Study Overseas

The landscape of healthcare is changing. The location for service is changing from hospital-based to alternative locations - home, rehabilitation center, subacute care center, and urgent care center. Clients cross international borders to receive healthcare. The age of the client is changing from younger clients to older clients. Healthcare personnel are changing from a common ethnic origin to a variety of ethnic origins. Clients come from many different ethnic backgrounds. All of this change creates the need for healthcare personnel to be familiar with transcultural or intercultural principles of care.

Transcultural Nursing

Transcultural nursing is a recognized specialty in nursing. Transcultural nurses focus on the similarities and differences among cultures order to provide appropriate healthcare based on the client's values, beliefs, and healthcare practices. In addition to the client's cultural values, beliefs and healthcare practices affecting the healthcare provided and received, the healthcare provider's cultural values, beliefs and healthcare practices also impact the outcome of each care situation. Working together to provide the most appropriate care is difficult when cultural values are shared, it becomes much more difficult when cultural values differ or even clash.

One cultural value that may differ is the value of time. When the client does not sense the same urgency for appointments or therapies, misunderstandings can occur. Adapting schedules, rearranging appointments and being sensitive to cultural variations to the meaning in time will promote better understanding between healthcare provide and client.

Another cultural pattern that varies between ethnic or cultural groups is who makes the decisions. Frequently, the healthcare providers expect the parents to make healthcare decisions for a child. In some cultures, it may be a group decision or the decision may be made by the 'elder' in the family. The insistence that only the parents be informed of the condition of the child can cause friction within the family.

The Importance of Communication

Communication is critical to providing culturally appropriate healthcare. Speaking the same language does not guarantee comprehension between healthcare providers and between healthcare providers and the recipient of healthcare. English varies from country to country. Spanish varies between Spain and countries in Central and South America. Speaking different languages creates confusion and misunderstanding. A person that speaks a second language well may not know healthcare terminology in the second language.

Illness decreases a client's ability to communicate in a second language. Translators, although necessary, may add another layer uncertainty to the communication between healthcare providers and care recipients. Both verbal and non-verbal listening skills are necessary for today's professional.

How Can I be a Transcultural Nurse?

Education in cultural sensitive skills should be part of every health care program. Higher education institutions offer cultural anthropology, intercultural studies, foreign language, cross-cultural ministries, or similar courses. An objective of courses like these is to help a person gain an understanding of similarities and differences between groups of people. It would be impossible to learn specific similarities and differences for all groups of people.

Instead, the goal would be to become more cultural sensitive and gain an ability to recognize potential culturally sensitive situations. Some institutions are requiring students to meet a minimum requirement for cultural competency. Specific programs of study require courses in cultural studies.

Nursing programs have added courses such as Intercultural Nursing, Transcultural Nursing, Cross-Cultural Nursing, and Cultural Diversity in Health Care. The objectives for these courses include demonstrating awareness of other cultures, identifying personal cultural biases, and integrating cultural care in professional practice settings. These courses have a didactic (lecture) component and some may have a practicum or clinical component.

Cultural care and sensitivity is required of healthcare professionals today. Each professional will encounter cultural similarities and differences in their clients and their co-workers. An ability of manage quality care in the changing landscape of healthcare today is a skill that can be learned and must be practiced. The landscape is changing but the need for culturally sensitive, excellent care will never change.

Author
Barbara a.Ihrke
Division of Nursing Education
Indiana Wesleyan University