifeyinwa Utoh

10. 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. Ifeyinwa Utoh

11. 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. Ifeyinwa Utoh

12. Religion:Impact on health beliefs of clients and nursing practice Norman Ilagan

13. 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 Importance of Religion Norman Ilagan

14. According to Rosdahl, “in the United States, 35,000 churches with 1,500 different identified sects exist” Types of Religions Norman Ilagan

15. Learn about major religious differences Respect their confidences Maintain a nonjudgmental attitude Consider your personal values when seeking a nursing position Religion:Impact on Nursing Practice Norman Ilagan

16. Socialization:Impact on health beliefs of clients and nursing practice Marie Jimenez

17. 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 Marie Jimenez

18. Nursing Shortage • Current trend in nursing • Causes of nursing shortage • How quality patient care is affected in relation to time and safety Marie Jimenez

19. 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 Marie Jimenez

20. Problem Areas related to Cultural Competency in Nursing Practice Eva Cox

21. Problems in Communicating and Working Across Cultures • Language Barrier • Age • Attention • Gender • Prejudice, stereotyping, and ethnocentrism Eva Cox

22. 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 Eva Cox

23. Therapeutic Communication Techniques • Nonverbal Technique • Use of Silence • Clarification • Reflection Eva Cox

24. 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 Eva Cox

25. 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” Eva Cox

26. Legislations & Resolutions Related to Issues on Cultural Competency Crispo Alvar

27. 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.

28. 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.

29. 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.

30. 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 –

31. The fourteen (14) established standards • 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.

32. 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.

33. 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.

34. 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.

35. The Nurse’s Role in Developing Cultural Competency Zoya Poltilov

36. 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 Zoya Poltilov

37. 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 Zoya Poltilov

38. 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 Cultural Assessment Zoya Poltilov

39. 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 Zoya Poltilov

40. Summary & Conclusion

41. Crispo Alvar Eva Cox Norman Ilagan Marie Jimenez Zoya Poltilov Ifeyinwa Utoh Tsering Yanchen The End