Cultural Competency : Cultural Analysis

In taking care of a patient, it is important for nurses to respect the patient, their beliefs, and their right to autonomy. Provision One in the Code of Ethics states “the nurse practices with compassion and respect for inherent dignity, worth, and unique attributes of every person” (ANA, 2015, p. 7). With a Jehovah’s Witness patient, the nurse must first acquire information regarding their religion and how it may impact their care and their wishes related to their healthcare. Once their patient’s beliefs are noted and understood, the nurse must establish a professional and therapeutic relationship with their patient without bias to their religion and the associated beliefs. The duty to act without bias can be found outlined in Provision 1.2 (ANA, 2015).

Cultural competency can be viewed as an ongoing journey of commitment and active engagement through the process of cultural awareness, knowledge, skills and cultural encounter (Coolen, 2012).Trust is the underlying purpose behind cultural competency in the development of health care provider and patient relationship. Health care professionals need to become more sensitive, respectful and attentive to the patients cultural beliefs and practices. Self-awareness is particularly important when communicating where barriers exists, unconscious prejudices may hinder the successful building of therapeutic relationships. In order to provide culturally sensitive pain management, a patients pain must be considered within the context of the individual’s

Cultural competency is critical in psychology practice. In the United States, the groups, which considered as cultural and ethnic minorities, are growing in the population (APA, 2003). Culture often influences the content and quality of people’s experience, perception, and response. Thus, it is important for psychologists to be aware of cultural influences on client’s presenting experience(s) (Gardiner & Kosmitzki, 2010). Without a regard for cultural influence, there is a significant risk for the psychologist to misunderstand, misinterpret, and misguide his or her client. Such misunderstanding, misinterpretation, and misguidance are not only unhelpful but can be detrimental for the client (Corey, Corey, & Callanan, 2011; Pope, & Vasquez, 2011).

It is not always easy to decide about the care of a patient, because the patient’s cultural beliefs do not always coincide with the beliefs of the nurse. Ephesians 4:2 in “Be completely humble and gentle; be patient, bearing with one another in love” (English Standard Version). God has loved us unconditionally from the beginning of time, and has always been patient with us. It is time that humans show the love that God has for us onto others and respect one another no matter the differences. This paper will discuss the importance of respecting another person’s culture, what stigma is and whether if Lia’s family viewed her that way, brief history of the Hmong, the preventions that could have taken place, and how to incorporate

I have learned that it is important that educators  and health providers be trained on cultural competency to understand the population they are serving. Marks, Sims, and Osher (King, Sims, & Osher, n.d.) define cultural competency  as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross–cultural situations" ( as cited in Cross et al., 1989; Isaacs & Benjamin, 1991). Health providers and educators should investigate demographic patterns or trends in the place where they live and work. This brings awareness of the types of cultures that they might come across when they are working with people. Organizations should integrate and implement policies that promote the value of  diversity, self-assessment, manage the dynamics of difference, acquire and institutionalize cultural knowledge, and adapt to diversity and the cultural contexts of communities they serve (Georgetown  University, 2004). Georgetown University (2004) also stresses that culture competency grows gradually and is always open for improvement.

I like this about the Hmong though; they stand up for what they believe in. Their stubbornness still caused conflicts between the Lee’s and Lia’s doctors. A great example of Hmong stubbornness is on page 51. There was a Hmong infant and it had a problem which required multiple blood samples. The parents believed their baby would die if any more blood was removed. The doctor tried to explain himself but the Hmong parents got angrier and said that they’d commit suicide if he took any more blood without their consent. Another example of Hmong stubbornness is in their Shee Yee Folktale on page 170. The Shee Yee was a healer and magician who got in a fight with nine soul stealing dab. The Shee Yee was very stubborn and wouldn’t allow the dab to catch him by any means necessary. This relates to the Hmong culture because they stand firm in what they believe in and “are not intimidated by being outnumbered” (Fadiman 1997:17).

