Reflections

Class,

This my final post to the class blog. We have come to the end of this segment of the class. As part of the class requirements for participation, remember to complete the brief online survey after you have submitted your final assignment. The submission box will not upload your assignment or close until the survey has been completed.

Final discussion question: Reflect on the class goals and objectives provided in the class syllabus then discuss in your post what you have learned during this class.

Last thought: Always remember, respectfulness and understanding of cultural differences within our diverse client population and among other healthcare workers helps to promote integrity and professionalism of self along with the nursing profession.

Wanda

Multidisciplinary Approaches to Cultural Competence

Class,

The end of our learning journey is very near. The finish line is lying before us just a few yards away. Last reminder: Your final assignment is due in two days. Do not forget to use the grading rubric as a guide to meet all the criteria requirements for the assignment. I am available to assist you with any questions or concerns you may have.

The utilization of more than one service or department in the provision of patient care helps to provide optimal, consistent, and quality patient healthcare outcomes. Nurses are just one discipline in world of multiple disciplines created for the unique needs of each patient. It is the responsibility of nurses as patient advocates to obtain and utilize all available resources to meet the needs of the client and the community.

The number of cultural competency initiatives in healthcare is increasing due to many factors, including changing demographics, quality improvement and regulatory requirements, equitable care missions, and accreditation standards. To facilitate organization-wide transformation, a hospital or healthcare system must establish strategic goals, objectives, and implementation tasks for culturally competent provision of care (Gertner, Sabino, Mahad, Deitric, Patton, Grim, et al., 2010, p. 190).

Gertner, E. I., et al. (2010). Developing a culturally competent health network: A planning framework and guide. Journal of Healthcare Management, 55(3), 190-204. Retrieved September 12, 2010 from EBSCOhost Health Source: Nursing/Academic Edition.

Go to the online library and read the following articles:

· Gertner, E. I., et al. (2010). Developing a culturally competent health network: A planning framework and guide. Journal of Healthcare Management, 55(3), 190-204.

· Pecukonis, E., Doyle, O., Bliss, D. (2008). Reducing barriers to interprofessional training: Promoting interprofessional cultural competence. Journal of Interprofessional Care, 22(4), 417-428.

As a new nurse, how would you apply such a strategy as discussed in the article by Gertner at the unit level, department level, and at the hospital or hospital organization level? What barriers to multidisciplinary culturally competent care would you anticipate and how would you eliminate such barriers? Provide rationale for your answers.

Wanda

Cultural Sensitivity and Ethics

Class,

When we thick about cultural competency or cultural sensitivity we have to remember to look beyond obvious interpretations to these terms and focus on their subtle meaning. Cultural sensitivity is dependent on cultural meaning. Cultural meaning of illness and disease are subjective and unique to family, community, and society. “It is not an accident that certain diseases and symptoms dominate a society’s consciousness, while others are ignored” (Tong, 2007, p.72).

In this perspective, it becomes necessary for nurses to balance the equation between cultural sensitivity and cultural meaning in the provision of healthcare. Considerations include rights of the client, rights of the client versus recommendations for medical treatment, and the rights of the client versus perceived rights of the family. Ethical principles that govern health care in these areas are nonmaleficence, beneficence, autonomy, and justice.

Nonmaleficence suggests that an individual should be allowed to do whether they please provided no one else is harm. This is a view that is endorsed by many Americans.

Beneficence suggests that an individual wants to be benefited; they want the best possible care.

Paternalism proposes intentional limitation of an individual’s autonomy in order to benefit another person or group.

Justice would suggest we are all treated equally and receive the same quality of care, but real life situations demonstrate otherwise, especially when medically necessary treatment or drug outstrips demand. Example of this would be limitation of vaccines during the recent pandemic of influenza.

Tong, R. (2007). New perspectives in health care ethics. Upper Saddle River, NJ: Pearson Prentice Hall.


Study the following video in addition to your assigned readings. Be ready to participate in our class discussion in two days.

Wanda

Legal Implications

Class,

Can you see the shining light at the end of the tunnel? We are in the last two weeks of the course. Reminder: Your final major assignment is due by the end of the next class week. As always, do not hesitate to contact me if you have any questions or concerns.

