Importance of Cultural Competence in Nursing
Cultural competence is defined as possessing the skills and knowledge necessary to appreciate, respect, and work with individuals from different cultures. It is a concept that requires self-awareness, awareness and understanding of cultural differences, and the ability to adapt to clinical skills and practices as needed. For instance, before my grandmother had passed, my family wanted to do a traditional prayer ceremony for her in the hospital. It is where we have a monk in the same room, doing the a Buddhist Prayer for peace.
Indeed, with the help of the staff members on her floor, the nurses understood why my family request a monk to do a Buddhist Prayer and to have our whole family attends the prayer. In fact, the nurses would only allow two people to see my grandmother at a time, but in this case, the nurses allowed to have my whole family and the monk to be with our grandmother. Of course, without the help of Josepha Campinha-Bacote theory, Buddhist Prayer in the hospital would not have been allowed.
According to the article, “The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care,” Josepha Campinha-Bacote mentioned a model that “requires health care providers to see themselves as becoming culturally competent rather than already being culturally competent. This process involves the integration of cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire” ( Josepha Campinha-Bacote, 2010). Moreover, along the article, Campinha mentioned some Assumptions of the Model.
There are five assumptions of the model: 1. Cultural competence is a process, not an event. 2. Cultural competence consists of five constructs: cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire. 3. There is more variation within ethnic groups than across ethnic groups (intra-ethnic variation). 4. There is a direct relationship between the level of competence of health care providers and their ability to provide culturally responsive health care services. 5.
Cultural competence is an essential component in rendering effective and culturally responsive services to culturally and ethnically diverse clients. Furthermore, when Campinha-Bacote was pursing her undergraduate nursing degree in Connecticut, she developed the developmental stages of this model back in 1969. During this time, there were conflict in race relations. “Being a second-generation Cape Verdean and raised in an exclusively Cape Verdean community,” Capinha-Bacote felt she did not fit in either of the groups. From there, that is when she explored the area of cultural and ethnic groups.
After completing her baccalaureate, master’s, and doctoral degrees in nursing, she continued her interest in cultural groups to the fields of transcultural nursing and medical anthropology. To fully understand the model, each model will be defined. First, Cultural Awareness is the self-examination and in-depth exploration of one’s own cultural and professional background. This method involves the recognition of ones biases, prejudices, and assumptions about individuals who are different. Second, Cultural Knowledge is the process of seeking and obtaining a sound educational foundation about diverse cultural and ethnic groups.
To obtain this knowledge, the health care provider must focus on the integration of three specific issues: health-related beliefs and cultural values, disease incidence and prevalence, and treatment efficacy. Third, Cultural Skill is the ability to collect relevant cultural data regarding the client’s presenting problem as well as accurately performing a culturally based physical assessment. Here, this process involves learning how to conduct cultural assessments and culturally based physical assessments.
Fourth, Cultural Encounter is the process that encourages the health care provider to directly engage in cross-cultural interactions with clients from culturally diverse backgrounds. Directly interacting with clients from diverse cultural groups will improve ones existing beliefs about a cultural group and will prevent possible stereotyping that may have occurred. Lastly, Cultural Desire is the motivation of the health care provider to want to, rather than have to, engage in the process of becoming culturally aware, culturally knowledgeable, culturally skillful, and familiar with cultural encounters.
Here, cultural desire involves the concept of caring. The constructs of cultural awareness, cultural knowledge, cultural encounters, and cultural desire have an interdependent relationship with each other, and no matter when the health care provider enters into the process, all five constructs must be addressed and/or experienced. Here, an example will be as follow for the reason of The Process of Cultural Competence. In the Orthodox Jewish community, there are many strict cultural guidelines that the women must obey to.
When looking for treatment in the Orthodox Jewish law, it permits men and women from being alone together unless they are close family member, or married to each other. This law applies when the women is being examined by a physician or a health care provider. For the Orthodox Jewish woman, a female provider is preferable, but the woman will choose the provider she feels is qualified to provide her with the best quality of care and who has the best reputation in his/her field (Schnall, 2006).
Spousal involvement in the delivery of a child is limited; a nurse may misunderstand a husband lack of support as being neglectful to his wife, the nurse is not being culturally sensitive to the Orthodox couple. The nurse must understand according to the Jewish laws, if a woman is unclean with mucous discharge, bloody show, or amniotic fluid, the husband must exit the room as he is not allowed stay in the room with his wife while she is being examined, unless she is fully covered and will not be exposed to him.
To be considered clean again after childbirth or menstruation, the women must go to a ritual bath called the “Mikveh”. The Orthodox Jewish women must consult with their Rabbi for approval of procedures, treatments, amniocentesis, or elective cesarean sections. In such cases, Orthodox Jewish couples may call their rabbi to ask for guidance on the subject or to get a blessing from him that all will give the couple an approval within a matter. Overall, the model of cultural competence has been used as a framework for health care organization to offer culturally relevant services.