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?

Richard Thai

Baldy View Regional Occupational Program

“A Nurse I Am” – Culturally Competent Care

The United States is becoming increasingly diverse. According to the U.S. Census Bureau, minorities comprise about one-third of the U.S. population and are expected to become the majority by the year 2042 (Bernstein & Edwards, 2008). As caregivers, nurses must be aware of and sensitive to the cultural differences between themselves and their patients in order to provide the most competent care. Cherokee’s presentation of “A Nurse I Am” demonstrates how culturally proficient nurses utilize sensitivity and the client’s individual culture, ethnicity, and background, in an effort to promote client care and recovery.

To be truly sensitive to clients, one must consider and try to understand the client’s race, ethnicity, culture, and cultural heritage. Two nurses from the film that exemplified the statement made by Joyce Newman-Giger are Dr. Mona Counts and Mr. Robert Wilkinson.

Even in the population-sparse regions of the Appalachians near Mt. Morris, Pennsylvania where the demographics consist primarily of lower socioeconomic Caucasians, Mona examines each of her patient’s subcultural and individual backgrounds when performing her assessments. Working with the understanding that “Health in Appalachia is function, not just an absence of disease,” Mona evidently understands her patients’ circumstances and respectfully explains their diagnoses and patient teaching in familiar terms. When examining a patient who was re-hospitalized because of COPD, Mona’s patient history assessment was thorough and inquisitive. The result was that the client was fully cooperative and descriptive, which allowed Mona to uncover her habit of smoking. Mona offered her patient nicotine patches for comfort, which the patient did not know she could have. Comments made by her clients such as “[Mona] cares about her patients…you’re not a statistic to her” and “…she talks to you, she tells you what you need to know, not some of this college stuff that she would understand, she breaks it down so we understand…” exhibit her success in dealing with patients who do not share her background. Statements such as, “If it wasn’t for her I wouldn’t go to the doctor…,” reveal that without this sensitivity to patient cultures, there are patients who would choose not go to their health care professionals.

The discussion on cultural sensitivity tends to overlook the differences that come from being a boy or a girl patient or to accommodate the child’s parents. As a pediatric oncology nurse, Bob provides culturally proficient care to both. Bob clearly understands the grief that parents encounter when they discover their child has cancer. He understands that the parents are clients too; a nurse must realize what they are going through and how they can help them be prepared for what is to come. For his young patients, Bob’s story about the teenaged female cancer patient who had relapsed demonstrates his proficiency of care. Bob offered himself as a nurse and as a kind of father figure. He allowed her to express herself and she opened up to him about boyfriends and other issues she had. Bob brought comfort to her by offering humor and his presence when she needed to cry. Furthermore when she came to the realization that she might die, he showed his respect by being honest with her, even if it meant telling her he didn’t have the answers. Statements such as “Bob takes care of his patients as if they were his own children…” and “…we were just in a home away from home” demonstrate Bob’s ability to utilize his experiences as a father and a nurse to provide the type of care his patients need.

Mona’s and Bob’s care for their patients redefined my ideas on the meaning of cultural competency. Culturally competent care requires an understanding that all patients are unique. They are influenced but not defined by their culture, so each patient should not be generalized. Each patient must be approached and examined individually. A nurse must understand who their patients are, rather than merely understanding what they are or what health issues they may have. I must take the time and effort to listen to my clients’ voice their values and experiences, as well as their problems, to progressively move towards being culturally competent and so that I can be an advocate rather than an obstacle in their care. I have to understand that I will encounter many cultures that are very different from mine. What the patients want is respect and this can only be gained by being honest and sincere. Only when I can gain that respect can we truly move towards the goal of health promotion.

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