2013 Winning Essay

2013 A Nurse I Am Scholarship winners were asked to answer the following:

A. The movie "A Nurse I Am" provides a wealth of insights and approaches to be considered by future nurses, new nurses and seasoned nurses. According to Joyce Newman-Giger, "When nurses consider race, ethnicity, culture, and cultural heritage, they become more sensitive to clients.” Considering this statement, what two nurses in the film seem to best portray or consider the importance of culture in their approach to patient care? Explain why.

B. The United States thrives as an expanding multicultural pluralistic society. As a nurse, how and why will you step forward to offer culturally competent care?

Mary Thies

Oregon Health and Science University

Diversity nourishes and strengthens a community. Respect and compassion for diversity, varied cultural backgrounds and complex life stories are essential practical qualities of an expert nurse. Understanding a patient’s story allows the nurse to care for each patient in a unique and appropriate way, and I strive to respect each patient’s culture as I learn and grow in my nursing practice. I am inspired by both versions of the film “A Nurse I Am,” which offer wonderful examples of expert nurses implementing patient care with respect to individual needs and backgrounds. Both Mona Counts, RN, Nurse Practitioner, and Ardis Bush, RN, Nurse Manager, actively investigate their clients’ stories, culture and heritage to inform and enhance their patient care, making them both excellent nurses.

Mona Counts is the primary care provider for over 5,000 patients in Appalachia, where most of the population presents from rural, impoverished communities. She displays exceptional patient care for individuals with a focus on history, motivations and personalized goals. She devotes attention to the patient’s needs, beginning each conversation at the patient’s eye level, sitting or kneeling. She asks direct, objective questions without judgment to gain information. Mona Counts notices subtle changes in behavior, appreciates client gains, and does not request more than the patient is capable of giving. She considers the context in which she is offering care, and understands that not all patients have the means or desire to visit her in an official clinic, or to pay for her services. She is an assertive and aggressive advocate for proper government assistance for all of her patients, and often takes trades for services that are reflective of the population’s culture. She treats each patient, including those with difficult medical histories, high anxiety and those out of her typical clinic setting with respect and appreciation. She asks for small, realistic behavioral changes, and offers health goals that are realistic for her patients in accordance with their individual abilities and culture. In her example, I will incorporate a thorough understanding of a patient’s background with their plan of care. Mona Counts exemplifies cultural consideration and care in her rural Appalachian nursing practice.

Ardis Bush, a nurse manager in an acute setting, offers advocacy, dignity and recognition to each patient with a calm and comforting demeanor. She notices changes in her patient’s face, tone of voice and searches for what is not being said. She is illustrated defending her patient’s right to pain management, treating the patient with fairness and consideration. She recognizes that pain is a patient experience, not for the nurse or staff to describe or determine. Ardis Bush searches for what is meaningful to each client and uses this information to motivate small changes, in common with Mona Counts. Under her care, each patient on a trajectory of illness and recovery is acknowledged in his or her present state,and she ensures the patient understands what the doctors have said, acknowledging how cultural variances play a role in how information is interpreted. She displays cultural consideration for her friend undergoing chemotherapy and supports her enduring difficult treatment out of deference to her cultural and familial expectations. She treats each patient, including her own sister, with commitment and individualized compassion to best reflect the individual’s needs. I greatly admire Ardis Bush’s ability to communicate with patients from a mix of cultures and I will remember her example as I care for diverse patients, each with unique needs, hopes and ways of communicating.

I am thrilled to enter the nursing profession in the United States, a vast cultural melting pot offering as many diverse points of view as there are citizens. In order to best serve each client, to teach effectively for healing and to assist in accomplishing health goals, I must explore the patient’s heritage. As a nurse in this modern society, it is imperative that I begin my interaction with each patient by exploring his or her culture, upbringing and history. I will listen to patient stories for clues to individual values and motivating factors. I will learn about diverse cultural heritages by committing to continuing education in transcultural nursing. I will regularly practice open-ended communication, motivational interviewing and cultural awareness in my interactions with patients, family and co-workers. I strive for my personal best in every aspect of my life and I will draw inspiration from these films as I step forward to provide the most culturally sensitive and appropriate care for all my patients, raising the standard of care throughout the nursing process.

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