Nursing Care to People from Culturally and Linguistically Diverse Backgrounds

Introduction

Cultural competence focuses on the capability of a given health system to make better health as well as well-being by incorporating culture in health service provision. As a result, it is measured within all the levels of the health care system. It involves sets of behaviour, attitudes as well as policies that appear together within a system, agency or professionals to conduct their duties efficiently within cross-cultural circumstances. It therefore focuses on four given levels that include the systematic, organizational, and professional as well as the individual level (Servonsky & Gibbons, 2005).

These levels deal with collective issues of fairness in healthcare access in addition to the outcomes of health. The levels correlate such that competence at either the individual or professional level is strengthened by the systematic as well as the organizational commitment and capability. Cultural competence therefore acts as a vital foundation for efficient clinical as well as patient-centered care. As a notion, it improves the professional in addition to the ethical responsibility of health practitioners and is therefore essential for health providers who make every effort to offer the best health care to all patients (Opper 2006).

Cultural safety on the other hand refers to the experience coming out of the health care beneficiary. Cultural safety has its beginnings in the experiences of the New Zealand nurses intended to bring positive transformations to the health status of the Maori people of New Zealand. Cultural safety is therefore purposely used to imply deeds to protect from risks patients or communities from health hazards as well as their general well-being. It involves considerations towards the physical, social, spiritual as well as patients’ cultural elements (Richardson et.al., 2009).

It is much more similar to clinical safety and enables the patient to feel safer in healthcare interactions in addition to being involved in health service changes. Cultural safety provides individuals with the power to remark on health care resulting in the development of positive experiences. It also allows them to participate in changes involving health services as well as health programs. It openly recognizes the experiences of the beneficiary or the recipient of health care with its major focus being on the clinical healthcare interaction level with an emphasis on an individual patient. This is mainly based on the patient’s feeling of being secure with regards to healthcare interactions as well as the practitioner’s individual attitude meaning that the individual attitudinal transformations will positively change the situation of the healthcare (Braithwaite & Majumdar 2005).

Australian health system for instance exists within a socio-political environment that is made up of certain features including cultural discrimination and class grouping. These features impact the healthcare system with patients and healthcare professionals going through various experiences in the system. Clients’ experiences are affected by their ethnicity, race, class and gender because the various backgrounds of health care professionals are different from those of the clients, hence negative outcomes for the health care processes. Health care staff therefore go through experiences that affect the interplay involving their interactions.

The phenomenon of the rising culturally and linguistically diverse communities has received growing attention in the recent past reflecting disparities with regards to health care access amongst various groups. The occurrences are thought to be due to political and social instability, environmental catastrophes in a number of countries, economic unsteadiness, refugee schemes as well as the opening of regions and borders by various free nations. Cultural competence and cultural safety however play a number of critical roles towards equal opportunities with regard to better health care for all irrespective of the various discriminative elements (Ward et.al. 2005).

Recognizing the adversity of behaviours and values

Cultural competence and cultural safety play a significant role in the delivery of nursing care to people from culturally and linguistically diverse backgrounds. They recognise the adversity of behaviours as well as values within the culturally and linguistically diverse groups in addition to acknowledging the notion of culture being dynamic and individuals as change agents within their respective cultures. Cultural sensitivity as a consequence of cultural competence and safety takes the practitioners a step ahead into which they get to acknowledge the legality of the variations in realities as well as the experiences which may be either emotional, historical, social political and economical. It therefore ushers the starting process of person exploration in appreciating how individual attitudes and experiences affect the lives of the others, which is the patients. The understanding helps practitioners get familiar with their own attitudes as well as prejudice within a clinical context (Starr & Wallace, 2008).

Cultural safety alone offers a framework through which practitioners are able to be involved in the engagement with their patients allowing them to stress power as well as control with regards to their individual health as well as that of their wellbeing. With some equivalence to clinical safety, cultural safety is critical towards health professional training and as a concept is of specific significance to the health of the culturally and linguistically diverse groups. Having a focus on clinical interactions and predominantly on power relations involving patients and health practitioners, cultural safety demands a real affiliation where control is collective among the groups involved within health care (Servonsky & Gibbons, 2005).

