Importance of Cultural Diversity in Nursing

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The Culture Care Theory is a concept centered on the rapidly changing world. The roots of this theory reflect on Leininger’s nursing practice and branch off from her past experiences and creative thinking while in the field. The purpose of this theory is to reveal the essentials when dealing with diverse cultures in clinics, hospitals, communities, and worldwide. Leininger observed that children of different cultures had widely varying behaviors and needs. After deliberating on the linkage between nursing and anthropology with Margaret Mead, Leininger pursued her doctoral study in cultural anthropology. Through her doctoral practice, she became more aware of the relationship between cultural differences and health practices. Because of this, Leininger began developing a theory of cultural care for nursing. The goal of this theory involves more than simply being culturally aware. It involves planning nursing care based on knowledge; Knowledge that is culturally defined, classified and proven through testing to provide the best culturally congruent care. Ultimately, Leininger feels as though caregivers should be familiar with different cultures as it will help them make decisions catering to the individuality of the patient. Shining light on what makes a patient unique will not only make one a better nurse but a nurse who is appreciated and honored. Showing that you care by seeing past the illness of the patient and rather looking at them for who they truly were before they got ill is what breaks that barrier between a nurse who does their job through obligation and a nurse who does their job because it is their destiny.

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Living in Miami and wanting to pursue a career here, I must be able to assimilate to such an environment that I am not necessarily used to. Coming from Pennsylvania, where there is a lack of diversity to then traveling and living in one of the most diverse cities in the nation is definitely a change for me. Embracing this change and being able to integrate the culture here into my professional practice as a nurse is essential. Informing myself on Leininger’s theory will allow me to take this knowledge and put it into action for learning the cultures of my patients will allow me to form better bonds with them as well as a sense of trust, as from their eyes they will see that I genuinely care. Choosing such a topic will ultimately construct me into a more versatile nurse as I will be able to work with all people, no matter young, old, white, or one from a more multicultural background. Being a culturally well-rounded nurse is extremely important as migration is only increasing and societies are becoming more diverse. Being a nurse means that you provide care to anyone who walks through that door and needs assistance therefore you must be able to work with people of all backgrounds. Patients will be coming from all walks of life and each person has their own set of beliefs, values, and religions therefore a nurse must be prepared to be culturally congruent with them. When caring for a patient from a culture different from your own, you need to be aware of and respect his or her cultural preferences and beliefs; otherwise, they may consider you insensitive and indifferent. The Cultural Care theory basically focuses on obtaining an abundance of information on care and culture constructs. This theory is much different from others as it refrains from relying on the four metaparadigm concepts: Person, Environment, Health, and Professional Nursing. Instead of focusing on these four concepts, this theory contains three action modalities for providing culturally congruent care. The first modality is culture care preservation and-or maintenance, which is the assistive and supporting acts that help cultures to preserve beneficial care beliefs. The second modality is Culture care accommodation and-or negotiation which are the facilitative provider care actions that help cultures better adapt and cooperate with others for safe culturally congruent care. The third modality is Culture care repatterning and-or restructuring which are the enabling actions that help healthcare professionals to reorder and modify their lifeways and institutions for better health care patterns, practices, or outcomes (Leininger 1991 a/b, 1995). The goal Leininger wanted to reach was to challenge nurses to find specific and holistic care used by different cultures and to discover and use culturally based research care knowledge.

