Cultural Competence Model

As diversity increases, it increases the need for service providers to come up with better ways of serving people. The demand for cultural diversity is no different when it comes to the healthcare system. Increasing diversity is a huge development thus bringing both opportunities and challenges for the healthcare providers such as nurses. On the other hand, policymakers strive to create and come up with culturally competent services. As such, there are several models of service care that have come up to bridge the gap in healthcare when catering for the fast-growing multiethnic world. This article looks into application of nursing process when delivering health care to African Americans by studying various studies. 

Darnell & Hickson (2015) provide that cultural competence in health care refers to the ability to effectively deliver health care services that meet all the needs of the patients including: linguistic, social, financial and the cultural needs of the patients.  Having a culturally competent system helps to boost healthcare outcomes and promote quality of care. As a result, this can contribute to eliminating racial and ethnic disparities. According to Garneau & Pepin (2015), one of the ways in the health care system is moving towards these goals are by providing training based on cultural competence and cross-cultural matters in health care. Cross-cultural competence in health care service delivery is a practice that allows nurses to continually strive to achieve effectiveness (Diaz, Clarke & Gatua 2015).  For this model, it is important to understand that it is a continuous process that requires the nurses to be interested in multiple cultures, cultural awareness, cultural knowledge, and encounters. Each of these artifacts comes in handy when caring for patients from different cultures. In this segment, the focus is on how to apply these constructs when dealing with African American patients. 

Different responsibilities in the Application of the Nursing Process to Deliver Culturally Competent Care

Presently, all nurses in nursing practice have the responsibility and the accountability to acquire and apply cultural competencies in relationships with their clients as well as co-workers. As for the employers, it is their duty to create an environment that is fit for diversity. In addition, they have the task to evaluate the physical and psychological models that back up cultural awareness as well as diversity. Conversely, the role of educators in promoting cultural competence is by incorporating courses of cultural diversity in the nursing education curriculum (Shen, 2015). They are responsible for teaching concepts of cultural adeptness and diversity in the education system. The work of the regulatory bodies is to establish standards and guidelines that check cultural skills of the nurses. The reason for having the professional associations on board is because they help to call for cultural competence. In fact, both regulatory and professional bodies are in charge of showing how cultural competence works with their registered members (Shen, 2015). The role of nursing unions is that they promote concepts of culture and diversity within their circles and healthcare as a whole. Under collective agreements, nurses unions provide representation regarding discrimination cases, promoting cultural competence by collaborating with institutions like human rights as well as diversity committees. 

Cultural Competent Model for African American Population

Cultural Desire

The African American experience is different as opposed to other populations (Darnell & Hickson, 2015). Because of the extended period of slavery and other forms of dehumanization, the African Americans have expectations and standards that are different from the rest of the population. Therefore, designing a cultural competence model is helpful when trying to understand African American culture. As stated earlier, during caregiving nurses apply the constructs in the cultural competence model. One of the first construct in this model is cultural desire whereby the nurse has the motivation to want to become culturally competent with African-American patients. The importance of cultural desire is that it is the basis for cultural competence. As a nurse, the significance of cultural competence during caregiving stems from the need to learn about other cultures. Otherwise, it would be difficult for one to engage with their patient from a cultural point of view. As such, humility is one of the key factors when one is addressing their cultural desire (Darnell & Hickson, 2015). According to Darnell & Hickson, (2015), because of being humble, it is easy to understand the dignity and worth of others. In that regard, cultural desire is all about the observation of human dignity, social justice, human rights and most importantly, equity. According to research, there is a direct correlation between poor health outcomes and inequality. As a result, nurses should consciously try to connect cultural competence with fairness. It is best that cultural competence works together with social justice to achieve equality for all regardless their background in terms of race, sexual orientation, gender, language, and religion.

Cultural Skills

In the next construct, shows that cultural skills are relevant in collecting data from the patient. In addition, nurses demonstrate their cultural skills by performing an accurate cultural assessment without being insensitive. The purpose of cultural assessment is that it enables the patients to explain their illness without feeling embarrassed or intimidated. There are certain skills that nurse need when performing a physical examination test with African American patients. For instance, in culturally based questions, the nurses can be asked a question such as skin colors changes and such. This question is a sensitive issue because raises concerns from African American. However, nurses also have the ability to use skin color alterations and deviations to provide a diagnosis. For instance, when it comes to jaundice the skin color is yellow. When a nurse is doing their assessment, they should be aware that assessing African Americans requires a different approach as opposed to the rest. Take, for example, African Americans may feel sensitive because of the bleaching issue or feel prejudiced because of their race. Therefore, skin assessment or anything that is directly or indirectly linked to the African American race is an issue that requires a culturally sensitive caregiver. 

