Culture is considered to be among the most significant determining factors in healthcare preferences and practices. Therefore, the requirement for trans-cultural nursing cannot be overlooked. Culture is one of the cornerstones upon which the concept of nursing is based and defined. Leininger (2002) defined culture as a set of values, beliefs, and traditions followed by a particular group of people and passed down from one generation to the other. Culture can be considered to be the learnt, shared, and transmitted values, living practices of a specific grothaticinfluencees thinking, decisions, as well as actions in a particular manner. Communication is the most basic means of transmitting culture and preserving it. (Berenson LD, 2013). Culture isn’t static; rather, it is a dynamic, evolving process. Cultural values and norms vary from society to society.
Nurses work in a multi-cultural society and must be aware of the other cultures prevalent and refrain from assuming that others would conform to a specific cultural pattern. What is acceptable in some cultures may be considered odd in others (Berenson LD 2013). Treatment of individuals with respect requires both respect as well as understanding of their culture and values. Judging people belonging to other cultures purely based on conformity could lead to serious errors in judgments, misunderstandings, and lapses in care. Berenson LD (2013) goes a step further in proclaiming that knowledge of patients’ cultures as well as individual beliefs would be as important as the knowledge of their physical problems, functional limitations, and responses to illness to provide safe, effective, and comprehensive nursing care. Nurses must consider specific cultural factors that impact individual patients and, hence, keep in mind that intra-cultural variation requires each patient to be assessed for individual cultural differences.
Black (2008) is of the view that nursing care presently has gone beyond just treating illnesses through diagnosis and prescribing a cu;e, rather, it has become a holistic approach to patient care with the help of trans-cultural nursing. Trans-cultural nursing has been defined by Leininger (1997) 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 to provide culturally congruent, competent, and compassionate care’. Nurses must acquire the necessary skills essential for providing culturally-competent services through education as well as training, mentoring, and continuing professional development. Transcultural nursing strategy involves acknowledging the patient’s cultural needs, providing equal access to treatment, respecting cultural beliefs and practices, be it religion, diet, personal-care needs, daily routine, communication, as well as cultural-safety needs (Narayanasamy,2003). The meeting of patients and nurses involves the meeting of three cultures: those of the nurse, patient, and setting.
Nurses must put to good use their knowledge of cultural diversity in order to foster sensitive nursing care. By doing this, the nurses become more effective when it comes to initiating nursing assessments as well as serving as patients’ advocates. The knowledge of other cultures enables nurses to influence professional policies. Trans-cultural care is transformed into practice by a culturally sensitive nursing practice. It makes use of APIE (assess, plan, implement, evaluate) during the assessment, and the nurse must ascertain what the patient knows about their health and treatment. Cultural awareness, sensitivity, and competence play a vital role in nursing practice. Nurses need to respect the patient and the support group is very vital, whether it is family or religious leaders. Irrespective of the cultural differences, a nurse should strive to win the patient’s trust; in case language is a constraint, the nurse should look at other means of interpretation. Effective inter-personal communication requires the interpretation of not only the language but also the speech, tone, facial expressions, body language, as well as gestures between the communicants. Nurses should seek the help of a professional interpreter to ensure that the patient's needs are taken care of.
A prime way of keeping culture intact is through effective communication, either verbally or non-verbally. Nurse interacts with the patients and enquires about their opinion on ailment, their possible causes, as well as treatments. Additionally, they also hear and understand the patient’s experience and ability to comprehend the therapy and go with the flow. The nurses are also in constant communication with the patient’s family. However, the communication would differ from one culture to another. Thus, for a different culture, the nurse needs to incorporate different understanding levels. For example, an American would incorporate the verbal, body language along with a gamut of signals. They are pretty frank and direct in their approach. They maintain eye contact, which is the symbol of faith and truthfulness between the patient and the nurse. On the other hand, an Asian would rarely confront and absorb their pain and maintain silence. They also do not maintain eye contact while talking, which they term as showing admiration. Arab patients, on the other hand, nd are cordial and will answer queries as we abide by the requests. They expect their pain to be taken care of as fast as possible.
The NMC code of nurses states that they should 'Treat people as individuals'. This standard implies that the nurses should not differentiate between the patients on any basis. Patients from different cultures should be treated equally. Since the job of a nurse is set in a diverse and dynamic environment, they should refrain from insulting or upsetting their patients. Care should be taken that their faith and beliefs are not offended. As per the NMC standard, “Treat people as individuals and uphold their dignity”, a nurse should handle the patients with utmost care, kindness, reverence, and empathy. They should ensure that the patients are dealt with in a very cautious manner and refrain from assuming anything. The diverse cultural background of all the patients and their individual preferences should be kept in mind while giving out treatment to them.
To conclude, nurses work in a multi-cultural society and must be aware of the other cultures prevalent and refrain from assuming that others would conform to a specific cultural pattern. Trans-cultural care is transformed into practice by a culturally sensitive nursing practice. Cultural awareness, sensitivity, and competence play a vital role in nursing practice. Nurses need to respect the patient, and the support group is very vital, whether it i family or religious leaders. Irrespective of the cultural differences, a nurse should strive to win the patient’s trust. In case language is a constraint, the nurse should look at other means of interpretation. A prime way of keeping culture intact is through effective communication, either verbally or non-verbally. NMC code of nurses, 'Treat people as individuals', implies that the nurses should not differentiate between the patients on any basis. The diverse cultural background of all the patients and their individual preferences should be kept in mind.
References
Dayer-Berenson, L., 2013. Cultural competencies for nurses. Jones & Bartlett Publishers.
Gmc-uk.org. (2017). GMC | Members' code of conduct.
Leininger, M., 1997. Transcultural nursing research to transform nursing education and practice: 40 years. Journal of Nursing Scholarship, 29(4), pp.341-348.
Leininger, M., 2002. Culture care theory: A major contribution to advancing transcultural nursing knowledge and practices. Journal of transcultural nursing, 13(3), pp.189-192.
Narayanasamy, A., 2003. Transcultural nursing: how do nurses respond to cultural needs?.BRITISH JOURNAL OF NURSING-LONDON-MARK ALLEN PUBLISHING LIMITED-, 12, pp.185-198.
