Culture & Indigenous Health Flashcards
What are the characteristics of culture?
- Shared patterns of learned values
- Transmitted over time
- Distinguish members of one group from another
- Done through language, ethnicity, spirituality, education, economic status
- Significant to that person
What’s one of the most important things to remember about culture?
Even though people may identify with a specific culture, it’s still very personal & individualistic — even within the same culture, have individual values
What are characteristics of culture in nursing profession?
- Uniform, stethoscope, textbooks (materials)
- Professionalism, the way we carry ourselves, empathy, advocacy (values)
Surface vs. beneath the surface of culture:
Small piece of culture on outside:
- Clothing, food, celebrations, language, etc.
Beneath the surface:
- The way people communicate, friendship, family, life & death, attitudes towards others, religion, etc.
According to the RNAO, what’s the first step towards achieving cultural competence?
Self-awareness:
- Attitudes have direct & significant impact
- Self reflection allows to recognize own cultural values – valuing differences can help strengthen nursing profession role
- Language & cultural differences ‘act as barriers’ to genuine relationships with patients in HC
- Cannot make assumptions, can lead to mistakes
Describe cultural imposition.
Person poses their culture on a patient, believes their values are more important
Understand where that patient is coming from so avoid misinterpretation
- Patient comes into room, we ask to change into gown, ask family to leave, use medical jargon
– We hold power in that situation, supporting instead of imposing
– Labeling patients can be offensive
Ex. ‘Noncompliant,’ ‘aggressive’
– Affects the way they are treated later on in HC system
What is cultural sensitive care in nursing?
- Everyone has a culture, it’s individual with many influential factors (Ex. family), it can change over time
- Influenced by personal & professional values
- Nurse is responsible for assessing & responding to client’s personal cultural expectations & needs
Describe cultural humility.
- Process of self reflection to understand personal & systemic biases to develop and maintain respectful processes & relationships based on mutual trust, as we are often not aware of biases
- Humbly acknowledging one’s self as a learner when it comes to understanding another’s experiences
What is the difference between cultural competence & humility?
Competence implies an end point, humility is a commitment of active engagement
What are the impacts of post-European contact on modern Indigenous healthcare?
Structural racism:
- Negative consequences of colonialism
Resulted in variety of issues:
- Funding issues for access to care
- Federal, provincial, territorial jurisdictions, lack of adequate services or delayed services
- Flown out to southern hospitals to receive care - removed from all supports to receive adequate care
Child healthcare:
- Children apprehended & placed in non-Indigenous homes to ‘save’ them
- Assimilation
- Higher rates of child poverty
- Underfunding of education, crowded housing
- Higher incarceration rate
Overall, substandard HC outcomes
What do health issues look like from an Indigenous perspective?
- Unconscious bias – are you imposing your own values of why they have these health issues, or looking from a broader perspective?
- Diabetes, cancer, COPD, etc. more prevalent, but should not be stereotyped due to these illnesses & should be treated equitably
- Many health disparities due to colonialism, structural racism, and abuse
What does unconscious bias mean and how is it prevalent in HC?
Reflecting on interactions with patients AND coworkers; subtle, difficult to prove from patient’s standpoint; can’t even be sure it’s happening, but it feels like it; making assumptions of patient’s heritage without background are harmful
Ex. ‘Maybe they didn’t understand you’ or ‘If you make mistakes no one will cover for you’
POC treated more severely or harshly when mistakes made; emotional & mental toll; feeling of vulnerability and embarrassment, exclusion
What are some examples of implicit biases in HC? (change the way a HC provider looks at the patient)
- Race, ethnicity, gender, socioeconomic status, age, etc.
- People who use intravenous drugs, disabled, have AIDS, etc.
What are the negative implications of bias in HC?
There is a significant positive relationship between unconscious bias & level of care received:
- Unconscious bias = poor care
- Less likely to engage in HC system
- Bias can influence diagnosis & treatment decisions
What are some strategies that can be used to deal with unconscious bias?
- Be open, curious to understand where person is coming from
- Be honest & reflective of your own personal opinions
- Continuously learning
- Respect & advocate for patients