Cultural Encounters

Sometimes, deliberate seeking of face-to-face interaction with the patients is necessary. As such, cultural encounter involves careful interaction with the patient. According to studies, it helps to do away with stereotyping, overgeneralizing, close-ended mindset based on certain groups of people. When patients have a bad experience with the caregivers, it can greatly affect their need to seek quality health care. According to research, about 15% of African Americans compared to 2% Caucasians felt that healthcare practitioners treated them unfairly or with little respect (Shen, 2015). However, most of the African American patients are suspicious of health care practitioners because of their cultural encounters.  As such, effective cultural encounters are important when trying to establish trust in such relationships. 

Cultural Awareness

During caregiving, nurses’ should be in a position to do self-examination as well as their personal bias and stereotypes. The assumption and prejudice that people hold can prevent them from looking deeper and address real concerns. As such, it is best if nurses can develop a conscious awareness of other different cultures. During this time, a nurse should be able to answer is they are aware of any prejudiced attitude they have against the African American patients. For instance, some people find the African American dialect odd. Despite that all African Americans can speak English; their sociolinguistic is different and referred to African American English. According to (Diaz, Clarke & Gatua, 2015) the biggest problem with AAE speakers is that they face criticism because the stereotype is that the language is inferior to the standard American English. Therefore, nurses’ personal beliefs, as well as biased against African Americans, may give rise to a situation where the patients feel unequally treated (Garneau & Pepin, 2015). Take for example; African Americans face a higher risk of misdiagnosis for psychiatric disorders. As such, the nurses are likely to give them anti-psychiatric drugs regardless the diagnosis. The explanation behind this is that African American patients are more aggressive and this leads to the anti-psychotic prescription. 

Cultural Knowledge

Whenever a nurse seeks and obtains education about culture, they are elevating their status in offering cultural competent services. The African American people have certain beliefs that are important when it comes to nursing practice. For instance, it is necessary to learn about African American lifestyle including diet. In other African American cultures such as the Haitian people, magic is the center of their lives. Some African Americans have a negative attitude towards seeking treatment because they believe it makes them weak. Such characteristic of the African American culture is useful when it comes to seeking an underlying cause of a health problem. For instance, because most Africans are financially challenged, they are more susceptible to stress. Other factors that can cause stress are such as racism. Because the efforts behind nursing care are to provide a holistic solution to the problem, it is necessary to look at the cause of some health problems. However, digging into the background of the patient requires a nurse who is knowledgeable about the background factors. 

Significance of Cultural Competent Model

Having a team of nurses who can adopt the cultural competent model is a huge step towards bridging the gap between African American patients and medical institutions (Shen, 2015). As stated earlier, most African Americans feel that the health care practitioners are not fair when it comes to giving them treatment. Therefore, the intervention of such cases using the cultural competent model is going to help reduce the doubt the patients have against the system. Secondly, this model helps to away with issues such malpractices. Generally, the provision of quality care as a result of employing the cultural competent model is advantageous because of the positive healthcare outcomes. 

Conclusion

According to various studies, the process of providing quality health care is dependent on the cultural competence model. The aim of the model is to provide the nurses with a base when providing health care services to African American patients. In addressing the patients, the nurses should be in a position to ask if they are in line with the culturally competent model.  Most importantly, cultural competence is not an isolated aspect regarding medical care but an important step towards overall excellence in health caregiving.  In addition, efforts to improve health care start from an individual perspective but are also a collective effort. 

References

Darnell, L. K., & Hickson, S. V. (2015). Cultural competent patient-centered nursing 

care. Nursing Clinics, 50(1), 99-108.

Diaz, C., Clarke, P. N., & Gatua, M. W. (2015). Cultural competence in rural nursing education: 

are we there yet?. Nursing Education Perspectives, 36(1), 22-26.

Garneau, A. B., & Pepin, J. (2015). Cultural competence: A constructivist definition. Journal of 

Transcultural Nursing, 26(1), 9-15.

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in 

nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.