Cultural competency is a set of appropriate behaviours, attitudes and policies among professionals and enables them to work efficiently in cross-cultural situations (NCCC, 2006). A culturally competent health care system can eliminate cultural inequities, provide greater quality of care, and have less patient dissatisfaction and more positive health consequences. A conclusion reached in a study (Palafox et al., 2002) states, culture influences the outcome of medical examination and; therefore, it is vital to provide culturally competent health care services. Cultural competency is especially important in the context of radiographic examination due to the variety of culturally different patients a radiographer comes in contact. The following case study effectively highlights the impact of cultural competency.

Lia Lee was a Hmong infant born with epilepsy. Lia’s parents were immigrants to a Western nation. However, the parents held tightly onto traditional beliefs from their native country. The incongruent belief structure of the East and West created difficulty when the two systems collided in an effort to care for Lia Lee. Specifically, when the drug therapy prescribed for Lia Lee was not followed by her parents. Subsequently the child’s medical team contacted child services, which lead to Lia’s removal from her family. The result of the cultural misunderstanding was fragmented family. In addition to fueling the distrust of the western healthcare system by an already marginalized community.

In our today’s society, we are faced with multiple cultures that affect our ways of thinking, acting, and leaving. Cultural competency reflects one’s culture. Culture reflects the way the children are raised, their way of communicating, what is acceptable or not acceptable, the way they overcome challenges, their clothes, and how we go about medical treatment and so on. I know because I come from a very strong cultural background where it is considered bad to look at older people straight in the eyes while talking to them. Culture can be defined as “the learned and shared beliefs, values and life ways of a designated or particular group that are generally transmitted intergenerational and influence one’s thinking and action modes” (Leininger, 2002).

“The new mestiza copes by developing a tolerance for contradictions, a tolerance for ambiguity. She learns to be an Indian in Mexican culture, to be Mexican from an Anglo point of view. She learns to juggle cultures. She has a plural personality, she operates in a pluralistic mode—nothing is thrust out, the good, the bad, and the ugly, nothing rejected, nothing abandoned. Not only does she sustain contradictions, she returns the ambivalence into something else”

Fadiman begins the book by introducing Lia Lee and her family, stating that they were immigrants from Hmong, now residing in Merced, California. She spoke about how Hmong traditions varied greatly from American traditions. Foua, Lia Lee’s mother, had delivered all of her children by herself and her husband, Nao Kao, was always around to provide anything that she needed. Lia Lee was the first one in her family to be born in a hospital. At the time of the birth, no one Foua knew spoke any English. Although Foua thought some things that occurred in the hospital were odd, she was happy with how everything had turned out.

As we have seen, the government impacted the Lee family by not having the proper programs implemented in time to save her life but the life of Lia Lee has had an enormous impact on the government’s implementation of cross-cultural programs, interpreter training, and even a shaman program. Although the government changed the life of the Lees their story had a more permanent effect on the government. This is a story of miscommunication causing a tragedy, but in the long run institutionalizing a brand new program to prevent this from happening again. It changed the way that American hospitals deal with people of other cultures now. This story is rich with the fascinating Hmong culture and the American medical system. What one could learn from this book is enormous and could help change the way American’s view other

Some of the author’s major points are the lack of understanding of what cultural competence really means which is bringing confusion about ways it can be utilized in the social work field. The confusion of the utilization of cultural competence is leading to the lack of consensus concerning the effective training that providers should obtain and the population being served with the cultural competence skills lack clear description. According to the author, the most popular cultural competence intervention in the healthcare system is the cultural competency training which is for health care providers and the two approaches that have been utilized in creating the intervention are; the programs aimed at improving knowledge which is group specific,

This book is certainly an eye opener. I always knew that culture played an important part in one’s everyday experience, but I never imagine it to be so extensive and tragic. When Dan Murphy stated “when you fail one Hmong patient, you fail the whole community”(p.253), I believe that he meant that as other Hmong families hear about Lia’s family tragic experience, they too feel the fear and disappointment caused by the health system of modern society. When another Hmong family has a sick child, they will hesitate to bring their child to the hospital because of the thinking that they may be forced to go against their cultural regimes. I think that whole Hmong family will neglect analyzing the Lia’s situation, and again run from the thinking that

Understand cultural competence and why is it important especially for that have a diverse workforce.