This week we will explore legal implications related to cultural competence and ethical nursing care.

The American Hospital Association (ANA) developed the document A Patient’s Bill of Rights to promote optimal patient care through effective health care as a result of collaborative team approach, the provision of open and honest communication, respectfulness of person and professional values, and sensitivity to differences.

Hospitals must ensure a health care ethic that respects the role of patients in decision making about treatment choices and other aspects of their care. Hospitals must be sensitive to cultural, racial, linguistic, religious, age, gender, and other differences as well as the needs of persons with disabilities.

These rights are most reflective of cultural competence in the first statement of the bill: "The patient has the right to considerate and respectful care".

American Hospital Association. (1998). A Patient’s Bill of Rights. Retrieved September 8, 2010 from http://www.patienttalk.info/AHA-Patient_Bill_of_Rights.htm

Consider elements of the patient’s rights bill along with assigned chapter readings to identify intervention and prevention strategies you would use in the following scenario:

A Vietnamese couple enters the emergency room and the husband says to you, “Doctor!” The wife is obviously pregnant, but she does not appear to be in labor; she does not show any signs of discomfort or distress. You are the triage nurse and the emergency room is extremely busy. You are unsuccessful in your communication attempts to let the couple know you are trying to get an interpreter. In the interim while waiting on an interpreter, the wife asks, “Restroom”, so you delegate to an unlicensed person to escort the patient to the ladies room. At a later time, a loud cry is heard from the ladies room. It is the pregnant Vietnamese patient who had precipitously delivered her baby in the restroom.

Provide rationales with references in your response.

Wanda

Nursing Theory Related to Cultural Competency

Class,

Review the video clips on cultural competent nursing care based on Leininger’s Cultural Care Diversity and Universality theory. Do you see any aspects of your behaviors, beliefs, and attitudes in your nursing care and nurse-patient interactions? It is usually easier to identify inappropriate behaviors in others before we are able identify inappropriate behaviors in ourselves. Unconsciously, we may not always pay attention to subtle cues when we are busy trying to care for more than one patient or patient and family. Always remember to ask yourselves, what type of nursing care would you expect for yourself or a loved one? After reviewing the video clip, what would you do differently to improve your nursing care and nurse-patient relationships? Just food for thought.

Wanda

Class,

Congratulations! You have made to the half way mark; we are now in week five! In the previous weeks, we have examined and discussed cultural anthropologic aspects of today’s society along with influences that lead to the creation of our diverse society in America. Can we agree America is approaching a closer reflection of global societies? We have examined a movie video clip with intensive cultural and ethical influences that identifies many issues we may encounter in meeting the healthcare needs of today’s diverse patient populations. Our discussion sessions in the rubrics about the movie clip provided opportunities to share views, opinions, and ideas which clearly demonstrated there are not always clear cut decisions to make in such situations. The video clip also served as a guide to interpret the impact of cultural diversity and ethics on the economics of nursing care and healthcare systems. Additionally, we examined the use of multidisciplinary team approaches to resolve ethical dilemmas, and we examined culturally and ethically sensitive intervention and prevention nursing strategies to promote and improve nurse-patient relationships and healthcare outcomes.

This week, we will explore nursing theories in the application of cultural competent and ethically sound nursing care. Review the concepts of the nursing metaparadigm of person, health, environment and nursing as they relate to cultural diversity and ethics. Madeline Leininger’s Cultural Care Diversity and Universality theory would seem to be the most and only theory applicable to support culture competence and ethical decision making. Critical thinking and decision making in the real world, however, suggests the use and application of more than one theory to achieve the better nursing and client outcomes.

Are there other nursing theorists and theories you think would be applicable in your decision making processes to achieve the best nursing and client outcomes? Provide rationales for your selection(s) and scenario(s) in your responses in the rubric discussion section.

Reminder: Your next assignment is due one week from today.

Have a great week and I look forward to your responses in the discussion rubrics. As always, do not hesitate to contact me if you have any questions or concerns.

Wanda

Movie Insights

Hello Class,

You were asked to review the move trailer "John Q" in the blog. What are your thoughts? How many conflicting ethical dilemmas were you able to identify? What cultural influences were in play with this movie? Do you see any issues that could have been prevented? If so, how?

Wanda