With the application of this, the cultural groups are able to be aware of the historical, political as well as socio-cultural certainties in the health and well-being of the culturally and linguistically diverse groups. One essential criticism of cultural safety practice has often been the effective transformation in the health care outcomes involving patients who may not go after the health professional practitioners’ personal attitudinal change; however, willingly they are able to be moulded. It therefore requires going further than this stage involving structural transformations in organizational as well as the systematic layers of the culturally and linguistically diverse groups (Servonsky & Gibbons, 2005).

Addressing Health Disparities

Healthcare professionals come across clients with a wide variety of perspectives with regard to health as well as health care. Cultural competence and cultural safety play a significant role in addressing the various health disparities among various disadvantaged groups. Cultural competence and cultural safety enable the understanding of the various perspectives involved in health and health care which is critical to addressing health disparities. Cultural competence is of great significance especially to public health nurses as it provides a basis for continuous interactions between individuals from culturally and linguistically diverse backgrounds. Other than direct care provision, public health care nurses are in most cases able to act as advocates for minority populations by coming up with better public policies, health support interventions as well as community-related disease control activities (Starr & Wallace, 2008).

As cultural competent professional care providers, public health nurses are able to efficiently involve themselves in practice, policy-making and various advocacy activities that take concerns of individuals from culturally and linguistically diverse backgrounds. According to the United States Department of Health and Human Services (2005), the provision of culturally proficient health care has been known to successfully address the disparities of health. As a result of cultural competence, public health nurses and other specialists are authorized to develop the understanding as well as proficiency with regard to caring for individuals from diverse cultural, socio-economic, racial, educational, and ethnic settings. Nurses in this case are held responsible for in view of cultural variations when coming up with and getting used to approaches particular to diverse individuals or groups as in the case of those of culturally and linguistically diverse backgrounds (Starr & Wallace, 2008).

Certain factors are often linked with the culturally competent professional health care providers including the public health nurses who have a responsibility of providing health care to diverse communities. Having good knowledge with regards to cultural diversity, they are known to be extensively associated with a high level of cultural consciousness, and cultural sensitivity as well as cultural competence scores. Moreover, they are known to express high degrees of self-confidence when it comes to caring for various population groups as well as dealing with related changes involving behavior and practice.

Cultural diversity, cultural consciousness, cultural sensitivity as well as cultural competence make up the four constructs of the health provider level which are in most cases mutually dependent and are all critical for the realization of culturally harmonious care. Cultural competence considers the reality that diversity globally is on the rise. The diversity entails culturally and linguistically diverse groups in addition to members of other special population groups for instance the homeless. It is obvious in all life aspects and is different in terms of quantity as well as quantity across various regions and times as changes in population and customer base occur (Berry-Caban & Crespo 2008).

Queensland for instance appears as a culturally as well as linguistically diverse state. Having a population of approximately 4.3 million comprising people from more than 200 cultures and speaking more than 220 languages, it comes out as the most diverse region in the world. Its richness in addition to its diverse community has its roots in the original Australians, Aboriginals and the Torres Island people. The insertion of culturally as well as linguistically diverse people in the Queensland community goes on to bring richness and enhance productivity to the state (Opper, 2006).

The culturally as well as linguistically diverse communities comprise of early and later settlers, immigrants, refugees, and humanitarian entrants. People irrespective of race, religion or other cultural settings have access to various services involving themselves freely as well as having fair opportunities within the civil society. Whereas some from the cultural as well as the linguistic settings go through success and benefiting positive results of cultural competence, the present truth is that a considerable section of the people from culturally and linguistically diverse communities go through difficulties, prejudice, unfairness and racism (Calma, 2010).