The Culture Care Theory acts as a major influence on nurses as it guides them to conceptual thinking, practice, and research. “Leininger encouraged nurses to use creativity to discover cultural aspects of human needs and to use these findings to make culturally congruent therapeutic decisions” (Leininger 1991). With that being said, as I prepare for clinical in the upcoming term, I want to look up to this theory as a guide towards me becoming something more than just a nurse. Rather, as a nurse who is not only selfless but also one who takes responsibility for their actions, and for as long as I am responsible, I will make sure that every patient I meet gets the care that they deserve. How will I do this? As I go through clinical I will find the necessary time to research and observe cultures all around me. I will learn culture as if it were my own and use my knowledge to my advantage. For instance, individuals from Asia perceive another’s faced as angrier, unapproachable, and unpleasant when making direct eye contact. In fact, some deem it belittling and rude. Now if a nurse was not knowledgeable on Asian culture, they could potentially make their patient feel uncomfortable and this could also result in the patient feeling as though they are incompetent and may even request a new nurse. Coming in, having researched such cultures, I will be able to prevent such an event from occurring and could even go above and beyond their expectations. I see myself doing research on the diets of their cultures and using this as a tool to determine what vitamins and nutrients they may be lacking as well as using their diet to make sure the food they receive from day to day is to their liking to ensure that they are getting the adequate intake of nutrients to take their medications. This is especially important for those who cannot communicate properly because we somehow need to get a general idea of how they live their life, but through research, I can obtain information on what they may be eating though there are always exceptions. If someone from a different culture isn’t getting food that they are used to or that they have never seen before, they will more than likely refrain from eating it, which is a problem. We must make sure they are eating otherwise they simply won’t get better. Through applying culturally congruent care, I will be able to ensure that my patients are comfortable and feel at home regardless of the unfortunate circumstances.

People of different cultures have their own set of beliefs, values, and practices. The differences that make them unique can sometimes make it challenging to offer health care that accommodates each individual, but at least trying to be culturally aware can help in some aspects. As one may not know, different cultures believe in different treatments, so a treatment feasible for one may not be ideal for another. This is all the more reason why nurses must be sensitive when treating patients and should always put forth what is in the best interest of the patient rather than themselves. In a given scenario where a patient may deny a treatment because it is against their beliefs and lifestyle, a nurse must be prepared to reconstruct their plan to accommodate the needs of the patients. Given this circumstance, one must consider all options and negotiate with the patient. If I were in this situation, before treatment even began, I would go about learning more about my patient through an interview technique. I would start by using an indirect approach, meaning that I would externalize questions by referencing problems in others. This would allow the patient to open up and though a traditional patient may not be willing to discuss questions regarding their feelings and fears, they may be able to illustrate their concerns by discussing illness in others. Saying things like, “Patients who are as ill as you are” would help me to avoid direct inquiry and would permit discussion of issues often left undisclosed. Another way to learn more about my patient to alter their health care plan would be to broaden inquiries on the patient’s family history. One’s family history often reveals information and issues that are not given spontaneously. It would be helpful to discuss the whereabouts and current events of family members while looking for similar symptoms or illnesses in the family. I would look for problems and events within the family and community that the patient ties to the illness experience and this would allow me to gain more knowledge on my patient and how to go about the treatment process. These cross-cultural problem-solving techniques will not only allow the patient to become familiar with me as I will give them insight and share my life experiences and beliefs as they do the same, but it will also show that I care. As that barrier starts to break and we form a bond, they will not only be willing to share information they may have been scared to share in the past but ultimately, I will be given the necessary tools to aid them back to health; my goal has been achieved.

In summation, Leininger had a vision for the future of healthcare, she envisioned that people from all backgrounds would be able to receive the healthcare that they deserve. She wanted nurses to explore their horizons and gain knowledge of the different cultures as the diversity of the world continues to climb. Not everyone is the same, and those differences are what make every one of us unique. Leininger longed for health care professionals to embrace those differences. Embracing those differences and bringing light to the cultures of their patients is ideal when trying to develop a plan catered to one’s lifestyle. Simply put, how can you aid someone back to health if you know nothing about their background and who they are? Finding out about one’s family history, what they eat, and what they believe in is just the start to building that bridge of trust between a nurse and their patient. As clinics are closely approaching, I wish to use the Culture Care Theory in my own practice. I will continue to learn more about my patient for it is my duty to aid them back to full recovery and I will do just that by any means necessary.   

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