Fostering steady and proper display of competency behaviours amongst health care providers

Cultural competence as a behavioral construct, involves actions in reaction to cultural consciousness, diversity as well as sensitivity. This entails an individual’s capability to express particular behaviors in public for instance learning cultures within the community, adapting care with regards to various client needs as well as documenting considerations and adaptations towards care. The goal here lies on promoting consistent as well as appropriate expression of competent behaviour. Public health nurses are endowed with a number of opportunities for culturally varied encounters that impact upon cultural consciousness, cultural sensitivity as well as culturally proficient behaviours.

Cultural consciousness as a cognitive construct reveals an understanding of the dissimilarities that exist between various groups. Cultural sensitivity as an attitudinal construct on the other hand entails individuals’ attitudes to themselves and to others with their sincerity towards understanding within numerous cultural dimensions. Assessing cultural competences from the public health nurses’ individual point of view offers an insight into the various encounters as well as improving care delivery to the customers at risk (Blackman, 2009).

Enhancing sensitivity to the client’s healthcare needs

Cultural competency also acts as a significant approach as it impacts more on how various patients access as well as respond to the health care services. Patients along with their health care providers exist and operate within a combination of various cultural arenas. When they interact, their different cultures shape their assumptions along with their perceptions. The cross-cultural interactions between the health care providers and their patients in most cases influence healthcare choices as well as the outcomes (Berry-Caban & Crespo, 2008).

Additionally, lack of awareness of the patient’s culture normally results into a culture gap that affects quality health care provision. These are often determined by professional, socio-economic, ethnical/race and the community connection. Cultural competency therefore enables the enhancement of the health care services since the health care provision staff become sensitive to the cultural needs of their clients. As a critical skill, cultural competence enables healthcare providers to enhance their knowledge in addition to appreciating variations between different groups (Tate, 2003).

On the contrary, once the cultural gap is present between the health care providers along with the patients, miscommunications as well as other forms of misunderstandings appear as the consequences thus hindering the successful health care provision. Beliefs and practices with regards to health care should therefore form a critical element in the patient assessment as well as his or her treatment plans.

Implications for nursing practice

Precise assessment of community diversity and its impact is critical to suitable culturally harmonious health care. For cultural competence to prosper within a given nation and away from a given institution or organization there should be an understanding regarding how cultural competence as a set of organizational objectives and practice links to the entire and unchallengeable right to equal opportunity. There should therefore be a commitment towards creating equal opportunities (Calma, 2006).

Moreover, without a clear understanding of the various unique characteristics, the healthcare provider finds himself or herself at a discrete disadvantage. This is because most of the complexities handled by various professionals serving disadvantaged groups are often made difficult due to a lack of bilingual or culturally proficient staff. In order to offer better health care to culturally and linguistically diverse communities, cultural competency is required to be incorporated within all the health care bodies and be incorporated too in the various curriculums for the training offered to different health care professionals.

Education with regard to cultural competency as well as safety should be incorporated into all the nursing programs’ curricula. This will be able to improve the understanding of other cultures, recognise individual cultural prejudices as well as learn innovative advances towards integrating cultural sensitivity into the practice setting. The idea here lies in expanding knowledge therefore assisting nurses to acquire an understanding of the similarities and variations coming from the various ethnic settings. This eventually enhances cultural consciousness as well as gaining the capability to recognise the prospective culturally sensitive circumstances (Tate, 2003).

Conclusion

Cultural competence and cultural safety are in no doubt ways of meeting the diverse needs of culturally and linguistically diverse communities. They act as a significant foundation for efficient clinical as well as patient-centred care. It enhances the professional and ethical responsibilities of various health practitioners. The absence of cultural competence among the health care providers offers unfavourable consequences with regard to health care service delivery. Even with the speedily growing populations of culturally and linguistically diverse communities, there exists a lack of understanding of the impacts as well as implications of the rise in their demographics on the healthcare professions. It is therefore crucial that the health care providers have crucial skills in order to exchange information (Blackford, 2005).

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Frequently Asked Questions (FAQs)